Whitbourne7eU - PPT - Ch06 Schizophrenia

SCHIZOPHRENIA SPECTRUM
AND OTHER PSYCHOTIC

DISORDERS
CHAPTER 6
Copyright © 2014 McGraw-Hill Education. All rights reserved. No reproduction or distribution without the prior
written consent of McGraw-Hill Education.
SCHIZOPHRENIA
• The broad category of schizophrenia includes a set of disorders in
which individuals experience distorted perception of reality and
impairment in thinking, behavior, affect, and motivation.
• A disorder with a range of symptoms involving disturbances In:

• Content of thought
• Form of thought
• Perception
• Affect
• Sense of self
• Motivation
• Behavior
• Interpersonal functioning
SYMPTOMS OF SCHIZOPHRENIA
POSITIVE + NEGATIVE -
Positive symptoms: Negative symptoms:
Exaggerations or distortions of Symptoms that involve

normal thoughts, emotions, and functioning below the level of
behavior normal behavior
SYMPTOMS OF SCHIZOPHRENIA
POSITIVE + NEGATIVE -
 Delusions  Restricted affect

 Hallucinations  Avolition
 Disorganized speech  A-sociality
 Disturbed behavior
Researchers proposed that positive symptoms reflected

activated dopamine levels in the nervous system and negative
symptoms reflected abnormalities in brain structure.
DIAGNOSTIC FEATURES OF SCHIZOPHRENIA
CHARACTERISTICS OF SCHIZOPHRENIA
• Bleuler coined the term schizophrenia
• The four fundamental features are still referred to as

Bleuler’s Four A’s:
• Association (thought disorder)
• Affect (emotional disturbance)
• Ambivalence (inability to make or follow through on
decisions)
• Autism (withdrawal from reality)
FEATURES OF SCHIZOPHRENIA
• Inappropriate affect is the extent to which a

person’s emotional expressiveness fails to
correspond to the content of what is being
discussed.
• Paranoia is the irrational belief or perception that

others wish to cause you harm, may be associated
with delusions or auditory hallucinations related to a
theme that somebody is persecuting or harassing
them.
SCHIZOPHRENIA SPECTRUM
• Schizophrenia is now classified as a spectrum

disorder rather than a single disease entity, leading
to new diagnostic categories that included, for
example, personality and affective disorders.
• Section 3 of the DSM-5 includes a set of symptom

severity ratings.
DIMENSIONS OF PSYCHOSIS SYMPTOM
SEVERITY IN SECTION 3 OF DSM-5
STATISTICS
• Schizophrenia affects slightly more males than females

• For every three men who develop schizophrenia over the course
of their lives, two women are affected with the disorder.
• Researchers estimate the lifetime prevalence as about

5% and the prevalence at any one time of about 3%.
• People with schizophrenia are two to three times more

likely to die compared to others within their age group.
COURSES OF SCHIZOPHRENIA
• Continuous
• Remission
• Recurrent
• Extended
OTHER PSYCHOTIC DISORDERS
OTHER PSYCHOTIC DISORDERS
• Schizophrenia-like disorders that involve

abnormalities in one or more of the five domains:
• Delusions
• Hallucinations
• Disorganized thinking (speech)
• Grossly disorganized or abnormal motor behavior (including
catatonia)
• Negative symptoms
BRIEF PSYCHOTIC DISORDER
• A diagnosis that clinicians use when an individual develops

symptoms of psychosis that do not persist past a short period of time.
• Symptoms must be present for more than a day, but recover in less
than a month.
• Symptoms
• Delusions
• Hallucinations
• Disorganized speech
• Grossly disorganized or catatonic behavior
SCHIZOPHRENIFORM DISORDER
• A disorder with essentially the same symptoms as

schizophrenia, but that lasts from 1 to 6 months
SCHIZOAFFECTIVE DISORDER
• Schizophrenia with co-occurring mood disorder
DELUSIONAL DISORDERS
• Erotomanic
• Grandios
• Jealous
• Persecutory
• Somatic
BIOLOGICAL THEORIES
• Brain structure and genetics

• Ventricular enlargement and cortical atrophy
• Diffusion tensor imaging (DTI)
• Dopamine hypothesis
BIOLOGICAL THEORIES
• Genetic abnormalities affects:

• Brain development
• Synaptic transmission
• Immune functioning
• Manufacturing of important proteins involved in
neurotransmission
• Neurodevelopmental hypothesis
BIOLOGICAL TREATMENT
• Neuroleptics
• “Typical” or “first generation”
• “Atypical” or “second generation”
• Consequences
• Extrapyramidal symptoms (EPS)
• Tardive dyskinesia
FIGURE 6.2 - NEUROPSYCHOLOGICAL
PERFORMANCE PROFILE OF
SCHIZOPHRENIA
PSYCHOLOGICAL PERSPECTIVE
• Deficit in social cognition

• Brains become less activated when given a social
cognition task
• Difficulty in working on people-oriented jobs
• Substance abuse
PSYCHOLOGICAL TREATMENT
• Token economy
• Cognitive-behavioral therapy
• Cognitive training
FIGURE 6.4 - DEVELOPMENTAL
CASCADE TOWARD SCHIZOPHRENIA
SOCIOCULTURAL PERSPECTIVE
• Focus on the family system

• Faulty modes of behavior and communication
• Cognitive distortions
• High degree of expressed emotion
• Social class and income

• Associated with environmental stressors of poverty
• Contracting the disease leads to social and economic
“downward drift”
SOCIOCULTURAL TREATMENT
• Assertive Community Treatment (ACT): A team of

professionals from psychiatry, psychology, nursing,
and social work reach out to clients
BIOPSYCHOSOCIAL PERSPECTIVE
• Theories focus on underlying brain mechanisms as

expressed in cognitive deficits
• Individuals with these disorders receive integrated
care:
• Maximizing their chances of recovery
• For more information on material covered in this
chapter, visit our Web site:
• http://www.mhhe.com/whitbourne7eupdate

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SCHIZOPHRENIA SPECTRUM

AND OTHER PSYCHOTIC

• A disorder with a range of symptoms involving disturbances In:

Exaggerations or distortions of Symptoms that involve

 Delusions  Restricted affect

Researchers proposed that positive symptoms reflected

• Bleuler coined the term schizophrenia

• The four fundamental features are still referred to as

• Inappropriate affect is the extent to which a

• Paranoia is the irrational belief or perception that

• Schizophrenia is now classified as a spectrum

• Section 3 of the DSM-5 includes a set of symptom

• Schizophrenia affects slightly more males than females

• Researchers estimate the lifetime prevalence as about

• People with schizophrenia are two to three times more

• Schizophrenia-like disorders that involve

• A diagnosis that clinicians use when an individual develops

• A disorder with essentially the same symptoms as

• Schizophrenia with co-occurring mood disorder

• Brain structure and genetics

• Genetic abnormalities affects:

• Deficit in social cognition

• Focus on the family system

• Social class and income

• Assertive Community Treatment (ACT): A team of

• Theories focus on underlying brain mechanisms as

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