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Summary 1.6 Normal or Abnormal - Problem 6 - Schizophrenia
Summary of the first problem of the course 1.6 Normal or Abnormal - Schizophrenia
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P6 – SchizophreniaWhat is schizophrenia? Severe psychotic disorder with alternating clear and distorted perception of the
world
A. 2+ each for min. 1 month (also has to have either 1/2/3)
1. Delusions
2. Hallucinations
3. Disorganized speech (derailment/incoherence)
4. Grossly disorganized/catatonic behavior
5. Negative symptoms (e.g. avolition/less em. Ex)
B. Life before much better
C. 6+ months (with min 1 month of symptoms of A) – Prodromal =
very early signs/residual periods
D. No major depressive/manic episodes
E. Not caused by substance/other medical condition
F. If history of autism, diagnose only if hallucinations/severe
delusions
• Psychosis = significant loss of contact with reality (can also occur in depression)
Symptoms of schizophrenia?
Delusions
• Beliefs that involve misinterpretation of perceptions or experiences
• Become fixed beliefs that aren’t changeable
• Is able to bring reason and logic to support them, no matter how irrational they are
• Could be bizarre (aliens spying on you) & non-bizarre (police spying on you)
Types:
• Persecutory delusions – belief of being persecuted, spied upon, in danger (usually as a result of a
conspiracy)
• Grandiose delusions –they are someone with fame/power/ abilities
• Delusions of control –thoughts, feelings, actions = controlled by external forces (e.g.
extraterrestrial/ supernatural)
• Nihilistic delusions –some aspect of either the world or themselves has ceased to exist (e.g. one
can believe he/she is dead)
• Erotomanic delusions – (rare) believes someone is in love with him
• Somatic – health or organ related
• Delusion of guilt or sin – death or a disaster that one provoked
• Delusions of reference - patient believes that unsuspicious occurrences refer to him or her in
person (e.g. music played on the radio is especially for them)
Hallucinations
• “Sensory experience in which one sees, hears, smells, tastes or feels something that isn’t there”
(Auditory – most common, olfactory, gustatory, tactile)
• + frequent, persistent, bizarre, complex
• 70% of schiz. – but many aware that they may not be real
, • Voices seen as “not me” - external sources
• Visual – 2nd most common - colors or shapes/very specific (e.g. person)
• Somatic – sensation inside them
• Normal ppl - more auditory if lots of stress & caffeine (together) – cuz caffeine increase amount
of cortisol released
o fMRI study showed increase in Broca’s area (speech production) pointing toward the
hypothesis of hearing one own’s inner speech
Reality-monitoring deficit – a problem distinguishing - what actually occurred/not
Self-monitoring deficit – problem distinguishing own thoughts & thoughts of others
Disorganized thinking/Speech
• “Formal thought disorder” – how disorganized thought is expressed in disorganized speech
• More common in males; more lateralized
• Derailment – Go from one topic to another quickly in a convo
• Loose associations (thoughts) - only they see logic in the sentence
• Tangentiality (speech) –answers to questions may be irrelevant & tangential (talk about topics
unrelated)
• Clanging/clang association –speaking chosen according to word sounds (e.g. rhyming)
• Neologisms – made up words
• Word salads – mix of random words & phrases
• Poverty of content
• Circumstantial – too much unnecessary detail given
Disorganized Motor behavior
• May be childlike and silly/inappropriate
• May be inappropriate to the context (e.g. masturbating in public)
• Unpredictable and agitated & difficulty completing goals
• May dress in an inappropriate way
Catatonic motor behavior
• slow motor activity,
• ↓ reactivity to en. (catatonic stupor = rigidity),
• maintaining immobile postures (catatonic rigidity),
• resisting attempts to be moved (catatonic negativism),
• purposeless and excessive motor activity that consists of simple, stereotyped movements
(catatonic excitement or stereotypy)
• mutism – no verbal response
!!Psychotic drugs only work in positive symptoms not on the negative ones
!!Positive ones do not respond to psychological treatment as they are irrational and cannot be rationalized
Negative symptoms – absence of behs normally present (Positive symptoms = excess/distortion of
beh/experience)
A) Reduced expression
B) Reduction in motivation/pleasure
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