week 7 - schizophrenia, psychosis, and addictions

positive symptoms

• psychosis

  • hallucination

  • delusion

• unusual or disorganized speech patterns

psychosis

• two primary forms

  • hallucination

  • delusion

hallucination

• involves a person having a sensory experience that occurs without any clear stimulus

delusion

• involves a person holding beliefs that most others consider impossible or highly improbable

negative symptoms

• Relate to emotional and affective engagement with the world.

• Variations in speech:

  • Reduced speech

  • “Poverty of content”

• Avolition

  • characterized by a profound lack of motivation or the inability to start and complete goal-directed activities

    • i.e. bathing

• Anhedonia

  • the inability to experience joy or pleasure

disturbances in cognition

• Adverse impacts to:

  • Memory

  • Attention

  • Learning

• As a consequence, individuals diagnosed with schizophrenia may struggle to participate in conventional components of modern life.

history and classification

• The classification of schizophrenia has always been contested.

  • Political, social, ideological pressures

• Emil Kraepelin‘s use of “Dementia Praecox”.

  • Diagnosis associated with crime and violence.

  • deeply tied to racist ideologies and diagnosed to black men

• Eugene Bleuler developed the term “Schizophrenia”.

  • Depicted as a disease of “white male genius”, or “sensitive people”, or people suffering from psychological trauma.

• The diagnosis of schizophrenia has become a complex metaphor for race.

Debates on Cause

• Genetic Causes

  • Adoption Studies

  • Twin Studies

• Issue of Class and Socio-Economic Status

  • Drift Hypothesis

  • Practitioner Bias

Treatment Debates

• Somatic Treatments

• Antipsychotic Medications

• Psychological Therapy

• Community-Based Care

Somatic Treatments

• Electroconvulsive Therapy

• Lobotomy

Antipsychotic Medications

• Chlopromazine

• Typical

  • fluphenazine

  • haloperidol

  • trifluoperazine

• Atypical

  • aripiprizole

  • clozapine

  • risperidone

Psychological Therapy

• Cognitive-Behavioural Therapy

• Metacognitive Training

Community-Based Care

• Peer Support

stigma and popular representations schizophrenia in the media

• Violence

  • Portrayals of schizophrenia in literature, film, and news media are inherently violent.

• Tropes

  • “Mad Genius”, woman as manipulative seducer

  • reinforce ideas that people with schizophrenia are unrelatable and distinctly different.

• Stereotyping

  • Contributes to self-stigmatization and internalizing stereotypes.

addiction defined

• Represents the repetitive consumption of a substance, or repetitive engagement in an activity, that is considered problematic.

issue of body or substance

• in the 19th century, addiction came to be understood in one of two ways:

  • as an issue with the body

  • an issue with the addictive substance itself

medicalization and politics

• Relying on science to explain addiction has significantly shaped our political and medical responses to addiction.

Medical Models of Addiction

• “Dependence”, World Health Organization (1964)

  • Language surrounding what we consider addictive behaviours is both contested and ever-changing.

  • Expanding beyond substance-related addiction.

• Social Attribution Theory

  • how people interpret and explain the causes of their own and others' behaviors

treatment trends over time

• reformatory treatment

• psychoanalysis

• psychotherapies

• medication

• “war on drugs”

• harm reduction

reformatory treatment

• Enforced separation from a substance.

• Forerunner for modern residential rehabilitation

psychoanalysis

• View of addiction as underlying neurosis and psychic conflict

psychotherapies

• Cognitive-Behavioral Therapy

• Motivation Enhancement Therapy

• Social Behavioural Network Therapy

medication

• Methadone

• Buprenorphine

• Opiate Replacement Therapy or Maintenance Therapy

• Naltrexone

• Disulfiram

• Acamprosate

• Nalmefene.

“war on drugs”

• The goal of abstinence has also influenced public policy and how governments approach addiction.

harm reduction

• Blends elements of social justice with healthcare to treat addiction in a way that fundamentally respects the rights of drug users.