Lecture 9 Flashcards
schizophrenia
general consensus of schizophrenia
a debilitating psychiatric condition which is characterised by the individual demonstrating a loss of contact with reality
statistics
affects approximately 1% of the population - 1 in 100
typical onset during the 20 - 30s
affects men in teens to 20s
affects women equally 20s to 30s
early accounts of schizophrenia
Haslam 1810 produced detailed patient notes of James Matthew’s
the patient believed he was being controlled by a mind machine which he named the “air loom”
he continued these beliefs no matter what people showed him - they couldn’t be disputed
Mordel
cases study of a 13 year old boy who underwent rapid intellectual decay, displaying homicidal thoughts towards his father
the disorder was termed “dementia praecox” following the believe that the brain had degenerated, the brief was it was heredity
Kraeplin
“dementia praecox” was a form of mental deterioration in early life
considered the condition hereditary
physical abnormalities were a sign of markers for the condition such as deformities of finger and toes
Bleuler
disagreed with the term “dementia praecox”
argued it can occur before and after adolescence and that deterioration isn’t the only outcome
instead he focused on the psychological aspects of the condition and provided us with the term schizophrenia meaning split mind
Bleuler’s psychological aspects of sz
4 fundamental features of SZ:
blunted affect
loosening of associations
ambivalence
loss of awareness of external events
blunted effect
reduced emotional response to stimuli
for example, is there is a loud bang they won’t react
loosing of associations
disordered or contradictory responses
they find it difficult to learn environmental cues
ambivalence
unable to make decisions
loss of awareness of external events
preoccupied on the internal world
this may be unrelated ti the external world
postive symptoms
an excess of experiences which are not normal
negative symptoms
the absence of normal behaviour or experiences
cognitive symptoms
deficits in cognitive abilities
examples of positive symptoms
delusions - a fixed belief that have no basis
hallucinations - perceptions without external stimulus
disorganised thinking/speech or behaviour
delusions
an erroneous belief held with conviction despite contradictory evidence
different types of delusions include:
persecutions - people plotting against the individual
grandiose - persons has great fame, wealth or power
very common, around 90% experience these
hallucinations
a sensory experiment without an external stimulus to provoke it
auditory hallucinations are most common - this must be consistent not just a one off
disordered thought/speech and behaviour
disorganised thoughts - difficulty in concentrating, had to complete tasks
disordered speech - difficulty in making sense, may jump around in conversations, or appear to present logical sentences but have made up words
disordered behaviour - may dress oddly to others, demonstrate odd reactions
examples of negative symptoms
5As
blunted affect - reduced emotional response to stimuli
alogia - diminished speech output, difficult to communicate with others
anhedonia - inability to feel pleasure during enjoyable activities
asociality - reduction in social initiative
avolitation - inability to complete goal directed tasks due to lack of motivation
examples of cognitive symptoms
these tend to be stable throughout
difficulty sustaining attention
impaired working memory
poor abstract thinking
poor problem solving
low psychomotor speed
difference between + and -
+ symptoms are often the defining factor and are easy to treat
- symptoms are most problematic, and are often made worse by medication
cognitive symptoms are also hard to treat, with medication often making them worse
Sz phases
prodromal phase - negative symptoms occur, marked by social withdrawal and loss of interest in normal activities
active phase - positive symptoms e.g. a psychosis which marks the disturbance as sz
residual phase - postive symptoms decrease, negative symptoms remain
DSM-5 criteria A
two or more of the following present for significant portions of time during one month period at least of these mist be present
1. delusions
2. hallucinations
3. disorganised speech
- disorganised or catatonic behaviour
- negative symptoms
DSM-5 criteria B and C
B) social or occupational dysfunction: quality of work/interpersonal relationships or self-care if significantly below level before disturbance
C) duration: continuous signs of disturbance persist for at least 6 months. must include at least in month of symptoms from A