Abnormal
Psychology
Second Canadian Edition
Gerald C. Davison
John M. Neale
Kirk R. Blankstein
Gordon L. Flett
Prepared by:
Traci McFarlane
Chapter 11
Schizophrenia
Schizophrenia
• Schizophrenia

Psychotic disorder characterized by major
disturbances in thought, emotion, and
behaviour
 Disordered thinking in which ideas are not
logically related, faulty perception and
attention, flat or inappropriate affect, and
bizarre disturbances in motor activity
Clinical Symptoms of Schizophrenia
• Positive symptoms

Excesses or distortions
 Disorganized speech (thought disorder)
• Incoherence
• Loose associations

Delusions
 Hallucinations
Clinical Symptoms of Schizophrenia
• Negative symptoms






Behavioural deficits
Avolition
Alogia
Anhedonia
Flat affect
Asociality
Clinical Symptoms of Schizophrenia
• Other symptoms

Catatonia
• Catatonic immobility
• Waxy flexibility

Inappropriate affect
Differential Diagnosis
•
•
•
•
•
•
Mood disorders
Schizoaffective disorder
Personality disorders
Schizophreniform disorder
Brief psychotic episode
Delusional disorder
Categories of Schizophrenia in
DSM-IV
• Disorganized schizophrenia
• Catatonic schizophrenia
• Paranoid schizophrenia

Delusions of persecution
 Grandiose delusions
 Delusional jealousy
 Ideas of reference
• Evaluation of the subtypes

Undifferentiated schizophrenia
 Residual schizophrenia
Etiology of Schizophrenia
• Genetic data

Family studies
 Twin studies
 Adoption studies
Etiology of Schizophrenia
• Biochemical factors

Dopamine activity
The Brain and Schizophrenia
Etiology of Schizophrenia
• Psychological stress

Social class and schizophrenia
• Sociogenic hypothesis
• Social-selection theory

The family and schizophrenia
• Schizophrenic mother
• Expressed emotion (EE)
Therapies for Schizophrenia
•
•
•
•
Biological treatments
Psychological treatments
Case management
Study by Paul & Lentz (1977)

Social learning ward
 Milieu therapy ward
 Routine hospital managment
Biological Treatments
• Shock and psychosurgery

Prefrontal lobotomy
• Drug Therapies






Phenothiazine: Chlorpromazine (Thorazine)
Butyrophenones: Haloperidol (Haldol)
Thioxanthene: Thiothixene (Navane)
Tricyclic dibenzodiazepine: Clozapine
(Clozaril)
Thienbenzodiazepine: Olanzapine (Zyprexa)
Benzisoxazole: Risperidone (Risperdal)
Psychological Treatments
• Psychodynamic therapies
• Social-skills training
• Family therapy and reducing expressed
emotion






Educating about schizophrenia
Information about medication
Avoiding blaming
Improving communication and problem-solving
Encouraging expanded social contacts
Instilling hope that things can improve
Psychological Treatments
• Cognitive behavioural therapy





Reframe psychosis
Identify triggers for psychosis
Reduce physiological arousal
Enhance coping skills
Modification of beliefs
• Personal therapy
• Reattribution therapy
• Attending to basic cognitive function
Therapies for Schizophrenia
• Case management

Assertive Community Treatment (ACT)
• General trends in treatment

Families and patients can be given realistic
and scientifically sound information
 Medication is only part of treatment
 Early intervention affects course and
treatment
 Integrated treatment is not widely available
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