Intro- Schizo
-The symptoms of schizophrenia vary greatly, and so do its triggers, course, and responsiveness to treatment
-In fact, a number of clinicians believe that schizophrenia is actually a group of distinct disorders that happen to have some features in common
Schizo Symptoms:
-The symptoms can be grouped into 3 categories:
Positive symptoms
: excesses of thought, emotion and behavior
Negative symptoms
: deficits of thoughts, emotions and behavior
Psychomotor symptoms
: unusual movements and gestures
-Some people with schizophr
Positive symptoms
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Symptoms of schizo that seem to be excesses of or bizarre additions to normal thoughts, emotions or behaviors
-Consist of Delusions, disorganized thinking and speech, heightened perceptions and hallucinations
Positive symptoms: Delusions
-Delusions:
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A strange false belief firmly held despite evidence to the contrary.
-Delusions of persecution: re the most common in schizophrenia. People with such delusions believe they are being plotted or discriminated against, spied on, slandered, thr
Positive Symptoms: Disorganized thinking and speech
-People with schizophrenia may not be able to think logically and may speak in peculiar ways
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Formal thought disorder
: A disturbance in the production and organization of thought.
-Often they take the form of positive symptoms (pathological excesses), a
Positive symptoms: Heightened perceptions and hallucinations
Heightened Perceptions
:
-Ppl w/ schizo may feel that their senses are being flooded by all the sights and sounds that surround them.
-Laboratory studies repeatedly have found problems of perception and attention among people with schizophrenia
-It is als
Positive Symptoms: Inappropriate affect
-Inappropriate affect: Display of emotions that are unsuited to the situation; a symptom of schizophrenia.
-They may also undergo inappropriate shifts in mood.
Negative Symptoms
-Negative symptoms: Symptoms of schizophrenia that seem to be deficits of normal thought, emotions, or behaviors.
-Consist of: Poverty of speech, restricted affect, loss of volition, and social withdrawl
Negative Symptoms: Poverty of speech
Alogia:
A decrease in speech or speech content; a symptom of schizophrenia. Also known as poverty of speech.
-Some people with this negative kind of formal thought disorder think and say very little. Others say quite a bit but still manage to convey littl
Negative Symptoms: Restricted affect
-Blunted Affect- Many ppl w/ schizo have this. It is when they show less anger, sadness, joy, and other feelings than most people.
-Flat affect: Showing no emotion at all
-Their faces are still, their eye contact is poor, and their voices are monotonous.
Negative symptoms: Loss of Volition
-Many people with schizophrenia experience avolition, or apathy, feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action
-Similarly, individuals with the disorder may display ambivalence, or co
Negative symptoms: Social withdrawal
-People with schizophrenia may withdraw from their social environment and attend only to their own ideas and fantasies. Because their ideas are illogical and confused, the withdrawal has the effect of distancing them still further from reality
Psychomotor symptoms
-Ppl with schizophrenia sometimes experience psychomotor symptoms, for example, awkward movements or repeated grimaces and odd gestures.
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Catatonia
-A pattern of extreme psychomotor symptoms, found in some forms of schizophrenia, which may include catato
Course of Schizo
-Schizophrenia usually first appears between the person's late teens and mid-30s
-Although its course varies widely from case to case, many sufferers seem to go through three phases�prodromal, active, and residual
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Prodromal phase
- symptoms are not yet
Biological View- Genetic Factors
-Following the principles of the diathesis-stress perspective, genetic researchers believe that some people inherit a biological predisposition to schizophrenia and develop the disorder later when they face extreme stress, usually during late adolescence
Biological View- Biochemical abnormalities
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Dopamine hypothesis
-The theory that schizo results from excessive activity of the neurotransmitter dopamine. This is the foundation for current biochemical explanations of schizophrenia
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Antipsychotic drugs
: Drugs that help correct grossly confused o
Biological View- Abnormal Brain Structure
-Using brain scans, they have found, for example, that many people with schizophrenia have enlarged ventricles�the brain cavities that contain cerebrospinal fluid
- In addition to displaying more negative symptoms and fewer positive ones, patients who hav
Biological views- Viral Problems
-Some investigators suggest that the brain abnormalities may result from exposure to viruses before birth
-the virus enters the fetus' brain and interrupts proper brain development or perhaps the virus may remain quiet until puberty or young adulthood
-Un
Psychological Views
-Freud believed that schizo develops from 2 psychological processes: 1. regression to a pre-ego stage 2. efforts to reestablish ego control
-people who develop schizophrenia regress to the earliest point in their development, to the pre-ego state of prima
Cognitive explanation
-A leading cognitive explanation of schizophrenia agrees with the biological view that during hallucinations and related perceptual difficulties the brains of people with schizophrenia are actually producing strange and unreal sensations�sensations trigge
SocioCultural views- Multicultural factors
-Rates of schizophrenia appear to differ between racial and ethnic groups, particularly between African Americans and white Americans
-As many as 2.1 percent of African Americans receive a diagnosis of schizophrenia, compared with 1.0 percent of white Ame
Sociocultural Views- Social labeling
-Many sociocultural theorists believe that the features of schizo are influenced by the diagnosis itself.
-once the label is assigned to someone, it becomes a self-fulfilling prophecy
-Study conducted where 10 normal people selfadmitted themselves into a
Sociocultural Views- Family dysfunctioning
-Many studies suggest that schizophrenia, like a number of other mental disorders, is often linked to family stress
-Parents of people with the disorder often 1. display more conflict, 2. have greater difficulty communicating with one another and 3. are m
Institutional care in the past
-For more than half of the twentieth century, most ppl diagnosed with schizo were institutionalized in a mental hospital
-Because patients with this disorder failed to respond to traditional therapies, the primary goals of these establishments were to res
Institutional Care becomes better
-In the 1950s, clinicians developed two institutional approaches that finally brought some hope to patients who had lived in institutions for years: milieu therapy, based on humanistic principles, and the token economy program, based on behavioral princip
Institutional Care Becomes better- Milieu Therapy
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Milieu therapy
: A humanistic approach to institutional treatment based on the belief that institutions can help patients recover by creating a climate that promotes self-respect, individual responsible behavior, and meaningful activity.
-In such settin
Institutional Care Becomes Better- Token Economy
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Token economy program:
A behavioral program in which a person's desirable behaviors are reinforced systematically throughout the day by the awarding of tokens that can be exchanged for goods or privileges.
-Used principles of operant conditioning
-Accep
Treatment- Antipsychotic Drugs
-The antipsychotic drugs developed throughout the 1960s, 1970s, and 1980s are now referred to as "conventional" antipsychotic drugs in order to distinguish them from the "atypical" antipsychotics (also called "second generation" antipsychotic drugs) that
Treatment: Antipsychotic drugs effectiveness
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Extrapyramidal effects
: Unwanted movements, such as severe shaking, bizarre grimaces, twisting of the body, and extreme restlessness, sometimes produced by conventional antipsychotic drugs.
---Most common extrapyramidal effect is Parkinsonian symptoms
Treatment: Newer antipsychotic drugs
-"atypical" antipsychotic drugs have been developed in recent years (see Table 12-3). The most widely used of these new drugs include clozapine (trade name Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodo
Psychotherapy
-By helping to relieve their thought and perceptual disturbances, antipsychotic drugs allow people with schizophrenia to learn about their disorder, participate actively in therapy, think more clearly, and make changes in their behavior.
-The most helpful
Psychotherapy- CBT
-The therapists believe that if individuals can be guided to interpret such experiences in a more accurate way, they will not suffer the fear and confusion produced by their delusional misinterpretations
-Thus the therapists use a combination of behaviora
Psychotherapy- Family Therapy
-Over 50 percent of persons who are recovering from schizophrenia and other severe mental disorders live with their families: parents, siblings, spouses, or children
-Generally speaking, persons with schizophrenia who feel positively toward their relative
Psychotherapy- Social Therapy
-Clinicians offer practical advice; work with clients on problem solving, decision making, and social skills; make sure that the clients are taking their medications properly; and may even help them find work, financial assistance, appropriate health care
Community Approach- Features of effective community care
-People recovering from schizophrenia and other severe disorders need medication, psychotherapy, help in handling daily responsibilities, guidance in making decisions, training in social skills, residential supervision, and vocational counseling�a combina
The Community Approach- Community treatment failed?
- In fact, in any given year, 40 to 60 percent of all people with schizophrenia and other severe mental disorders receive no treatment at all
-Two factors are primarily responsible: poor coordination of services and shortage of services.
1. Poor Coordinat
Community approach- Consequences of inadequate community treatment
-Many of the people with schizophrenia and other severe disorders return to their families and receive medication and perhaps emotional and financial support, but little else in the way of treatment .
-Around 8 percent enter an alternative institution suc
Community Approach- Promise of community treatment
-Despite these serious problems, proper community care has shown great potential for assisting in the recovery from schizophrenia and other severe disorders, and clinicians and many government officials continue to press to make it more available.
-In the