SCHIZOPHRENIC DISORDERSA class of disorders marked by delusions, hallucinations, disorganized speech, and deterioration of adaptive behavior

GENERAL SYMPTOMS Delusions and irrational thoughts Delusions are false beliefs that are

maintained even though they clearly are out of touch with reality

Delusions of grandeur Deterioration of thought Deterioration of adaptive behavior Hallucinations: sensory perceptions that

occur in the absence of a real, external stimulus or are gross distortions of perceptual input

Disturbed emotion

SUBTYPES Paranoid type: dominated by delusions of

persecution, along w/delusions of grandeur Catatonic type: striking motor disturbances,

ranging from muscular rigidity to random motor activity

Disorganized type: particularly severe deterioration of adaptive behavior

Undifferentiated type: idiosyncratic mixtures of schizophrenic symptoms

POSITIVE VS. NEGATIVE SYMPTOMS Negative symptoms

involve behavioral deficits, such as flattened emotions, social withdrawal, apathy, impaired attention, and poverty of speech

Positive symptoms involve behavioral excesses or peculiarities, such as hallucinations, delusions, bizarre behavior, and wild flights of ideas

COURSE AND OUTCOME Schizophrenia usually

emerges during adolescence or early adulthood

Emergence may be sudden or gradual

Mild disorders are usually successfully treated

For some, it is chronic and permanent hospitalization is required

Males tend to have earlier onset, relapse, and more hospitalizations

ETIOLOGY OF SCHIZOPHRENIA

GENETIC VULNERABILITY Strong evidence to

support hereditary influence

Identical twin concordance rates at about 48%

Born to two schizophrenic parents---46%

NEUROCHEMICAL FACTORS Excess dopamine is a possibility Possible interaction between dopamine and

serotonin

STRUCTURAL ABNORMALITIES IN THE BRAIN CT scans and MRIs

show enlarged brain ventricles in schizophrenic patients

A smaller thalamus may play a part

Psychs don’t know if these are cause or effect of schizophrenia

NEURODEVELOPMENTAL HYPOTHESIS Schizophrenia is

caused in part by various disruptions in the normal maturation processes before or at birth

Studies focus on viral infections

EXPRESSED EMOTION Focuses on family

dynamics influence the course of schizophrenia

Expressed emotion is the degree to which a relative of a schizophrenic patient displays highly critical or emotionally overinvolved attitudes toward the patient

PERSONALITY DISORDERSA class of disorders marked by extreme, inflexible personality traits that cause subjective distress or impaired social and occupational functioning

PERSONALITY DISORDERS DSM-IV lists ten

disorders clustered into 3 main groups:

1) Anxious-fearful 2) Odd-eccentric 3) Dramatic-

impulsive

DIAGNOSTIC PROBLEMS Personality disorders

tend to overlap one another

Current revisions are underway for the new DSM-V, set to be published in 2013

ANTISOCIAL PERSONALITY DISORDER DEF: marked by

impulsive, callous, manipulative, aggressive, and irresponsible behavior that reflects a failure to accept social norms

Lack a conscience More common

among males Seen in 3-4% of pop.

ETIOLOGY May be a genetic disposition Inherited sluggish autonomic systems Inadequate or dysfunctional family systems

may be a cause

PSYCHOLOGICAL DISORDERS AND THE LAW

INSANITY DEF: a legal status

indicating that a person cannot be held responsible for his or her actions because of mental illness

M’naghten rule: insanity exists when a mental disorder makes a person unable to distinguish right from wrong

INVOLUNTARY COMMITMENT DEF: people

hospitalized in psychiatric facilities against their will

Criteria: 1) people are

dangerous to themselves

2) dangerous to others

3) treatment is needed

CULTURE AND PATHOLOGY

ARE EQUIVALENT DISORDERS FOUND AROUND THE WORLD? Severe disorders are pancultural Culture-bound disorders: abnormal

syndromes found only in a few cultural groups

Koro, windigo, anorexia nervosa