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Module1: Schizophrenia

Introduction Unlike other disorders, no main symptom of schizophrenia o Patients have combinations of many symptoms Symptoms of Schizophrenia Paranoid o Positive Symptoms: increased presentation in schizophrenics Disorganized o Negative symptoms: decreased presentation in schizophrenics Catatonic Symptoms o Catatonic Symptoms: odd movement behaviours not in response to environment (rigidity) Patient may experience only some of these symptoms; severity varies Positive Symptoms 1. Disorders of thought: train of thought is loosely connected Speech = vague/abstract (ramble) 2. Delusions: irrational belief supported by no external evidence (persecuted by others) Character on TV speaking about/to them Delusion of thought broadcast belief that others can hear ones thoughts Thought withdrawal individuals thoughts being removed from head before thinking Thought insertion thoughts being placed in head by others 3. Hallucinations: perceptions that arent really there Auditory hallucinations: voices in head/ speaking to her from parts of body o Negative things, commenting on behaviour, giving orders Negative Symptoms Point to decrease in engagement with outside world o Less interested in people/events in world, more concerned with internal ideas/fantasies Growing estrangement from family/coworkersneglect in personal appearance Affect: emotional responsiveness o Flat/blunted affect = little emotional response o Inappropriate affect = inappropriate emotional reaction to situation Laughs when speaking about loss of family member Catatonic Behaviour Behaviours unrelated to stimuli (unlike positive & negative symptoms) o Catatonic rigidity/stupor: involve dramatic reduction in movement sometimes cease all movement Individual maintains single posture for long periods of time, resists being moved

Waxy Flexibility : patients arms & legs moved into many position, but moves back to original position very slowly Catatonic Excitement: repeated/stereotyped motor movements = no purpose/ unrelated to environment active/frantic movements

Subtypes of Schizophrenia Paranoid: hallucinations thought/affect/motor behaviour = normal o Paranoid Schizophrenia (John Nash Nobel prize winner a beautiful mind) Dominant symptom = delusion/auditory hallucinations with single theme Thinking = relatively logical Shows anger/anxiety to disturbing delusions Catatonic: strong motor disruption stupor(rigidity); excitement Dominant symptom psychomotor disturbances (catatonic stupor, catatonic excitement, or alteration between the 2) Stereotyped postures or mannerism together with waxy flexibility Disorganized : incoherent thought/speech; disorganized behaviour; social withdrawal; possible motor disturbance marked psychomotor disturbance & social withdrawal Most disruptive schizophrenia thought/speech marked incoherent Loose associations of thought/speech; disorganized behaviour Flat or inappropriate affect Delusions = incoherent/fragmentary Undifferentiated Schizophrenia: cases which dont fit into the 3 other categories Causes of Schizophrenia Diathesis stress hypothesis: genetic predisposition for disorder & environmental stress triggering symptoms o Consistent epidemiological evidence for genetic predisposition Probability individual will develop symptoms increases the more they are related to someone who has disorder Identical twins, more likely than fraternal to both have schizophrenia Adoption studies Schizophrenia more common in biological than adoptive families o Some researchers believe abnormalities in brain structure/changes in levels of neurotransmitters Environmental events triggering schizophrenic symptoms not determined o Stress/problems with relationships with others (especially immediate family) o Higher levels of dysfunction in families of schizophrenics Hard to tell if it was there before or after disorder appeared Treatment of Schizophrenia Many years chronic care (most unbearable disorder if untreated) o Until 1960s many patients long term psychiatric care

o After 1960s effective drug treatments available Pharmacological treatment = most common therapy BUT drugs not equally successful with everyone many drugs have unpleasant side effects o Some people rather experience symptoms than side effects Psychotherapy alone not helpful in treating major symptoms o May help develop new coping strategies once drug relieve symptoms Cognitive behavioural therapy (CBT) taught to think about psychosis in way to better cope o Identify/avoid triggers & learn positive way to react to triggers o Encourages compliance with meds through rewarding o Addresses environmental factors that may trigger illness o Family therapy teaches family how to be positive/supportive Educates about schizophrenia & teaches how to react to it

Module2: Dissociative Disorders


Introduction Historically confused with schizophrenia Symptomsdistance individual (physically/psychologically from anxiety producing events) Dissociative Identity Disorder Formally known as multiple personality disorder Single individual has many distinct personalities/alters At any time, one alter dominates persons behaviour o The personality that comes in for treatment knows nothing of the other alters o Other alters know main personality and about each other Alters differ from each other age, sex, race, ethnicity, hair styles, music/clothes taste vocab o Different IQ, allergies, reactions to drugs Alters only come one at a time Dissociative Identity Disorder & Sexual Abuse Caused childhood trauma clinical attention o Begins in childhood (generally before 9 years) majority = females Alters = response to traumatic incidents shields main personality from trauma o Memory of abuse gone; segregated into separate personalities/memories of alters Controversy might not be produced by childhood trauma o Produced by coaxing of well intentioned therapists eager to help find alters Memories implanted through suggestion

Module 3: Personality Disorders


Introduction Differ from schizophrenia and dissociative disorders others had specific set of symptoms added to personality

o Symptoms may change behaviour/thought rest of personality = unchanged Personality disorders no specific symptoms o Individuals basic personality leads to maladaptive behaviours/thoughts Difficult to function with others Axis 1 of DSM schizophrenia & dissociative disorders Axis 2 of DSM Personality disorders (& development disordersautism & learning disabilities) Personality Disorders have 3 clusters 1. Odd & eccentric cluster (symptoms similar to schizophrenia) 2. Anxious and fearful cluster (symptoms similar to anxiety disorders) 3. Dramatic and erratic cluster (more unique symptoms)

Antisocial Personality Disorder (psychopathic personality) Misunderstood from movies/TV/newspaper killer Majority not murderers **history of erratic & irresponsible behaviours** o Begin in childhood/early teens & continue to adulthood o Child frequent liar, truant from school, thief o Adult dont honour financial obligations (bills/debt) o Employee late to work/ drunk when shows up Selfish & self-centered trouble postponing satisfaction/ planning ahead o Will manipulate/mistreat others to get what he wants, Aggressive, abusive o Trouble keeping jobs/close relationships with others, sexually promiscuous o Outgoing, sensation seeker, likes risks not concerned about safety of others/himself Evidence for criminality/anti social behaviour running in families o Hutchings & Mednick (1977) o Adopted child with criminal record higher chance if biological father had criminal record than adoptive father o Family disruption (divorce, desertion) more frequent in APD than in population Biological model changes inbrain function o Brain of antisocial individual = under aroused o Sensation seeking/anti social behaviour = ways of bringing level of brain arousal back to normal (portrayed on EEGs) Psychodynamic model lacks adequate superego (abnormal resolution of Oedipus complex) o No treatment has been found to be consistently successful very resistant to reform Borderline Personality Disorder Unstable/changeable emotions/behaviours o Jackie has small disagreement with best friend, now never wants to talk to her again Frequent mood changes irritable, sarcastic, angered easily, unpredictable o Unstable view of self & insecure o Want lots of attention; dont want to be alone o Self damage; high risk of suicide

Gambling, random sexual activity, spending sprees

Histrionic Personality Disorder Personality disorder usually diagnosed with BPD o Attention seeker, overly dramatic, self-centered, shallow, obsessed with attractiveness High rates of depression, poor physical health Narcissistic Personality Disorder full of themselves Obsessed with superiority/uniqueness; thinks shes perfect & demands respect because everyone is beneath her o Relationship difficulties only dates people who admires her a lot, then convinced theyre not good enough for her o Job security issues cant stand criticism, quits if boss suggest change in work o Frustrated that people dont recognize superiority blames it for inability to have steady relationship/job * Events leading to behaviour does not = personality disorder; must be inherent personality

Module 4: Conclusion
Introduction Psychological disorder is not fixed entity that can be easily identified & which you either have or dont Mental disorder = set of symptoms which we give common name o Not all symptoms appear in all cases; some may be more intense form person to person o No crisp line distinguishing normal from abnormal or healthy from pathological o symptoms shade almost unnoticeably from pathological to normal