1. Unit 11: Abnormal Psychology Lesson 4: Schizophrenia Essential Question – What are the causes, effects, and treatment options of psychological disorders? Key Vocabulary – Psychotic Disorders – Schizophrenia (several types): Paranoid Disorganized Catatonic. – Dopamine (& relationship to Parkinsons) – Symptoms of Schizophrenia Positive v. Negative symptoms Disorganized Thinking (Delusions; breakdowns in selective attention; word salad) Disturbed perceptions (hallucinations) Inappropriate actions / feelings – Antipsychotic medications: Haldol, Zyprexa, Risperdol DAILY COMMENTARY: – Describe the basic differences (neurologically and in behavior) between MDD and bipolar disorder. – What neurotransmitters are most relevant in understanding anxiety disorders? – Write and briefly describe the causes and symptoms of two of your disorders. – How are these disorders treated? Upcoming Deadlines: – Assigned Readings: Daily – Present Projects: April 15-17 – Vocab Quizzes: Lessons 1-4: April 10 th ( nope. Nevermind. Not today… – Mock Exam: MC Section: – 4/17 (Unit 11 test score will be based on relevant questions from the mock exam) FRQ Section: Monday, April 13

2. Disorders & Therapies Project 30 Minutes now to research your assigned disorders Suggested resources: – Myers & Griggs; web-based research; the DSM  My disorder chart is complete. I understand the: diagnostic criteria (symptoms) Course & prevalence (when it sets in, how common it is) Etiology (causes) Treatment (medical, therapies, etc.); include at 2-3 options for each disorder  I have a clear understanding of how each disorder might be treated, and can discuss the strengths and weaknesses of different approaches to treatment  I’ve designed an interactive, multimedia presentation on each assigned disorder.  I’ve practiced presenting on each disorder.

3. 3 Schizophrenia If depression is the common cold of psychological disorders, schizophrenia is the cancer. Nearly 1 in a 100 suffer from schizophrenia, and throughout the world over 24 million people suffer from this disease (WHO, 2002). Schizophrenia strikes young people as they mature into adults. It affects men and women equally, but men suffer from it more severely than women.

4. 4 Symptoms of Schizophrenia The literal translation is “split mind.” A group of severe disorders characterized by the following: 1.Paranoia 2.Delusions 3.Word salad 4.Fragmented thinking & speech

5. Video Clips 4 patients with schizophrenia: – http://www.youtube.com/watch?v=bWaFqw8Xnp A http://www.youtube.com/watch?v=bWaFqw8Xnp A San Fransisco man: http://www.youtube.com/watch?v=rCbf- pKtkhU http://www.youtube.com/watch?v=rCbf- pKtkhU

6. 6 Other forms of delusions include, delusions of persecution (“someone is following me”) or grandeur (“I am a king”). Disorganized & Delusional Thinking This morning when I was at Hillside [Hospital], I was making a movie. I was surrounded by movie stars … I’m Marry Poppins. Is this room painted blue to get me upset? My grandmother died four weeks after my eighteenth birthday.” (Sheehan, 1982) This monologue illustrates fragmented, bizarre thinking with distorted beliefs called delusions (“I’m Mary Poppins”).

7. 7 Disturbed Perceptions A schizophrenic person may perceive things that are not there (hallucinations). Frequently such hallucinations are auditory and lesser visual, somatosensory, olfactory, or gustatory. L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign

8. 8 Inappropriate Emotions & Actions A schizophrenic person may laugh at the news of someone dying or show no emotion at all (apathy). Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia).

9. 9 Positive and Negative Symptoms Schizophrenics have inappropriate symptoms (hallucinations, disorganized thinking, deluded ways) that are not present in normal individuals (positive symptoms). Schizophrenics also have an absence of appropriate symptoms (apathy, expressionless faces, rigid bodies) that are present in normal individuals (negative symptoms).

10. 10 Chronic and Acute Schizophrenia When schizophrenia is slow to develop (chronic/process) recovery is doubtful. Such schizophrenics usually display negative symptoms. When schizophrenia rapidly develops (acute/reactive) recovery is better. Such schizophrenics usually show positive symptoms.

11. 11 Subtypes

12. 12 Understanding Schizophrenia Schizophrenia is a disease of the brain exhibited by the symptoms of the mind. Dopamine Overactivity: Researchers found that schizophrenic patients express higher levels of dopamine D4 receptors in the brain. Brain Abnormalities

13. 13 Abnormal Brain Activity Brain scans show abnormal activity in the frontal cortex, thalamus, and amygdala of schizophrenic patients. Adolescent schizophrenic patients also have brain lesions. Paul Thompson and Arthur W. Toga, UCLA Laboratory of Neuro Imaging and Judith L. Rapport, National Institute of Mental Health

14. 14 Abnormal Brain Morphology Schizophrenia patients may exhibit morphological changes in the brain like enlargement of fluid-filled ventricles. Both Photos: Courtesy of Daniel R. Weinberger, M.D., NIH-NIMH/ NSC

15. Unit 11: Abnormal Psychology Lesson 4: Schizophrenia (Continued) Essential Question – What are the causes, effects, and treatment options of psychological disorders? Key Vocabulary – Psychotic Disorders – Schizophrenia (several types): Paranoid Disorganized Catatonic. – Dopamine (& relationship to Parkinsons) – Symptoms of Schizophrenia Positive v. Negative symptoms Disorganized Thinking (Delusions; breakdowns in selective attention; word salad) Disturbed perceptions (hallucinations) Inappropriate actions / feelings – Antipsychotic medications: Haldol, Zyprexa, Risperdol DAILY COMMENTARY: – What are the differences between paranoia, hallucinations, and disorganized thinking? Give an example of each. – For what disorder might a psychiatrist prescribed Zoloft (an SSRI) How about Xanax? Lithium? Upcoming Deadlines: – Assigned Readings: Daily – Present Projects: April 15-17 – Vocab Quizzes: Lessons 1-7: 4/15 – Mock Exam: MC Section: – 4/17 (Unit 11 test score will be based on relevant questions from the mock exam) FRQ Section: Monday, April 13

16. 16 Viral Infection Schizophrenia has also been observed in individuals who contracted a viral infection (flu) during the middle of their fetal development.

17. 17 Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 1991). 0 10 20 30 40 50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated

18. 18 Genetic Factors The following shows the prevalence of schizophrenia in identical twins as seen in different countries.

19. 19 Psychological Factors Psychological and environmental factors can trigger schizophrenia if the individual is genetically predisposed (Nicols & Gottesman, 1983). Genain Sisters The genetically identical Genain sisters suffer from schizophrenia. Two more than others, thus there are contributing environmental factors. Courtesy of Genain Family

20. 20 Warning Signs Early warning signs of schizophrenia include: Birth complications, oxygen deprivation and low-birth weight. 2. Short attention span and poor muscle coordination.3. Poor peer relations and solo play.6. Emotional unpredictability.5. Disruptive and withdrawn behavior.4. A mother’s long lasting schizophrenia.1.

21. 21 Schizophrenia Symptoms Inappropriate symptoms present (positive symptoms) Appropriate symptoms absent (negative symptoms) Hallucinations, disorganized thinking, deluded ways. Apathy, expressionless faces, rigid bodies.

22. 22 Antipsychotic Drugs Classical antipsychotics [Chlorpromazine (Thorazine)]: Remove a number of positive symptoms associated with schizophrenia such as agitation, delusions, and hallucinations. Atypical antipsychotics [Clozapine (Clozaril)]: Remove negative symptoms associated with schizophrenia such as apathy, jumbled thoughts, concentration difficulties, and difficulties in interacting with others.

23. 23 Atypical Antipsychotic Clozapine (Clozaril) blocks receptors for dopamine and serotonin to remove the negative symptoms of schizophrenia.

24. Researching Schizophrenia Complete PsychSim5 Module: – “Losing Touch with Reality”