* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Chapter 16
Emil Kraepelin wikipedia , lookup
Substance use disorder wikipedia , lookup
Test anxiety wikipedia , lookup
Obsessive–compulsive personality disorder wikipedia , lookup
Major depressive disorder wikipedia , lookup
Bipolar disorder wikipedia , lookup
Impulsivity wikipedia , lookup
Bipolar II disorder wikipedia , lookup
Claustrophobia wikipedia , lookup
Psychological trauma wikipedia , lookup
Panic disorder wikipedia , lookup
Autism spectrum wikipedia , lookup
Conduct disorder wikipedia , lookup
Depersonalization disorder wikipedia , lookup
Memory disorder wikipedia , lookup
Personality disorder wikipedia , lookup
Death anxiety (psychology) wikipedia , lookup
Antisocial personality disorder wikipedia , lookup
Conversion disorder wikipedia , lookup
Eating disorders and memory wikipedia , lookup
Social anxiety disorder wikipedia , lookup
Anxiety disorder wikipedia , lookup
Asperger syndrome wikipedia , lookup
Eating disorder wikipedia , lookup
Munchausen by Internet wikipedia , lookup
Schizoaffective disorder wikipedia , lookup
Diagnosis of Asperger syndrome wikipedia , lookup
Schizophrenia wikipedia , lookup
Mental disorder wikipedia , lookup
Generalized anxiety disorder wikipedia , lookup
Depression in childhood and adolescence wikipedia , lookup
Sluggish schizophrenia wikipedia , lookup
Separation anxiety disorder wikipedia , lookup
Glossary of psychiatry wikipedia , lookup
Diagnostic and Statistical Manual of Mental Disorders wikipedia , lookup
Spectrum disorder wikipedia , lookup
Dissociative identity disorder wikipedia , lookup
Child psychopathology wikipedia , lookup
Causes of mental disorders wikipedia , lookup
Chapter 16 Psychological Disorders A. What is Normal? Symptoms of Psychological Disorders –Deviation from a norm –Maladaptive –Emotional Discomfort Why do you think the U.S. has such a high prevalence of mental disorders? A. What is Normal? Deviation from a statistically calculated norm: abnormal abnormal normal If a person behaves in a way that a majority of people do (approximately 68%) then the behavior is normal. If not, the behavior is abnormal A. What is Normal? Shortcomings of this definition –It doesn’t discriminate between desirable and undesirable abnormality –Just because a statistical majority of people engage in a particular behavior does not mean that society would like to encourage it as being normal A. What is Normal? Emotional Discomfort If a person’s behavior causes him/her distress than the behavior is considered to be abnormal A. What is Normal? Shortcomings of this definition – Some behavior are so abhorrent that despite someone’s comfort level if it is not normal behavior A. What is Normal? Deviation norm from a social/cultural – A cultural norm is what society deems as being acceptable. There are norms that cover all types of behaviors. When do we notice norms? A. What is Normal? Shortcomings of this definition –There are different norms for different cultures, and different age groups. Additionally, norms change over time. A. What is Normal? Maladaptivity If a behavior interferes with a person’s ability to function it is considered to be abnormal. If a person is still able to function adequately in everyday life, than it is not abnormal. Explaining Psychological Disorders Biological Factors: – The earliest supporter of this view was Hippocrates. He saw mental disorders as being some kind of physical illness. He believed that disorders were caused by imbalances of the four humors (bodily fluids) which are blood, black bile, phlegm, and yellow bile. – Hippocrates believed that depression resulted from an excess of black bile (melancholia) Explaining Psychological Disorders Neurobiological model: – This model looks at problems in anatomy and physiology of the brain and other areas. – This model dominates modern research on the causes—and treatments—of psychological disorders. People who adhere to this model see mental disorders as being caused by a physical illness, and believed it can be diagnosed, treated and cured. Explaining Psychological Disorders Psychological Processes: – In this view, mental disorders are seen as being caused by inner turmoil or other psychological events. – Psychological models: Include the psychodynamic, cognitive-behavioral, and phenomenological (humanistic) approaches Explaining Psychological Disorders Sociocultural Context: – Sociocultural explanations rely on factors such as gender and age, physical and social situations, cultural values and expectations, and historical eras. Culture-general disorders appear in most societies while culture-specific forms appear only in certain ones. Explaining Psychological Disorders Diathesis-Stress as an Integrative Approach – Diathesis-stress model: This model views genetics, early learning, and biological processes as contributing factors to psychological disorders. – In other words, a person’s inherited characteristics, biological processes, and early learning experiences may create a predisposition (or diathesis) for a psychological disorder, but whether or not the disorder appears depends on the stressors the person encounters Classifying Psychological Disorders A Classification System: DSM-IV-TR This is the most comprehensive and authoritative set of guidelines available for diagnosing psychological disorders. It includes the symptoms, the exact criteria that must be met to make a diagnosis, and the typical course for each mental disorder. Classifying Psychological Disorders Axis I: Clinical Syndromes: comprises descriptive criteria of 16 major mental disorders) – Diagnosis of disorders are made on Axes I and II – It is on this axis that clinician record any major disorders that are apparent. Classifying Psychological Disorders Axis II: Personality disorders: these disorders are patterns of personality traits that are longstanding, maladaptive, and inflexible and involve impaired functioning or subjective distress. Examples include borderline, schizoid, and antisocial personality disorders) and mental retardation Classifying Psychological Disorders Axis III: General Medical Conditions Physical disorders of conditions are recorded on this axis. Examples include diabetes, arthritis, and hemophilia) Classifying Psychological Disorders Axis IV: Psychosocial and Environmental Problems: Types and levels of stress, it may be a negative life event, an environmental difficulty or deficiency, a familial or other interpersonal stress, an inadequacy of social support or personal resources, or another problem that describes the context in which a person’s difficulties have developed Classifying Psychological Disorders Axis V: Global Assessment of Function (GAF) Scale: Has a rating of that ranges from 100 (Superior functioning in a wide range of activities) to 1 (Persistent danger of severely hurting self or others). Estimate are made of the individual’s current level of adaptive functioning as a whole and of the individual’s highest level of functioning in the past year Classifying Psychological Disorders Diagnosis of disorders are made on Axes I and II Axes III, IV, and V are used to record supplemental information about the patient Classifying Psychological Disorders Purposes and Problems of Diagnosis – Goals: Help identify appropriate treatment for clients and to accurately and consistently group patients with similar disorders so that research efforts can more easily identify underlying causes of mental illness – Limitations Validity: Some argue that attempts on improving the consistency of the diagnosis has taken away from the validity of the diagnosis Classifying Psychological Disorders Purposes and Problems of Diagnosis –Limitations Interrater Reliability: Studies have shown that 80% of the time there is agreement between independent raters Neurosis Mild personality disorder, usually does not impair one’s ability to function in society. Symptoms: – Depression – Anxiety – Self-defeating patterns of behavior Psychosis Serious personality disorder, usually incapacitating preventing one from functioning in society. Symptoms – Loss of contact with reality – Hallucinations: inappropriate feelings that come to us from one of our senses – Delusions: false but persistent beliefs despite evidence to the contrary Psychosis Types of Hallucinations: – Auditory Hallucinations: hearing things that are not there – Visual Hallucinations: seeing things that aren’t there Psychosis Types of Hallucinations: – Tactile Hallucinations: feeling things that aren’t there – Olfactory Hallucinations: smelling things that aren’t there – Gustatory Hallucinations: tasting things that aren’t there Psychosis Symptoms of Psychosis – Delusions: false but persistent beliefs despite evidence to the contrary Psychosis Types of Delusions: – Delusions of Grandeur: thinking you are someone of great importance Psychosis Types of Delusions: – Delusions of Reference: thinking that you are the center of attention, that people are looking at, or talking about you – Delusions of Depersonalization: thinking you are turning into an inanimate or vegetative object Psychosis Types of Delusions: – Delusions of Persecution: thinking that people are out to get you or harm you – Delusions of Guilt: thinking that you have just committed a terrible wrong Anxiety Disorders Anxiety: Freud called anxiety a “free floating fear” meaning that it is not attached to any particular object or event. Anxiety is a general feeling of doom and dread. Anxiety disorders are marked by feelings of excessive apprehension Anxiety Disorders Generalized Anxiety Disorder: A person with General Anxiety Disorder (GAD) is continually tense, apprehensive, and in a state of autonomic nervous system (ANS) arousal. This anxiety is persistent and many escalate into a panic attack Anxiety Disorders Generalized Anxiety Disorder: – People with this disorder worry constantly about yesterday’s mistakes and tomorrow’s problems. In particular, they worry about minor matters related to family finances, work and personal illness. They often dread decisions and brood over them endlessly. Their anxiety is commonly accompanied by physical symptoms I wish I could tell you exactly what’s the matter. Sometimes I feel like something terrible has just happened when actually nothing has happened. Other times, I’m expecting the sky to fall down any minute. Most of the time I can’t point my finger at something specific. Still, I feel tense and jumpy. The fact is that I am tense and jumpy almost all the time. Sometimes my heart beats so fast, I’m sure it’s a heart attack. Little things can set it off. The other day I thought a Supermarket clerk had overcharged me a few cents on an item. She showed me that I was wrong, but that didn’t end it. I worried the rest of the day. I kept going over the incident in my mind, feeling terribly embarrassed at having raised the possibility that the clerk had committed an error. The tension was so great, I wasn’t sure I’d be able to go to work in the afternoon. That sort of thing is painful to live with. Taylor Manifest Anxiety Scale 1. F 2. T 3. F 4. F 5. T 6. T 7. T 8. T 9. F 10.T 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. T F T T F T T F T F 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. T T T T T T T T F T 31. 32. 33. 34. 35. 36. 37. 38. 39. 40. T F T T T T T F T T 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. T T T T T T T T T F Anxiety Disorders Phobic Disorder: Phobic disorders are marked by a persistent, irrational fear of a specific object or situation. – What’s the difference between a phobia and a fear? Phobia is the Greek word for morbid fear after the lesser Greek god, Phobos Anxiety Disorders Specific Phobias: involve fear and avoidance of a specific stimuli or situation. – About 10% of the general population will experience a specific phobia at some point in their lives. – More than twice as many women as men suffer from specific phobia. Anxiety Disorders Specific phobia tend to fall into four categories 1. Fear of particular situations: such as flying driving, tunnels, bridges, elevators, crowds, or enclosed placed 2. Fear of features of the natural environment: such as heights, water, thunderstorms, or lightning 3. Fear of injury or blood: including the fear of injections, needles, and medical or dental procedures 4. Fear of animals and insects: such as snakes, spiders, dogs, cats, slugs, or bats Hilda is 32 years of age and is terrified of snow. She cannot go outside in the snow. She cannot even stand to see snow or hear about it on the weather report. Her phobia severely constricts her day-today behavior. Probing in therapy revealed that her phobia was caused by a traumatic experience at age 11. Playing at a ski lodge, she was buried briefly by a small avalanche of snow. She had no recollection of this experience until it was recovered in therapy. Anxiety Disorders Social Phobias: a fear of being negatively evaluated by others or publicly embarrassed by doing something impulsive, outrageous, or humiliating. Social phobia goes well beyond the shyness that everyone sometimes feels at social gatherings. Rather, the person with social phobia is paralyzed by fear of social situations, especially if the social situation involves performing even routine behaviors in front of others. Anxiety Disorders Agoraphobia: a fear of situations the person views as difficult to escape from if panic begins to build. Many people with this disorder become trapped in their own homes or in similar safe zones. Anxiety Disorders Phobias are considered anxiety disorders because they focus general feelings of anxiety onto a feared object or situation General Facts about phobias – Phobias are twice as high for females than males – Phobias are more prevalent in blacks than in whites or Hispanics – Phobias tend to be chronic (lasts between 24-31 years) – Typical onset is childhood or young adulthood Anxiety Disorders Common Phobias and the Feared Objects Acrophobia: High Places Agoraphobia: Open Places Astraphobia: Thunderstorms Claustrophobia: Enclosed Places Anxiety Disorders Common Phobias and the Feared Objects Hematophobia: Blood Mysophobia: Contamination Pyrophobia: Fire Xenophobia: Foreigners/Strangers Hippophobia: Horses Anxiety Disorders Panic Disorder: Periodic episodes of extreme terror (panic attacks) without warning or obvious cause are characteristic of people with panic disorder. Anxiety Disorders Obsessive-Compulsive (OCD) Disorder – Obsessions: are unwanted thoughts, ideas or mental images that occur over and over again – Compulsions: are repetitive, ritual behaviors, often involving cleaning or checking. Anxiety Disorders Obsession-Compulsive Disorder marked by persistent uncontrollable intrusions of unwanted thoughts (obsessions) and urges to engage in senseless rituals (compulsions) – Rate: 3% of the general population – Onset: for males 6-15; for females 20-29 – Demographics: for commonly found among upper income, highly intelligent groups, males and females are equally likely to suffer from this disorder Anxiety Disorders The patient was a 49-year-old man whose main symptom was an obsession with the number 13. If he heard the word he felt a “shock” and experienced a subsequent period of acute anxiety. His everyday life was a continuous effort to avoid any reference to 13, so much that his activities were seriously handicapped. In some way or another, it seems as if everyone was always saying “13” to him. If they met him in the morning they would say, “Oh, good morning,” or later in the day it would be “Good afternoon” (13 letters each). He stayed in bed on the 13th day of each month, skipped the 13th tread in a stairway, and found it necessary to count letters and phrases, his steps, and streets, to avoid the number 13. Anxiety Disorders Shirley was an outgoing popular high school student with average grades. Her one problem was that she was late for school almost everyday. Before she could leave the house in the morning, she had to be very sure that she was clean, so she needed to take showers that lasted two hours. She also spent a long time dressing, because each act—for example, putting on her stockings, underclothes, skirt, and blouse– had to be counted and repeated precisely 17 times. When asked about her washing and counting, she said she knew that is was crazy but that she just had to do it and couldn’t explain why. She said that she had struggled against this problem for three years but had no success Anxiety Disorders Causes of Anxiety Disorders – Biological Factors: Twin studies suggest there may be a weak genetic predisposition to anxiety disorders. Also, identical twins reared apart often times have independently developed phobias. Most anxiety disorders, such as panic disorder, obsessive-compulsive disorder, and generalized social phobia, appear to run in families. Excessive amounts of serotonin are present in people with obsessive-compulsive disorder. Anxiety Disorders Causes of Anxiety Disorders – Cognitive Factors: Cognitive theorists maintain that certain styles of thinking make some people particularly vulnerable to anxiety disorders. According to these theorists, some people are more likely to suffer from problems with anxiety because they tend to: misinterpret harmless situations as threatening focus excessive attention on perceived threats selectively recall information that seems threatening Anxiety Disorders Causes of Anxiety Disorders – Learning Factors Learned Helplessness Classical Conditioning Stimulus Generalization Observational Learning Operant Conditioning Somatoform Disorder Psychological disorders in which the symptoms take a bodily form without physical cause. This type of disorder is more common in Asian, Latin American, and African cultures where people are less open about their feelings. Even though these symptoms have a psychological cause rather than a medical cause, they are still genuinely felt. Somatoform Disorder Conversion Disorder: – Freud called it hysteria – A person with conversion disorder experiences a change or a loss of physical functioning in a major part of the body for which there is no medical explanation (although they are still genuinely felt) – People with this disorder are strangely indifferent to their problems Somatoform Disorder Conversion Disorder: – Conversion disorders tend to appear when a person is under stress. – These physical symptoms often help reduce stress by enabling the person to avoid unpleasant situations. For instance, a stomachache may mean getting out of going to school. – Today, conversion disorder is rare. It accounts for only about 2 percent of diagnoses. Somatoform Disorder One university student, for example, experienced visual impairment that began each Sunday evening and became total blindness by Monday morning. Her vision would begin to return Friday evenings and was fully restored in time for weekend football games and other social activities Somatoform Disorder Hypochondriasis: A person misinterprets normal physical sensations as symptoms of a disease. He/She fusses over every symptom. Sympathy may reinforce the complaints Somatoform Disorder Somatization Disorder – In this disorder, a person makes dramatic, but vague, reports about a multitude of physical problems rather than a specific illness Somatoform Disorder Pain Disorder – This disorder is characterized by severe, often constant, pain with no apparent physical cause Dissociative Disorders Dissociation: The process of separating a portion of the personality that is causing undue emotional stress from the rest of the normally functioning personality. (The individual may view parts of their activity as separate from him/herself) Dissociative Disorders Types of Dissociative Disorders – Dissociative Amnesia – Dissociative Fugue – Dissociative Identity Disorder Dissociative Disorders Dissociative Amnesia The failure to recall events or personal information. A sudden memory loss. Memory lapses generally concern the personal aspects of an individual’s life. Amnesia can be caused by a traumatic event (psychogenic) or a head injury (organic) I forgot Dissociative Disorders Psychogenic Amnesia vs. Organic Amnesia 1. Loss of memory for both recent and distant past 2. Lose identity but general knowledge remains intact 3. Have no anterograde amnesia (memory loss for events after amnesia starts) 4. Amnesia often reverses itself very abruptly 1. Loss of memory for the recent past but memory for distant past is essentially intact 2. Lose both personal identity as well as general knowledge 3. Primary symptom is anterograde 4. Memory returns gradually for retrograde amnesia, anterograde hardly ever returns A young man dressed in work clothes came to the emergency room of a hospital in the city in which he lived with the complaint that he did not know who was. He seemed dazed, was not intoxicated, and carried no identification. After being kept in the hospital for a few days, he woke up one morning in great distress, demanding to know why he was being kept in the hospital and announcing that he had to leave immediately to attend to urgent business. With recovery of his memory, the facts related to his amnesia emerged. The day his amnesia began, he had been the driver in an automobile accident that resulted in the death of a pedestrian. Police officers on the scene were convinced that the driver had not been in the wrong: The accident had been the pedestrian’s fault. The police told the driver to fill out a routine form and to plan on appearing at the coroner’s inquest. The man filled out the form at the home of a friend, accidentally left his wallet at his friend’s home, and mailed the form. After mailing the form, he became dazed and amnesiac. He was led to the hospital by a stranger. The amnesia was probably related to the stress of the fatal accident, fear of the inquest, and worry that he might actually have been responsible for the accident. Dissociative Disorders Dissociative Fugue: Dissociative Fugue = a sudden loss of personal memory and the adoption of a new identity in a new locale Amnesia + flight from the geographic location 3) Dissociative Disorders Dissociative Identity Disorder This is rare disorder that is characterized by the development of two or more separate and independent personalities within the same person Dissociative Disorders Dissociative Identity Disorder – Each personality has its own set of memories, typical behaviors (i.e. each personality has its own voice and mannerisms). – Frequently none of the personalities has any awareness of the others. People with multiple personalities usually are not violent. The 21 Faces of Sarah In a well-publicized criminal case, Mark Peterson, 31, and Oshkosh grocery worker, was prosecuted for sexually assaulting a 26-year-oldwoman, who, according to her psychiatrist, had at least 21 distinct personalities. Peterson met the woman, who introduced herself to him as Franny, a few days before the assault. Others present at that time told him that the woman’s true name was Sarah and that she suffered from multiple personality disorder. On a coffee shop date Franny told Peterson about Jennifer, another personality, whom she described as a “20-year-old female who likes to dance and have fun.” When they returned to Peterson’s car, he summoned Jennifer and asked, “Can I love you?” She answered, “O.K.” During the encounter, another personality, 6-year-old Emily, suddenly intruded to peek. Ignoring Peterson’ pleas to keep what happened a secret, Franny and Emily reported the encounter to Sarah, the predominant personality. Sarah called the police to report that she had been sexually assaulted. Peterson’s defense centered on the idea that the woman was not mentally ill and had consented to have sex. The spectacular trial included appearances by Sarah, Franny, Jennifer, and Emily. Jennifer’s testimony was perhaps most crucial. When questioned about the sexual encounter, she said, “I didn’t know what he was doing.” When asked if she and Peterson had sex, Jennifer responded, “I don’t know. What’s sex?” The Wisconsin jury had several issues to consider: (1) Whether Sarah was mentally ill at the time of the sexual act, (2) Whether she was able to appraise Peterson’s conduct, and (3) Whether Peterson knew of Sarah’s condition. In Wisconsin it is a crime to engage in sexual intercourse with a person you believe to be mentally ill and who cannot assess your conduct. Psychiatrists who had treated Sarah testified that she was not faking her disorder, was incapable of judging her action, and had been traumatized when she saw her father crushed while he was working under a car. Ruth Reeves, a neighbor and close friend of the woman, told the court that she had forewarned Peterson of Sarah’s multiple personality disorder. Mood Disorders Types of Mood Disorders –Major Depression –Dysthymic Disorder –Bipolar Disorder (Formerly known as Manic Depression) 5) Mood Disorders Major Depression: This is often referred to as the common cold of psychological disorders. Why do you think that is? Mood Disorders Major Depression This is a mood disorder in which a person, for no apparent reason, experiences two or more weeks of depressed moods, feeling of worthlessness and diminished interest or pleasure in most activities. The person may become deeply discouraged about everything and may experience fatigue. Depressed people often feel that they are helpless. They feel there is nothing they can do to change things Mood Disorders Symptoms of Depression: – Persistent depressed mood for most of the day – Loss of interest or pleasure in all, or almost all, activities – Significant weight loss or gain – Sleep changes – Fatigue or loss of energy, boredom – Feelings of worthlessness or unfounded guilt Mood Disorders Symptoms of Depression: (continued) – Reduced ability to concentrate – Recurrent thoughts of death or suicide – Physical complaints – Loss of friends – Tearfulness – Poor grade, truancy, disciplinary problems – Social behavior changes Mood Disorders Dysthymic Disorder: A person shows the sad mood, lack of interest, and loss of pleasure associated with major depression, but less intensely and for a longer duration (The duration must be at least two years to quality) Mood Disorders Suicide and Depression – Suicide is most closely tied to depression than to any other psychological disorder. – Suicide rates are high in some northern European countries, and Japan but low in Greece, Italy, Ireland and the Middle East (these countries have strong religious prohibitions) Mood Disorders Bipolar Disorder (formerly known as manic depressive disorder) The person alternate between the hopelessness and lethargy of depression and the hyperactive, wildly optimistic, impulsive phase of mania (excited and overly active periods) Bipolar Disorder is less common than major depression 5) Mood Disorders Mania During the manic phase the person may sing, shout, talk continuously, move around rapidly. He has little need for sleep. Mood Disorders Mania He is easily irritated if crossed. The person may show few sexual inhibitions. His speech may be flighty. It is difficult to interrupt him. He has grandiose optimism. Bipolar disorder may lead to reckless spending and investment sprees. Mood Disorders Then they go through a normal phase Then they go through a depressive phase. (The depressive phase usually lasts longer than the manic phase) Mood Disorders Bi Polar Disorder – 1% of the total U.S. population has bipolar disorder. Only 15-25% show a definite cycles of manic-depressive behaviors. – Recovery rate is about 90%. Mood Disorders CAUSES OF MOOD DISORDERS – Biological Factors Neurotransmitters such as serotonin and norepinephrine – A shortage of serotonin and norepinephrine is related to depression. An overabundance is related to mania. Hormones such as cortisol – Mood disorders have also been related to malfunctions of the endocrine system, especially the hypothalamic-pituitary-adrenocortical system (HPA) Mood Disorders CAUSES OF MOOD DISORDERS – Biological Factors Genetic influences – Twin studies have shown there is a hereditary component to both Bi-Polar and Depression Disorders. If an identical twin has bi-polar disorder, the other twin has a 70% chance of also having the disorder. A fraternal twin has a 20% change of having bi-polar disorder if his/her twin suffers from it. People who are adopted and have mood disorders are more likely to find a history of mood disorders in their biological families rather than in their adopted families. Mood Disorders CAUSES OF MOOD DISORDERS – Psychological Factors Psychodynamic theorists: Depression is due to the feelings of loss associated with childhood or unresolved anger toward parents (Horney). Freud believed that depression was the result of a loss of a loved one. He contents that in addition to grief we feel anger over feelings of abandonment. Some of that anger is directed inward which results in depression Mood Disorders CAUSES OF MOOD DISORDERS – Psychological Factors Behavioral theorists: Behaviorists believe that depression is the result of learned helplessness. They say that people become depressed when they have no control over negative events. Mood Disorders CAUSES OF MOOD DISORDERS – Cognitive theorists: Cognitive theorists believe that those with depression have self-defeating beliefs. They tend to magnify bad experiences and minimize good experiences. This ruminating style is especially characteristics of women. Depressed people have a tendency to explain bad events as being stable, global, and internal. Schizophrenia The term schizophrenia means literally “split mind” Schizophrenia Positive Symptoms of Schizophrenia – Break of contact with reality – Hallucinations – Delusions – Disorganized and Bizarre Behaviors – Disturbances in emotions, speech and thoughts Schizophrenia Positive Symptoms of Schizophrenia – Disturbances in thoughts and speech Neologisms: (literally “new words”). At times, a schizophrenic’s speech includes the rare appearance of words and phrases not found in even the most comprehensive dictionary. Neologisms (new words) are sometimes formed by combining parts of two or more regular words. Neologisms may also involve the use of common words in a new way Schizophrenia Positive Symptoms of Schizophrenia –Disturbances in thoughts and speech Echolalia: Repeating words said in their presence over and over and over again Schizophrenia Positive Symptoms of Schizophrenia – Disturbances in thoughts and speech Derailment (loose associations): The tendency for one thought to be logically unconnected, or only superficially related to the next. Sometimes the associations are based on the double meanings or on the way words sound Schizophrenia Example of Derailment: He pushed back the blankets from the bed. He saw the river bed was covered with small stones washed down from the quarry. The hunter came fast because he was following his quarry over the hill. Schizophrenia Positive Symptoms of Schizophrenia – Disturbances in thoughts and speech Irrelevant Replies: Giving answer to questions that are not relevant Example: How old are you? As old as the pyramids crumbling into dust. Where do you live? I exist in the world, from it, of it, and by it. Schizophrenia Positive Symptoms of Schizophrenia –Disturbances in thoughts and speech Word Salad: Combining words and phrases in what appears to be a completely disorganized fashion. Unlike neologisms, word salad suggests no effort to communicate. In word salad, nothing is related to anything else. Schizophrenia Example of word salad It’s all over for a squab true tray and there ain’t no music, there ain’t no nothing besides my mother and my father who stand alone upon the Island of Capri where there is no ice, there is no nothing but changers, changers, changers. That comes like in first and last names, so that thing does. Well, it’s my suitcase, sir. I’ve got to travel all the time to keep my energy alive. Schizophrenia Symptoms of Schizophrenia –Disturbances in thoughts and speech Clanging: The pairing of words that have no relation to one another beyond the fact that they rhyme or sound alike Schizophrenia Negative Symptoms of Schizophrenia – Anhedonia: lack of interest in living, loss of pleasure in life – Alogia (mutism): Total Silence – Flat Affect: Person shows no emotion – Avolition: Loss of motivation Schizophrenia Types of Schizophrenia – Catatonic Schizophrenia Agitated Immobile – Paranoid Schizophrenia – Disorganized Schizophrenia – Undifferentiated Schizophrenia Schizophrenia Types of Schizophrenia – Paranoid Schizophrenia Accounts for 40% of schizophrenics; appears late in life (25-30). Characterized by delusions of persecutions & grandeur. These are often accompanied by hallucinations supporting the delusion. Schizophrenia Types of Schizophrenia – Paranoid Schizophrenia (continued) Paranoid Schizophrenics are more likely than other schizophrenics to have a good outcome because it tends to be acute. Under certain circumstances, they may function relatively well Schizophrenia Types of Schizophrenia – Catatonic Schizophrenia: Accounts for 8% of all schizophrenics. The major symptoms is a disturbance in motor activity. The person may remain stiffly immobile and refuse to speak of be extremely agitated. Catatonic Schizophrenia is rarely seen today. However, it was common up to 30 to 40 years ago Schizophrenia Types of Schizophrenia – Disorganized Schizophrenia Accounts for 5% of all schizophrenics. Incoherence in expression Childish disregard for social conventions Resists wearing clothing Urinate and defecate at inappropriate times Schizophrenia Disorganized Schizophrenia (continued) – May eat with their fingers – Show emotional responses that are inappropriate to the situation – Giggling – Silly mannerisms – Inexplicable gestures Schizophrenia Types of Schizophrenia – Undifferentiated Schizophrenia This accounts for 40% of all schizophrenics. They have symptoms of schizophrenics (disordered thinking, etc) but the symptoms don’t clearly fit one of the other specific types Schizophrenia Causes of Schizophrenia – Biological Factors Brain Abnormalities: Schizophrenics (this is more true of schizophrenic with negative symptoms rather then positive) tend to have enlarged ventricles and less brain tissue than non-schizophrenics Schizophrenia Causes of Schizophrenia – Biological Factors Dopamine: In general, those with schizophrenia have an excess of receptors for dopamine. Drugs that block dopamine receptors lessen positive schizophrenia symptoms. Drugs that increase dopamine levels (i.e. cocaine, and amphetamines) increase positive schizophrenia symptoms. Schizophrenia Causes of Schizophrenia – Biological Factors Genetics: The odds of any person being schizophrenic are 1 in 100. The odds rise to 1 in 10 if one parent has schizophrenia. If a person has an identical twin with schizophrenia, the odds are 50 in 100. Schizophrenia Causes of Schizophrenia – Psychological Factors There are no psychological factors alone that cause schizophrenia. However, a life of a lot of stressors will increase the chances that a predisposition of schizophrenia will result in schizophrenic symptoms Personality Disorders Personality disorders are psychological disorders characterized by inflexible and enduring behavioral patterns that impair social functioning. These disorders usually do not involve anxiety, depression, or loss or contact with reality. They may however, coexist with other psychological disorders. Personality Disorders Lasting, rigid patterns of behavior that seriously diminish functioning. Related to Anxiety Avoidant personality disorder Dependent personality disorder Dramatic or Impulsive Behaviors Borderline personality disorder, Antisocial personality disorder Odd or Eccentric Behaviors Paranoid personality disorders, Schizoid personality disorders Mental Illness and the Law MENTALLY INCOMPETENT: Being unable to understand the proceedings and charges against you. If you are declared mentally incompetent to stand trial you are protected from prosecution. This is a rare occurrence. INSANITY: If you are judged to be not guilty by reason of insanity at the time of the crime it means that the mental illness prevented the person from: 1. understanding what he/she was doing 2. knowing that what they were doing was wrong 3. resisting the impulse to do wrong