Chapter 14 - Schizophrenia

Which women are most at risk of developing postpartum psychosis?

Women with a history of bipolar disorder, schizophrenia, or depression are particularly vulnerable to the disorder. Women who have previously experienced postpartum depression or postpartum psychosis have an increased likelihood of developing postpartum psychosis after subsequent births.

Family Intervention Programs

Work with families of people with schizophrenia to help them cope with the burdens of care and assist them in developing more cooperative, less-confrontational ways of relating to others. Family conflicts and negative family interactions can heap stress of family members of schizophrenia, increasing the risk of recurrent episodes.

How many people are diagnosed with schizophrenia worldwide?

-1% -Slightly more frequent and severe in men than women. -2-3% of general population have schizotypal personality disorder; a milder form of the disease because patients don't manifest overtly psychotic behaviour.

What are the brain explanations for auditory hallucinations?

-Abnormal activation of the primary auditory cortex. -Failure to recognize internally generated speech as one's own. Cross-activtation with the auditory areas, so what most people experience as thoughts become "voiced". -Abnormal attention to the subvocal stream that accompanies verbal thinking. -Musical hallucinations result from the activation of the brain network involving auditory areas, motor cortex, visual areas, basal ganglia, cerebellum, hippocampus, and amygdala.

What brain areas are known to be abnormal in people with schizophrenia?

-Decreased brain volume. -Enlarged ventricles -Frontal lobe dysfunction -Reduced volume of thalamus -Abnormalities in temporal lobe areas.

What are the socioeconomic effects of schizophrenia?

-Found more frequently in the lower economic groups. -Theorists argue that the disorder causes victims from higher social levels to fall to lower social levels and remain there. Called the "downward drift".

What are the developmental effects of schizophrenia?

-Typically develops during a persons late adolescence or early adulthood. -In some cases, the onset of the disorder is acute and occurs suddenly, within a few weeks or months. -Then a rapid transformation in personality and behaviour leads to an acute psychotic episode. -In most cases, there is a slower, more gradual decline in functioning.

What percentage of the world receives a diagnosis of schizophrenia?

1%

What percent of the population develops schizophrenia?

1%; the prevalence rises to 3% among 2nd degree relatives with the disorder and 10% among 1st degree relatives. This does not establish a genetic basis for the disorder.

What are the most common hallucinations in order prevalence?

1) Auditory - 75% 2) Visual - 39% 3) Somatic - 29% 4) Tactile, gustatory, and olfactory - 7%

What are the biggest challenges to the dopamine hypothesis?

1) The recent discovery of a new group of antipsychotic drugs, called second-generation antipsychotic drugs, are often more effective than the traditional ones. The drugs bind not only to D-2 dopamine receptors, like the traditional, or conventional, antipsychotic drugs, but also to many D-1 receptors and to receptors for other neurotransmitters such as serotonin. Schizophrenia could be related to abnormal activity or interactions of both dopamine and serotonin and perhaps other neurotransmitters (ex: glutamate and GABA), rather than to abnormal dopamine activity alone. 2) Some theorists claim that excessive dopamine activity contributes primarily to the positive symptoms of schizophrenia such as delusions and hallucinations. Positive symptoms respond well to the conventional antipsychotic drugs, which bind so strongly to D-2 receptors, whereas some of the negative symptoms (such as restricted affect and loss of volition) respond best to the second-generation antipsychotic drugs, which bind less strongly to D-2 receptors. 3) Other studies suggest that negative symptoms may be related primarily to abnormal brain structure, rather than to dopamine overactivity.

What is the viral theory of schizophrenia?

1) Various studies point to genetic factors, poor nutrition, fetal development, birth complications, immune reactions, and toxins. They also suggest that brain abnormalities may result from exposure to viruses before birth. The viruses enter the fetus' brain and interrupt proper brain development, OR the viruses remain quiet until puberty or young adulthood, activated by changes in hormones or by another viral infection, and help to bring about schizophrenic symptoms. 2) Animal model investigations, found that an unusually large number of people with schizophrenia are born during the winter. The winter birth rate among people with schizophrenia is 5 to 8 percent higher than among other people. This could be because of an increase in fetal or infant exposure to viruses at that time of year. 3) Investigations of fingerprints. People with schizophrenia often have significantly more or fewer ridges than their nonschizophrenic identical twins. Fingerprints form in the fetus during the 2nd trimester, when the fetus is most vulnerable to certain viruses. The fingerprint irregularities of some people with schizophrenia could reflect a viral infection contracted during the prenatal period, an infection that also predisposed the individuals to schizophrenia. 4) Studies show mothers of schizophrenic children were more likely to have been exposed to the influenza virus during pregnancy than were mothers of people without schizophrenia. 5) Other studies have found antibodies to certain viruses, incl. viruses usually found in animals, in the blood of 40% of research participants with schizophrenia. The presence of such antibodies suggests that these people had at some time been exposed to those particular viruses.

Schizophrenia Dx Checklist

1. For 1 month, individual displays two or more of the following symptoms much of the time: (a) Delusions (b) Hallucinations (c) Disorganized Speech (d) Very abnormal motor activity, including catatonia (e) Negative Symptoms 2. At least one of the individual's symptoms must be delusions, hallucinations, or disorganized speech. 3. Individual functions much more poorly in various life spheres than was the case prior to the symptoms. 4. Beyond this 1 month of intense symptomology, individual continues to display some degree of impaired functioning for astroturfing least 5 additional months.

What are the diagnostic features of schizophrenia?

1. Positive Symptoms: Excesses of thought, emotion and behaviour. -Delusions -Hallucinations -Disordered thinking and speech -Disorganized behavior 2. Negative Symptoms: Deficits of thought, emotion and behaviour. -Loss of volition -Blunted with flat affect -Social withdrawal 3. Psychomotor Symptoms: Unusual movements or gestures. -Catatonia -Eye movement dysfunction

What percentage of White Americans receive a diagnosis of schizophrenia?

1.4%

Which family members have the highest genetic risk of developing schizophrenia?

1st degree relatives. MZ Twins and offspring of dual matings are the highest. MZ Twins: 48% Dual Matings: 46% DZ Twins: 17% Siblings with 1 schizophrenic parent: 17% Parents: 6%

What is the percentage of African Americans who receive a diagnosis of schizophrenia?

2.1% They are more likely than white American patients to be assessed as having symptoms of hallucinations, paranoia, and suspiciousness and are overrepresented in state hospitals.

How many people worldwide think aliens walk among us disguised as humans?

20%

How many people in the USA and Britain believe they have been visited by aliens?

22-37%

Do people recover from schizophrenia?

25% or more do recover completely, the majority 75% appx continue with at least some residual problems for the rest of their lives. The phases may last days or years, and a fuller recovery from schizophrenia is more likely in people who functioned well before the disorder (premorbid functioning); whose initial disorder is triggered by stress, comes on abruptly, or develops during middle age; and who receive early treatment, preferably during prodromal phase. Relapses are apparently more likely during times of stress.

Schizophrenia Quick Facts

A chronic psychotic disorder characterized by disturbed behaviour, thinking, emotions, and perceptions. -Affects people from all walks of life and all socioeconomic groups. -Characterized by an array of diverse symptoms. -Usually begins in late adolescence or early adulthood. -Perhaps the most devastating disorder of humankind. -A pervasive disorder that affects a wide range of psychological processes involving cognition, affect, and behaviour. -The DSM criteria for the disorder requires that psychotic behaviours must be present at some point during the course of the disorder and that signs of the disorder be present for at least 6 months.

Loose Associations/Derailment

A common thinking disturbance in schizophrenia, characterized by rapid shifts from one topic of conversation to another. The most common formal thought disorder, rapidly shifting from one subject to another, believing that their incoherent statements make sense. A single, perhaps unimportant word in one sentence becomes the focus of the next.

Loose Associations and Derailment

A common thinking disturbance in schizophrenia, characterized by rapid shifts from one topic of conversation to another. Also known as "derailment". Ex: A single, perhaps unimportant word in one sentence becomes focus of the next.

DISCERN

A computer neural network programmed it to store information in ways that parallel the ways the human brain organizes words, sentences, and other bits of information into knowledge and memories. Researchers simulated the effects of a dopamine flood by programing the computer system to process information at a faster and faster rate, while at the same time programming it to ignore less and less data. When it had finished being reprogrammed, it began to display patterns of functioning that were similar to those found in people with schizophrenia. The researchers further found that the computer's delusional stories were similar to those produced by human participants with schizophrenia after they had been given similar pieces of information.

Alogia

A decrease in speech or speech content; a symptom of schizophrenia. Also known as poverty of speech. Some people with this negative kind of formal thought disorder think and say very little. Others say quite a bit but still manage to convey little meaning.

How is schizophrenia diagnosed?

A diagnosis of schizophrenia is called for only after symptoms of the disorder continue for six months or more. In at least one of those months, the person must be in an active phase, marked by significant delusions, hallucinations, or disorganized speech. In addition, there must be a deterioration in the person's work, social relations, and ability to care for themselves. Many researchers believe that to help predict the course of the disorder, there should be a distinction between Type 1 and Type 2 schizophrenia.

Formal Thought Disorders

A disturbance in the production and organization of thought. People with schizophrenia may not be able to think logically and may speak in peculiar ways. They can cause the sufferer great confusion and make communication extremely difficult. Often they take the form of "positive" symptoms (pathological excesses), as in loose associations, neologisms, perseveration, and clang.

Formal Thought Disorder

A disturbance in the production and organization of thought. Includes loose association or derailment, neologisms, perseveration, and clang.

R.D. Lang

A famous clinical theorist who combined sociocultural principles with existential philosophy. Arguing that schizophrenia is actually a constructive process in which people try to cure themselves of the confusion and unhappiness caused by their social environment. Left alone to complete this process, people with schizophrenia would indeed achieve a healthy outcome.

What are the long term outcomes for those suffering from schizophrenia?

A fully recovery from the disorder is more likely in people who: 1. With good premorbid functioning 2. Whose disorder was triggered by stress 3. With abrupt onset 4. With later onset 5. Who receive early treatment

Phenothiazines

A group of antihistamine drugs that became the first group of effective antipsychotic medications. Discovered in the 1950s by researchers who were looking for antihistamine drugs to combat allergies. They failed as antihistamines, but they were effective in reducing schizophrenic symptoms, and clinicians began to prescribe them widely.

L-Dopa

A medication that raises Parkinson's patients' dopamine levels. It apparently raises the dopamine activity so much that it produces psychosis. Some people with Parkinson's disease develop schizophrenia-like symptoms if they take too much of it.

Loss of Volition/Avolition

A negative symptom of schizophrenia. The person may have a loss of motivation or directedness, drained energy and interest, inability to start or follow through on courses of action, ambivalence, and more likely in people who have the disorder for years.

Restricted Affect

A negative symptom of schizophrenia. They may show less anger, joy, sadness and other feelings expressed by most people. Some show almost no emotion at all - flat affect. Their faces are still, eye contact poor, voices monotonous - showing a "mask". They may FEEL just as much positive or negative emotion but very little expression of it.

Social Withdrawal

A negative symptom of schizophrenia. They withdrawal from their social environment, retreat to their own ideas and fantasies - exacerbates the condition and increases their distance from reality, and leads to a breakdown of social skills; including the ability to accurately recognize other people's needs and emotions.

Poverty Of Speech

A negative symptoms of schizophrenia. The person may speak very little or speak a lot but conveying very little meaning.

Catatonia

A pattern of extreme psychomotor symptoms, found in some forms of schizophrenia, which may include catatonic stupor, rigidity, or posturing. Stupor, fixed rigid posturing, almost no movement or excitement. Can take on extreme forms. They may become unaware of the environment and maintain a rigid/fixed posture (even bizarre) and seemingly strenuous positions for hours as their limbs become stiff or swollen. They may exhibit odd gestures and bizarre facial expressions or become unresponsive and curtail spontaneous movement. Show highly excited/wild behaviour or slow to a state of stupor.

How is the relationship between substance abuse and mental dysfunctioning complex?

A person's mental disorder may precede their substance abuse, and they may take a drug as a form of self-medication or as a result of impaired judgment. Conversely, substance abuse may cause or exacerbate psychopathology. Cocaine and amphetamines exacerbate the symptoms of psychosis and can quickly intensify the symptoms of schizophrenia. Substance abuse and mental disorders interact to create a complex and distinct problem that is greater than the sum of its parts. The course and outcome of each disorder can be significantly influenced by the other.

Schizophrenia

A psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of strange perceptions, disturbed thought processes, unusual emotions, and motor abnormalities. Various psychotic symptoms, such as delusions, hallucinations, disorganized speech, restricted or inappropriate affect, and catatonia. Lifetime prevalence: 1.0% Duration: 6 months or more. Both genders are affected equally. Average onset is 23 years for men and 28 years for women. Dx Checklist: 1. For 1 month, individual displays two or more of the following symptoms much of the time: (a) Delusions (b) Hallucinations (c) Disorganized speech (d) Very abnormal motor activity, including catatonia (e) Negative symptoms 2. At least one of the individual's symptoms must be delusions, hallucinations, or disorganized speech. 3. Individual functions much more poorly in various life spheres than was the case prior to the symptoms. 4. Beyond this 1 month of intense symptomology, individual continues to display some degree of impaired functioning for at least 5 additional months. The term comes from the Greek words for "split mind."

Second-Generation Antipsychotic Drugs

A relatively new group of antipsychotic drugs whose biological action is different from that of the conventional antipsychotic drugs. Also known as atypical antipsychotic drugs.

Atypical Antipsychotic Drugs

A relatively new group of antipsychotic drugs whose biological action is different from that of the conventional antipsychotic drugs. Also known as second-generation antipsychotic drugs.

Attentional Deficits

A schizophrenic impairment. The ability to focus on relevant stimuli and ignore irrelevant ones is basic to learning and thinking. They'll have difficulty filtering out irrelevant stimuli which makes it nearly impossible for them to focus and to organize thoughts - can't filter out unessential information.

Personal Identity Confusion

A schizophrenic impairment. The cluster of attributes and characteristics that define themselves as individuals and give meaning and direction to their lives. They may fail to recognize themselves as unique individuals and be unclear about how much of what they experience is part of themselves. In psychodynamic terms; this phenomenon is sometimes referred to as loss of ego boundaries.

Delusions

A strange false belief firmly held despite clear contradictory evidence and despite the fact that others don't share the belief. A false belief that is firmly maintained in spite of incontrovertible and obvious proof to the contrary. Ideas they believe wholeheartedly but that have no basis in fact. The deluded person may consider the ideas enlightening or may feel confused by them. Some people hold a single delusion that dominates their lives and behavior; others have many delusions. Delusions of persecution, reference, control and grandeur (thought broadcasting, thought insertion, and thought withdrawal). Unless we are engaged in daydreaming or purposefully letting thoughts wander, our thoughts tend to be tightly knit together. The connections (associations) between our thoughts tend to be logical and coherent. A person with the disorder has loose thought associations and lack coherence and logic.

Flat Effect

A symptom of schizophrenia in which the person shows almost no emotion at all. A blunted/restricted affect—they show less anger, sadness, joy, and other feelings than most people and some show almost no emotions at all. Their faces are still, their eye contact is poor, and their voices are monotonous. In some cases, people with these problems may have anhedonia, a general lack of pleasure or enjoyment. In other cases, the restricted affect may reflect an inability to express emotions as others do.

Avolition

A symptom of schizophrenia marked by apathy and an inability to start or complete a course of action. Apathy, feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action. This problem is particularly common in people who have had schizophrenia for many years, as if they have been worn down by it. They may feel ambivalence, or conflicting feelings, about most things.

Double-Bind Hypothesis

A theory that some parents repeatedly communicate pairs of messages that are mutually contradictory, helping to produce schizophrenia in their children. The children cannot avoid displeasing their parents because nothing they do is right, so the symptoms of schizophrenia represent the child's attempt to deal with the double binds. A child who is repeatedly exposed to double-bind communications will adopt a special life strategy for coping with them. Ex: Always ignore primary communications and respond only to metacommunications: be suspicious of what anyone is saying, wonder about its true meaning, and focus on clues only in gestures or tones. People who increasingly respond to messages in this way may progress toward paranoid schizophrenia. Closely related to the psychodynamic notion of a schizophrenogenic mother.

Schizophrenogenic (Schizophrenia-Causing) Mothers

A type of mother—supposedly cold, domineering, and uninterested in the needs of her children—who was once thought to cause schizophrenia in her child. Frieda Fromm-Reichmann's theory.

Schizophrenia Spectrum Disorders

A variety of disorders that all bear a similarity to schizophrenia including; brief psychotic disorder, schizophreniform disorder, schizoaffective disorder, delusional disorder, psychotic disorder due to another medical condition, and substance/medication psychotic disorder.

What have researchers linked schizophrenia to during the past decade?

Abnormal brain structure - especially cases dominated by negative symptoms.

Frontal Lobe Dysfunction - Schizophrenia

Abnormalities in brain circuitry connecting the prefrontal cortex and lower brain structures, including parts of the limbic system; involved in regulating emotions and memory.

What have researchers linked negative-dominated symptom schizophrenia to?

Abnormalities in brain structure.

What is the average annual income of people with schizophrenia?

Above $70,000 - 0.3% $40,000 to $70,000 - 0.4% $20,000 to $40,000 - 0.7% Below $20,000 - 1.9%

Negative Symptoms of Schizophrenia

Absence or deficit of normally present behaviors. They affect the person's ability to function in daily life and include such features as lack of emotions, emotional expression, loss of motivation and pleasure in normally enjoyable activities, social withdrawal or isolation, and limited output of speech.

Antipsychotic Drugs

Antipsychotic drugs that block dopamine receptors in the brain reducing dopamine activity. Quells the more obvious symptoms such as hallucinations and delusions. Medications that help remove the symptoms of schizophrenia. 1st generation drugs are phenothiazines. 2nd generation drugs are atypical antipsychotics - that have the advantage of fewer neurological side effects and a lower risk of TD. Drugs that help correct grossly confused or distorted thinking. Often produce troublesome muscular tremors, symptoms that are identical to the central symptom of Parkinson's disease, a disabling neurological illness.

How many people in the world suffer from schizophrenia?

Approximately 1/100 people during their lifetime. An estimated 24 million people worldwide are afflicted with it, including 2.5 million in the United States.

What do PET scans reveal when a person with schizophrenia is experiencing auditory hallucinations?

At the moment a patient was having auditory hallucinations, it showed heightened activity in Broca's area, a brain region that helps people produce speech, and in the auditory cortex, the brain area that helps people hear sounds. Conversely, the front of the brain, which is responsible for determining the source of sounds, was quiet during the hallucinations. Thus people who are hallucinating seem to hear sounds produced by their own brains, but their brains cannot recognize that the sounds are actually coming from within.

How did the undesired reaction to antipsychotic drugs lead to an important clue in schizophrenia?

Because the drugs produced symptoms similar to Parkinson's disease, Scientists already knew that people who suffer from Parkinson's have abnormally low levels of the neurotransmitter dopamine in some areas of the brain and that lack of dopamine is the reason for their uncontrollable shaking. If antipsychotic drugs produce Parkinsonian symptoms in people with schizophrenia while removing their psychotic symptoms, perhaps the drugs reduce dopamine activity. Scientists reasoned, if lowering dopamine activity helps remove the symptoms of schizophrenia, perhaps schizophrenia is related to excessive dopamine activity in the first place.

What are the two kinds of biological abnormalities that could lead to inheriting schizophrenia?

Biochemical abnormalities and abnormal brain structure.

What are the schizophrenia prevalence rates of those who are adoptees?

Biological relatives of adoptees with schizophrenia are more likely than their adoptive relatives to develop schizophrenia or another schizophrenia spectrum disorder.

Enlarged Ventricles - Schizophrenia

Brain scans have found that many people with schizophrenia have them. They are the brain cavities that contain cerebrospinal fluid. This enlargement may be a sign of poor development or damage in related brain regions.

Psychosocial Rehabilitation

Cognitive rehabilitative training to help people with schizophrenia - to strengthen basic cognitive skills such as attention and memory to improve function in social and occupational roles. People with schizophrenia typically have difficulties functioning in social and occupational roles and performing work that depends upon basic cognitive abilities involving attention and memory. These problems limit their ability to adjust to community life, even in the absence of overt psychotic behaviour. Recently, promising results were reported for cognitive rehabilitation training to help schizophrenia patients strengthen such basic cognitive skills as attention and memory.

Other Impairments of Schizophrenia

Confusion with personal identity and attentional deficits. If they are confused with their personal identity they may fail to recognize themselves as unique individuals and be unclear about how much of what they experience is part of themselves. If they have issues with attention, they'll have difficulty filtering out irrelevant stimuli which makes it nearly impossible for them to focus and to organize thoughts - can't filter out unessential information.

Psychosis

Defined as a state in which a person loses contact with reality in many key ways. The hallmark of schizophrenia. A significant loss of contact with reality. Their ability to perceive and respond to the environment becomes so disturbed that they may not be able to function at home, with friends, in school, or at work. They may have hallucinations (false sensory perceptions) or delusions (false beliefs), or they may withdraw into a private world. Can be substance-induced or caused by brain injury, but most psychoses appear in the form of schizophrenia.

What are acute episodes of schizophrenia characterized by?

Delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behaviour.

What do around 1/2 of people with schizophrenia have trouble with?

Difficulties with memory and other kinds of cognitive functioning.

Eye Movement Dysfunction

Difficulty tracking a slow-moving target across field of vision. Many schizophrenia patients suffer from some form of this dysfunction. They can't track the slow moving target and rather than steadily track it, their eyes fall back and then catch up in a jerky movement. They are common in people with schizophrenia and in their 1st degree relatives which suggests a genetically transmitted trait (biomarker) associated with genes linked to the disorder.

The Schizophrenogenic Mother

Discredited early thinking that focused on the role of the schizophrenogenic mother who was described as cold, aloof, overprotective and domineering. -Stopped children from gaining self-esteem, stifled their independence, and forced them into being dependent on her. -Children reared by such mothers were believed to be at special risk for developing schizophrenia. -Especially if fathers were passive; the father failing to counteract the mother's pathogenic influences. Evidence fails to support this belief that negative family interactions directly cause schizophrenia. Rather, people who have a genetic vulnerability to schizophrenia may be more likely to develop the disorder if they live in an environment wracked by stressful family and social relationships.

Inappropriate Affect

Display of emotions that are unsuited to the situation; a symptom of schizophrenia. They may smile when making a somber statement or upon being told terrible news, or they may become upset in situations that should make them happy. They may also undergo inappropriate shifts in mood such as a romantic moment with a partner, then suddenly begin yelling obscenities at them. These emotions may be merely a response to other features of the disorder. When told information they might not even hear the conversation, they might be reacting to the other stimuli, such as auditory hallucinations, flooding their senses.

What do many people with schizophrenia have regarding their brain structures?

Enlarged ventricles—the brain cavities that contain cerebro-spinal fluid. Some studies suggest they have smaller temporal and frontal lobes than other people, smaller amounts and cortical white and grey matter, and/or abnormal blood flow—either reduced or heightened—in certain areas of the brain. Other studies have linked schizophrenia to abnormalities of the hippocampus, amygdala, and thalamus, among other brain structures.

What is one prenatal theory for a predisposition to schizophrenia?

Factors other than genetics. It could be the result of a prenatal problem, and twins, especially identical twins, would still be expected to have a higher concordance rate.

Schizophrenia Genetic Factors and Family Pedigree Studies

Family pedigree studies have repeatedly found that schizophrenia is more common among relatives of people with the disorder. The more closely related they are to the person with schizophrenia, the greater likelihood they'll develop the disorder. Twins have received the most research. -Studies of identical twins found that if one twin develops the disorder, there is a 48% chance that the other twin will develop it as well. -Fraternal twins have a 17% chance of developing the disorder. The closer the genetic relationship between schizophrenia patients and their family members, the greater the likelihood (concordance rate) that the relatives will also have schizophrenia. 1st degree relatives (parents, children, siblings) the 10-fold risk of developing the disorder than general members of the population.

Somatic Hallucinations

Feelings that something is happening inside the body, such as a snake is crawling around in one's stomach.

What is dopamine role in schizophrenia?

Findings suggest that in schizophrenia, messages traveling from dopamine-sending neurons to dopamine receptors on other neurons, particularly to the D-2 receptors, may be transmitted too easily or too often. Dopamine neurons are known to play a key role in guiding attention. People whose attention is severely disturbed by excessive dopamine activity might well be expected to suffer from the problems of attention, perception, and thought found in schizophrenia.

Gustatory Hallucinations

Food or drink tastes strange on a regular basis. Ex: coffee/tea tastes like metal, or food tastes like its been poisoned.

Hypnopompic Hallucinations

Geometric patterns, faces or landscapes experienced by some people as they are awakening.

Hypnagogic Hallucinations

Geometric patterns, faces, or landscapes experienced by some people while falling asleep.

What is the percentage of risk for a person to biologically inherit schizophrenia from second degree relatives?

Half-siblings - 6% Grandchild - 5% Nephew/Niece - 4% Uncle/Aunt - 2%

In schizophrenia, what often occurs together?

Hallucinations and delusions. They eventually feed into each other. A person who hears voices issuing commands may also have the delusion that the commands are being placed in their head by someone else. Or a person with a delusion of persecution may hallucinate the smell of gas or poison in their bedroom or in their food.

How are hallucinations different from illusions, imagery, dreaming and pseudohallucinations?

Hallucinations are the experiencing of sights, sounds, smells, and other perceptions that occur in the absence of external stimuli, whereas: -Illusions are distorted or misinterpreted real perceptions. -Imagery is under voluntary control and doesn't mimic real perception. -Dreaming occurs when a person is asleep. -Pseudohallucinations are internally triggered, vivid perceptions that are recognized by the individual as unreal, and partly under voluntary control.

Psychotic Disorder Due To Another Medical Condition

Hallucinations, delusions, or disorganized speech caused by a medical illness or brain damage. Lifetime prevalence: Unknown Duration: No minimum length

Substance/Medication Induced Psychotic Disorder

Hallucinations, delusions, or disorganized speech caused directly by a substance, such as an abused drug. Lifetime prevalence: Unknown Duration: No minimum length

What was Freud's view on schizophrenia?

He believed that it develops from two psychological processes: 1) regression to a pre-ego stage and 2) efforts to reestablish ego control. He proposed that when their world has been extremely harsh/withholding, some people regress to the earliest point in their development, to the pre-ego state of primary narcissism, in which they recognize and meet only their own needs. This sets the stage for schizophrenia. Their near-total regression leads to self-centered symptoms such as neologisms, loose associations, and delusions of grandeur. Once people regress to such an infantile state, they then try to reestablish ego control and contact with reality. Their efforts give rise to yet other psychotic symptoms.

What is the percentage of risk for a person to biologically inherit schizophrenia from first degree relatives?

Identical twins - 48% Children of two schizophrenic parents - 46% Fraternal twins - 17% Siblings - 9% Parents - 6%

What was the viewpoint on hallucinations throughout the ages?

In ancient times they attributed it as gifts from the Gods or the Muses. Prior to the 18th century, it was believed to be caused by supernatural forces such as Gods, demons, angels or djinns. In the Middle of the 18th century, they were believed to be caused by the overactivity of certain centers in the brain. In the 1990s, the cause is thought to be resulting from a network of cortical and subcortical areas.

Psychomotor Symptoms of Schizophrenia

Includes awkward movements, repeated grimaces, odd gestures, catatonia, and dysfunction in eye movements.

Learning Based Therapies

Includes the following: 1. Selective reinforcement of behaviour: Attention for appropriate behaviour; withdrawal of attention for bizarre verbalizations and behaviour. 2. Token economy: Individuals are rewarded for appropriate behaviour with tokens that can be exchanged for tangible reinforcers. 3. Social skills training: Clines are taught appropriate social behaviours through coaching, modelling, behaviour rehearsal and feedback.

Positive Symptoms of Schizophrenia

Involve a break with reality, as represented by the appearance of hallucinations and delusional thinking. Delusions, hallucinations, disorganized thinking and speech, heightened perception.

Postpartum Psychosis

It affects about 1-2 of every 1,000 mothers who have recently given birth. The symptoms are triggered by the enormous shift in hormone levels that takes place after delivery. Within days or few months of birth, the woman develops signs of losing touch with reality, such as delusions (ex: her baby is the devil); hallucinations (ex: hearing voices); extreme anxiety, confusion, and disorientation; disturbed sleep; and illogical or chaotic thoughts (ex: thoughts about killing herself or her child). Only a fraction of women with the disorder actually harm their children - estimated as high as 4%.

What are the problems with the dopamine hypothesis?

It has been challenged by the discover of a new type of antipsychotic drug ("atypical" antipsychotics) which are more effective than traditional medications and that also bind to D-1 receptors and serotonin receptors. It could be that schizophrenia is related to abnormal activity or interactions of both dopamine and serotonin, and perhaps other neurotransmitters as well, rather than to dopamine activity alone.

What is the treatment for MICAs?

It has been undermined by the tendency of patients to hide their drug abuse problems and for clinicians to overlook such problems. Unrecognized substance abuse may lead to misdiagnosis and misunderstanding of the disorders. The treatment of MICAs is further complicated by the fact that many treatment facilities are designed and funded to treat either mental disorders or substance abuse; only some are equipped or willing to treat both. As a result, it is not uncommon for MICA patients to be rejected as inappropriate for treatment in both substance abuse and mental health programs. Many such patients fall through the cracks in this way and find themselves in jail or homeless shelters. They need treatment programs committed to building trust and providing intensive case management. Therapists must tailor treatment programs to them and their unique combination of problems.

Why might dopamine be overactive in people with schizophrenia?

It may be that people with schizophrenia have a larger-than-usual number of dopamine receptors, D-2 receptors, or their dopamine receptors may be too sensitive or operate abnormally in some other way. When dopamine carries a message to a receiving neuron, it must bind to a receptor on the neuron. A larger number of receptors or abnormal operation by the receptors could result in more dopamine binding and thus more neuron firing. Autopsies have found an unusually large number of dopamine receptors in people with schizophrenia, and imaging studies revealed particularly high occupancy levels of dopamine at D-2 receptors in patients with schizophrenia.

What is the course of schizophrenia?

It varies widely from case to case. Many sufferers seem to go through three phases—prodromal, active, and residual. Each of these phases may last for days or years.

Homeless MICAs

Its estimated that 10-20% of the homeless population are MICAs. They typically remain homeless longer than other homeless people and are more likely to have to content with extremely harsh conditions.

What else can cause psychosis besides schizophrenia?

LSD, amphetamines, cocaine, injuries or diseases of the brain, and other severe psychological disorders such as major depressive disorder or bipolar disorder.

Neologisms

Made-up words that typically have meaning only to the person using them.

Schizophrenia Genetic Factors

Many genes, each with a small effect, probably contribute to the development of schizophrenia. Genes that play a role in brain development may be especially implicated. The more closely a person is related to an individual with schizophrenia, the greater likelihood they have for developing the disorder.

How can hallucinations be "normal"?

Many people experience hallucinations that are unrelated to disorders or substance ingestion. These hallucinations affect as many as 10-15% of the population. They occur on average every 3 days and last approximately 2-3 minutes. They can be controlled around 60% of the time and cause little distress or disruption - unless they are misinterpreted.

Psychomotor Symptoms

Many people with schizophrenia move relatively slowly, and some make awkward movements, repeated grimaces and odd gestures that seem to have a private purpose—perhaps ritualistic or magical. They can take extreme forms such as catatonia; catatonic stupor, catatonic rigidity, catatonic posturing, and catatonic excitement.

Schizoaffective Disorder

Marked symptoms of both schizophrenia and a major depressive episode or a manic episode. Lifetime prevalence: Unknown Duration: 6 months or more

What do sociocultural theorists believe is the cause of schizophrenia?

Multicultural factors, social labeling, and family dysfunctioning all contribute.

What do schizophrenia patients with enlarged ventricles show?

Negative symptoms and fewer positive ones, and tend to be more poorly adjusted socially before the onset of schizophrenia, to have more cognitive disturbances, and to respond less well to conventional antipsychotic drugs.

Which treatment method works best for those suffering with schizophrenia?

No single treatment approach meets all the needs of people with schizophrenia.

Do the majority of people with schizophrenia have schizophrenogenic mothers?

No.

Olfactory Hallucinations

Odors that no one else smells, such as the smell of poison or smoke.

What do behaviourist believe is the cause of schizophrenia?

Operant conditioning and principles of reinforcement as the cause. They propose that some people are not reinforced for their attention, proficiency and responding to social cues. As a result, they stop attending to cues and focus on irrelevant cues—the brightness of light in a room, a bird flying above, or the sound of a word rather than its meaning. As they attend more and more to irrelevant cues, their responses become increasingly bizarre. Because the bizarre responses are rewarded with attention or other types of reinforcement, they are likely to be repeated again and again. It is considered a partial explanation for schizophrenia. It may help explain why a given person displays more psychotic behavior in some situations than in others.

What do people with briefer forms of psychosis receive?

Other diagnoses such as brief psychotic disorder.

Why was schizophrenia considered a "wastebasket disorder" for diagnosticians?

Particularly for those in the USA, where the label was at times assigned to anyone who acted unpredictably or strangely. The disorder is defined more precisely today, but still its symptoms vary greatly, and so do its triggers, course, and responsiveness to treatment.

What countries have better recovery rates?

Patients who live in developing countries have better recovery rates than patients in Western and other developed countries. They are more likely to recover from their disorder and less likely to have continuous or episodic symptoms, impaired social functioning, or to require heavy antipsychotic drugs or hospitalization. The argument is developing countries tend to be more supportive and therapeutic than those of developed countries, leading to more favorable outcomes for people with schizophrenia,

What is the behavioural treatment for schizophrenia?

Patients with schizophrenia are capable of learning at least some appropriate verbal and social behaviors if hospital personnel consistently ignore their bizarre responses and reinforce normal responses with attention or other rewards.

Besides people with schizophrenia, who else experiences hallucinations?

People experiencing delirium (visual type) - 27% Alzheimer's patients (visual/auditory types) - 25% Vision impairments (visual type) - 20% Hearing impairments (auditory type) - 20% Loss of smell (olfactory type) - 20% Migraine sufferers (visual/olfactory types) - 10%

Mentally Ill Chemical Abuser (MICA)

People who display both a severe mental disorder and a substance use disorder. Also known as dual diagnosis patients. Substances combined with a mental disorder can produce a pattern of severe psychosis. When substances are out of reach, the patients typically calm down, become more coherent, and are treatment ready in the community. Tend to be young, male, and between 20-50% of all people with chronic mental disorders may be MICAs. They often rate below average in social functioning, school achievement, and above average in poverty, acting-out behaviour, emergency room visits, and crime. More commonly report distress and have poor treatment outcomes over those who don't use substances.

What is the father-child prevalence on schizophrenia?

People whose fathers were over 50 yrs when they were born are more likely to develop schizophrenia than those born to fathers under 50 yrs. Various explanations, but no clear reason has been found.

What is the diathesis-stress relationship?

People with a biological predisposition will develop schizophrenia only if certain kinds of events or stressors are also present. Genetic researchers believe that some people inherit a biological predisposition to schizophrenia and develop the disorder later when they face extreme stress, usually during late adolescence or early adulthood.

Suicide and Schizophrenia

People with schizophrenia are more likely to attempt suicide than the general population. It is estimated that as many as 25% of people with schizophrenia attempt suicide.

Catatonic Posturing

People with schizophrenia assume awkward, bizarre positions for long periods of time. They may, for example, spend hours holding their arms out at a 90-degree angle or balancing in a squatting position.

Delusions of Reference

People with schizophrenia attach special and personal meaning to the actions of others or to various objects or events. They might believe neutral comments carry personal messages directed at them and can come in negative forms. These communications might come from TV, radio, people on the street. The messages might also come from objects or events with no basis in reality. Ex: A person interprets the arrows on street signs as indicators of the direction they should take. Ex: "People on the bus are talking about me" or "The neighbours hear everything I say."

Delusions of Control

People with schizophrenia believe that their feelings, thoughts, and actions are being controlled by other people. Believing that one's thoughts, feelings, impulses, or actions are controlled by external forces such demons or the Devil.

Delusions of Grandeur

People with schizophrenia believe themselves to be great inventors, religious saviors, or other specially empowered persons. Believing oneself to be Jesus, or on a special mission, or having grand but illogical plans for saving the world.

Temporal Lobe Abnormalities - Schizophrenia

People with schizophrenia have also been found to have smaller temporal and frontal lobes, smaller amounts of grey matter, abnormal blood flow to certain brain areas.

Catatonic Rigidity

People with schizophrenia maintain a rigid, upright posture for hours and resist efforts to be moved.

Social Withdrawl

People with schizophrenia may withdraw from their social environment and attend only to their own ideas and fantasies because their ideas are illogical and confused. The withdrawal has the effect of distancing them still further from reality. This seems also to lead to a breakdown of social skills, including the ability to recognize other people's needs and emotions accurately.

Catatonic Stupor

People with schizophrenia stop responding to their environment, remaining motionless and silent for long stretches of time.

Tactile Hallucinations

Perceptions of tingling, burning, or electric-shock sensations.

Delusional Disorder

Persistent delusions that are not bizarre and not due to schizophrenia; persecutory, jealous, grandiose, and somatic delusions are common. Lifetime prevalence: 0.1% Duration: 1 month or more

People with schizophrenia have an increased risk of what?

Physical, often fatal illness. On average, they live 20 years less than other people.

What are the three categories of symptoms of schizophrenia?

Positive symptoms (excesses of thought, emotion, and behavior). Negative symptoms (deficits of thought, emotion, and behavior). Psychomotor symptoms (unusual movements or gestures).

What symptoms can co-occur in the same patient with schizophrenia?

Positive, negative and disorganized symptoms. Ex: they could socially withdrawal (negative symptom) while at same time show bizarre behaviour (disorganized symptom), and also be muttering clang sentences to themselves (positive symptom).

What is the percentage of risk for a person to biologically inherit schizophrenia from third degree relatives?

Relatively low. From first cousins, spouses and general population is 2%.

How strong is the dopamine-schizophrenia link?

Research has supported and helped clarify the hypothesis. Some people with Parkinson's disease develop schizophrenia-like symptoms if they take too much L-dopa, a medication that raises Parkinson's patients' dopamine levels. The L-dopa apparently raises the dopamine activity so much that it produces psychosis. Research on amphetamines - which stimulate the central nervous system. Investigators noticed in the 1970s that people who take high doses of amphetamines may develop amphetamine psychosis—a syndrome very similar to schizophrenia. They also found that antipsychotic drugs can reduce the symptoms of amphetamine psychosis, just as they reduce the symptoms of schizophrenia. Eventually researchers learned that amphetamines and similar stimulant drugs increase dopamine activity in the brain, thus producing schizophrenia-like symptoms. Investigators located areas of the brain that are rich in dopamine receptors and have found that phenothiazines and other antipsychotic drugs bind to many of these receptors. The drugs are dopamine antagonists—drugs that bind to dopamine receptors, prevent dopamine from binding there, and so prevent the neurons from firing. Researchers have identified five kinds of dopamine receptors in the brain—called the D-1, D-2, D-3, D-4, and D-5 receptors—and have found that phenothiazines bind most strongly to the D-2 receptors.

The Dopamine Hypothesis

Schizophrenia involves an over-reactivity of dopamine transmission in the brain. The major source of evidence for the dopamine model is found in the effects of antipsychotic drugs called neuroleptics. This theory is based on the effectiveness of the medications. Over past 4 decades, researchers developed this hypothesis to explain findings. Certain neurons using dopamine fire too often, producing symptoms of schizophrenia. The medications were originally developed for treating allergies but found to cause a Parkinson's disease-like tremor response in patients. Scientists knew that Parkinson's patients had abnormally low dopamine levels, which caused their shaking. This relationship between symptoms suggested that symptoms of schizophrenia were related to excess dopamine. -Ex: people with Parkinson's develop schizophrenic symptoms if they take too much L-dopa, a medication that raises dopamine levels. -Ex: people who take high doses of amphetamines, which increase dopamine activity in the brain, may develop amphetamine psychosis - a syndrome similar to schizophrenia. Researchers have located the dopamine receptors to which antipsychotic drugs bind - the drugs are apparently dopamine antagonists that bind to receptors, preventing dopamine from binding and the neuron from firing. This suggests that in schizophrenia, the messages travelling from dopamine-sending neurons to dopamine-receptors (D-2) may be transmitted to easily or too often. An appealing theory because certain dopamine receptors are known to play a key role in guiding attention. Research since the 60s supports and clarifies this hypothesis.

Downward Drift Theory

Schizophrenia is found among lower socioeconomic groups. This led theorists to believe that the stress of poverty is itself a cause of the disorder, or that it causes it sufferers to fall from a higher to lower socioeconomic level or to remain poor because they are unable to function effectively.

Type II Schizophrenia

Schizophrenia thought to be dominated by more negative symptoms, such as restricted affect, poverty of speech, and loss of volition. The negative symptoms of this type may be tied largely to structural abnormalities in the brain.

Type I Schizophrenia

Schizophrenia thought to be dominated by positive symptoms, such as delusions, hallucinations, and certain formal thought disorders. Patients generally seem to have been better adjusted prior to the disorder, to have later onset of symptoms, and to be more likely to show improvement, especially when treated with medications. The positive symptoms of this type may be linked more closely to biochemical abnormalities in the brain.

Catatonic Excitement

Sometimes people with schizophrenia exhibit a different form of catatonia, they move excitedly, sometimes wildly waving their arms and legs.

Auditory Hallucinations

Sounds and voices that see to come from outside the head. "Hearing voices" most common. Affects 3/4 of schizophrenia patients. They hear sounds and voices that come from outside their head. They can talk directly to them sometimes giving commands or warnings, or they may be experienced as overheard. People with them actually produce the nerve signals of sound in their brains, "hear" them, and then believe that external sources are responsible.

Clang

Speech found in schizophrenia; rhyming when thinking or expressing themselves, and rhyming in sentences but still not making much sense. Ex: "Well, hell, it's well to tell." OR "So hot, you know it runs on a cot."

What has the genetic view been supported by?

Studies of: (1) relatives of people with schizophrenia (2) twins with schizophrenia (3) people with schizophrenia who are adopted (4) genetic linkage and molecular biology

What are the primary causes of death of people with schizophrenia?

Suicide, accidents, inadequate medical care, infections, heart disease, diabetes, unhealthy lifestyles and homelessness.

Prodromal Phase of Schizophrenia

Symptoms are not yet obvious, but the person is beginning to deteriorate. They may withdraw socially, speak in vague or odd ways, develop strange ideas, or express little emotion.

Active Phase of Schizophrenia

Symptoms become apparent. Sometimes this phase is triggered by stress or trauma in the person's life.

Negative Symptoms

Symptoms of schizophrenia that seem to be deficits in normal thought, emotions, or behaviors. These are "pathological deficits," characteristics that are LACKING in a person. Poverty of speech, blunted and flat affect, loss of volition, and social withdrawal are commonly found in schizophrenia. Something has been taken away. They greatly affect one's life and activities.

Positive Symptoms (Schizophrenia)

Symptoms of schizophrenia that seem to be excesses of or bizarre additions to normal thoughts, emotions, or behaviors. They are "pathological excesses," or bizarre additions, to a person's behavior. Delusions, disorganized thinking and speech, heightened perceptions and hallucinations, and inappropriate affect are the ones most often found in schizophrenia.

What was Frieda Fromm-Reichmann's notion on schizophrenia?

That cold or unnurturing parents may set schizophrenia in motion. She described the mothers of people who develop the disorder as cold, domineering, and uninterested in their children's needs. These mothers may appear to be self-sacrificing but are actually using their children to meet their own needs. At once overprotective and rejecting, they confuse their children and set the stage for schizophrenic functioning. She called them schizophrenogenic (schizophrenia-causing) mothers.

What does research say about disorganized speech and thinking?

That people may have this type of speech or thinking long before their full pattern of schizophrenia unfolds.

What have studies shown in support Freud's theory on schizophrenia?

That people with schizophrenia have great difficulty forming an integrated sense of self. Studies have often found that people with schizophrenia went through severe stress or traumas early in their lives.

What is the cognitive view on schizophrenia?

That people with schizophrenia take a "rational path to madness". This process of drawing incorrect and bizarre conclusions (delusions) may be helped along by a cognitive bias that many people with schizophrenia have—a tendency to jump to conclusions.

What is one of the leading explanations for schizophrenia?

That people with this disorder are overwhelmed by the stimuli around them. Excessive dopamine floods the brain, leading them to process stimulus information at too high a rate. They are unable to forget or disregard extraneous sensory information, which leads to a process dubbed "hyperlearning." As a result of hyperlearning, people with schizophrenia cannot distinguish between reality and illusion or recognize the barriers between unrelated pieces of information or unrelated experiences.

What does research suggest about auditory hallucinations?

That they actually produce the nerve signals of sound in their brains, "hear" them, and then believe that external sources are responsible. One line of research measured blood flow in Broca's area, the region of the brain that helps people produce speech and found more blood flow in the area while patients were having auditory hallucinations. A related study instructed six men with schizophrenia to press a button whenever they had an auditory hallucination. PET scans revealed increased activity near the surfaces of their brains, in the tissues of the auditory cortex, the brain's hearing center, when they pressed the button.

What does Oliver Sacks book Hallucinations say about sensory distortions?

That they are actually a common part of human experience, and the potential to hallucinate is present in everyone.

Lycanthropy

The delusion of being an animal, is a rare psychological syndrome.

Hallucinations

The experiencing of imagined sights, sounds, or other perceptions in the absence of external stimuli. Sensory perceptions occurring in the absence of external stimuli that become confused with reality. Can occur in any sensory modality. Seems real but occurs in absence of any external perceptual stimulus. Possible causes are: -Disturbances in brain chemistry - neurotransmitter dopamine. Drugs that lead to dopamine production such as cocaine (which can induce them). -Auditory may be a form of inner speech that for unknown reasons because attributed to external sources rather than to one's own thoughts. Auditory stimuli are the most common; voices and sounds that come form outside their heads. Voices that may talk directly to them, giving commands, warning of dangers, or they may just be overheard like a conversation overhead.

Expressed Emotion

The general level of criticism, disapproval, hostility, and intrusiveness expressed in a family. People recovering from schizophrenia are considered more likely to relapse if their families rate high in expressed emotion. People with schizophrenia greatly disrupt family life, in so doing they themselves may help produce the family problems that clinicians and researchers continue to observe.

Decreased Brain Volume - Schizophrenia

The most prominent finding of structural abnormalities is loss of brain tissue (gray matter).

What are sensations and perception like for someone with schizophrenia?

The perceptions and attention of some people with schizophrenia seem to intensify. They may feel that their senses are being flooded by all the sights and sounds that surround them, making it almost impossible for them to attend to anything important. It has been documented in studies that people with schizophrenia have issues with perception and sensory stimuli. They have trouble focusing on one sound when there are multiple noises and sounds accompanying it. They also have demonstrated deficiencies in smooth pursuit eye movements; indicating a weakness that can be related to attention problems. These perception and attention problems might develop years before the onset. The problems could lead to memory impairments.

Heightened Perceptions

The perceptions and attention of some people with the disorder seem to intensify. They may feel their senses are being flooded by all the sights and sounds that surround them. This makes it almost impossible for them to attend to anything important.

Dopamine Hypothesis

The theory that schizophrenia results from excessive activity of the neurotransmitter dopamine. Certain neurons that use the neurotransmitter dopamine (particularly neurons in the striatum region of the brain) fire too often and transmit too many messages, thus producing the symptoms of schizophrenia. This hypothesis has undergone challenges and adjustments in recent years, but it is still the foundation for current biochemical explanations of schizophrenia.

Delusions of Persecution

These are the most common in schizophrenia. People with such delusions believe they are being plotted or discriminated against, spied on, slandered, threatened, attacked, conspired against, or deliberately victimized. Ex: A person believes that their neighbours are trying to irritate them, that other people are trying to harm them, or "The CIA is out to get me."

What do many sociocultural theorists believe about the features of schizophrenia?

They are influenced by the diagnosis itself. Society assigns the label "schizophrenic" to people who fail to conform to certain norms of behavior. Once the label is assigned it becomes a self-fulfilling prophecy that promotes the development of many schizophrenic symptoms.

What have family pedigree studies found repeatedly with schizophrenia and schizophrenia-like brain abnormalities?

They are more common among relatives of people with the disorder. The more closely related the relatives are to the person with schizophrenia, the more likely they are to develop the disorder.

What is it called when both members of a pair of twins have a particular trait?

They are said the be a concordant for that trait.

What do psychodynamic theorists believe about schizophrenia today?

They believe that biological abnormalities leave certain people particularly prone to extreme regression or other unconscious acts that may contribute to schizophrenia.

What do psychodynamic self-theorists believe about schizophrenia?

They believe that schizophrenia reflects a struggling fragmented self, suggest that biological deficiencies explain the failure of people with schizophrenia to develop an integrated self.

Why are African Americans more likely to receive a diagnosis of schizophrenia?

They could be more prone to develop it, or unintentionally biased by majority groups. They are more likely than white Americans to be poor.

What do the parents of people with schizophrenia often exhibit?

They display more conflict, have more difficulty communicating with one another, and are more critical of and overinvolved with their children than other parents

What symptoms to people with schizophrenia experience in between acute episodes?

They may still be unable to think clearly, may speak in a flat tone, may have difficulty perceiving emotions in other people's facial expressions, and mays show little if any facial expressions or emotions themselves.

Residual Phase of Schizophrenia

They return to a prodromal-like level of functioning. They may retain some negative symptoms, such as blunted emotion, but have a lessening of the striking symptoms of the active phase.

Perseveration

Thought disorder found in schizophrenia in which they repeat their words and statements again and again. Repeating the same activity (word or behaviour) over and over again.

When does schizophrenia first appear?

Typically in the person's late teens to mid-thirties.

Visual Hallucinations

Vague perceptions of colors or clouds, or distinct visions of people or objects. Seeing things that aren't there - they may be vague perceptions of colours, shapes, or even very real people/objects that aren't there.

Schizophreniform Disorder

Various psychotic symptoms, such as delusions, hallucinations, disorganized speech, restricted or inappropriate affect, and catatonia. Lifetime prevalence: 0.2% Duration: 1-6 months

Brief Psychotic Disorder

Various psychotic symptoms, such as delusions, hallucinations, disorganized speech, restricted or inappropriate affect, and catatonia. Lifetime prevalence: Unknown Duration: Less than 1 month

What do genetic linkage and molecular biology studies suggest about schizophrenia?

Various studies have identified possible gene defects on chromosomes 1, 2, 6, 8, 10, 13, 15, 18, 20, and 22 and on the X chromosome, each of which may help predispose a person to develop schizophrenia. It is most likely that schizophrenia, like a number of other disorders, is a polygenic disorder, caused by a combination of gene defects.

What do double-bind messages typically consist of?

Verbal communication (the primary communication) and an accompanying—and contradictory—nonverbal communication (the metacommunication). The two messages are incongruent.

Diathesis-Stress Model

Views the development of schizophrenia in terms of an interaction or combination of diathesis or genetic predisposition to develop the disorder, and stressful life factors; especially environmental stress that exceeds the individuals stress threshold or coping resources. Environmental stressors could include psychological factors (family conflict, child abuse, emotional deprivation, abandonment) as well as physical environment influences such as early brain trauma or injury. Believes that biology is only a partial explanation of schizophrenia. -Some people that have biological problems never develop schizophrenia. -Possibility biology sets the stage for the disorder but psychological and sociocultural factors must be present for it to appear. Genetic researchers believe that some people inherit a biological predisposition to schizophrenia. Their disposition (disorder) are triggered by later exposure to extreme stress. The theory has been supported by studies of relatives, twins, adoptees, genetic linkage studies and molecular biology. While biochemical, brain structure and viral findings are beginning to shed light on the mysteries of schizophrenia, they offer only a partial explanation. Several lines of evidence support this model.

Which three types of hallucinations are the least common in schizophrenia?

Visual, gustatory and olfactory.

Command Hallucinations

Voices that instruct them to perform certain acts such as harming themselves or others. A form of auditory hallucination.