1. Schizophrenia and Other Disorders
Module 43
Schizophrenia and Other
Disorders
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2. Schizophrenia and Other Disorders Schizophrenia
Schizophrenia: A psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression.
The word itself means “split” (schizo) “mind” (phrenia).
Schizophrenia is the chief example of a psychotic disorder, which is marked by irrationality, distorted perceptions, and lost contact with reality.
With treatment and a supportive environment, over 40 percent of people with schizophrenia will have periods of a year or more with normal life experience. But just 1 in 7 of those diagnosed will make a complete and enduring recovery.

3. Schizophrenia and Other Disorders Schizophrenia Symptoms of Schizophrenia
43-1: WHAT PATTERNS OF PERCEIVING, THINKING, AND FEELING CHARACTERIZE SCHIZOPHRENIA?
Positive symptoms: Presence of inappropriate behavior
Negative symptoms: Absence of appropriate behavior
Disturbed Perceptions
Hallucinations: Seeing, feeling, tasting, smelling things that exist only in the mind
Disorganized Thinking and Speech
Delusions: False beliefs
May have paranoid tendencies
Word salad (senseless speech) and a breakdown in selective attention

4. Schizophrenia and Other Disorders Schizophrenia Symptoms of Schizophrenia
Diminished and Inappropriate Emotions
Flat affect: Emotionless, a state of no apparent feeling
Impaired theory of mind: Difficulty reading other peoples’ facial emotions and states of mind
Emotional deficiencies occur early in illness and have a genetic basis
Inappropriate motor behavior, with motionless catatonia or senseless, compulsive actions

5. Schizophrenia and Other Disorders Schizophrenia Onset and Development of Schizophrenia
43-2: HOW DO CHRONIC AND ACUTE SCHIZOPHRENIA DIFFER?
Chronic schizophrenia (also called process schizophrenia)
Form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood
As people age, psychotic episodes last longer and recovery periods shorten
Acute schizophrenia (also called reactive schizophrenia)
Form of schizophrenia that can begin at any age, frequently occurs in response to an emotionally traumatic event, and has extended recovery periods
Often positive symptoms that respond to drug therapy

6. Schizophrenia and Other Disorders Schizophrenia Understanding Schizophrenia
43-3: WHAT BRAIN ABNORMALITIES ARE ASSOCIATED WITH SCHIZOPHRENIA?
Brain Abnormalities
Dopamine Overactivity
Resulting hyper-responsive dopamine system could intensify brain signals, creating positive symptoms
Abnormal Brain Activity and Anatomy
Often low activity in frontal lobes
Vigorous activity in thalamus and amygdala when experiencing hallucinations
Enlarged, fluid-filled areas and corresponding shrinkage and thinning of cerebral tissue
Smaller-than-normal cortex and corpus callosum

7. Schizophrenia and Other Disorders Schizophrenia Understanding Schizophrenia
43-4: WHAT PRENATAL EVENTS ARE ASSOCIATED WITH INCREASED RISK OF DEVELOPING SCHIZOPHRENIA?
Prenatal Environment and Risk
Low birth weight
Maternal diabetes
Older paternal age
Lack of oxygen during delivery
Maternal prenatal nutrition
Midpregnancy viral infection (factors examined include flu incidence, population density, season of birth)

8. Schizophrenia and Other Disorders Schizophrenia Understanding Schizophrenia
43-5: HOW DO GENES INFLUENCE SCHIZOPHRENIA?
Genetic Influences
Odds of being diagnosed with schizophrenia are nearly 1 in 100; 1 in 10 for those with diagnosed family member
Risk for adopted children is related to biological parent
Schizophrenia influenced by many genes
Some influence the activity of dopamine and other brain neurotransmitters
Others affect the production of myelin
Epigenetic factors influence gene expression

9. Schizophrenia and Other Disorders Schizophrenia Understanding Schizophrenia
RISK OF DEVELOPING SCHIZOPHRENIA
Risk of developing schizophrenia.
The lifetime risk of developing schizophrenia varies with one’s genetic relatedness to someone having the disorder. Across countries, barely more than 1 in 10 fraternal twins, but some 5 in 10 identical twins, share a schizophrenia diagnosis. (Data from Gottesman, 2001.)

10. Schizophrenia and Other Disorders Schizophrenia Understanding Schizophrenia
SCHIZOPHRENIA IN IDENTICAL TWINS
When twins differ, only the one afflicted with schizophrenia typically has enlarged, fluid-filled cranial cavities (right) Suddath et at., 1990). The difference between the twins implies some nongenetic factor, such as a virus, is also at work.

11. Other Disorders Dissociative Disorders
43-6: WHAT ARE DISSOCIATIVE DISORDERS, AND WHY ARE THEY CONTROVERSIAL?
Dissociative disorders
Controversial, rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings
Dissociative identity disorder (DID) (formerly called multiple personality disorder)
Rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities
Skeptics note that dissociative identity disorder, formerly known as multiple personality disorder, increased dramatically in the late twentieth century; is rarely found outside North America; and may reflect role playing by people who are vulnerable to therapists’ suggestions. Others view this disorder as a manifestation of feelings of anxiety, or as a response learned when behaviors are reinforced by anxiety-reduction.

12. Other Disorders Dissociative Disorders
Understanding Dissociative Identity Disorder
Increased dramatically in the late twentieth century.
Is rarely found outside North America.
DID may reflect role playing by people who are vulnerable to therapists’ suggestions.
Some psychodynamic theorists view this disorder as a manifestation of feelings of anxiety.
Some learning theorists view this disorder as a response learned when behaviors are reinforced by anxiety-reduction.
Some clinicians include dissociative disorders under the umbrella of posttraumatic stress disorder.

13. Other Disorders Personality Disorders
43-7: WHAT ARE THE THREE CLUSTERS OF PERSONALITY DISORDERS? WHAT BEHAVIORS AND BRAIN ACTIVITY CHARACTERIZE THE ANTISOCIAL PERSONALITY?
Personality disorders: Inflexible and enduring behavior patterns that impair social functioning.
These disorders forms three clusters, characterized by:
anxiety, that predisposes the withdrawn avoidant personality disorder
eccentric or odd behaviors, such as the emotionless disengagement of schizotypal personality disorder
dramatic or impulsive behaviors as seen in borderline personality disorder, narcissistic personality disorder, and antisocial personality disorder

14. Other Disorders Personality Disorders
Antisocial Personality Disorder
A person with antisocial personality disorder displays:
Lack of conscience for wrongdoing, even toward friends and family members
Often impulsiveness, fearlessness, irresponsibility
Criminality is not an essential component of antisocial behavior—and many criminals do not fit the description of antisocial personality disorder (since they show responsible concern for their friends and family members).

15. Other Disorders Eating Disorders
43-8: WHAT ARE THE THREE MAIN EATING DISORDERS, AND HOW DO BIOLOGICAL, PSYCHOLOGICAL, AND SOCIAL-CULTURAL INFLUENCES MAKE PEOPLE MORE VULNERABLE TO THEM?
Anorexia nervosa: Person (usually an adolescent female) maintains a starvation diet despite being significantly underweight
People with anorexia nervosa continue to diet and sometimes exercise excessively because they view themselves as fat.
Bulimia nervosa: Person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use), sometimes followed by fasting or excessive exercise
Binge-eating disorder: Significant binge eating, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa
American rates: 0.6% anorexia, 1% bulimia, and 2.8% binge-eating
People with bulimia nervosa secretly binge and then compensate by purging, fasting, or excessive exercise.
People with binge-eating disorder have binge-eating episodes but do not follow with purging, fasting, and exercise.

16. Other Disorders Eating Disorders
Understanding Eating Disorders
Family environment for those diagnosed with anorexia is often competitive, high-achieving, protective
Those with eating disorders often have low self-evaluations, set perfectionistic standards, and are intensely concerned with how others perceive them
Heredity: Disorders seen more in identical twins than in fraternal twins
Cultural pressures: Ideal body shapes vary across cultures and time
Other influences: Low self-esteem, and negative emotions interact with stressful life experiences
Prevention programs have had success; especially effective when interactive and focused on girls over age 15