SCHIZOPHRENIA

TYPES Disorganized: -Incoherent Speech -Hallucinations -Bizzare Behavior -DelusionsCatatonic:-Stuporor -Extreme Excitement Paranoid: -Illogical delusions combined with hallucinations. - No Incoherence

TYPES (cont’d) Undifferentiated: -Combined schizophrenic symptoms that do not clearly fit in any of the other categories Residual: -Those who suffer from a past episode of schizophrenia but are currently free of symptoms.

Types (cont’d) Positive: - any form in which the person displays active symptoms, such as delusions or hallucinations Negative: - Any form in which there is a deficit, such as a withdrawl and poverty of thought processes rather than by active symptoms.

POSITIVE SYMPTOMS Delusions Delusions of grandeur Delusions of grandeur Believing that you are famous or important Delusions of Persecution Delusions of Persecution Believing that someone is out to get you “one of us worked with a world class cyclist. She believed that other competitors were determined to sabotoge her efforts…they would spray her bike with chemicals that would take her strength away…” Source: Barlow/Durand pg.425

POSITIVE SYMPTOMS Hallucinations The experience of sensory events without any input from the surrounding environment. The experience of sensory events without any input from the surrounding environment. Auditory Hallucination Hearing things that aren’t there Hearing things that aren’t there Brain Imaging techniques have tried to localize where hallucination occurs in the brain, and have found that schizophrenics suffer from loss of gray matter over time. Brain Imaging techniques have tried to localize where hallucination occurs in the brain, and have found that schizophrenics suffer from loss of gray matter over time.

Brain Imaging Grey matter loss in adolescents with schizophrenia. Warmer colors denote regions with the most significant losses. From the National Academy of Sciences, USA.

Brain Imaging (Cont’d) Broca’s area (speech) in the brain has been found to be active during auditory hallucinations. –This supports the notion that people with auditory hallucinations are not actually hearing others speak, but are listening to their own thoughts. Normal Brain Schizophrenic Brain Coronal MR scans from a chronic schizophrenic (bottom) and normal comparison subject (top).

NEGATIVE SYMPTOMS Avolition: The inability to initiate and persist in activities. People with avolition show little interest in performing even basic day-to-day activities, like keeping up with personal hygiene. Alogia The relative absence of speech. A person with alogia may respond to questions with very brief replies. They may appear uninterested in the conversation.

NEGATIVE SYMPTOMS (Cont’d) Anhedonia Presumed lack of pleasure in some people with schizophrenia. An indifference to activities that are typically considered pleasurable. Affective Flattening Inability to show emotion that would be normally expected. They may stare vacantly and their voice may be flat and toneless.

DISORGANIZED SCHIZOPHRENIA Interviewer: “I was sorry to hear that your Uncle Bill died a few years ago.” David: “Yes, he died. He was sick, and now he’s gone. He likes to fish with me, down at the river. He’s going to take me hunting. I have guns. I can shoot you and you’d be dead in a minute. Source: Barlow/Durand pg. 428.

DISORGANIZED SCHIZOPHRENIA “If anyone gets into the house, they say I’d get shot. That’s the eagle. The eagle works through General Motors. They have something to do with my General Motors Check I get every month…when you do the 25 of the clock it means that you leave the house 25 after 1 to mail letters so they can check on you. If you don’t do something they tell you to do, Jesus makes the shotgun sound and then…” Etta, as quoted in Barlow and Durand, CD Rom.

DISORGANIZED SCHIZOPHRENIA  Typical speech patterns may reveal: Lack of insight (awareness that they have a problem). Tangential responses (go off on a tangent to the question instead of directly addressing it). Demonstration of loose association or derailment (a swift change in the topic to an unrelated area).

DISORGANIZED SCHIZOPHRENIA  Typical behavior may reveal: Inappropriate Affect (laughing/crying at improper times) Hoarding Catatonia (motor dysfunction)  Catatonic Immobility  Waxy Flexibility  Wild Agitation  Holding unusual postures

Paranoid Schizophrenia Suffer from delusions and/or hallucinations Suffer from delusions and/or hallucinations Usually to a theme; persecution or grandeur Usually to a theme; persecution or grandeur Their cognitive skills and affect are relatively intact Their cognitive skills and affect are relatively intact A picture of a cat, as drawn by a patient with schizophrenia as his condition grew progressively worse.

Catatonic Schizophrenia Typical behavior may reveal: Typical behavior may reveal: Display of odd mannerisms with their bodies and faces Display of odd mannerisms with their bodies and faces Remaining in fixed positions or engagement in excessive activity Remaining in fixed positions or engagement in excessive activity Repitition or mimic of words or movements of others Repitition or mimic of words or movements of others

The Basics  People with schizophrenia may fluctuate between severe and moderate levels of impairment throughout their lives.  Schizophrenia is generally seen by early adulthood –Causative factors are present early on –Possibly that brain damage early in the developmental period later causes it

Genetics  Genes are responsible to making some individuals vulnerable to schizophrenia Adoptive Parents Do not have Schizophrenia Child develops Schizophrenia Child with family History of schizophrenia Is adopted