Download Understanding Schizophrenia: Positive, Negative, and Disorganized Symptoms - Prof. B. Gros and more Study notes Psychology in PDF only on Docsity! Chapter 12
Schizophrenia and Other Psychotic Disorders
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Nature of Schizophrenia and Psychosis: An Overview • Schizophrenia vs. Psychosis – Psychotic behavior – Cluster of disorders characterized by hallucinations and/or loss of contact with reality – Schizophrenia – A type of psychosis with disturbed thought, perception, language, emotion, and behavior Schizophrenia: The “Disorganized” Symptoms • The Disorganized Symptoms – Include severe and excess disruptions in speech, behavior, and emotion • Nature of Disorganized Speech – Cognitive slippage – Illogical and incoherent speech – Tangentiality – “Going off on a tangent” and not answering a question directly – Loose associations or derailment – Taking conversation in unrelated directions • Disorganized Affect – Inappropriate emotional behavior (e.g., crying when one should be laughing) • Disorganized Behavior – Includes a variety of unusual behaviors – Catatonia – Spectrum from wild agitation, waxy flexibility, to complete immobility Subtypes of Schizophrenia • Paranoid Type – Intact cognitive skills and affect, and do not show disorganized behavior – Hallucinations and delusions center around a theme (grandeur or persecution) – best prognosis • Disorganized Type – Marked disruptions in speech and behavior, flat or inappropriate affect – Hallucinations and delusions have a theme, but tend to be fragmented – This type develops early, tends to be chronic, lacks periods of remissions Subtypes of Schizophrenia (cont.) • Catatonic Type – Show unusual motor responses and odd mannerisms (e.g., echolalia, echopraxia) – This subtype tends to be severe and quite rare • Undifferentiated Type – Major symptoms of schizophrenia, but fail to meet criteria for another type • Residual Type – One past episode of schizophrenia – Continue to display less extreme residual symptoms (e.g., odd beliefs) Schizophrenia: Some Facts and Statistics • Onset and Prevalence of Schizophrenia worldwide – About 0.2% to 1.5% (or about 1% population) – Usually develops in early adulthood, but can emerge at any time • Schizophrenia Is Generally Chronic – Most suffer with moderate-to-severe impairment throughout their lives • Schizophrenia Affects Males and Females About Equally • Schizophrenia Appears to Have a Strong Genetic Component Figure 12.2 Gender differences in onset of schizophrenia in a sample of 470 patients Schizophrenia: Genetic Influences • Family Studies – Inherit a tendency for schizophrenia, not a specific form of schizophrenia – Schizophrenia in the family increases risk for schizophrenia in other family members • Twin Studies – Risk of schizophrenia in monozygotic twins is 48% – Risk of schizophrenia drops to 17% for fraternal (dizygotic) twins • Adoption Studies Risk for schizophrenia among children of twins
Figure 12.5
18%
16%
14%
12%
10%
8%
6%
4%
2%
0%
Monozygotic Monozygotic Dizygotic Dizygotic
schizophrenic “normal” schizophrenic “normal”
twin co-twin twin co-twin
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Schizophrenia: Neurobiological Influences • Neurobiology and Neurochemistry: The Dopamine Hypothesis – Drugs that increase dopamine (agonists), result in schizophrenic- like behavior – Drugs that decrease dopamine (antagonists), reduce schizophrenic-like behavior – Examples include neuroleptics and L-Dopa for Parkinson’s disease Some ways drugs affect neurotransmission
Figure 12.6
Agonistic
effects Dendrite
Synaptic vesicle
Drug produces an increase in the Drug helps increase the release Drug activates the receptors
creation of the neurotransmitter. of the neurotransmitter. of the neurotransmitter.
Antagonistic
effects
Drug interferes with the release Drug occupies the receptors, Drug causes the neurotransmitter to
of the neurotransmitter. blocking the neurotransmitter. leak from the synaptic vesicle.
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Medical Treatment of Schizophrenia • Antipsychotic (Neuroleptic) Medications – Medication is often the first line of treatment for schizophrenia – Began in the 1950s – Most medications reduce or eliminate the positive symptoms of schizophrenia – Acute and permanent extrapyramidal and Parkinson-like side effects are common – Poor compliance with medication is common Psychosocial Treatment of Schizophrenia • Psychosocial Approaches: Overview and Goals – Behavioral (i.e., token economies) on inpatient units – Community care programs – Social and living skills training – Behavioral family therapy – Vocational rehabilitation • Psychosocial Approaches Are Usually a Necessary Part of Treatment
