SCHIZOPHRENIC DISORDERSA class of disorders marked by delusions, hallucinations, disorganized speech, and deterioration of adaptive behavior

GENERAL SYMPTOMS

Delusions and irrational thoughts Delusions are false beliefs that are

maintained even though they clearly are out of touch with reality

Delusions of grandeur Deterioration of thought Deterioration of adaptive behavior Hallucinations: sensory perceptions that

occur in the absence of a real, external stimulus or are gross distortions of perceptual input

Disturbed emotion

SUBTYPES

Paranoid type: dominated by delusions of persecution, along w/delusions of grandeur

Catatonic type: striking motor disturbances, ranging from muscular rigidity to random motor activity

Disorganized type: particularly severe deterioration of adaptive behavior

Undifferentiated type: idiosyncratic mixtures of schizophrenic symptoms

POSITIVE VS. NEGATIVE SYMPTOMS

Negative symptoms involve behavioral deficits, such as flattened emotions, social withdrawal, apathy, impaired attention, and poverty of speech

Positive symptoms involve behavioral excesses or peculiarities, such as hallucinations, delusions, bizarre behavior, and wild flights of ideas

COURSE AND OUTCOME

Schizophrenia usually emerges during adolescence or early adulthood

Emergence may be sudden or gradual Mild disorders are usually successfully

treated For some, it is chronic and permanent

hospitalization is required Males tend to have earlier onset, relapse,

and more hospitalizations

ETIOLOGY OF SCHIZOPHRENIA

GENETIC VULNERABILITY

Strong evidence to support hereditary influence

Identical twin concordance rates at about 48%

Born to two schizophrenic parents---46%

NEUROCHEMICAL FACTORS

Excess dopamine is a possibility Possible interaction between dopamine and

serotonin

STRUCTURAL ABNORMALITIES IN THE BRAIN

CT scans and MRIs show enlarged brain ventricles in schizophrenic patients

A smaller thalamus may play a part Psychs don’t know if these are cause or

effect of schizophrenia

NEURODEVELOPMENTAL HYPOTHESIS

Schizophrenia is caused in part by various disruptions in the normal maturation processes before or at birth

Studies focus on viral infections

EXPRESSED EMOTION

Focuses on family dynamics influence the course of schizophrenia

Expressed emotion is the degree to which a relative of a schizophrenic patient displays highly critical or emotionally overinvolved attitudes toward the patient

PERSONALITY DISORDERSA class of disorders marked by extreme, inflexible personality traits that cause subjective distress or impaired social and occupational functioning

PERSONALITY DISORDERS

DSM-IV lists ten disorders clustered into 3 main groups:

1) Anxious-fearful 2) Odd-eccentric 3) Dramatic-impulsive

DIAGNOSTIC PROBLEMS

Personality disorders tend to overlap one another

Current revisions are underway for the new DSM-V, set to be published in 2013

ANTISOCIAL PERSONALITY DISORDER

DEF: marked by impulsive, callous, manipulative, aggressive, and irresponsible behavior that reflects a failure to accept social norms

Lack a conscience More common among males Seen in 3-4% of pop.

ETIOLOGY

May be a genetic disposition Inherited sluggish autonomic systems Inadequate or dysfunctional family systems

may be a cause

PSYCHOLOGICAL DISORDERS AND THE LAW

INSANITY

DEF: a legal status indicating that a person cannot be held responsible for his or her actions because of mental illness

M’naghten rule: insanity exists when a mental disorder makes a person unable to distinguish right from wrong

INVOLUNTARY COMMITMENT

DEF: people hospitalized in psychiatric facilities against their will

Criteria: 1) people are dangerous to themselves 2) dangerous to others 3) treatment is needed

CULTURE AND PATHOLOGY

ARE EQUIVALENT DISORDERS FOUND AROUND THE WORLD?

Severe disorders are pancultural Culture-bound disorders: abnormal

syndromes found only in a few cultural groups

Koro, windigo, anorexia nervosa