Schizophrenia and Dissociative Identity Disorder (DID) Vocabulary Flashcards

Overview of Schizophrenia and Dissociative Identity Disorder (DID)

Definitions and Key Terms

• Psychosis: Severe distortion of reality that may include:

  • Hallucinations: Sensory experiences without external stimuli (e.g., auditory hallucinations like hearing voices).

  • Delusions: Strongly held beliefs that are false, despite evidence against them.

• Schizophrenia: A pervasive form of psychosis characterized by disrupted thought, emotion, and behavior.

Schizophrenia Spectrum Disorders (DSM-5)

• Schizophrenia: Symptoms persist for at least 6 months.

• Brief Psychotic Disorder: Symptoms last less than a month.

• Schizophreniform Disorder: Symptoms last between 1 month and 6 months.

• Schizoaffective Disorder: Symptoms of schizophrenia and a mood disorder concurrent.

• Substance/Medication-Induced Psychotic Disorder: Psychotic symptoms caused by drugs or medications.

Criteria for Schizophrenia (DSM-5)

1. Presence of two (or more) of the following for a significant time during a month:

   • Delusions

   • Hallucinations

   • Disorganized speech

   • Grossly disorganized or catatonic behavior

   • Negative symptoms

2. Functioning in major areas is significantly impaired.

3. Symptoms persist for at least 6 months.

4. Exclusion of schizoaffective disorder, major mood disorders with psychotic features, or substance effects.

5. Additional criteria related to autism or childhood communication disorder for diagnosis.

Symptoms of Schizophrenia

• Positive Symptoms:

  • Active distortion of reality, such as delusions (e.g., persecution, grandeur) and hallucinations.

• Negative Symptoms:

  • Absence of normal behavior:

  • Avolition: Lack of motivation.

  • Alogia: Reduced speech output.

  • Anhedonia: Loss of pleasure.

  • Affective flattening: Diminished emotional expression.

• Disorganized Symptoms:

  • Disorganized speech (cognitive slippage, tangentiality).

  • Inappropriate emotional expressions and behaviors, including catatonic symptoms (e.g., stupor, mimicking, immobility).

Course and Causes of Schizophrenia

• Natural History: Includes stages from premorbid to chronic phases with varying symptom presentation (positive, negative, and cognitive symptoms).

• Genetic Research:

  • Higher risk in identical twins; adoption studies confirm genetic factors.

• Neurobiological Influences:

  • Dopamine Hypothesis: Overactivity of dopamine related to symptoms; simplifications noted.

  • Structural brain changes, including hypofrontality and enlarged ventricles.

• Psychological/Social Influences:

  • Stress can trigger onset or relapse.

  • Family dynamics and expressed emotion play roles.

Treatment of Schizophrenia

• Medical:

  • Antipsychotic medications introduced in the 1950s; effective in reducing positive symptoms but can cause side effects like tardive dyskinesia.

• Psychosocial Treatment:

  • Behavioral therapies, community programs, skills training, family therapy, and patient engagement in treatment planning. Cultural considerations are essential in treatment.

Overview of Dissociative Disorders

• Definition: Severe disruptions in consciousness, memory, identity, and perception. Includes:

  • Depersonalization-Derealization Disorder: Experiencing oneself or the environment as unreal.

  • Dissociative Amnesia: Inability to recall personal information following trauma.

  • Dissociative Identity Disorder (DID): Characterized by distinct personality states and significant memory gaps.

  • False Memories : Interest in repressed memories had led to some patients thinking they have repressed memories of abuse, which later shown to be false, but can be very damaging to patients and their families. (Fairly easy to create)

DID Characteristics Under DSM-5

• Identity Disruption: Marked discontinuity in self-perception and behavior.

• Gaps in Memory: Memory lapses not consistent with ordinary forgetting.

• Significant Distress: The symptoms interfere with functioning in social, occupational contexts.

• Exclusion of Other Causes: Not part of recognized cultural practices or due to physical effects of substances.

Causes and Treatment of DID

• Causes: Often linked to severe childhood trauma or abuse; seen as a coping mechanism for trauma, closely related to PTSD.

• Treatment Focus: Aims to integrate identities through confronting trauma, which may involve hypnosis. Importance of awareness regarding false memories created during therapeutic processes.