Schizophrenia
Lori Ridgeway
PSYC 3560
What is Schizophrenia?

Deterioration in fx



Psychosis




Extreme disturbances in thoughts, perceptions,
emotions, motor fx
Affects social, occupational, personal fx
Hallucinations
________________
Withdrawal
Positive & negative sxs
Positive Sxs


Bizarre ________________ to behavior
________________



Ideas that have no basis in fact
Persecution most common
Other types



Grandeur
Control
Reference
Positive Sxs, Cont’d…

Hallucinations




Sensory perceptions in absence of stimuli
Premorbid perception & attention problems
______________ most common
Other types




Visual
Olfactory
Tactile
Somatic
Positive Sxs, Cont’d…

Disorganized thinking & speech

Formal thought disorders



Can’t think &/or speak logically
Loose associations (______________) most common
Other types




Neologisms
Perseveration
Clang
Inappropriate affect

Emotions don’t match situation
Negative Sxs


Pathological ________________ in behavior
Poverty of speech




Alogia
Reduction in speech or speech content
May say little or may convey little meaning
Flat affect


Show almost ________________
Anhedonia vs. inability to express emotion
Negative Sxs, Cont’d…

Loss of volition




Avolition
Apathy, ________________
Trouble with goal-directed behavior
Social withdrawal



Withdraw into own ideas & fantasies
Separate further from reality
Loss of social skills
Psychomotor Sxs



Motoric disturbances
Gestures not related to environment
Catatonia





______________
Posturing
Rigidity
Waxy flexibility
Excitement
Dx Criteria

_______ or more characteristic sxs present for 1 mo








Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative sxs
Social/occupational dysfunction
Signs of disturbance for 6 mos
Exclusions
Subtypes: ________________






Prominent delusions or auditory hallucinations
 Usually related & has theme
 Persecutory or grandiose most common
Better cognitive/affective functioning
Disorganized speech, catatonic behavior,
flat/inappropriate affect not prominent
Later onset
Less impairment
Better outcomes
Subtypes: Disorganized







Disorganized speech &/or behavior
Flat or inappropriate affect
________________
Any delusions/hallucinations are fragmented
& no theme
Early onset
Greater impairment
Worse prognosis
Subtypes: Catatonic

Psychomotor disturbance

Immobility


Excessive activity


purposeless
Peculiar voluntary movements


catalepsy = ________________
posturing
Negativism

rigid posture, can’t move
Gender Differences


Overall prevalence approx. 1%
Age of onset







Men  18 to 25 years of age
Women  ________________ years of age
Late onset much less common in men
Women  better premorbid functioning
Women  more positive sxs
Men  more negative sxs
Women  better outcomes
Cultural & Social Factors




Hallucinations with religious content
Beliefs that seem delusional
Language differences (i.e., disorganized speech)
Higher rates in ________________



Overdiagnosis
Poverty & divorce
More common in lower SES groups



Approx. 0.5% in high SES, but 2% in low SES
Stress/poverty
“Downward drift”
Course

________________ phase

Active phase
Early onset





More negative sxs
More brain abnormalities & cognitive impairment
Worse premorbid fx & prognosis
Contributors to better outcomes




Acute onset / late onset
Mood disturbance
Early treatment
Being female
Comorbidity



________________ disorders
Anxiety disorders
Personality disorders


May be prodromal
Suicide


10% commit suicide
30%-40% make at least one attempt
Biological Explanations


Genetics
 ______% among first-degree relatives
 Twin studies
 Adoption studies
Biochemical differences
 Type I (positive sxs)
 Dopamine hypothesis
Bio , Cont’d…

Structural differences
 Type II (negative sxs)
in brain

___________________________

Abnormal blood flow
Decreased size of temporal lobe

Psychological Explanations

Psychodynamic


Behavioral


Schizophrenogenic _____________
Operant conditioning
Cognitive


perceptual disturbances
Problems when try to underst&
Sociocultural Explanations

________________




Family dysfunction



Label applied to nonconformists
Self-fulfilling prophecy
Rosenhan (1973)
Double-bind hypothesis
Expressed emotion
Sociocultural-existential


Constructive process
Self-cure
Diathesis-Stress




________________ view of cause
Combination of factors
Predisposition combined with environment
Biological factors better identified
Childhood Onset



Difficult to dx
Insidious onset
Differences



Some sxs common in other disorders



Delusions & hallucinations less elaborate
Visual hallucinations more common
Odd movements/postures
PDD/Autism
Sx or normal child behavior?