Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
Schizophrenia Spectrum
o John Haslam – superintendent of a British
Hospital who outlined a description of the
symptoms of Schizophrenia in his book
Observations on Madness and Melancholy
o Philippe Pinel – French physician who
described cases of schizophrenia
o Benedict Morel – used the term demence
precoce meaning early or premature loss of
mind to describe schizophrenia
o Emil Kraepelin – unified the distinct categories
of schizophrenia under the name Dementia
Praecox
▪ Combined several symptoms of insanity that
had usually been viewed as reflecting
separate and distinct disorders:
a. Catatonia – alternating immobility and
excited agitation
b. Hebephrenia – silly and immature
emotionality
c. Paranoia – delusions of grandeur or
persecution
▪ Distinguished dementia praecox
▪ Also noted the numerous symptoms in
people with dementia praecox, including
hallucinations, delusions, negativism, and
stereotyped behavior
o Eugen Bleuler – introduced the term
schizophrenia (“splitting of mind”)
▪ Associative Splitting
o Positive Symptoms:
1. Delusions – misrepresentation of reality
(disorder of thought content)
▪ Persecutory – belief that one is going to be
harmed, harassed and so forth
▪ Referential – certain gestures, comments,
environmental cues, and so forth are
directed at one-self)
▪ Grandiose – when an individual believes that
he or she has exceptional abilities, wealth,
or fame
▪ Erotomanic – when an individual believes
falsely that another person is in love with
him or her
▪ Nihilistic – conviction that a major
catastrophe will occur
▪ Somatic – focus on preoccupations
regarding health and organ function
▪ Thought Withdrawal – thoughts have been
“removed” by outside force
▪ Thought Insertion – thoughts have been put
into one’s mind
▪ Delusions of Control – one’s body or actions
are being acted on or manipulated by some
outside force
▪ Capgras Syndrome – person believes
someone he or she knows has been
replaced by a double
▪ Cotard’s Syndrome – the person believes he
or she is dead
▪ Clerambault Syndrome - characterized by
the delusional idea, usually in a young
woman, that a man whom she considers to
be of higher social and/or professional
standing is in love with her
▪ Fregoli Syndrome – a person holds a
delusional belief that different people are in
fact a single person who changes his or her
appearance or is in disguise
▪ Motivational View of Delusions – look at
these beliefs as attempts to deal with and
relieve anxiety and stress
▪ Deficit View of Delusions – sees these
beliefs as a resulting from brain dysfunction
that creates these disordered cognitions or
perceptions
2. Hallucinations – experience of sensory
events without any input from the
surrounding environment
▪ Auditory Hallucination – most common form
experienced by people with schizophrenia
▪ Most active part during Hallucination is
Broca’s Area (speech production)
▪ Autoscopic Hallucination - individual
experiences, all or part of the person's own
body appeared within the external space,
viewed from his/her physical body
▪ Hypnagogic Hallucination – happens during
sleep
▪ Ictal Hallucination – associated with
temporal lobe foci
▪ Hypnopompic Hallucinations – happens
when waking up
o Negative Symptoms – usually indicate absence
or insufficiency of normal behavior
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
a. Avolition – inability to initiate and persist messages, which cased schizophrenia to
activities develop
b. Anhedonia – lack of pleasure o Families with high expressed emotion view the
c. Asociality – lack of interest in social symptoms of schizophrenia as controllable and
interactions that the hostility arises when family members
d. Flat Affect/Affective Flattening – do not think that patients just do not want help
show emotions when you would normally themselves
expect them to o Treatment: Individual, Group and Family
o Disorganized Symptoms Therapy, Social Skills Trainings, Neuroleptic
1. Disorganized Speech – individual may Medications
switch from one topic to another (derailment Delusional Disorder, Brief Psychotic Disorder,
or loose associations) or answers to Schizophreniform Disorder
questions may be related or completely
unrelated (tangentiality)
▪ Word Salad
▪ Clang associations – are groups of words
chosen because of the catchy way they
sound, not because of what they mean
2. Inappropriate Affect – laughing or crying at
improper times
3. Grossly Disorganized or abnormal motor
behavior – childlike silliness to
unpredictable agitation o Persistent belief that is contrary to reality in the
o Neologisms – construction of new words in absence of other characteristics of
order to communicate with schizophrenics schizophrenia
thoughts o Persistent delusion that is not result of brain
o More severe symptoms of schizophrenia first seizures or of any severe psychosis
occur in late adolescence or early adulthood o Tend not to have flat affect, anhedonia, or other
o Prodromal Stage – 1-2 year period before the negative symptoms
serious symptoms occur but when less severe o Socially isolated due to being suspicious
yet unusual behaviors start to show o Shared Psychotic Disorder (Folie a deux) –
themselves condition in which an individual develops
o Schizophrenia is partially the result of delusions simply as a result of a close
excessive stimulation of striatal dopamine d2 relationship with a delusional individual
receptors o Subtypes:
o It appears that several brain sites are a. Erotomanic
implicated in the cognitive dysfunction b. Grandiose
observed among people with schizophrenia, c. Jealous
especially prefrontal cortex, various related d. Persecutory
cortical regions and subcortical circuits, e. Somatic
including thalamus and the striatum f. Mixed
o Schizophrenogenic Mother – used for a time to g. Unspecified
describe a mother whose cold, dominant, and o Specifiers:
rejecting nature was thought to cause ▪ With bizarre content
schizophrenia in her children ▪ First episode, currently in acute episode
o Double bind communication – used to portray ▪ First episode, currently in partial remission
communication style that produced conflicting ▪ First episode, currently in full remission
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
▪ Continuous
▪ Current severity
o Global functioning is generally better than that
observed in Schizophrenia
o Proportion of individuals go on to develop
schizophrenia
o Prevalent in older individuals
o Delusional Disorder can be distinguished from
Schizophrenia and Schizophreniform by the
absence of other symptoms of active phase of
schizophrenia
o Delusions in Schizophrenia show greater
disorganization , whereas in Delusional
Disorder, they show greater conviction, greater
extension, and greater pressure o Specifiers:
o If delusions occur exclusively during mood ▪ With Good Prognostic Features
episodes, the diagnosis is MDD or BD, with ▪ Without Good Prognostic Features
psychotic features ▪ With Catatonia
o Delusional Disorder can be diagnosed only in ▪ Current Severity
the total duration of all mood episodes remains o Some people who experience the symptoms of
brief relative to the total duration of the schizophrenia for a few months only
delusional disturbance o Development similar to schizophrenia
Schizophrenia, Schizoaffective Disorder

o Presence of one or more positive symptoms

lasting a month or less
o May appear in adolescence or early adulthood
o Requires a full remission of all symptoms and
eventual full return to the premorbid level of
functioning within 1 month of the onset
o Can experience relapse
o If psychotic symptoms persist for at least 1 day
in PD, an additional diagnosis of Brief Psychotic
Disorder may be appropriate
o Specifiers:
▪ First episode, currently in acute episode
▪ First episode, currently in partial remission
▪ First episode, currently in full remission
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
▪ Continuous Catatonia
▪ With catatonia
▪ Current severity
o Emerge between the late teens and the mid-
30s
o Onset prior to adolescence is rare
o Abrupt or Insidious
o Prognosis is influenced both by duration and by
severity of illness and gender
o Course and outcome in schizophrenia are
heterogeneous, and prognosis is uncertain at
the onset of psychosis
o There is a tendency for reduced psychotic
experience during late life
o Cognitive impairment and negative symptom Neurodevelopmental Disorders
pathology are core features of schizophrenia Intellectual Developmental Disorder, Global
o The essential features of schizophrenia are the Developmental Delay
same in childhood, but it is more difficult to
make diagnosis
o Late-onset cases are overrepresented by
women, who may have married

o Evident in childhood as significantly below-

o Specifiers:
▪ Bipolar Type
▪ Depressive Type
▪ First episode, currently in acute episode
▪ First episode, currently in partial remission
▪ First episode, currently in full remission
▪ Continuous
▪ With Catatonia
▪ Current Severity
o Typical onset is early adulthood
o Some individuals will have a change in
diagnosis from schizoaffective disorder to a
mood disorder or to schizophrenia over time
average intellectual and adaptive functioning
o Difficulties with day-to-day activities to an
extent that reflects both severity of their
cognitive deficits and the type and amount of
assistance they receive
o Difficulties in conceptual, social, and judgment
o Causes: deprivation, abuse, neglect, exposure
to disease or drugs during pre-natal,
difficulties during labor and delivery, infections
and head injury
o Phenylketonuria, Lesch-Nyhan Syndrome,
Down Syndrome, Fragile X Syndrome
o Onset: developmental period
o Although IDD is generally nonprogressive, in
certain genetic disorders there are periods of
worsening, followed by stabilization, and in
others progressive worsening of intellectual
function in varying degrees
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
o Generally lifelong, although severity changes o Children’s progression in mastering speech
over time sound production should result in most
o Major Neurocognitive Disorder may co-occur intelligible speech by age 3 years
with IDD o Continue to use immature phonological
simplification processes past the age when
most children can produce words clearly
o Respond well to treatment, and speech
difficulties improve over time
o When LD is also present, Speech Disorder has
poorer prognosis and may be associated with
SLD
Language Disorder, Speech Sound Disorder, o Selective Mutism may develop in children with
Childhood-Onset Fluency Disorder, Social Speech Disorder because of their
Communication Disorder embarrassment about their impairments, but
many children with SM exhibit normal speech
in “safe” settings

o Emerges during early developmental period

o Regional, social, or cultural/ethnic variations
must be considered when an individual is being
assessed for Language Impairment
o Definitive diagnosis of IDD may not be made
o Occurs by age 6 for 80%-90% of affected
until the child is able to complete standardized
individuals, with age at onset ranging from 2 to
assessments
7 years
o Declines in critical social and communication
o Can be insidious or more sudden
behavior during the first 2 years of life are
o When the speech dysfluencies are in excess of
evident in most children presenting with ASD
those usually associated with these problems,
and should signal the need for ASD assessment a diagnosis of childhood-onset fluency disorder
may be made
o Slower reading rates may not accurately
reflect the actual reading ability of children who
stutter

Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
o Rare among children younger than 4 years
o A diagnosis of social (pragmatic)
communication disorder should be considered
only if the current symptoms or developmental
history fails to reveal evidence of symptoms
that meet the diagnostic criteria for
restricted/repetitive patterns of behavior,
interests, or activities of ASD
o A separate diagnosis of SCD in IDD or GDD
unless social communication deficits are
clearly excess of intellectual limitations
Autism Spectrum Disorder
Abnormal Psychology
o Specifiers:
▪ Current severity
▪ With or without accompanying intellectual
impairment
▪ With or without accompanying language
impairment
▪ Associated with a known genetic or other
medical condition or environmental factor
▪ Associated with a neurodevelopmental,
mental, or behavioral problem
▪ With catatonia
o First become evident in early childhood, with
some cases presenting a lack of interest in
social interaction in the first year of life
o Symptoms recognized during the second year
of life
o Two major characteristics:
✓ Impairments in social communication and
social interaction
▪ Failure to develop age-appropriate social
relationships
▪ Problems with social reciprocity, nonverbal
communication, and initiating and
maintaining social relationships
▪ Inability to engage in Joint Attention
✓ Restricted, repetitive patterns of behavior,
interests, or activities
▪ Extremely upset about small changes
(maintenance of sameness)
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
o Associated with declines in critical social and Attention-Deficit/Hyperactivity Disorder
communication behaviors in the first 2 years of
life
o Not degenerative disorder, and it is typical for
learning and compensation to continue
throughout life
o Individuals with lower levels of impairment
may be better able to function independently
o The developmental course and absence of
restrictive, repetitive behaviors and unusual
interests in ADHD help in differentiating ASD
and ADHD
o A concurrent diagnosis of ADHD should be
considered when attentional difficulties or
hyperactivity exceeds that typically seen in
individuals of comparable amental age
o ADHD is one of the most common comorbidities
in ASD
o A diagnosis of ASD in individual with IDD is
appropriate when social communication and
interaction are significantly impaired relative to
the developmental level of the individual’s
nonverbal skills
o IDD is appropriate diagnosis when there is no
apparent discrepancy between the level of
social communicative skills and other
intellectual skills
o The diagnosis of ASD supersedes that of social
communication disorder whenever the criteria
for ASD are met, and care should be taken to
enquire carefully regarding past or current
restricted/repetitive behavior
o Rett Disorder – genetic condition that affects
mostly females and is characterized by hand
wringing and poor coordination
o Clear genetic component
o Evidence of brain damage combined with
psychosocial influences
o Treatment: Behavioral Focus, Inclusive
Schooling, Medication

o Difficulty in sustaining their attention on a task

or activity
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
o Hereditary, abnormal neurology, maternal
smoking, negative responses by others
creating low self-esteem
o Most often identified during elementary school
years when inattention becomes more
prominent and impairing
o In preschool, the main manifestation is
hyperactivity
o IED may be diagnosed in the presence of ADHD
o Fidgetiness and restlessness in ADHD are
typically generalized and not characterized by
repetitive stereotypic movements o The course of developmental coordination
o A diagnosis of ADHD in IDD requires that disorder is variable but stable at least to 1-year
inattention or hyperactivity be excessive for and 2-year follow-up
mental age o Onset: early childhood
Specific Learning Disorder o If criteria for both ADHD and DCD are met, both
can be given

o Begins within the first 3 years of life

o Onset of complex motor stereotypies may be in
infancy or later in the developmental period

o Performance that is substantially below what

would be expected given the person’s age, IQ
score, and education
o There are genes that affect learning, and they
may contribute to problems across domains
o Treatment: Education Intervention
Developmental Coordination Disorder, Stereotypic
Movement Disorder, Tic Disorders
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
Neurocognitive Disorders
Delirium

o Characterized by impaired consciousness and

cognition during the course of several hours or
days
o Appear confused, disoriented, and out of touch
with their surroundings
o Prevalent among older adults
o Effects may be more lasting
o Can be brought by improper use of medication
o May be experienced by children who have high
fevers or who are taking certain medication
o Tic – sudden, rapid, recurrent, non-rhythmic
o Often occurs during the course of dementia
motor movement or vocalization
o Have full recovery with or without treatment,
o Tourette’s – both multiple motor and one or
especially those who are not elderly
more vocal tics (more than 1 year)
o Treatment: Psychosocial Intervention,
o Persistent – single or multiple motor or vocal
Benzodiazepines, Antipsychotics
tics but not both (more than 1 year)
Major and Mild Neurocognitive Disorders
o Provisional – single or multiple motor and/or
vocal tics (less than 1 year)
o onset: typically between ages 4 and 6 years
o Motor Stereotypies are defined as involuntary
rhythmic, repetitive, predictable movements
that appear purposeful but serve no obvious
adaptive function; often self-soothing or
pleasurable and stop with distraction
o Chorea – rapid, random, continual, abrupt,
irregular, unpredictable, nonstereotyped
actions that are usually bilateral and affect all
parts of the body
o Dystonia – simultaneous sustained contraction
of both agonist and antagonist muscles,
resulting in a distorted posture or movements
of the parts of the body

Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
o Gradual deterioration of brain functioning that
affects memory, judgment, language, and other
advanced cognitive process
o Created to focus attention on the early stages
of cognitive decline; modest impairments in
cognitive abilities but can, with some
accommodations
Neurocognitive Disorder due to…
A. Alzheimer’s Disease – most common type of
neurocognitive disorder, usually occurring
after the age 65, marked most prominently by
memory impairment
▪ Usually begins with mild memory problems,
lapses of attention, and difficulties in
language and communication
▪ Excessive senile plaques (sphere-shaped
deposits of beta-amyloid protein that form in
the spaces between certain neurons and in
certain blood vessels of the brain as people
age) and neurofibrillary tangles (twisted
protein fibers that form within certain
neurons)
Abnormal Psychology
▪ Creutzfeldt-Jakob disease – known to be
caused by slow-acting virus
B. Vascular Injury
C. Frontotemporal Degeneration – Pick’s Disease,
rare disorder that affects the frontal and
temporal lobe
D. Traumatic Brain Injury
E. Lewy Body Disease – involves the build up of
clumps of protein deposits called Lewy Bodies,
within many neurons
▪ Features significant movement difficulties,
visual hallucinations, and sleep
disturbances
▪ Second most common neurocognitive
disorder
F. Parkinson’s Disease – slowly progressive
neurological disorder marked by tremors,
rigidity, and unsteadiness
G. HIV infection
H. Substance-Use
I. Huntington’s Disease – inherited progressive
disease in which memory problems, along with
personality changes and mood difficulties,
worsen over time
▪ Have movement problems too, such as
severe twitching and spasms
J. Prion Disease – Creutzfeldt-Jakob Disease,
symptoms include spasms of the body caused
by slow acting virus that may live in the body
for years before the disease develops
K. Another Medical Condition
Causes and Treatment
o Smokers are less likely than nonsmokers to
develop Alzheimer’s because nonsmokers
tends to live longer
o Some genes that are now identified are
deterministic – if you have one of these genes
you have nearly 100% chance of developing
Alzheimer’s disease
o No cure so far……
Dementia
o Dementia – describe a group of symptoms
affecting memory, thinking, and social abilities
severely enough to interfere daily life
a. Alzheimer’s Disease – most common cause of
dementia
▪ Have beta-amyloid plaques and fibrous
tangles made up of tau proteins
 Abnormal Psychology
Phase 5: Schizophrenia, Neurodevelopmental &
Neurocognitive Disorders
Source: Barlow, Durand & Hofmann (2018), Comer & Comer (2017), DSM-V, DSM-V-TR
▪ Apraxia, Anomia, Amnesia, Agnosia, Aphasia
b. Vascular Dementia – caused by damage to the
vessels supplying blood to the brain
▪ Difficulties with problem-solving, slowed
thinking, and loss of focus and organization
c. Lewy Body Dementia – abnormal balloonlike
clumps of protein that have been found in the
brains of people
▪ Acting out one’s dreams in sleep, visual
hallucinations, problems with attention and
focus, uncoordinated movement, tremors,
rigidity
d. Frontotemporal Dementia – breakdown of
nerve cells and their connections in the frontal
and temporal lobes of the brain
e. Mixed Dementia
f. Huntington’s Disease
g. Creutzfeldt-Jakob Disease
h. Parkinson’s Disease
end