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Schizophrenia

Schizophrenia. Lori Ridgeway PSYC 3560. What is Schizophrenia?. Deterioration in fx Extreme disturbances in thoughts, perceptions, emotions, motor fx Affects social, occupational, personal fx Psychosis Hallucinations ________________ Withdrawal Positive & negative sxs. Positive Sxs.

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Schizophrenia

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  1. Schizophrenia Lori Ridgeway PSYC 3560

  2. What is Schizophrenia? • Deterioration in fx • Extreme disturbances in thoughts, perceptions, emotions, motor fx • Affects social, occupational, personal fx • Psychosis • Hallucinations • ________________ • Withdrawal • Positive & negative sxs

  3. Positive Sxs • Bizarre ________________ to behavior • ________________ • Ideas that have no basis in fact • Persecution most common • Other types • Grandeur • Control • Reference

  4. Positive Sxs, Cont’d… • Hallucinations • Sensory perceptions in absence of stimuli • Premorbid perception & attention problems • ______________ most common • Other types • Visual • Olfactory • Tactile • Somatic

  5. Positive Sxs, Cont’d… • Disorganized thinking & speech • Formal thought disorders • Can’t think &/or speak logically • Loose associations (______________) most common • Other types • Neologisms • Perseveration • Clang • Inappropriate affect • Emotions don’t match situation

  6. Negative Sxs • Pathological ________________ in behavior • Poverty of speech • Alogia • Reduction in speech or speech content • May say little or may convey little meaning • Flat affect • Show almost ________________ • Anhedonia vs. inability to express emotion

  7. Negative Sxs, Cont’d… • Loss of volition • Avolition • Apathy, ________________ • Trouble with goal-directed behavior • Social withdrawal • Withdraw into own ideas & fantasies • Separate further from reality • Loss of social skills

  8. Psychomotor Sxs • Motoric disturbances • Gestures not related to environment • Catatonia • ______________ • Posturing • Rigidity • Waxy flexibility • Excitement

  9. Dx Criteria • _______ or more characteristic sxs present for 1 mo • Delusions • Hallucinations • Disorganized speech • Disorganized or catatonic behavior • Negative sxs • Social/occupational dysfunction • Signs of disturbance for 6 mos • Exclusions

  10. Subtypes: ________________ • Prominent delusions or auditory hallucinations • Usually related & has theme • Persecutory or grandiose most common • Better cognitive/affective functioning • Disorganized speech, catatonic behavior, flat/inappropriate affect not prominent • Later onset • Less impairment • Better outcomes

  11. Subtypes: Disorganized • Disorganized speech &/or behavior • Flat or inappropriate affect • ________________ • Any delusions/hallucinations are fragmented & no theme • Early onset • Greater impairment • Worse prognosis

  12. Subtypes: Catatonic • Psychomotor disturbance • Immobility • catalepsy = ________________ • Excessive activity • purposeless • Peculiar voluntary movements • posturing • Negativism • rigid posture, can’t move

  13. Gender Differences • Overall prevalence approx. 1% • Age of onset • Men  18 to 25 years of age • Women ________________ years of age • Late onset much less common in men • Women better premorbid functioning • Women  more positive sxs • Men more negative sxs • Women better outcomes

  14. Cultural & Social Factors • Hallucinations with religious content • Beliefs that seem delusional • Language differences (i.e., disorganized speech) • Higher rates in ________________ • Overdiagnosis • Poverty & divorce • More common in lower SES groups • Approx. 0.5% in high SES, but 2% in low SES • Stress/poverty • “Downward drift”

  15. Course • ________________ phase • Active phase • Early onset • More negative sxs • More brain abnormalities & cognitive impairment • Worse premorbid fx & prognosis • Contributors to better outcomes • Acute onset / late onset • Mood disturbance • Early treatment • Being female

  16. Comorbidity • ________________ disorders • Anxiety disorders • Personality disorders • May be prodromal • Suicide • 10% commit suicide • 30%-40% make at least one attempt

  17. Biological Explanations • Genetics • ______% among first-degree relatives • Twin studies • Adoption studies • Biochemical differences • Type I (positive sxs) • Dopamine hypothesis

  18. Bio , Cont’d… • Structural differences • Type II (negative sxs) • ___________________________ in brain • Abnormal blood flow • Decreased size of temporal lobe

  19. Psychological Explanations • Psychodynamic • Schizophrenogenic _____________ • Behavioral • Operant conditioning • Cognitive • perceptual disturbances • Problems when try to underst&

  20. Sociocultural Explanations • ________________ • Label applied to nonconformists • Self-fulfilling prophecy • Rosenhan (1973) • Family dysfunction • Double-bind hypothesis • Expressed emotion • Sociocultural-existential • Constructive process • Self-cure

  21. Diathesis-Stress • ________________ view of cause • Combination of factors • Predisposition combined with environment • Biological factors better identified

  22. Childhood Onset • Difficult to dx • Insidious onset • Differences • Delusions & hallucinations less elaborate • Visual hallucinations more common • Some sxs common in other disorders • Odd movements/postures • PDD/Autism • Sx or normal child behavior?

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