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Understanding Schizophrenia: Symptoms, Diagnosis, and Subtypes, Exercises of Abnormal Psychology

An in-depth exploration of schizophrenia, a psychotic disorder characterized by changes in thinking, feeling, and behavior. Learn about the most common symptoms, positive and negative, and their impact on various aspects of a person's life. Discover the different subtypes of schizophrenia, including catatonic, disorganized, undifferentiated, residual, and schizoaffective disorder.

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Abnormal Psychology – PSY404 VU
©Copyright Virtual University of Pakistan
180
LESSON 38
SCHIZOPHRENIA I
Schizophrenia is a psychotic disorder. The most common symptoms of schizophrenia include changes
in the way a person thinks, feels, and relates to other people and environment. Psychosis is a state in
which individuals lose contact with reality. It frequently appears in the form of schizophrenia, a
disorder in which previously adaptive levels of social, personal, and occupational functioning deteriorate
into distorted perceptions, disturbed thought processes, deviant emotional states, and motor
abnormalities. Approximately 1 percent of the world's population suffers from this disorder. Many
clinicians believe that schizophrenia is a group of distinct disorders that share some common feature
1- Loss of contact with reality.
2- Deterioration at social, personal, and occupational level of functioning.
3-Distorted perceptions, disturbed thought processes, deviant emotional states, and motor
abnormalities.
4- Delusions defined as false beliefs based on incorrect inferences about reality.
5- Hallucinations are sensory experiences that are not caused by actual external stimuli.
Examples
i) Mr. A was first hospitalized for hearing voices ten years ago when he was in senior school. His
medications have now seemed to prevent his bizarre beliefs and odd behavior but he has never been
able to stay at school or work.
ii) Mr. B had his first psychotic episode during college, he manifested paranoid delusions that his mind
was controlled by forces that broadcast to him through radio waves and that he was sure that there was
a plot to kill him.
iii) A homeless woman collects empty bottles, cans and cartons from trash and last week she set up a
camp under a tree and spent days there. Regardless of the weather she wears in layers all the clothing
she possesses.
iv) A student reported to the department chairperson that one of her professors is plotting against her,
all the students are after her and the university doctor has plans to kill her.
These are all examples of people suffering from Schizophrenia.
Is Schizophrenia a disease like diabetes?
Or some overwhelming stress leads to Schizophrenia?
Do Schizophrenic people perceive and experience reality differently?
Can Schizophrenia be cured?
Why study Schizophrenia?
The answer to all these questions is complex and difficult.
The most common symptoms of schizophrenia include changes in the way a person thinks, feels,
and relates to other people and the outside environment.
No single symptom or specific set of symptoms is characteristic of all schizophrenic patients.
Schizophrenia is officially defined by various combinations of psychotic symptoms in the absence
of other forms of disturbance, such as mood disorders (especially manic episodes), substance
dependence, delirium, or dementia.
Is Schizophrenia a disease like diabetes?
Schizophrenia is a devastating disorder for both the patients and their families.
It can disrupt many aspects of the person’s life, well beyond the experience of psychotic symptoms.
Why study Schizophrenia?
Schizophrenia also has an enormous impact on society.
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LESSON 38

SCHIZOPHRENIA I

Schizophrenia is a psychotic disorder. The most common symptoms of schizophrenia include changes in the way a person thinks, feels, and relates to other people and environment. Psychosis is a state in which individuals lose contact with reality. It frequently appears in the form of schizophrenia, a disorder in which previously adaptive levels of social, personal, and occupational functioning deteriorate into distorted perceptions, disturbed thought processes, deviant emotional states, and motor abnormalities. Approximately 1 percent of the world's population suffers from this disorder. Many clinicians believe that schizophrenia is a group of distinct disorders that share some common feature 1- Loss of contact with reality. 2- Deterioration at social, personal, and occupational level of functioning. 3-Distorted perceptions, disturbed thought processes, deviant emotional states, and motor abnormalities. 4- Delusions defined as false beliefs based on incorrect inferences about reality. 5- Hallucinations are sensory experiences that are not caused by actual external stimuli.

Examples i) Mr. A was first hospitalized for hearing voices ten years ago when he was in senior school. His medications have now seemed to prevent his bizarre beliefs and odd behavior but he has never been able to stay at school or work. ii) Mr. B had his first psychotic episode during college, he manifested paranoid delusions that his mind was controlled by forces that broadcast to him through radio waves and that he was sure that there was a plot to kill him. iii) A homeless woman collects empty bottles, cans and cartons from trash and last week she set up a camp under a tree and spent days there. Regardless of the weather she wears in layers all the clothing she possesses. iv) A student reported to the department chairperson that one of her professors is plotting against her, all the students are after her and the university doctor has plans to kill her. These are all examples of people suffering from Schizophrenia.

  • Is Schizophrenia a disease like diabetes?
  • Or some overwhelming stress leads to Schizophrenia?
  • Do Schizophrenic people perceive and experience reality differently?
  • Can Schizophrenia be cured?
  • Why study Schizophrenia?

The answer to all these questions is complex and difficult.

  • The most common symptoms of schizophrenia include changes in the way a person thinks, feels, and relates to other people and the outside environment.
  • No single symptom or specific set of symptoms is characteristic of all schizophrenic patients.
  • Schizophrenia is officially defined by various combinations of psychotic symptoms in the absence of other forms of disturbance, such as mood disorders (especially manic episodes), substance dependence, delirium, or dementia.

Is Schizophrenia a disease like diabetes?

  • Schizophrenia is a devastating disorder for both the patients and their families.
  • It can disrupt many aspects of the person’s life, well beyond the experience of psychotic symptoms.

Why study Schizophrenia?

• Schizophrenia also has an enormous impact on society. docsity.com

  • Among mental disorders, it is the second leading cause of disease burden.
  • The onset of schizophrenia typically occurs during adolescence or early adulthood.
  • The period of risk for the development of a first episode is considered to be between the ages of 15 and 35.

The problems of most patients can be divided into three phases of variable and unpredictable duration: prodromal, active, and residual.

1- Prodromal Phase

  • The prodromal phase precedes the active phase and is marked by an obvious deterioration in role functioning as a student, employee, or homemaker.
  • Prodromal signs and symptoms are similar to those associated with schizotypal personality disorder. They include peculiar behaviors (such as talking to one’s self in public), unusual perceptual experiences, outbursts of anger, increased tension, and restlessness.
  • Social withdrawal, indecisiveness, and lack of willpower are often seen during the prodromal phase.
  • Symptoms such as hallucinations, delusions, and disorganized speech are characteristic of the active phase of the disorder.

2- Residual Phase

  • The residual phase follows the active phase of the disorder and is defined by signs and symptoms that are similar in many respects to those seen during the prodromal phase.
  • At this point, the most dramatic symptoms of psychosis have improved, but the person continues to be impaired in various ways.
  • The symptoms of schizophrenia can be divided into three dimensions: positive symptoms, negative symptoms, and disorganization.

a) Positive symptoms, also called psychotic symptoms.

  • They are active manifestations of abnormal behaviors or an excess or distortion of normal behavior include hallucinations and delusions.
  • The symptoms of schizophrenia can be divided into three dimensions: positive symptoms, negative symptoms, and disorganization.
  • Positive symptoms are characterized by the presence of an aberrant response (such as hearing a voice that is not really there).

b) Negative symptoms , on the other hand, are characterized by the absence of a particular response (such as emotion, speech, or willpower).

  • Hallucinations are sensory experiences that are not caused by actual external stimuli.
  • Although hallucinations can occur in any of the senses, those experienced by schizophrenic patients are most often auditory.
  • Hallucinations should be distinguished from the transient mistaken perceptions that most people experience from time to time.
  • Hallucinations strike the person as being real, in spite of the fact that they have no basis in reality.
  • They are also persistent over time.
  • Many schizophrenic patients express delusions, or idiosyncratic beliefs that are rigidly held in spite of their preposterous nature.
  • Delusions have sometimes been defined as false beliefs based on incorrect inferences about reality.
  • This definition has a number of problems, including the difficulty of establishing the ultimate truth of many situations.
  • In the most obvious cases, delusional patients express and defend their beliefs with utmost conviction, even when presented with contradictory evidence.
  • Delusional patients typically are unable to consider the perspective that other people hold with

regard to their beliefs. docsity.com

  • Catatonia most often refers to immobility and marked muscular rigidity, but it can also refer to excitement and overactivity.
  • Catatonic posturing is often associated with a stuporous state, or generally reduced responsiveness.
  • Another kind of bizarre behavior involves affective responses that are obviously inconsistent with the person’s situation.
  • The most remarkable features of inappropriate affect are incongruity and lack of adaptability in emotional expression.

Brief Historical Perspective

  • Descriptions of schizophrenic symptoms can be traced far back in history, but they were not considered to be symptoms of a single disorder until late in the nineteenth century.
  • At that time, Emil Kraepelin, a German psychiatrist, suggested that several types of problems that previously had been classified as distinct forms of disorder should be grouped together under a

single diagnostic category called dementia praecox.

  • This term referred to psychoses that ended in severe intellectual deterioration (dementia) and that had an early or premature (praecox) onset, usually during adolescence.
  • Kraepelin argued that these patients could be distinguished from those suffering from other disorders (most notably manic–depressive psychosis) largely on the basis of changes that occurred as the disorder progressed over time, primarily those changes involving the integrity of mental functions.
  • In 1911, Eugen Bleuler published an influential monograph in which he agreed with most of Kraepelin’s suggestions about this disorder.
  • He did not believe, however, that the disorder always ended in profound deterioration or that it always began in late adolescence.
  • Kraepelin’s term dementia praecox was, therefore, unacceptable to him.
  • Bleuler suggested a new name for the disorder— schizophrenia.
  • This term referred to the splitting of mental associations, which Bleuler believed to be the fundamental disturbance in schizophrenia.
  • DSM-IV-TR lists several specific criteria for schizophrenia.
  • The first requirement (Criterion A) is that the patient must exhibit two (or more) active symptoms for at least 1 month.
  • The DSM-IV-TR definition also takes into account social and occupational functioning as well as the duration of the disorder (Criteria B and C).
  • The DSM-IV-TR definition requires evidence of a decline in the person’s social or occupational functioning as well as the presence of disturbed behavior over a continuous period of at least 6 months.
  • The final consideration in arriving at a diagnosis of schizophrenia involves the exclusion of related conditions, especially mood disorders.

Subtypes DSM-IV-TR recognizes five subtypes of schizophrenia. i) The catatonic type is characterized by symptoms of motor immobility (including rigidity and posturing) or excessive and purposeless motor activity. ii) The disorganized type of schizophrenia is characterized by disorganized speech, disorganized behavior, and flat or inappropriate affect. iii) The most prominent symptoms in the paranoid type are systematic delusions with persecutory or grandiose content. iv) The undifferentiated type of schizophrenia includes schizophrenic patients who display prominent psychotic symptoms and either meet the criteria for several subtypes or otherwise do not meet the criteria for the catatonic, disorganized, or paranoid types.