Schizophrenia

Schizophrenia Schizophrenia -- “split mind” which refers to a split from reality. Key features that define the psychotic disorders are: Delusions Hallucinations Disorganized thinking Disorganized behavior Negative Symptoms

Symptoms of Schizophrenia Positive symptoms: the presence of inappropriate behaviors (hallucinations, Delusions, disorganized or delusional talking) Negative symptoms: the absence of appropriate behaviors Preview Question 11: What patterns of thinking, perceiving, feeling, and behaving characterize schizophrenia?

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. Photos of paintings by Krannert Museum, University of Illinois at Urbana-Champaign August Natter, Witches Head. The Prinzhorn Collection, University of Heidelberg L. Berthold, Untitled. The Prinzhorn Collection, University of Heidelberg

Disorganized & Delusional Thinking Many psychologists believe disorganized thoughts occur because of selective attention failure (fragmented and bizarre thoughts). Fragmented, bizarre thinking with distorted beliefs is called delusions. Examples: Belief in themselves to be a messiah Somebody may believe that CIA or Russian spies are after them.

Disturbed/abnormal motor behaviors Catatonia: Stupor – no psychomotor activity Mutism – no or very little verbal response Negativism – Opposition or no response to instructions or external stimuli Patients with schizophrenia may continually rub an arm, rock a chair, or remain motionless for hours (catatonia).

Negative Symptoms Inappropriate Emotions & Actions Flat Affect/ Affective Flattening "Affect" refers to emotional expression. It is, distinguished by a restricted range of expressed emotion Alogia difficulty of speech, is the lessening of speech fluency and productivity, thought to reflect slowing or blocked thoughts, and often manifested as short, empty replies to questions Avolition Loss of motivation, difficulty, or inability to initiate and persist in goal-directed behavior (examples of avolition include: no longer interested in going out and meeting with friends, no longer interested in activities that the person used to show enthusiasm for, no longer interested in much of anything, sitting in the house for many hours a day doing nothing Someone may tell a person they lost a loved one, and schizophrenic may not show any emotions

Onset and Development of Schizophrenia 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.

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.

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

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

Abnormal Brain Morphology Research has shown that individuals with schizophrenia reportedly have a smaller thalamus

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

Genetic Factors The likelihood of an individual suffering from schizophrenia is 50% if their identical twin has the disease (Gottesman, 2001). 0 10 20 30 40 50 Identical Both parents Fraternal One parent Sibling Nephew or niece Unrelated

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

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

Somatic Symptom Disorder Conversion Disorder Physical symptoms occurring due to psychological conflict No physical cause to the symptoms Stressful experience will be followed by medical illness Blindness Inability to speak Numbness Paralysis Health concerns Physical symptoms arising from psychological factors

Somatic Symptom Disorder Illness Anxiety Disorder Preoccupation with having or acquiring a serious illness Great level of anxiety about health concerns Health concerns Physical symptoms arising from psychological factors

Dissociative Disorders Dissociation means the disconnection or separation of something from something else or the state of being disconnected. Dissociative Identity Disorder (DID) Disruption of identity characterized by two or more distinct personality states Recurrent gaps in memory (Unable to recall everyday events) Difficult time recalling events experienced by “other” personalities Brought on my stress triggers

Dissociative Disorders Dissociative Amnesia An inability to recall important autobiographical information Usually of a traumatic or stressful nature (“selective” amnesia) Dissociative Fugue State – Memory loss accompanied by flight from the person’s home and establishing a new identity

Dissociative Disorders Depersonalization disorder (DPD) also known as depersonalization-derealization syndrome, is a mental disorder in which the person has persistent or recurrent feelings of depersonalization Depersonalization – experiences of unreality or detachment of their own body Derealization – experiences of unreality or detachment with their surroundings

Neurodevelopmental Disorders Autism Spectrum Disorder Deficit in social emotional reciprocity and communication Restricted, repetitive behaviors Symptoms must be present in the early development (early childhood) Three levels of severity Attention Deficit Hyperactivity Disorder Persistent pattern of inattention – difficulty sustaining attention hyperactivity-impulsivity – constant fidgeting, excessive talking, inability to wait