Transcript Models in Psychopathology

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
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Brain pathology in schizophrenia
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
PET scans of the Genain Sisters
(Normal)
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
CET (Computer EEG Tomographic)
scans of the Genain Sisters
(Normal)
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Prenatal Exposure to Influenza and Risk
of Adult Schizophrenia
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Family Dynamics in Schizophrenia
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Treatment of Schizophrenia
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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
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
The role of therapy in preventing relapse
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
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
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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
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005
Other Psychotic Disorders
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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.
Abnormal Psychology, 11/e
by Sarason & Sarason © 2005