Download Positive Sxs

Schizophrenia
Lori Ridgeway
PSYC 3560
What is Schizophrenia?
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Deterioration in fx
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Psychosis
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Extreme disturbances in thoughts, perceptions,
emotions, motor fx
Affects social, occupational, personal fx
Hallucinations
________________
Withdrawal
Positive & negative sxs
Positive Sxs
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Bizarre ________________ to behavior
________________
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Ideas that have no basis in fact
Persecution most common
Other types
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Grandeur
Control
Reference
Positive Sxs, Cont’d…
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Hallucinations
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Sensory perceptions in absence of stimuli
Premorbid perception & attention problems
______________ most common
Other types
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Visual
Olfactory
Tactile
Somatic
Positive Sxs, Cont’d…
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Disorganized thinking & speech
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Formal thought disorders
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Can’t think &/or speak logically
Loose associations (______________) most common
Other types
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Neologisms
Perseveration
Clang
Inappropriate affect
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Emotions don’t match situation
Negative Sxs
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Pathological ________________ in behavior
Poverty of speech
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Alogia
Reduction in speech or speech content
May say little or may convey little meaning
Flat affect
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Show almost ________________
Anhedonia vs. inability to express emotion
Negative Sxs, Cont’d…
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Loss of volition
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Avolition
Apathy, ________________
Trouble with goal-directed behavior
Social withdrawal
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Withdraw into own ideas & fantasies
Separate further from reality
Loss of social skills
Psychomotor Sxs
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Motoric disturbances
Gestures not related to environment
Catatonia
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______________
Posturing
Rigidity
Waxy flexibility
Excitement
Dx Criteria
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_______ or more characteristic sxs present for 1 mo
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Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative sxs
Social/occupational dysfunction
Signs of disturbance for 6 mos
Exclusions
Subtypes: ________________
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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
Subtypes: Disorganized
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Disorganized speech &/or behavior
Flat or inappropriate affect
________________
Any delusions/hallucinations are fragmented
& no theme
Early onset
Greater impairment
Worse prognosis
Subtypes: Catatonic
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Psychomotor disturbance
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Immobility
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Excessive activity
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purposeless
Peculiar voluntary movements
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catalepsy = ________________
posturing
Negativism
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rigid posture, can’t move
Gender Differences
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Overall prevalence approx. 1%
Age of onset
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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
Cultural & Social Factors
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Hallucinations with religious content
Beliefs that seem delusional
Language differences (i.e., disorganized speech)
Higher rates in ________________
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Overdiagnosis
Poverty & divorce
More common in lower SES groups
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Approx. 0.5% in high SES, but 2% in low SES
Stress/poverty
“Downward drift”
Course
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________________ phase
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Active phase
Early onset
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More negative sxs
More brain abnormalities & cognitive impairment
Worse premorbid fx & prognosis
Contributors to better outcomes
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Acute onset / late onset
Mood disturbance
Early treatment
Being female
Comorbidity
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________________ disorders
Anxiety disorders
Personality disorders
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May be prodromal
Suicide
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10% commit suicide
30%-40% make at least one attempt
Biological Explanations
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Genetics
 ______% among first-degree relatives
 Twin studies
 Adoption studies
Biochemical differences
 Type I (positive sxs)
 Dopamine hypothesis
Bio , Cont’d…
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Structural differences
 Type II (negative sxs)
in brain
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___________________________
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Abnormal blood flow
Decreased size of temporal lobe
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Psychological Explanations
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Psychodynamic
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Behavioral
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Schizophrenogenic _____________
Operant conditioning
Cognitive
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perceptual disturbances
Problems when try to underst&
Sociocultural Explanations
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________________
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Family dysfunction
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Label applied to nonconformists
Self-fulfilling prophecy
Rosenhan (1973)
Double-bind hypothesis
Expressed emotion
Sociocultural-existential
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Constructive process
Self-cure
Diathesis-Stress
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________________ view of cause
Combination of factors
Predisposition combined with environment
Biological factors better identified
Childhood Onset
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Difficult to dx
Insidious onset
Differences
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Some sxs common in other disorders
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Delusions & hallucinations less elaborate
Visual hallucinations more common
Odd movements/postures
PDD/Autism
Sx or normal child behavior?