Psychological Disorders: Schizophrenia & Dissociative Disorders

Disorganized Thinking and Speech

• Disorganized Thinking: Refers to a lack of coherent connections between thoughts and ideas when speaking or thinking.
  • Example: Jumping between various unrelated topics while speaking (e.g., moving from discussing a dream to clocks to personal interests).
• Disorganized Speech: Similar to thinking, it includes erratic jumps in subject matter and incoherent phrases, making it difficult for listeners to follow the conversation.
  • Visual cues: Often requires visual references to help organize thoughts.

Disorganized Motor Behavior

• Disorganized Motor Behavior: Demonstrated through unusual or difficult-to-control body positions.
  • Example: Sitting in an uncomfortable position for long periods, leading to stiffness when trying to move.
• Catatonia: A severe state within disorganized behavior characterized by lack of movement or response, and sometimes mimicking others' actions without conscious intention.
  • Examples of Catatonia: Unresponsiveness to external stimuli, mirroring movements of people around them.

Symptoms: Positive vs. Negative

• Positive Symptoms: Excessive behaviors such as heightened excitement or movements (e.g., overwhelming energy).
• Negative Symptoms: Represent a decrease or lack of normal functions, like movement (e.g., stupor where there is little to no movement).

Flat Effect

• Definition: A lack of emotional expression characterized by no facial expressions or vocal tone.
  • Example: A child responding flatly to reprimands with lack of emotional engagement, indicating no remorse.
• Observations: Emotional responses are muted, even to significant events such as death or winning a lottery.

Dopamine Hypothesis

• Core Idea: Schizophrenia is linked to excessive activity of the neurotransmitter dopamine in the brain.
  • Symptoms: This overactivity can lead to delusions and hallucinations.
• Understanding Dopamine: Considered a 'feel-good' neurotransmitter, its imbalance is critical to understanding schizophrenia etiology.

Dissociative Disorders Overview

• Definition: Characterized by disruptions in consciousness, memory, identity, or perception.
  • Key Points: Often a response to trauma, separating individuals from their experiences.

Dissociative Identity Disorder (DID)

• Definition: Presence of two or more distinct identities or personality states within a single individual.
  • Features: Each personality may have its own behaviors, memories, and ways of interacting with the world.
  • Switching: When an individual shifts from one personality to another, they may not remember actions or events that occurred under the other identity.

Dissociative Amnesia

• Definition: Inability to recall important autobiographical information, usually following a traumatic event.
  • Example: Forgetting personal identity or traumatic events without suppression efforts (unlike repression, which is conscious).

Dissociative Fugue

• Definition: A subtype of dissociative amnesia where individuals may wander or travel away from their home, often adopting a new identity.
  • Characteristics: They display confusion about personal identity and lack memory about the event that led to the fugue state.

Key Concepts to remember

• Distinctions between disorders: While DID and schizophrenia can be confused, DID revolves around identity and trauma, while schizophrenia typically revolves around psychosis.
• Treatment: Therapeutic approaches may vary significantly based on the disorder, focusing on cognitive-behavioral strategies or other methods to encourage stability and integration of experiences.

Exam Preparation Notes

• Understand the differences between types of schizophrenia symptoms (positive vs negative).
• Familiarize with dissociative disorders and their traumatic underpinnings.
• Be ready to differentiate between various psychological disorders based on defined characteristics and symptoms.