Schizophrenia Lori Ridgeway PSYC 3560. What is Schizophrenia? Deterioration in fx Extreme...

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

Bizarre ________________ to behavior ________________

Ideas that have no basis in fact Persecution most common Other types

Grandeur Control Reference

Positive Sxs, Cont’d…

Hallucinations Sensory perceptions in absence of stimuli Premorbid perception & attention problems ______________ most common Other types

Visual Olfactory Tactile Somatic

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

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

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

Psychomotor Sxs

Motoric disturbances Gestures not related to environment Catatonia

______________ Posturing Rigidity Waxy flexibility Excitement

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

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

Subtypes: Disorganized

Disorganized speech &/or behavior Flat or inappropriate affect ________________ Any delusions/hallucinations are fragmented

& no theme Early onset Greater impairment Worse prognosis

Subtypes: Catatonic

Psychomotor disturbance Immobility

catalepsy = ________________

Excessive activity purposeless

Peculiar voluntary movements posturing

Negativism rigid posture, can’t move

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

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”

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

Comorbidity

________________ disorders Anxiety disorders Personality disorders

May be prodromal Suicide

10% commit suicide 30%-40% make at least one attempt

Biological Explanations

Genetics ______% among first-degree relatives Twin studies Adoption studies

Biochemical differences Type I (positive sxs) Dopamine hypothesis

Bio , Cont’d…

Structural differences Type II (negative sxs) ___________________________ in brain Abnormal blood flow Decreased size of temporal lobe

Psychological Explanations

Psychodynamic Schizophrenogenic _____________

Behavioral Operant conditioning

Cognitive perceptual disturbances Problems when try to underst&

Sociocultural Explanations

________________ Label applied to nonconformists Self-fulfilling prophecy Rosenhan (1973)

Family dysfunction Double-bind hypothesis Expressed emotion

Sociocultural-existential Constructive process Self-cure

Diathesis-Stress

________________ view of cause Combination of factors Predisposition combined with environment Biological factors better identified

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?