Abnormal Psychology Chapter 13 Schizophrenia Spectrum and other Psychotic Disorders

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prodromal phase
Precedes an active phase-deterioration in role functioning, may be seen by others as a change in personality, peculiar behaviors, unusual perceptual experiences, outbursts of anger, increased tension, restlessness, social withdrawal, indecisiveness, lack of willpower
positive symptoms
hallucinations, dellusions
negative symptoms
lack of initiative, social withdrawal, emotional deficits
verbal communication problems, bizarre behavior
sensory experiences not caused by actual external stimuli
idiosyncratic beliefs that are rigidly held in spite of their preposterous nature
diminished emotional expression
fail to express emotion, neither happy nor sad, indifferent, apathetic, expressionless, no normal fluctuations in pitch and intonation in voice, lack of concern,
inability to experience pleasure
lack of willpower, indecisiveness, ambivalence, apathy
impoverished thinking
-poverty of speech
-thought blocking: train of thought interrupted before complete
poverty of speech
reductions in the amount of speech
loose associations/derailment
changing topics too abruptly
persistently repeating a word or phrase
irrelevant responses to questions
catatonic behavior
obvious reduction in reactivity to external stimuli
marked muscle rigidity
reduced/awkward spontaneous movements
excitement and overactivity (pacing, repetitive motions)
criteria for schizophrenia
Criteria A: must exhibit 2+ active symptoms for at least one month (at least one being 1,2, or 3)
1 Delusions
2 Hallucinations
3 Disorganized Speech
4 Grossly disorganized or catatonic behavior
5 Negative Symptoms (diminished emotional expression or avolition)

Criteria B: Lower level of functioning for significant time since onset

Criteria C: Continuous for 6+ months (at least one month of active-phase but may include prodromal and residual periods–negative symptoms or lesser form of active symptoms)

Criteria D: No MDD or Manic episodes with active phase and any mood disorders occur for only a minority of the active and residual phases

Criteria E: no other attributable medical cause

Criteria F: if already diagnosed with autism spectrum disorder or childhood onset communication disorder then there must be prominent hallucinations or delusions for at least one month in addition to other symptoms to make a diagnosis of schizophrenia

stuporous state
associated with catatonic posturing
=generally reduced responsiveness
inappropriate affect
incongruity and lack of adaptability in emotional expression
-responses are inconsistent with the persons situation (ex. feel one thing in result of situation but respond in unrelated way)
schizophreniform disorder
shows symptoms more than one month but less than 6 months
DSM-5 changes
eliminated subtyping based on symptoms (paranoid, disorganized, catatonic, undifferentiated)
delusional disorder
do not meet full criteria
at least one month
realistic delusions (followed, poisoned…could occur but are not)
Only impaired in regards to delusions, not other aspects of life

-negative symptoms
-disorganized speech
-catatonic behavior

Brief psychotic disorder
psychotic symptoms for 1+ days but <1 month -often follows a stressful event -return to normal functioning after
schizoaffective disorder
– Schizophrenic symptoms overlap with Major Depressive or Manic episode
—-so psychotic symptoms must be present in the absence of mood disturbance for at least two weeks otherwise it is just MD/Manic episode with psychotic features
Schizophrenia lifetime prevalence
1% of US and Europe
Schizophrenia gender differences?
-30-40% more likely
– onset 4-5 years earlier (18-25 v. 25-30W)
-poor social functioning, more schizotypal traits
-more negative symptoms
-more chronic course, more resistant to treatment

-more hallucinations and paranoia, more emotional and impulsive

Schizophrenia- Cross Cultural Differences
Seen in all cultures
More in Urban areas
IPSS and DOS studies
—> outcomes better in developing countries, possibly because of greater tolerance and acceptance of pt
Brian areas with reduced size in pts
Ventricles enlarged
Brain areas with reduced activity
dorsolateral prefrontal cortex
dopamine hypothesis
possibly more dopamine receptors–> more sensitive to dopamine (D2 receptor targeted with antipsychotics)
Expressed Emotion (EE)
High EE :negative or hostile attitudes toward pt
overprotective, overinvolved
–> pt with High EE family member more likely to relapse
vulnerability marker criteria
distinguish between those that have it and not
stable characteristic over time
be able to predict future development of disorder
possible vulnerability markers for Schizophrenia
1) working memory impairment
2) eye-tracking dysfunction
central executive component of working memory
responsible for the manipulation and transformation of data in storage buffers
—> impaired in pts
eye-tracking dysfunction
trouble following swinging pendulum
pt have trouble with smooth-pursuit eyemovement
antipsychotic drugs
First and Second generation
-first had slightly more side effects
-block dopamine receptors
Extrapyramidal symptoms (EPS)
pathway that connects brain to motor neurons in spinal cord –> motor disturbances
Tardive Dyskinesia (TD)
abnormal uncontrollable movements of face and mouth and spastic movements of limbs –> from long term use of antipsychotics
atypical antipsychotic
less side effects
used in europe
family-oriented aftercare
educational component
moderate expectations
social skills training
structured modeling, role playing, social reinforcement
assertive community treatment
team of clinicians that provide many types of treatment during crisis periods(whenever they are) to keep disordered pts in the community
3 phases of Schizophrenia
prodromal, active, residual
Difference between psychotic, schizophreniform, schizophrenia
psychotic – 1 day
schizophreniform – <6 months Schizophrenia >6months
Categories: Abnormal Psychology