1. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. Edited by Elizabeth Rieger Images, Figures and Tables Chapter 4 4-1 Abnormal Psychology Leading Researcher Perspectives

2. Professor Patrick McGorry was announced as the 2010 Australian of the Year by the National Australia Day Council for his groundbreaking research in the area of early detection and intervention for psychosis Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-2 Courtesy of Professor Patrick McGorry

3. In the film A Beautiful Mind, Russell Crowe depicts the life of a man with schizophrenia. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-3 Everett Collection/Headpress Pty Ltd

4. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-4

5. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-5 Continued on next slide

6. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-6

7. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. The Early Psychosis Prevention and Intervention Centre (EPPIC) in Melbourne has pioneered early intervention in Australia for young people with psychosis. 4-7 Courtesy Orygen Youth Research Centre

8. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-8 Figure 1 The percentage of patients with schizophrenia who relapsed in the nine-month period following their discharge from hospital depending on whether they returned home to high or low expressed emotion (EE ) families, had high or low amounts of contact with family members, and were taking medication or not

9. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-9 Figure 2 The cognitive model of psychosis developed by Morrison (2001) using as an example the case of a mother distressed by fears of hurting her child

10. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-10 Figure 3 The percentage of high-risk patients developing psychosis and being prescribed antipsychotic medication one year after commencing CBT or regular symptom monitoring

11. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-11 Figure 4 The percentage of CBT and standard treatment patients who relapsed over the 12 months of the study

12. Proposed changes for psychotic disorders in DSM-V A new ‘psychosis risk syndrome’ is to be created, which is a less severe form of psychosis in which the symptoms are not intense enough or of long enough duration to meet criteria for another psychotic disorder. The subtypes of schizophrenia in the DSM-IV-TR are to be removed due to concerns regarding their validity. Schneider’s concept of first-rank symptoms is to be discarded and, instead, two or more symptoms of psychosis including delusions, hallucinations, disorganised speech, catatonia and/or negative symptoms must be present for one month or more, and that one of the first three symptoms must be present. Further clarification of the diagnosis of schizoaffective disorder is to be included in order to improve the reliability of its diagnosis. For example, the term ‘prominent mood symptoms’ would be replaced by the more specific term ‘symptoms meeting criteria for a major mood episode’. 4-12 Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al.

13. Chapter 4 Summary Core symptoms of psychotic disorders include positive symptoms (hallucinations, delusions, thought disorder, disorganised behaviour) and negative symptoms (alogia, avolition, blunted affect). The diagnosis of a specific psychotic disorder (such as schizophrenia) is based on the range of symptoms present, the duration of the symptoms, the precipitating factors and the impact upon the person’s functioning. Psychotic disorders are associated with secondary problems including substance use, depression and anxiety. Sufferers often experience significant interruptions to their lives, including unemployment and stigma. Psychosis typically develops for the first time in late adolescence and early adulthood, often with many months of non-specific changes in mental state preceding the onset of acute psychotic symptoms. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-13

14. Chapter 4 Summary (continued) A wide range of factors have been examined as possible causes of psychosis under the framework of the Stress Vulnerability Model of psychosis. Contributors to vulnerability include biological factors (e.g., genes and changes in brain structures) and psychosocial factors (e.g., trauma, abuse and dysfunctional cognitions). Precipitating factors which interact with vulnerability include illicit substances, stressful life events and exposure to hostility and criticism in relationships. Once a comprehensive assessment has been completed and psychosis is accurately diagnosed, acute phase treatments focus upon the immediate reduction of symptoms and associated distress, while longer term recovery requires a broad array of psychological, social and biological interventions. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-14

15. Chapter 4 Summary (continued) Comprehensive treatments include a focus on staying well after psychosis and achieving a satisfying quality of life. Researchers are beginning to report that some treatments may be effective in preventing or postponing the onset of psychosis in young people at ‘ultra-high risk’ of psychosis. Consumers of psychiatric services have developed their own empowering Consumer Recovery Model of psychosis with a strong emphasis upon recovery, the strengths of the individual and the reduction of stigma. Copyright © 2011 McGraw-Hill Australia Pty Ltd PPTs t/a Abnormal Psychology: Leading Researcher Perspectives 2e by Rieger et al. 4-15