Schizophrenia and other Psychotic Disorders. Psychotic Disorders Symptoms Alternations in perceptions, thoughts, or consciousness (delusions and hallucination)

Schizophrenia

and

other

Psychotic

Disorders

Psychotic Disorders Symptoms

Alternations in perceptions, thoughts, or consciousness (delusions and hallucination)

DSM-IV categories Schizophrenia Schizophreniform disorder Schizoaffective disorder Delusional disorder Brief psychotic disorder Shared psychotic disorder Psychotic disorder due to general medical condition Substance-induced psychotic disorder

Abnormal Psychology, 11/e by Sarason & Sarason © 2005

Schizophrenia

Symptoms Disturbance lasts at least 6 months, including One month of active phase that includes 2 positive

or one positive and one negative symptom, and Decline in social or occupational functioning.

DSM-IV subtypes Paranoid Catatonic Disorganized Undifferentiated Residual


Positive and Negative Symptoms

Positive Delusions – Faulty interpretations of reality Hallucinations – Faulty sensory perceptions Disordered speech Disorganized and bizarre behavior

Negative Flat affect Poverty of speech Lack of motivation or directedness Loss of energy Loss of feelings of pleasure


Positive Symptoms: Delusions Schizophrenia

Variety of bizarre content Being controlled or persecuted by others Finding reference to oneself in other’s behavior

or in printed materials Depression

Unjustified guilty Perceived bodily changes

Mania Great self-importance Grandiosity

Delusional disorder Loved by celebrity/high-status person Suspect spouse or lover of being unfaithful Possession of special and unrecognized talent


Negative Symptoms Flat affect

Avoid eye contact Immobile, expressionless face Lack of emotion when discussing emotional material Apathetic and uninterested Monotonous voice, low and difficult to hear

Poverty of speech Long lapses before responding to questions or failure to answer Restriction on quantity of speech Slow speech

Loss of directedness Slow movements Reduction of voluntary movements Inability to initiate activities Little interest in social participation Abnormal Psychology, 11/e

by Sarason & Sarason © 2005

Models of Schizophrenia No known cause, but research has focused on

Genetic factors Schizophrenic spectrum disorders Neuro-developmental model Family studies Twin studies Adoption studies Diathesis-stress theory and family and

community vulnerability High-risk studies focusing on family and birth

history and markers of attention and cognition deficits


Brain pathology in schizophrenia


PET scans of the Genain Sisters

(Normal)


CET (Computer EEG Tomographic) scans of the Genain Sisters

(Normal)


Prenatal Exposure to Influenza and Risk of Adult Schizophrenia


Family Dynamics in Schizophrenia


Treatment of Schizophrenia

Antipsychotic drugs – Some have side effects (e.g. tardive dyskinesia)

Skills training programs Family therapy programs Community support Combined treatment approaches Long-term outcome studies- Prognosis poor though

deteriorative effects plateau after 5 to 10 years


The role of therapy in preventing relapse


Skills Training in Schizophrenia Social skills

Self-awareness Affect regulation Social cue recognition

Cognitive skills Training in elementary cognitive functions Strategies for dealing with cognitive deficits Cognitive restructuring about source of hallucinations

Self-care and symptom-identification Improved grooming and self-care Self-monitoring for symptoms of relapse

Skills for dealing with stress Identify indicators of stress Apply cognitive and behavioral techniques Abnormal Psychology, 11/e

by Sarason & Sarason © 2005

Family Interventions in Schizophrenia

Education about probable causes, symptoms. and course

Information about treatment Instruction in problem-solving and crisis

management skills Decease negative expressed emotion (EE) Relapse recognition


Other Psychotic Disorders

Schizoaffective disorder – Delusions or hallucinations combined with symptoms of depression or manic mood

Delusional disorder – Less bizarre than schizophrenia delusions; usually related to a particular topic and have some foundation in real life.

Shared psychotic disorder – Two or more people who share shame delusional belief; one originates, the other follows. Occurrence is rare.


Schizophrenia and other Psychotic Disorders. Psychotic Disorders Symptoms Alternations in perceptions, thoughts, or consciousness (delusions and hallucination)

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