Chp 16.2: Psychological Disorders II Flashcards
Schizophrenia
- Severe disturbances in cognition, speech, perception, emotion, and behaviour
- Means “split-mind” BUT different from DID
- The components of the mind (thoughts, speech, perception, emotion) become disconnected. It is a splitting of mental processes
Schizophrenia DSM V Disgnosis
Two or more of the following (including at least one so-called positive symptom*) have to be present for the better part of 30 days:
(1) delusions
(2) hallucinations
(3) disorganized speech
(4) very disorganized or catatonic behaviour
(5) flattening of affect, alogia, or avolition
Specific types of schizophrenias (although no longer part of DSM, several subcategories of schizophrenia are still commonly diagnosed )
- Paranoid Schizophrenia:
- Catatonic Schizophrenia
- Disorganized Schizophrenia
-Undifferentiated
Schizophrenia: the “leftovers” category
Paranoid Schizophrenia
- a preoccupation with one or more delusions
- experiencing frequent auditory hallucinations
Catatonic Schizophrenia
- motor disturbances: muscle rigidity or random/repetitive movements
o Alternate between stuporous states - oblivious to reality, can be molded and stay that way for hours (waxy flexibility)
o And agitated excitement - can be dangerous to others
Disorganized Schizophrenia
- disorganized speech
- marked loosening of associations
Type 1 schizophrenia
- Positive symptoms: delusions, hallucinations, disordered speech/thoughts
- neurotransmitter problems
- responds well to drug therapy
o Called positive because they represent ADDED pathological extremes of normal processes - Type-I have good history before breakdown, good prognosis after treatment
Type 2 schizophrenia
- Negative symptoms: lack of emotion, loss of motivation, absence of normal speech
e.g., flattening of affect, catatonia,
alogia, avolition. - does not respond well to drug therapy
- Type-II have history of poor functioning and poor outcome of treatment
Genetic predisposition in Schizophrenia
- Strong evidence for genetic predisposition but the specific genes involved are unknown
- The more closely related you are to a schizophrenia patient, the more likely to are for developing it in your lifetime
- Identical twins show high concordance rates (48%)
Brain abnormalities in Schizophrenia
• Structural abnormalities in brains (frontal lobes, temporal lobes, and/or limbic system)
-enlarged ventricles
-
longer ver:
• Destruction of neural tissue
• Mild to moderate brain atrophy – general loss or deterioration of neurons in the cerebral cortex and limbic system, together with enlarged ventricles
• Atrophy found in brain regions dealing with cognitive processes and emotion
• Thalamus abnormalities – causes disordered attention since it can’t filter info to cerebral cortex
• These structural differences are more common in patients who exhibit negative symptom -> explaining why they have poorer chance of recovery
Biochemical factors in Schizophrenia
• Dopamine hypothesis - positive symptoms are produced by an overactivity of dopamine in motivation, emotion and cognitive function areas
• They have more dopamine receptors on neurons than other people, they are over reactive to dopamine stimulation
o Drugs that reduce dopamine are effective
o Drugs that stimulate dopamine can induce hallucinations and delusions
Psychological Factors in Schizophrenia
• Freud: schizophrenia is a retreat from unbearable stress and conflict
o Represents extreme example of defense mechanism regression – person retreats to an earlier and more secure stage of psychosocial development in the face of overwhelming anxiety
o No evidence, but the life stress idea is widely accepted
• Cognitive: defect in attention mechanism that filters out irrelevant stimuli, overwhelmed by internal/ external stimuli
o Stimulus overload produces distractibility, thought disorganization
o Overwhelmed by disconnected thoughts and ideas
o Thalamus or frontal lobe problems may explain this
o Prefrontal cortex (distinguishes reality from fantasy) doesn’t work
Environmental Factors in Schizophrenia
• Stressful life events play an important role
• Have much higher emotional reactivity to stressful events than normal people
• Schizophrenic adoptive parents no more likely to have schizophrenic kids (children of biologically normal parents who are raised by schizophrenic adoptive parents do not show an increased risk of developing schizophrenia
• Children as young as 2 show odd movements, emotions. This may cause negative reactions from others, only making the problem worse.
• More likely to relapse if returning to home that is high in expressed emotion
o High levels of criticism (all you do is watch TV) , hostility (we’re sick of your craziness), over involvement (you’re not going out unless I’m with you)
o High expressed emotion may be either a cause of or a response to patients’ disordered behaviours
Sociocultural Factors in Schizophrenia
- Prevalence of schizophrenia higher in lower socioeconomic populations
- Social causation hypothesis - higher rates of schizophrenia in poor areas due to the higher stress that low income causes, particularly within urban environments
- Social drift hypothesis - schizophrenia causes lower occupational functioning, so schizophrenic people move to low-cost urban housing populations
- They are likely both a factor
- Schizophrenia occurs equally in all cultures
- Likelihood of recovery is greater in developing countries (compared to Canada and US), maybe due to stronger community orientation and social support
Diagnostic Criteria for Personality Disorders (PDs)
- there are several characteristics associated with people diagnosed with a PD
- their maladaptive cognitions, emotions, and behaviors tend to be stable, and inflexible
- ## often present from an early age
- people with PDs almost never seek treatment for PD, per se
-they will only seek treatment for co-morbid disorders such as depression or anxiety
