ABNORMAL PSYCHOLOGY

Schizophrenia Spectrum and Other Psychotic Disorders

John Haslam

superintendent of a British Hospital who outlined a description of the symptoms of Schizophrenia in his book Observations on Madness and Melancholy

Philippe Pinel

French physician who described cases of schizophrenia

Benedict Morel

used the term demence precoce meaning early or premature loss of mind to describe schizophrenia

Emil Kraepelin

unified the distinct categories of schizophrenia under the name Dementia Praecox

Catatonia

alternating immobility and excited agitation

Hebephrenia

silly and immature emotionality

Paranoia

delusions of grandeur or persecution

Eugen Bleuler

introduced the term schizophrenia (“splitting of mind”)

Delusions

misrepresentation of reality (disorder of thought content)

Persecutory

belief that one is going to be harmed, harassed and so forth

Referential

certain gestures, comments, environmental cues, and so forth are directed at one-self)

Grandiose

when an individual believes that he or she has exceptional abilities, wealth, or fame

Erotomanic

when an individual believes falsely that another person is in love with him or her

Nihilistic

conviction that a major catastrophe will occur

Somatic

focus on preoccupations regarding health and organ function

Thought Withdrawal

thoughts have been “removed” by outside force

Thought Insertion

thoughts have been put into one’s mind

Delusions of Control

one’s body or actions are being acted on or manipulated by some outside force

Capgras Syndrome

person believes someone he or she knows has been replaced by a double

Cotard’s Syndrome

the person believes he or she is dead

Clerambault Syndrome

characterized by the delusional idea, usually in a young woman, that a man whom she considers to be of higher social and/or professional standing is in love with her

Fregoli Syndrome

a person holds a delusional belief that different people are in fact a single person who changes his or her appearance or is in disguise

Motivational View of Delusions

look at these beliefs as attempts to deal with and relieve anxiety and stress

Deficit View of Delusions

sees these beliefs as a resulting from brain dysfunction that creates these disordered cognitions or perceptions

Hallucinations

experience of sensory events without any input from the surrounding environment

Auditory Hallucination

• most common form experienced by people with schizophrenia

• Most active part during Hallucination is Broca’s Area (speech production)

Broca’s Area

Most active part during Hallucination

Autoscopic Hallucination

individual experiences, all or part of the person's own body appeared within the external space, viewed from his/her physical body

Hypnagogic Hallucination

happens during sleep

Ictal Hallucination

associated with temporal lobe foci

Hypnopompic Hallucinations

happens when waking up

Negative Symptoms

usually indicate absence or insufficiency of normal behavior

Avolition

inability to initiate and persist activities

Anhedonia

lack of pleasure

Asociality

lack of interest in social interactions

Flat Affect/Affective Flattening

do not show emotions when you would normally expect them to

Disorganized Speech

individual may switch from one topic to another (derailment or loose associations) or answers to questions may be related or completely unrelated (tangentiality)

Clang associations

are groups of words chosen because of the catchy way they sound, not because of what they mean

Inappropriate Affect

laughing or crying at improper times

Grossly Disorganized or abnormal motor behavior

childlike silliness to unpredictable agitation

Neologisms

• construction of new words in order to communicate with schizophrenics thoughts

• More severe symptoms of schizophrenia first occur in late adolescence or early adulthood

Prodromal Stage

1-2 year period before the serious symptoms occur but when less severe yet unusual behaviors start to show themselves

Schizophrenogenic Mother

used for a time to describe a mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children

Double bind communication

• used to portray communication style that produced conflicting messages, which cased schizophrenia to develop

• Families with high expressed emotion view the symptoms of schizophrenia as controllable and that the hostility arises when family members think that patients just do not want help themselves

Delusional Disorder

• one or more delusions for at least 1 month

• persistent belief that is contrary to the reality in the absence of other characteristics of schizophrenia

• tend not to have flat affect, anhedonia, or other negative symptoms

• socially isolated due to being suspicious

• Shared Psychotic Disorder (Folie a Deux): condition in which an individual develops delusions simply as a result of a close relationship with a delusional individual

• Erotomanic, Grandiose, Jealous, Persecutory, Somatic, Mixed, Unspecified

• functioning is better than what is observed in Schizophrenia

• eventually develop schizophrenia

• absence of active phase of schizophrenia

Shared Psychotic Disorder (Folie a Deux)

condition in which an individual develops delusions simply as a result of a close relationship with a delusional individual

Brief Psychotic Disorder

• - presence of one of the ff: delusions, hallucinations, disorganized speech, catatonic behavior for at least 1 day but less than 1 month, with eventual full return to premorbid level of functioning -

• can experience relapse

• if psychotic symptoms persist for at least 1 day in PD, an additional diagnosis of Brief Psychotic Disorder may be appropriate

Schizophreniform Disorder

• two or more of the following, present during a 1-month period: delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms

• at least 1 month BUT less than 6 months

• development similar to schizophrenia

Schizophrenia

• two or more of the following, present during 1-month period: delusions, hallucinations, disorganized speech, catatonic behavior, negative symptoms

• disturbance in one or more major areas

• at least 6 months

• abrupt or insidious

• prognosis is influenced both by duration and by severity of illness and gender

• possible reduced psychotic experience during late life

• too much use of regression

Schizoaffective Disorder

• major mood ep + delusions or hallucinations for 2 or more weeks

• some individuals tend to change diagnosis into mood disorder or to schizophrenia over time

Substance

chemical compounds that are ingested to alter mood or behavior

Psychoactive substances

alter mood, behavior, or both

Substance Use

ingestion of psychoactive substances in moderate amounts that does not significantly interfere with social, educational, or occupational functioning

Substance Intoxication

physiological reaction to ingested substances

Substance Use Disorders

how much of a substance is ingested is problematic

Alcohol Use Disorder

A problematic pattem of alcohol use leading to clinically significant impairment or distress, as manifested by at least two of the following, occurring within a 12 month period.

Physiological Dependence

meaning the use of increasingly greater amounts of the drug to experience the same effect (tolerance) and a negative physical response when the substance is no longer ingested (withdrawal)

Alcohol

produced when certain yeast reacts with sugar and water, then fermentation takes place

Withdrawal Delirium (Delirium Tremens)

condition that can produce frightening hallucinations and body tremors

Breathalyzer

measures levels of intoxication GABA seems to be particularly sensitive to alcohol

Wernicke-Korsakoff Syndrome

Confusion, loss of muscle coordination, and unintelligible speech, believed to be cause by a deficiency of thiamine

Alcohol Dehydrogenase

metabolize alcohol

Korsakoff syndrome

• is a chronic memory disorder caused by severe deficiency of thiamine (vitamin B-1).

• most caused by alcohol misuse, but certain other conditions also can cause the syndrome

Caffeine

• most common psychoactive substance

• “gentle stimulant”

• found in tea, coffee, soda, and cocoa products

Cannabis (Marijuana)

• reactions include mood swings or even dream-like experiences

• chronic and heavy users report tolerance, especially to euphoric high: they are unable to reach the levels of pleasure they experienced earlier

Hallucinogens

most common, “LSD” produced synthetically in the laboratory

Inhalant

solvents, aerosol sprays, gases, nitrites, usually found at home or workplace

Opioid

• natural chemicals in the opium poppy that have narcotic effect (relieves pain and induce sleep)

• includes natural opiates, synthetic variation, and the comparable substances that occur naturally in the brain

• also includes Heroin

Sedative-, Hypnotic-, or Anxiolytic

- calming, sleep-inducing, and anxiety-reducing

includes barbiturates and benzodiazepines

barbiturates and benzodiazepines relax the muscles and can produce mild feeling of well being combining alcohol with these substances can be fatal (Manilyn Monroe case)

Stimulant

• most commonly consumed psychoactive drugs in US

• includes caffeine, nicotine, amphetamines, and cocaine

• Amphetamine: can induce feelings of elation and vigor and can reduce fatigue; prescribed to people with narcolepsy and ADHD

• another variants of Amphetamine are Methylenedioxymethamphetamine or ecstasy club drug (makes you feel euphoric) and methamphetamine (crystal meth)

• Cocaine: increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite

• Intranasal use and oral use of substances result in more gradual progression occurring over months to years

Amphetamine

can induce feelings of elation and vigor and can reduce fatigue; prescribed to people with narcolepsy and ADHD

Cocaine

increases alertness, produces euphoria, increases blood pressure and pulse, and causes insomnia and loss of appetite

Tobacco

• contains nicotine

• linked with signs of negative affect such as depression, anxiety, and anger

• being depressed increases your risk of becoming dependent on nicotine and, at the same time, being dependent will increase your risk of becoming depressed

Opponent-Process Theory

an increase in positive feelings will be followed shortly by an increase in negative feelings and vice versa

Expectancy Effect

expectancies develop before people actually use drugs, perhaps as a result of loved one’s use, advertising, etc.

Cross-Tolerance

tolerance for a substance has not taken before as a result of using another substance similar to it

Synergistic Effect

an increase of effects that occurs when more than one substance is acting on the body at the same time

Gambling Disorder

• persistent and recurring gambling behavior

• at least 4-symptoms within 12 months

• Onset can occur during adolescence or young adulthood but in other individuals it manifests during middle or even older adulthood

• Progression appears to be more rapid in women than in men

• An additional diagnosis of gambling disorder should be given only if the gambling behavior is not better explained by manic episodes