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Psychological Disorders (Chapter 16) Third Lecture Outline: Addiction Schizophrenia Child Disorders Drug Abuse and Addiction Substance abuse: Maladaptive pattern that impairs life or causes distress Addiction: Abuse & physiological tolerance (and withdrawal symptoms) Addiction varies by culture Policies of abstinence leads to increase instead of decrease in addiction Addiction has physiological, conditioning, and cognitive appraisal components (e.g., placebo effect) Someone with schizophrenia “Sometimes the voices are friendly; however, most often they are cruel and taunting. Hearing voices for the first time was very scary to me. I call my voices "superiors"; they are of demonic nature and continuously telling me "I'm evil and worthless". They often command me to hurt myself. I do as they say because they threaten to kill me or bury me alive; their terror controls my behavior.” “I also have visual hallucinations in which I see things that apparently no one else sees. I look at people's faces and they suddenly disintegrate or are so distorted that they appear in horrifying form, wicked,and I see the evilness of the devil locked within their eyes. I may look at you and project someone's else's picture on your face; everything becomes confusing and quite frustrating.” Schizophrenia Negative symptoms: Behavior deficits – blunting of emotions – language deficits – apathy and social avoidance Active symptoms: Behaviors present – – – – delusions: disordered thinking hallucination: unusual sensory experience disorganised incoherent speech other bizarre behavior Diagnositic criteria Adaptive functioning impaired Two or more of the following: – – – – – delusions hallucinations disorganized or incoherent speech grossly disorganized or catatonic behavior negative symptoms of anhedonia Six months of symptoms Rule out other disorders and drugs Types of Schizophrenia Paranoid: Delusions are grandiose or persecutory; not disorganized or catatonic, e.g., tin foil in attic Disorganized: Speech, behavior, and/or affect is inappropriate, not catatonic – e.g., roams the streets mumbling Catatonic: Motor disturbance such as catalepsy (waxy flexibility) or frozen Videotape #98: Cases Biological basis of schizophrenia Genetics: Schizophrenia “runs in families” – General population rate: 1 to 2 % – twin studies: monozygotic twins (100% genes), 44% concordant – dizygotic twins (50% genes) are 15% concordant – consaguinity studies: other relatives 5-10% – adoption studies: twins adopted away still have higher concordance than base rate Brain and neurotransmitter anomolies Dopamine hypothesis supported by drug effects – Amphetamine psychosis from too much dopamine – Parkinsonian tremors from too little: chlorapromazine side effect Vulnerability-Stress Model Late teen, young adult, age of onset 18-30 Biological Vulnerability Stressful Experiences Schizophrenia Symptoms Examples of childhood disorders Attention-deficit hyperactivity disorder – Innattention, impulsivity, hyperactivity Conduct disorders – stealing, truancy, fighting, swearing, destructive behavior Pervasive Developmental Disorder (Autism) – communication deficts, perserveration, echolalia, memory