Transcript PowerPoint chapter 04

Abnormal Psychology
Leading Researcher Perspectives
Edited by Elizabeth Rieger
Images, Figures and Tables
Chapter 4
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Professor Patrick McGorry was
announced as the 2010 Australian of
the Year by the National Australia Day
Council for his groundbreaking
research in the area of early detection
and intervention for psychosis
Courtesy of Professor Patrick McGorry
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In the film A Beautiful Mind, Russell
Crowe depicts the life of a man with
schizophrenia.
Everett Collection/Headpress Pty Ltd
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Continued on next slide
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The Early Psychosis Prevention and
Intervention Centre (EPPIC) in Melbourne
has pioneered early intervention in
Australia for young people with psychosis.
Courtesy Orygen Youth Research Centre
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Figure 1 The percentage of patients with schizophrenia who relapsed in the
nine-month period following their discharge from hospital depending on whether
they returned home to high or low expressed emotion (EE ) families, had high or
low amounts of contact with family members, and were taking medication or not
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Figure 2 The cognitive
model of psychosis
developed by Morrison
(2001) using as an
example the case of a
mother distressed by
fears of hurting her child
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Figure 3 The percentage of high-risk patients developing psychosis and
being prescribed antipsychotic medication one year after commencing CBT
or regular symptom monitoring
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Figure 4 The percentage of CBT and standard treatment patients who
relapsed over the 12 months of the study
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Proposed changes for psychotic
disorders in DSM-V
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A new ‘psychosis risk syndrome’ is to be created, which is a less
severe form of psychosis in which the symptoms are not intense
enough or of long enough duration to meet criteria for another
psychotic disorder.
The subtypes of schizophrenia in the DSM-IV-TR are to be removed
due to concerns regarding their validity.
Schneider’s concept of first-rank symptoms is to be discarded and,
instead, two or more symptoms of psychosis including delusions,
hallucinations, disorganised speech, catatonia and/or negative
symptoms must be present for one month or more, and that one of
the first three symptoms must be present.
Further clarification of the diagnosis of schizoaffective disorder is to
be included in order to improve the reliability of its diagnosis. For
example, the term ‘prominent mood symptoms’ would be replaced
by the more specific term ‘symptoms meeting criteria for a major
mood episode’.
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Chapter 4 Summary
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Core symptoms of psychotic disorders include positive symptoms
(hallucinations, delusions, thought disorder, disorganised behaviour)
and negative symptoms (alogia, avolition, blunted affect).
The diagnosis of a specific psychotic disorder (such as
schizophrenia) is based on the range of symptoms present, the
duration of the symptoms, the precipitating factors and the impact
upon the person’s functioning.
Psychotic disorders are associated with secondary problems
including substance use, depression and anxiety. Sufferers often
experience significant interruptions to their lives, including
unemployment and stigma.
Psychosis typically develops for the first time in late adolescence
and early adulthood, often with many months of non-specific
changes in mental state preceding the onset of acute psychotic
symptoms.
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Chapter 4 Summary (continued)
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A wide range of factors have been examined as possible causes
of psychosis under the framework of the Stress Vulnerability
Model of psychosis. Contributors to vulnerability include
biological factors (e.g., genes and changes in brain structures)
and psychosocial factors (e.g., trauma, abuse and dysfunctional
cognitions).
Precipitating factors which interact with vulnerability include illicit
substances, stressful life events and exposure to hostility and
criticism in relationships.
Once a comprehensive assessment has been completed and
psychosis is accurately diagnosed, acute phase treatments focus
upon the immediate reduction of symptoms and associated
distress, while longer term recovery requires a broad array of
psychological, social and biological interventions.
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Chapter 4 Summary (continued)
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Comprehensive treatments include a focus on staying well after
psychosis and achieving a satisfying quality of life.
Researchers are beginning to report that some treatments may
be effective in preventing or postponing the onset of psychosis in
young people at ‘ultra-high risk’ of psychosis.
Consumers of psychiatric services have developed their own
empowering Consumer Recovery Model of psychosis with a
strong emphasis upon recovery, the strengths of the individual
and the reduction of stigma.
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