Module 43: Schizophrenia and Order Disorders

delusion

a false belief, often of persecution or grandeur, that may accompany psychotic disorders

dissociative identity disorder (DID)

a rare dissociative disorder in which a person exhibits two or more distinct and alternating personalities. Formerly called multiple personality disorder.

fugue state

a sudden loss of memory or change in identity

Last week Tate went into the hospital for a painful medical procedure. Amazingly, he did not seem worried beforehand, and he showed no signs of autonomic nervous system arousal. In addition, Tate seems to lack a conscience for wrongdoing. It is possible that Tate would be diagnosed as having:

antisocial personality disorder

avoidant personality disorder.

anxiety, such as a fearful sensitivity to rejection that predisposes the withdrawn

One of the hallmarks of schizophrenia is disorganized speech. Theorists suggest that people with such disorganized speech may have:

breakdown in selective attention

catatonia

characterized by motor behaviors ranging from a physical stupor—motionless for hours—to senseless, compulsive actions, such as continually rocking or rubbing an arm, to severe and dangerous agitation.

dissociative disorders

controversial, rare disorders in which conscious awareness becomes separated (dissociated) from previous memories, thoughts, and feelings.

A person with positive symptoms of schizophrenia is most likely to experience

delusions

Mr. Harlan incorrectly believes that people are constantly laughing at him and that FBI agents are trying to steal his savings. Mr. Harlan is suffering from _____.

delusions

selective attention

disorganized thinking may be a breakdown

Thirty-year-old Nellie has been diagnosed with schizophrenia. Her selective attention is deficient, she is unable to ignore irrelevant stimuli, and she often gives her undivided attention to minute stimuli such as a spotlight shining in a window. This type of attention problem contributes to:

disorganized thoughts

borderline personality disorder

dramatic or impulsive behaviors, such as the attention-getting

schizotypal personality disorder.

eccentric or odd behaviors, such as the emotionless disengagement

personality disorder

inflexible and enduring behavior patterns that impair social functioning

Dissociative identity disorder is controversial because

it is almost never reported outside North America.

emotional intelligence

lack the ability to understand, manage, and perceive emotions

DID

rarely violent a good and a bad (aggressive side) Dr. Jekyll/Mr. Hyde varies by culture (less prevalent in Britain/India/Japan) an extension of our normal capacity for personality shifts symptoms as ways of coping with anxiety some have it under umbrella of posttraumatic stress disorder 11/12 have severe abuse in childhood

binge-eating disorder

significant binge-eating episodes, followed by distress, disgust, or guilt, but without the compensatory purging or fasting that marks bulimia nervosa 2.8%

flat affect

state of no apparent feeling

psychotic disorder

a group of psychological disorders marked by irrational ideas, distorted perceptions, and a loss of contact with reality

antisocial personality disorder

a personality disorder in which a person (usually a man) exhibits a lack of conscience for wrongdoing, even toward friends and family members; may be aggressive and ruthless or a clever con artist. before age 15 called sociopaths or psychopaths behave impulsively, and then feel and fear little frontal lobes, an area that helps control impulses, displayed reduced activity 11 percent less frontal lobe tissue than normal

schizophrenia

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished, inappropriate emotional expression.

anorexia nervosa

an eating disorder in which a person (usually an adolescent female) maintains a starvation diet despite being significantly underweight; sometimes accompanied by excessive exercise. 9 out of 10 females 0.6%

bulimia nervosa

an eating disorder in which a person alternates binge eating (usually of high-calorie foods) with purging (by vomiting or laxative use) or fasting. late teens/early twenties 1.0%

People with (anorexia nervosa/bulimia nervosa) continue to want to lose weight even when they are underweight. Those with (anorexia nervosa/bulimia nervosa) tend to have weight that fluctuates within or above normal ranges.

anorexia nervosa bulimia nervosa

Mr. James incorrectly believes that people are constantly laughing at him and that FBI agents are trying to steal his savings. Mr. James is suffering from:

delusions

brain abnormalities - dopamine

excess number of dopamine receptors intensify brain signals, creating positive symptoms such as hallucinations and paranoia Drugs that block dopamine receptors often lessen these symptoms. Drugs that increase dopamine levels, such as amphetamines and cocaine, sometimes intensify them

People with schizophrenia may hear voices urging self-destruction, an example of a(n)

hallucination

A personality disorder, such as antisocial personality, is characterized by

inflexible and enduring behavior patterns that impair social functioning.

Risk factors for brain abnormalities in people with schizophrenia include _____, maternal diabetes, older paternal age, and oxygen deprivation during delivery.

low birth weight

risk factors schizophrenia

low birth weight maternal diabetes older paternal age oxygen deprivation during delivery risk of famine/famine

PET scans of murderers' brains have revealed

lower-than-normal activation in the frontal lobes

schizophrenia patients

positive symptoms—the presence of inappropriate behaviors—may experience hallucinations, talk in disorganized and deluded ways, and exhibit inappropriate laughter, tears, or rage. Those with negative symptoms—the absence of appropriate behaviors—may have toneless voices, expressionless faces, or mute and rigid bodies.

narcissistic personality disorder

self-focused and self-inflating

Spencer has been diagnosed with schizophrenia. His parents have a difficult time understanding him because his speech is fragmented and bizarre. He jumps from one idea to another, sometimes within sentences, creating a:

word salad

rates

1 in 100 people schizophrenia 60% men

What factors contribute to the onset and development of schizophrenia?

Biological factors include abnormalities in brain structure and function, prenatal exposure to a maternal virus, and a genetic predisposition to the disorder. However, a high-risk environment, with many environmental triggers, can increase the odds of developing schizophrenia.

Which of the following statements is true of bulimia nervosa?

Bulimia is marked by weight fluctuations within or above normal ranges.

word salad

Jumbled ideas may make no sense even within sentences,

Victor exclaimed, "The weather has been so schizophrenic lately: It's hot one day and freezing the next!" Is this an accurate comparison? Why or why not?

No. Schizophrenia involves the altered perceptions, emotions, and behaviors of a mind split from reality. It does not involve the rapid changes in mood or identity suggested by this comparison.

motor behavior

may also be inappropriate and disruptive

fetal-virus idea YES

middle pregnancy flu epidemic densely popular areas born during winter/spring in utero in fall/winter flu season sick moms with viral infection

People with _____ personality disorder have a tendency to exaggerate their own importance. They do not accept criticism very well and are known to react to it with rage or shame

narcissistic

A person with schizophrenia who has _____ symptoms may have an expressionless face and toneless voice. These symptoms are most common with _____ schizophrenia and are not likely to respond to drug therapy. Those with _____ symptoms are likely to experience delusions and to be diagnosed with _____ schizophrenia, which is much more likely to respond to drug therapy.

negative chronic positive acute

expressed emotions

often utterly inappropriate, split off from reality

impaired theory of mind

they have difficulty reading other people's facial emotions and state of mind

hallucinations

they see, feel, taste, or smell things that exist only in their minds. usually sounds false perceptions

chronic schizophrenia

(also called process schizophrenia) a form of schizophrenia in which symptoms usually appear by late adolescence or early adulthood. As people age, psychotic episodes last longer and recovery periods shorten. - persistent and incapacitating negative symptom of social withdrawal - men average four years earlier than women's, more often exhibit negative symptoms and chronic schizophrenia

acute schizophrenia

(also called reactive schizophrenia) a form of schizophrenia that can begin at any age, frequently occurs in response to an emotionally traumatic event, and has extended recovery periods. -recovery is much more likely - positive symptoms that respond to drug therapy

anatomy

-abnormally low brain activity in the brain's frontal lobes, which help us reason, plan, and solve problems -brain waves that reflect synchronized neural firing in the frontal lobes decline noticeably -increased activity thalamus, the structure that filters incoming sensory signals and transmits them to the brain's cortex -increased activity amygdala, a fear-processing center -shrinkage and thinning of cerebral tissue -odds are at least 1 in 2 that the other twin will have them -greater the brain shrinkage, the more severe the thought disorder -smaller cortex, and the corpus callosum that connects the brain's two hemispheres and thalamus

genes

103 genome locations - effect production of dopamine and myelin (fatty substance that coats the axons of nerve cells and lets impulses travel at high speed )

Some clinicians view dissociative identity disorder as a natural, protective response to traumatic experiences during childhood, making it a form of:

PTSD

The psychodynamic and learning perspectives agree that dissociative identity disorder symptoms are ways of dealing with anxiety. How do their explanations differ?

The psychodynamic explanation of DID symptoms is that they are defenses against anxiety generated by unacceptable urges. The learning perspective attempts to explain these symptoms as behaviors that have been reinforced by relieving anxiety in the past.

Chances for recovery from schizophrenia are best when

onset is sudden, in response to stress.

given supportive environment

over 40 percent of people with schizophrenia will have periods of a year or more of normal life experience. But only 1 in 7 experience a full and enduring recovery