Disorder involving distortions in thoughts, perceptions and/or emotions. – This is the disorder people are referring to when they use terms like “madness,” “psychosis,” or “insanity.” Psychotic disorders: Schizophrenia

About 1 in every 100 people are diagnosed with schizophrenia. Symptoms of Schizophrenia 1.Disorganized Thinking. 2.Disturbed Perceptions 3.Inappropriate Emotions and Actions Psychotic disorders: Schizophrenia

overview/5511c579e503c1223e165511c579e503c1223e ?q=schizophrenia&FROM=LKVR5&GT1=LKVR5& FORM=LKVR16 (Answers TV intro clip) overview/5511c579e503c1223e165511c579e503c1223e ?q=schizophrenia&FROM=LKVR5&GT1=LKVR5& FORM=LKVR16 Psychotic disorders are named because the psychosis causes a loss of contact with reality. YouTube - Schizophrenia Part 1 - ABC 20/20 coverage YouTube - Schizophrenia Part 1 - ABC 20/20 coverage

Psychotic disorders: Schizophrenia Split into threes. With one listener in the middle, two people get close to each ear and tell a different story one about religion and one about physical harm. Listener report back how you felt! YouTube - Schizophrenia Part 2 - ABC 20/20 coverage

Psychotic disorders: Schizophrenia DSM classification for schizophrenia: Delusions – thoughts or ideas that are unreal – like you are Jesus or invincible etc Paranoia – think things or people are out to hurt you or are following you etc. Hallucinations – auditory – visual - touch Disorganized speech Disorganized behavior Social or occupational dysfunction At least six months duration No other explanation such as developmental disorders or medication drug taking side effects Age of onset 16 – 25 for males and 21 – 30 females

What Does it Look Like For sufferers of schizophrenia, the mind can be twisted in terrible ways. – May become bleak and devoid of meaning – Can become very overwhelming and filled with stimuli, hallucinations and delusions. In schizophrenia, emotions become blunted, thoughts turn bizarre, and language takes a strange turn. Take the following for example:

Sample Speech From Schizophrenic Patient The lion will have to change from dogs into cats until I can meet my father and mother and we dispart some rats. I live on the front of Whitton’s head. You have to work hard if you don’t want to get into bed…It’s all over for a squab true tray and there ain’t no squabs, there ain’t no men, there ain’t no music, there ain’t nothing besides my mother and my father who stand along upon the Island of Capri where is no ice. Well it’s my suitcase sir. (Roger, 1982)

Disorganized Thinking Fragmented and bizarre and distorted thinking with false beliefs. Disorganized thinking comes from a breakdown in selective attention.- they cannot filter out information. Delusions “Word salad”

Delusions (false beliefs) Delusions of Persecution Delusions of Grandeur

Other Delusions Thought broadcasting Thought insertion Nihilism (world, others, self = non- existent) David Berkowitz (aka Son of Sam)

Thought Disorders Incoherence “ The sheep are on the roof because twelve is New Jersey. ” Flight of ideas – speech intelligible but fast, abrupt change of topic Loose associations – Illogical, vaguely connected train of thought. Asked “ How are you feeling? ” may reply, “ Healthy, wealthy and wise. Three wise men run the bank, you know, they have a wealth of nations. ”

Thought Disorders Neologisms – inventing new words or distorting words. “ wretchedivism ” “ tetramatic ” lifestyle Clanging – sound of words, rather than meaning, determines content of speech “ The note in the till, by the goat eating swill, sank the boat on the hill ” Circumstantiality – unnecessary, tedious, inconsequential detail; rambling Perseveration – clinging to same idea, word, phrase, or sound repeatedly

Disturbed Perceptions hallucinations- sensory experiences without sensory stimulation. EXyqe85cuA (Janssen simulation) EXyqe85cuA

Inappropriate Emotions and Actions Laugh at inappropriate times. Flat Effect Senseless, compulsive acts. Catatonia- motionless Waxy Flexibility – limb/body part can be moved into another position that is then maintained. Body part feels as if it were made of wax.

Positive v. Negative Symptoms Positive Symptoms Presence of inappropriate symptoms Negative Symptoms Absence of appropriate ones.

One patient; many symptoms YouTube - Schizophrenia: Gerald, Part 1 YouTube - Schizophrenia: Gerald, Part 2

Types of Schizophrenia

Disorganized Schizophrenia typical image of mental illness with incoherent speech, hallucinations, delusions and odd behaviors disorganized speech or behavior, or flat or inappropriate emotion. Clang associations "Imagine the worst Systematic, sympathetic Quite pathetic, apologetic, paramedic Your heart is prosthetic"

Paranoid Schizophrenia Delusions and hallucinations but no catatonic symptoms and none of the incoherence of disorganized type Somebody is out to get me!!!!

Catatonic Schizophrenia a range of motor dysfunctions – Stupor: long periods of coma like, motionless state – Excitement: agitated and hyperactive Flat affect Waxy Flexibility – limb/body part can be moved into another position that is then maintained. Body part feels as if it were made of wax. parrot like repeating of another’s speech and movements

Undifferentiated Schizophrenia Many and varied Symptoms catchall term for schizophrenia symptoms that are erratic and do not it into one of the other categories, but are clear symptoms of the disorder

Residual type diagnosis for individuals who have suffered from schizophrenia, but have no major symptoms at the time

Causes of Schizophrenia Freud originally thought schizophrenia was a result of defective parenting or repressed childhood trauma. Impact of Drugs – Major tranquilizers which inhibit dopamine, can suppress the symptoms of schizophrenia – Drugs that provide excess dopamine can cause schizophrenic type behaviors in healthy people.

Causes of Schizophrenia: The Schizophrenic Brain Magnetic Resonance Imaging (MRI) Scan: Computer enhanced three-dimensional image of brain or body; based on magnetic field – MRIs show schizophrenic brains as having enlarged ventricles Positron Emission Tomography (PET) Scan: Computer- generated color image of brain activity; radioactive sugar solution is injected into a vein, eventually reaching the brain – Activity is abnormally low in frontal lobes of schizophrenics

Causes of Schizophrenia Loss of grey matter: Magnetic resonance images (MRI scans were created after repeatedly scanning 12 schizophrenia subjects over five years, and comparing them with 12 healthy controls, scanned at the same ages and intervals. Severe loss of gray matter is indicated by red and pink colors, while stable regions are in blue. STG =superior temporal gyrus DLPFC =dorsolateral prefrontal cortex.

Fig Lifetime risk of developing schizophrenia is associated with how closely a person is genetically related to a schizophrenic person. A shared environment also increases the risk. (Estimates from Lenzenweger & Gottesman, 1994.) Causes of Schizophrenia: The Genetic Link

Schizophrenia Treatments Much like the treatment for all psychological disorders, the treatment of schizophrenia has come a long way. Past treatments included: Lobotomies Insulin Shock Therapy Current treatment for schizophrenia is usually a combination of therapy and medication: Psychotherapy Schizophrenia Medication

Lobotomies One of the earliest treatments were lobotomies. This procedure consisted of cutting the connections to and from, or simply destroying, the prefrontal cortex.

The Process Doctors would access the frontal lobes through the eye sockets, instead of through drilled holes in the scalp. In 1945, he took an ice pick from his own kitchen and began to test the new surgical technique on cadavers.

The Process The technique involved lifting the upper eyelid and placing the point of a thin surgical instrument under the eyelid and against the top of the eye socket. A hammer was used to drive the pick through the bone, into the brain. It was then moved from side to side, severing nerve fibers connecting the frontal lobes to the thalamus. A hammer was used to drive the pick through the bone, into the brain. It was then moved from side to side, severing nerve fibers connecting the frontal lobes to the thalamus.

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