Abnormal Psych- Chapt 12

Negative Symptoms: Poverty of speech

*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

Positive symptoms: Heightened perceptions and hallucinations

*Heightened Perceptions*: -Ppl w/ schizo may feel that their senses are being flooded by all the sights and sounds that surround them. -Laboratory studies repeatedly have found problems of perception and attention among people with schizophrenia -It is also possible that these difficulties further contribute to the memory impairments that are experienced by many individuals with the disorder. *Hallucinations* - Hallucination: The experiencing of imagined sights, sounds, or other perceptions in the absence of external stimuli. -Auditory Hallucinations: most common in schizo. Ppl hear sounds and voices that seem to come from outside their heads. -Research suggests that people with auditory hallucinations actually produce the nerve signals of sound in their brains, "hear" them, and then believe that external sources are responsible. -Hallucinations and delusional ideas often occur together.

The Community Approach- Community treatment failed?

- In fact, in any given year, 40 to 60 percent of all people with schizophrenia and other severe mental disorders receive no treatment at all -Two factors are primarily responsible: poor coordination of services and shortage of services. 1. Poor Coordination of Services- -The various mental health institutions may not properly communicate with each other -There is also a problem with poor communication between state hospitals and community health centers, particularly at times of discharge -*Case manager*: A community therapist who offers a full range of services for people with schizophrenia or other severe disorders, including therapy, advice, medication, guidance, and protection of patients' rights. -Like the social therapists described earlier, they offer therapy and advice, teach problem-solving and social skills, ensure that medications are being taken properly, and keep an eye on possible health care needs. In addition, they try to coordinate available community services, guide clients through the community system, and, perhaps most importantly, help protect clients' legal rights. Many professionals now believe that effective case management is the key to success for a community program. 2. Shortage of Services: -They tend to devote their efforts and money to people with less disabling problems, such as anxiety disorders or problems in social adjustment. -Only a fraction of the patients treated by community mental health centers suffer from schizophrenia or other disorders marked by psychosis -There are various reasons for this shortage of services. Perhaps the primary one is economic -On the other hand, rather little of the additional money is going to community treatment programs for people with severe disorders. Much of it goes instead to prescription drugs, monthly income payments such as social security disability income, services for persons with mental disorders in nursing homes and general hospitals, and community services for people who are less disturbed -Today the financial burden of providing community treatment for persons with long-term severe disorders often falls on local governments and nonprofit organizations rather than the federal or state government, and local resources cannot always meet this challenge.

Psychological Views

-Freud believed that schizo develops from 2 psychological processes: 1. regression to a pre-ego stage 2. efforts to reestablish ego control -people who develop schizophrenia 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. -Their near-total regression leads to self-centered symptoms such as neologisms, loose associations, and delusions of grandeur. -Frieda Fromm-Reichmann thought mothers caused schizo ----*Schizophrenogenic mother*: A type of mother—supposedly cold, domineering, and uninterested in the needs of others—who was once thought to cause schizophrenia in her child. -These views are often rejected

Treatment: Newer antipsychotic drugs

-"atypical" antipsychotic drugs have been developed in recent years (see Table 12-3). The most widely used of these new drugs include clozapine (trade name Clozaril), risperidone (Risperdal), olanzapine (Zyprexa), quetiapine (Seroquel), ziprasidone (Geodon), and aripiprazole (Abilify) -As you have read, the drugs are called atypical because their biological operation differs from that of the conventional antipsychotic medications: the atypicals are received at fewer dopamine D-2 receptors and more D-1, D-4, and serotonin receptors than the others -In fact, atypical antipsychotic drugs appear to be more effective than the conventional drugs -The new drugs reduce not only the positive symptoms of schizophrenia, but also the negative ones -Another major benefit of the atypical antipsychotic drugs is that they cause fewer extrapyramidal symptoms and seem less likely to produce tardive dyskinesia, although some of them produce significant undesired effects of their own

Biological View- Biochemical abnormalities

-*Dopamine hypothesis*-The theory that schizo results from excessive activity of the neurotransmitter dopamine. This is the foundation for current biochemical explanations of schizophrenia -*Antipsychotic drugs*: Drugs that help correct grossly confused or distorted thinking. ---*Phenothiazines:* A group of antihistamine drugs that became the first group of effective antipsychotic medications. ---Researchers soon learned that these early antipsychotic drugs often produce troublesome muscular tremors, symptoms that are identical to the central symptom of Parkinson's disease, a disabling neurological illness ----This undesired reaction to antipsychotic drugs offered the first important clue to the biology of schizophrenia ----Scientists already knew that people who suffer from Parkinson's disease 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 persons with schizophrenia while removing their psychotic symptoms, perhaps the drugs reduce dopamine activity. ---*Atypical antipsychotic drugs:* A relatively new group of antipsychotic drugs whose biological action is different from that of the conventional antipsychotic drugs. ---it may be that schizophrenia is related to abnormal activity or interactions of both dopamine and serotonin and perhaps other neurotransmitters as well, rather than to abnormal dopamine activity alone

Treatment: Antipsychotic drugs effectiveness

-*Extrapyramidal effects*: Unwanted movements, such as severe shaking, bizarre grimaces, twisting of the body, and extreme restlessness, sometimes produced by conventional antipsychotic drugs. ---Most common extrapyramidal effect is Parkinsonian symptoms ---At least half of patients on conventional antipsychotic drugs experience muscle tremors and muscle rigidity at some point in their treatment; they may shake, move slowly, shuffle their feet, and show little facial expression -*Tardive dyskinesia*: Extrapyramidal effects that appear in some patients after they have taken conventional antipsychotic drugs for an extended time. -Patients over 50 years of age seem to be at greater risk. Tardive dyskinesia can be difficult, sometimes impossible, to eliminate -Similarly, today's clinicians try to prescribe the lowest effective dose for each patient and to gradually reduce or even stop medication weeks or months after the patient begins functioning normally

Institutional Care Becomes better- Milieu Therapy

-*Milieu therapy*: A humanistic approach to institutional treatment based on the belief that institutions can help patients recover by creating a climate that promotes self-respect, individual responsible behavior, and meaningful activity. -In such settings, patients are often given the right to run their own lives and make their own decisions. They can take part in community government, working with staff members to set up rules and decide penalties. Patients may also take on special projects, jobs, and recreational activities. -milieu-style programs have been set up in institutions throughout the Western world. The programs vary from setting to setting, but at a minimum staff members try to encourage interactions (especially group interactions) between patients and staff, to keep patients active, and to raise patients' expectations of what they can accomplish. -Research over the years has shown that patients with severe mental disorders in milieu hospital programs often improve and that they leave the hospital at higher rates than patients in programs offering primarily custodial care - Despite its limitations, milieu therapy continues to be practiced in many institutions, often combined with other hospital approaches.

Positive symptoms

-*Symptoms of schizo that seem to be excesses of or bizarre additions to normal thoughts, emotions or behaviors* -Consist of Delusions, disorganized thinking and speech, heightened perceptions and hallucinations

Institutional Care Becomes Better- Token Economy

-*Token economy program:* A behavioral program in which a person's desirable behaviors are reinforced systematically throughout the day by the awarding of tokens that can be exchanged for goods or privileges. -Used principles of operant conditioning -Accept behaviors include: caring for oneself and for one's possessions (making the bed, getting dressed), going to a work program, speaking normally, following ward rules, and showing self-control. -Researchers have found that token economies do help reduce psychotic and related behaviors ---*Problems*--- -One problem is that many token economy studies, unlike Paul and Lentz's, are uncontrolled. When administrators set up a token economy, they usually bring all ward patients into the program rather than dividing the ward into a token economy group and a control group. As a result, patients' improvements can be compared only with their own past behaviors—a comparison that may be misleading. -Token economy programs are no longer as popular as they once were, but they are still used in many mental hospitals, usually along with medication, and in many community residences as well. The approach has also been applied to other clinical problems, including intellectual developmental disorders, delinquency, and hyperactivity, as well as in other fields, such as education and business.

Cognitive explanation

-A leading cognitive explanation of schizophrenia agrees with the biological view that during hallucinations and related perceptual difficulties the brains of people with schizophrenia are actually producing strange and unreal sensations—sensations triggered by biological factors. -According to the cognitive explanation, however, further features of the disorder emerge when the individuals attempt to understand their unusual experiences -In short, according to this theory, people with schizophrenia take a "rational path to madness" -researchers have yet to provide clear, direct support for the cognitive notion that misinterpretations of such sensory problems actually produce a syndrome of schizophrenia.

Negative Symptoms: Restricted affect

-Blunted Affect- Many ppl w/ schizo have this. It is when they show less anger, sadness, joy, and other feelings than most people. -Flat affect: Showing no emotion at all -Their faces are still, their eye contact is poor, and their voices are monotonous. -Sometimes people even have anhedonia which is a general lack of pleasure or enjoyment

Psychotherapy

-By helping to relieve their thought and perceptual disturbances, antipsychotic drugs allow people with schizophrenia to learn about their disorder, participate actively in therapy, think more clearly, and make changes in their behavior. -The most helpful forms of psychotherapy include cognitive-behavioral therapy and two sociocultural interventions—family therapy and social therapy. Often the various approaches are combined.

Psychotherapy- Social Therapy

-Clinicians offer practical advice; work with clients on problem solving, decision making, and social skills; make sure that the clients are taking their medications properly; and may even help them find work, financial assistance, appropriate health care, and proper housing -Research finds that this practical, active, and broad approach, called social therapy or personal therapy, does indeed help keep people out of the hospital

Positive symptoms: Delusions

-Delusions: -*A strange false belief firmly held despite evidence to the contrary.* -Delusions of persecution: re the most common in schizophrenia. People with such delusions believe they are being plotted or discriminated against, spied on, slandered, threatened, attacked, or deliberately victimized. -Delusions of reference: they attach special and personal meaning to the actions of others or to various objects or events. -Delusions of grandeur: believe themselves to be great inventors, religious saviors, or other specially empowered persons. -Delusions of control:believe their feelings, thoughts, and actions are being controlled by other people.

Community Approach- Promise of community treatment

-Despite these serious problems, proper community care has shown great potential for assisting in the recovery from schizophrenia and other severe disorders, and clinicians and many government officials continue to press to make it more available. -In the United States, for example, the National Alliance on Mental Illness began in 1979 with 300 members and has expanded to around 240,000 members in more than 1,200 chapters -Made up largely of families and people affected by severe mental disorders, this group has become not only a source of information, support, and guidance for its members but also a powerful lobbying force in state and national legislatures; additionally, it has pressured community mental health centers to treat more persons with schizophrenia and other severe disorders.

Biological View- Genetic Factors

-Following the principles of the diathesis-stress perspective, 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 -Genetic view has been supported with studies about 1. relatives of people with schizo 2. twins with the disorder 3. people with schizo who are adopted *1. Relatives*- family pedigree studies have found that schizo is more common among relatives of ppl w/ the disorder -more closely the people are related the higher the chances is are of getting it. *2. Twins*- For identical twins: If one twin develops schizo, there is a 48% chance that the other twin will do so as well. For fraternal twins: if one twin develops it then there is only a 17% chance of the other twin getting the disorder *3. The biological roots of the adopted child*- Studies show that it is biological factors that cause schizo, not environmental factors. Researchers looked at the biological history of an adopted child and looked at their environment and it indicated that if the child had biological roots to schizo then they were more likely to develop it.

Institutional care in the past

-For more than half of the twentieth century, most ppl diagnosed with schizo were institutionalized in a mental hospital -Because patients with this disorder failed to respond to traditional therapies, the primary goals of these establishments were to restrain them and give them food, shelter, and clothing. Patients rarely saw therapists and generally were neglected. Many were abused. -Patients were transferred to back wards, or chronic wards, if they failed to improve quickly -The back wards were in fact human warehouses filled with hopelessness. Staff members relied on straitjackets and handcuffs to deal with difficult patients. More "advanced" forms of treatment included medical approaches such as lobotomy.

Institutional Care becomes better

-In the 1950s, clinicians developed two institutional approaches that finally brought some hope to patients who had lived in institutions for years: milieu therapy, based on humanistic principles, and the token economy program, based on behavioral principles. -These approaches particularly helped improve the personal care and self-image of patients, problem areas that had been worsened by institutionalization. The approaches were soon adapted by many institutions and are now standard features of institutional care.

Positive Symptoms: Inappropriate affect

-Inappropriate affect: Display of emotions that are unsuited to the situation; a symptom of schizophrenia. -They may also undergo inappropriate shifts in mood.

Community approach- Consequences of inadequate community treatment

-Many of the people with schizophrenia and other severe disorders return to their families and receive medication and perhaps emotional and financial support, but little else in the way of treatment . -Around 8 percent enter an alternative institution such as a nursing home or rest home, where they receive only custodial care and medication -34 percent of people with severe mental disorders live in totally unsupervised settings. -Finally, a large number of people with severe mental disorders have become homeless.There are between 400,000 and 800,000 homeless people in the United States, and approximately one-third have a severe mental disorder, commonly schizophrenia.

Negative symptoms: Loss of Volition

-Many people with schizophrenia experience avolition, or apathy, feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action -Similarly, individuals with the disorder may display ambivalence, or conflicting feelings, about most things.

Sociocultural Views- Social labeling

-Many sociocultural theorists believe that the features of schizo are influenced by the diagnosis itself. -once the label is assigned to someone, it becomes a self-fulfilling prophecy -Study conducted where 10 normal people selfadmitted themselves into a mental institution claiming they were hearing noises and then after a few days it was impossible to get released from the hospital without the social label

Sociocultural Views- Family dysfunctioning

-Many studies suggest that schizophrenia, like a number of other mental disorders, is often linked to family stress -Parents of people with the disorder often 1. display more conflict, 2. have greater difficulty communicating with one another and 3. are more critical of and overinvolved with their children than other parents -*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. -Individuals who are trying to recover from schizophrenia are almost four times more likely to relapse if they live with such a family than if they live with one low in expressed emotion -most hold a diathesis-stress view of schizophrenia, believing that biological factors set up a predisposition to the disorder, but that certain kinds of personal, family, or social stress are needed for the syndrome to spring to life.

Negative Symptoms

-Negative symptoms: Symptoms of schizophrenia that seem to be deficits of normal thought, emotions, or behaviors. -Consist of: Poverty of speech, restricted affect, loss of volition, and social withdrawl

Psychotherapy- Family Therapy

-Over 50 percent of persons who are recovering from schizophrenia and other severe mental disorders live with their families: parents, siblings, spouses, or children -Generally speaking, persons with schizophrenia who feel positively toward their relatives do better in treatment. - family members may be greatly upset by the social withdrawal and unusual behaviors of a relative with schizo -To address such issues, clinicians now commonly include family therapy in their treatment of schizophrenia, providing family members with guidance, training, practical advice, psychoeducation about the disorder, and emotional support and empathy -Research has found that family therapy—particularly when it is combined with drug therapy—helps reduce tensions within the family and so helps relapse rates go down (

Community Approach- Features of effective community care

-People recovering from schizophrenia and other severe disorders need medication, psychotherapy, help in handling daily responsibilities, guidance in making decisions, training in social skills, residential supervision, and vocational counseling—a combination of services sometimes called *assertive community treatment* -Some of the key features of effective community care programs are (1) coordination of patient services, (2) short-term hospitalization, (3) partial hospitalization, (4) supervised residencies, and (5) occupational training. 1. Coordinated Services: *Community mental health center*: A treatment facility that provides medication, psychotherapy, and emergency care to patients and coordinates treatment in the community. 2. Short-term hospitalization: -When people develop severe psychotic symptoms, today's clinicians first try to treat them on an outpatient basis, usually with a combination of antipsychotic medication and psychotherapy -If this approach fails, short-term hospitalization—in a mental hospital or a general hospital's psychiatric unit—that lasts a few weeks (rather than months or years) may be tried 3. Partial Hospitalization: *Day center*: A program that offers hospital-like treatment during the day only. Also known as a day hospital. -The day centers provide patients with daily supervised activities, therapy, and programs to improve social skills 4. Supervised Residences: *Halfway house:* A residence for people with schizophrenia or other severe problems, often staffed by paraprofessionals. Also known as a group home or crisis house. -The live-in staff usually are paraprofessionals—lay people who receive training and ongoing supervision from outside mental health professionals. -The houses are usually run with a milieu therapy philosophy that emphasizes mutual support, resident responsibility, and self-government. Research indicates that halfway houses help many people recovering from schizophrenia and other severe disorders adjust to community life and avoid rehospitalization 5. Occupational Training and Support: *Sheltered workshop*: A supervised workplace for people who are not yet ready for competitive jobs. -For some, the sheltered workshop becomes a permanent workplace -For others, it is an important step toward better-paying and more demanding employment or a return to a previous job -An alternative work opportunity for individuals with severe psychological disorders is supported employment. Here vocational agencies and counselors help people find competitive jobs in the community and provide psychological support while the individuals are maintaining employment

Positive Symptoms: Disorganized thinking and speech

-People with schizophrenia may not be able to think logically and may speak in peculiar ways -*Formal thought disorder*: A disturbance in the production and organization of thought. -Often they take the form of positive symptoms (pathological excesses), as in loose associations, neologisms, perseveration, and clang. -*Loose associations*: A common thinking disturbance in schizophrenia, characterized by rapid shifts from one topic of conversation to another. Also known as derailment. -Some ppl with schizo use *Neologisms*: made-up words that typically have meaning only to the person using them -Others may display the formal thought disorder of *perseveration,* in which they repeat their words and statements again and again. -Some use *clang*, or rhyme, to think or express themselves.

Negative symptoms: Social withdrawal

-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

Psychomotor symptoms

-Ppl with schizophrenia sometimes experience psychomotor symptoms, for example, awkward movements or repeated grimaces and odd gestures. -*Catatonia*-A pattern of extreme psychomotor symptoms, found in some forms of schizophrenia, which may include catatonic stupor, rigidity, or posturing. -Catatonic stupor: ppl stop responding to their environment, remaining motionless and silent for long stretches of time. -Catatonic rigidity: ppl maintain a rigid, upright posture for hours and resist efforts to be moved -Catatonic posturing: ppl assume awkward, bizarre positions for long periods of time. -Catatonic excitement: a different form of catatonia, move excitedly, sometimes with wild waving of arms and legs.

SocioCultural views- Multicultural factors

-Rates of schizophrenia appear to differ between racial and ethnic groups, particularly between African Americans and white Americans -As many as 2.1 percent of African Americans receive a diagnosis of schizophrenia, compared with 1.0 percent of white Americans -Similarly, studies suggest that African Americans with schizophrenia are overrepresented in state hospitals -It is not clear why African Americans have a higher likelihood than white Americans of receiving this diagnosis. One possibility is that African Americans are more prone to develop the disorder. Another is that clinicians from majority groups are unintentionally biased in their diagnoses of African Americans or misread cultural differences as symptoms of schizophrenia -Blacks and Hispanics tend to be poorer than whites so they are more prone to having it -It also appears that schizophrenia differs from country to country in key ways. ---the course and outcome of the disorder may vary considerably. ---According to a study conducted by the WHO, the 25 million schizo patients who lived in DEVELOPING countries have better recovery rates than schizo patients in western and already DEVELOPED countries ---Some clinical theorists believe that the psychosocial environments of developing countries tend to be more supportive and therapeutic than those of developed countries, leading to more favorable outcomes for people with schizophrenia ---Developing societies have more of a family base and they are less judgmental and critical of people.

Course of Schizo

-Schizophrenia usually first appears between the person's late teens and mid-30s -Although its course varies widely from case to case, many sufferers seem to go through three phases—prodromal, active, and residual -*Prodromal phase*- symptoms are not yet obvious, but the individuals are beginning to deteriorate. They may withdraw socially, speak in vague or odd ways, develop strange ideas, or express little emotion. -*Active Phase*- Symptoms become apparent. Sometimes this phase is triggered by stress or trauma in the person's life -*Residual phase*- they return to a prodromal-like level of functioning. The striking symptoms of the active phase lessen, but some negative symptoms, such as restricted emotions, may remain. -Although one-quarter or more of patients recover completely from schizophrenia, the majority continue to have at least some residual problems for the rest of their lives - Each phase may last for days or for years. A fuller recovery from schizophrenia is more likely in persons who functioned quite well before the disorder (had good premorbid functioning) or whose disorder was triggered by stress, came on abruptly, or developed during middle age. Relapses occur most often during times of life stress. -Many researchers believe that in order to help predict the course of schizophrenia there should be a distinction between so-called Type I and Type II schizophrenia. *Type I Schizo*- are thought to be dominated by positive symptoms, such as delusions, hallucinations, and certain formal thought disorders. Type I patients generally seem to have a better adjustment prior to the disorder, later onset of symptoms, and greater likelihood of improvement *Type II schizo*- Display more negative symptoms, such as restricted affect, poverty of speech, and loss of volition.

Biological views- Viral Problems

-Some investigators suggest that the brain abnormalities may result from exposure to viruses before birth -the virus enters the fetus' brain and interrupts proper brain development or perhaps the virus may remain quiet until puberty or young adulthood -Unusually large numbers of ppl with schizo are born during the winter -winter birth rate among people w/ schizo is 5-8% higher than normal -This could be because there is higher exposure to viruses during that time of year

Treatment- Antipsychotic Drugs

-The antipsychotic drugs developed throughout the 1960s, 1970s, and 1980s are now referred to as "conventional" antipsychotic drugs in order to distinguish them from the "atypical" antipsychotics (also called "second generation" antipsychotic drugs) that have been developed in recent years. ----*neuroleptic drugs*-An alternative term for conventional antipsychotic drugs, so called because they often produce undesired effects similar to the symptoms of neurological disorders.

Schizo Symptoms:

-The symptoms can be grouped into 3 categories: *Positive symptoms*: excesses of thought, emotion and behavior *Negative symptoms*: deficits of thoughts, emotions and behavior *Psychomotor symptoms*: unusual movements and gestures -Some people with schizophrenia are more dominated by positive symptoms and others by negative symptoms, although both kinds of symptoms are typically present. In addition, around half of people with schizophrenia display significant difficulties with memory and other kinds of cognitive functioning

Intro- Schizo

-The symptoms of schizophrenia vary greatly, and so do its triggers, course, and responsiveness to treatment -In fact, a number of clinicians believe that schizophrenia is actually a group of distinct disorders that happen to have some features in common

Psychotherapy- CBT

-The therapists believe that if individuals can be guided to interpret such experiences in a more accurate way, they will not suffer the fear and confusion produced by their delusional misinterpretations -Thus the therapists use a combination of behavioral and cognitive techniques: 1. They provide clients with education and evidence about the biological causes of hallucinations. 2. They help clients learn more about the "comings and goings" of their own hallucinations and delusions. The individuals learn, for example, to track which kinds of situations trigger the voices in their heads. 3. The therapists challenge their clients' inaccurate ideas about the power of their hallucinations, such as their notions that the voices are all-powerful, uncontrollable, and must be obeyed. The therapists also have the clients conduct behavioral experiments to put such notions to the test. 4. The therapists teach clients to more accurately interpret their hallucinations. Clients may, for example, increasingly adopt and apply alternative conclusions such as, "It's not a real voice, it's my illness." 5. The therapists teach clients techniques for coping with their unpleasant sensations (hallucinations). The clients may, for example, learn ways to reduce the physical arousal that accompanies hallucinations—applying special breathing and relaxation techniques or the like. Similarly, they may learn to distract themselves whenever the hallucinations occur -These behavioral and cognitive techniques often help schizophrenic individuals gain a greater sense of control over their hallucinations and reduce their delusional ideas. But they do not eliminate the hallucinations. -*new-wave cognitive-behavioral therapists* believe that the most useful goal of treatment is often to help clients accept their streams of problematic thoughts rather than to judge them, act on them, or try to change them ---therapists try to help clients become detached and comfortable observers of their hallucinations—merely mindful of the unusual sensations and accepting of them—while the individuals otherwise move forward with the events of their lives

Biological View- Abnormal Brain Structure

-Using brain scans, they have found, for example, that many people with schizophrenia have enlarged ventricles—the brain cavities that contain cerebrospinal fluid - In addition to displaying more negative symptoms and fewer positive ones, patients who have enlarged ventricles tend to experience a poorer social adjustment prior to the disorder and greater cognitive disturbances -Enlarged ventricles are actually a sign that nearby parts of the brain haven't developed properly or have been damaged and this might cause schizo -Some studies suggest that ppl with the disorder many also have smaller temporal and frontal loves than other people, smaller gray matter, and most important abnormal blood flow (either reduced or heightened) in certain areas of the brain -Other studies have linked schizo to abnormalities in the hippocampus, amygdala, and thalamus