Schizophrenia - AP Psychology - Andover HS Mr. Koch AP Psychology Andover High School

Schizophrenia Spectrum and Other Psychotic Disorders Schizotypal (Personality) Disorder Delusional Disorder Brief Psychotic Disorder Schizophreniform Disorder Schizophrenia Schizoaffective Disorder Substance/Medication-Induced Psychotic Disorder Psychotic Disorder Due to Another Medical Condition Catatonia Catatonia Associated With Another Mental Disorder (Catatonia Specifier) Catatonic Disorder Due to Another Medical Condition Unspecified Catatonia Other Specified Schizophrenia Spectrum and Other Psychotic Disorder Unspecified Schizophrenia Spectrum and Other Psychotic Disorder

Schizophrenia A severe and disabling pattern of extremely disturbed thinking, emotion, perception, and behavior that seriously impairs the ability to communicate and relate to others and disrupts most other aspects of daily functioning One of the most serious disorders Often involves loss of contact with reality Symptoms seen in all parts of world

Schizophrenia 1-2% of population Appears equally in various ethnic groups Equal rates M/F Usually develops in adolescence, early adulthood ~40% improve w/ treatment and function reasonably well Rest have continuous or intermittent symptoms that permanently disrupt functioning 10-13% of homeless population have schizophrenia

Case Study in Schizophrenia (Gerald)

Common Symptoms Disorders of thought/language Disorganization: “neologisms” (“new words”) only have meaning to themselves “loose associations” Tendency for one thought to be unconnected to another “Word salad” Jumble of words reflecting utterly chaotic thoughts

Schizophrenic Word Salad

Schizophrenia - AP Psychology - Andover HS Common Symptoms Disorders of thought/language (cont’d) Content Delusions – false beliefs “delusions of influence” Believe being controlled (body, thought, or behavior) by external forces “self-significant delusions” Exaggerated beliefs about oneself (i.e. delusions of grandeur) “delusions of persecution” Others are out to harass/harm them

Common Symptoms Disorders of Perception Inability to focus attention (may feel overwhelmed) May feel detached from world or own body Hallucinations – false perceptions Very common – often takes form of voices Can also be sights, smells, taste, touch sensations w/o external stimuli

Common Symptoms Disorders of emotion Other common symptoms Flat or inappropriate affect Other common symptoms Some are extremely agitated, others move very little Lack motivation/social skills Poor personal hygiene Inability to function in everyday situations

Subtypes of Schizophrenia Paranoid Disorganized Catatonic Undifferentiated Residual Some see this classification system as inadequate Not always accurate picture of behavior (symptoms overlap) Some show characteristics of multiple symptoms Instead some suggest describing according to “positive” and “negative” symptoms Subtypes eliminated in DSM-5 The subtypes were determined to have limited diagnostic stability, low reliability, and poor validity. They also have not shown distinctive patterns of treatment response or longitudinal course. Instead, the DSM-5 is suggesting rating severity of the core symptoms. The DSM-5 does list Catatonia separately and allows for diagnosis as a specifier for depressive, bipolar and psychotic disorders or as a separate diagnosis.

Variations of Schizophrenia “Positive” symptoms Presence of inappropriate behaviors (i.e. – hallucinations, delusions) “Negative” symptoms Absence of appropriate behaviors (i.e. – lack of emotion, tone, movement) Chronic (aka – “process”) Schizophrenia Develops gradually, recovery is unlikely Acute (aka – “reactive”) Schizophrenia Sudden onset (reaction to stress), recovery is more likely

Causes of Schizophrenia Strong genetic link Connected w/ brain abnormalities Low/unusual activity in frontal lobe increased activity in thalamus/amygdala Shrunken tissue in thalamic regions, cortex, and corpus callosum enlarged fluid-filled ventricles Connection to dopamine levels Excess of dopamine receptor sites (especially linked to “positive” symptoms) Neurodevelopmental problems (maternal famine, low birthweight, oxygen deprivation, flu/viral exposure, older parental age, etc) No environmental causes clearly produce schizophrenia (Diathesis-Stress Model)