Schizophrenia & Personality Disorders Notes

Schizophrenia

  • Definition (DSM-V): Chronic brain disorder affecting brain development and mental function, impacting behavior.
  • Diagnostic Criteria: Two or more of the following symptoms persistent for one month:
    1. Hallucinations
    2. Delusions
    3. Disorganized speech
    4. Disorganized or catatonic behavior
    5. Flat affect, diminished emotion or motivation

Symptoms of Schizophrenia

  • Positive Symptoms:
    • Delusions
    • Hallucinations
    • Disorganized speech
  • Negative Symptoms:
    • Flattened affect
    • Reduced speech
    • Lack of initiative

Thought Disorder

Catatonia

Potential Risk Factors

  • Genetics/Family History
  • Viral Infections
  • Lead Exposure
  • Neurochemical Irregularities
  • Prenatal Exposure to Hunger
  • Dense Living Environment

Treatments

  • Focuses on prevention, pharmaceuticals, and therapy.
  • Consideration must be made for side effects of pharmaceutical treatments.

Borderline Personality Disorder

  • Diagnostic Criteria: 5 or more of the following:
    1. Strong fear of real or imagined abandonment, frantic efforts to avoid it.
    2. Unstable and intense personal relationships.
    3. Identity Disturbance: Unstable image or sense of self.
    4. Impulsivity in at least two self-damaging areas.
    5. Suicidal Behavior/thoughts.
    6. Instability in mood.
    7. Feelings of emptiness.
    8. Intense or inappropriate anger.
    9. Stress-related paranoid ideation and or dissociative symptoms.
  • Example of Symptoms:
    • A 22-year-old woman engages in non-suicidal self-injury (pinching, scratching) to manage feelings of anger, anxiety, and guilt. The self-harm provides a sense of relief and control over emotions.
    • On anniversaries of her father's death, she experiences intense anger and hopelessness, leading to a non-lethal medication overdose, providing a temporary sense of control.
  • Prevalence Rates: 2-6%
  • Gender Differences: 1:3 (Male: Female)
  • Borderline vs. Bipolar

Psychopathy & Antisocial Personality Disorder (ASPD)

  • Psychopathy, Sociopathy and ASPD are used to describe individuals with ASPD.
  • Psychopathy is NOT listed in the DSM-V, but it is used in the description of ASPD.
  • Psychopathy/Psychopathic Personality Characteristics: Superficial charm, dishonesty, manipulativeness, self-centeredness, lack of remorse or shame, failure to follow any life plan, risk-taking, callous unemotional traits.
  • Failure to conform to social norms.
  • Lack of remorse.

Causes and Risk

  • Cause is unknown, but important factors altering brain function might be biological & genetic, environment & life experience
  • Risk factors:
    • Childhood Diagnosis of Conduct Disorder
    • Childhood abuse and/or neglect
    • Family history of ASPD

Can We Teach Empathy?

  • Empathy model: Includes self-empathy, communication, compassion. Promotes compassionate communication, dialogue, presence, mutual connection, emotional safety.

Dissociative Disorders

  • Involve disruptions in consciousness, memory, identity, perception, body representation.
  • Types:
    • Depersonalization / Derealization disorder
    • Dissociative amnesia
    • Dissociative Identity Disorder (DID)

Depersonalization / Derealization Disorder

  • Depersonalization
  • Derealization

Dissociative Amnesia

  • Inability to recall extensive amounts of personal information.
  • Most often related to a stressful experience, e.g. abuse in childhood.
  • Cannot be explained by ordinary forgetfulness
  • Dissociative Fugue

Dissociative Identity Disorder

  • Formerly "Multiple Personality Disorder"
  • Controversial
  • Two or more distinct personality states ("alters") that disrupt usual sense of identity.
  • Post Traumatic Model
  • Sociocognitive Model