Schizophrenia Spectrum Symptoms

PSY 366 Lecture 8.1 - Schizophrenia Spectrum Symptoms

Schizophrenia Core Feature

  • Inability to distinguish reality from imagination

Symptom Categories

Positive Symptoms (Adds something to experience)

  • Delusions

    • Fixed beliefs not subject to change based on evidence.

    • Can be categorized as:

    • Persecution: Belief that one is being targeted or conspired against.

    • Referential: Belief that common elements of the environment are direct messages.

    • Grandiose: An exaggerated sense of self-importance or identity.

    • Erotomanic: Belief that someone is in love with the individual.

    • Jealous: The conviction that a partner is being unfaithful.

    • Somatic: Preoccupation with assumed grotesque bodily function or sensation.

  • Hallucinations

    • Perception-like experiences without real-world stimuli.

    • Most common form is auditory hallucinations, wherein an individual may hear voices:

    • Unlike other disorders, the voice is not perceived as part of the self.

    • Can manifest as one voice or multiple voices, where multiple voices are more debilitating.

    • Types of auditory content can include criticizing, narrating, commanding (rare), or comforting.

    • Visual Hallucinations: May include forming or unformed images, with fully formed hallucinations being more common:

    • Unformed: E.g., things at the edge of vision.

    • Formed: People, animals, objects, events, or mythological figures, often frightening.

  • Disorganized Thinking (and Speech)

    • Typically diagnosable from disorganized speech patterns:

    • Switching topics inappropriately, tangentiality.

    • Presence of “word salad”: incoherent mixture of words.

  • Grossly Disorganized or Abnormal Motor Behavior

    • Behaviors can include childlike silliness, agitation, and issues with goal-directed behavior.

    • Catatonia: Decrease in reactivity to the environment which may include:

    • Ignoring instructions, adopting strange postures, or having a complete lack of motor responses.

    • May display stereotyped movements or echo speech.

Negative Symptoms (Takes something away from experience)

  • Often correlated with high severity of the disorder.

  • Signifies deficits or reductions from what is normal:

    • Examples include:

    • Diminished emotional expression.

    • Decreased self-motivated actions.

    • Reduced speech output (alogia).

    • Diminished pleasure from activities (anhedonia).

    • Reduced social interactions.

Symptom Temporal Dynamics

  • Schizophrenia is a chronic condition, but symptoms may change over time:

    • Prodromal Phase: Early symptoms that precede full-blown episodes.

    • Active Phase: Full manifestation of symptoms, typically featuring positive symptoms.

    • Residual Phase: Presence of negative symptoms, possibly with fewer active symptoms, often seen following an active phase.

    • Positive symptoms are more evident in the active phase, while negative symptoms are more commonly observed in prodromal and residual phases.