Describe scz characteristics Ronald told Rory (15)

• Para 1: positive and negative symptoms

  Schizophrenia is characterised by a combination of positive and negative symptoms. Positive symptoms refer to the addition of behaviours not usually seen in the general population, while negative symptoms involve a loss or reduction in typical functioning. It is likely Ronald described as a mixture of both to Rory.
• Para 2: positive symptom 1

  One positive symptom Ronald may have reported is hallucinations, particularly auditory ones, which are common in schizophrenia. He may have explained that he hears voices that others cannot hear, possibly commenting on his actions or insulting him. Lewandowski et al. (2009) found some individuals also experience tactile hallucinations, such as feeling sensations on their skin- Ronald may have described the sensation of insects crawling on him (formication), which felt real despite no cause physical cause. He might have also described delusions, another positive symptom, such as delusions of persecution - believing that someone is watching or trying to harm him (e.g. Thinking the government is monitoring him). Alternatively, Ronald may have shown delusions of grandeur , claiming he is a famous figure or has special powers. These beliefs would seem irrational to others, but would feel completely real to Ronald
• Para 3: positive symptom 2

  Another possible positive symptom is disordered thinking, which may have become obvious to Rory during conversation. Ronald’s speech may have been difficult to follow, jumping erratically from one topic to another without logical flow (known as knight’s move thinking). He may also have spoken about thought insertion, believing someone was placing thoughts in his mind, which could be very distressing and confusing for him.
• Para 4: negative symptom 1

  In terms of negative symptoms, Ronald might have shown alogia, or poverty of speech. Rory may have noticed that Ronald speaks less than usual and struggles to give meaningful responses, even in casual conversation. Ronald may also have mentioned avolition, describing a lack of motivation to engage in activities he used to enjoy, such as work or hobbies. Rory might have seen this as disinterest, but it reflects a loss of goal-directed behaviour. Another symptom Ronald may have experienced is anhedonia, where he no longer reacts emotionally to positive events - such as showing no excitement at good news or failing to laugh at a joke
• Para 5: negative symptom 2

  Ronald may have also displayed flatness of affect, where his emotional expression appeared muted. Rory could have noticed that Ronald spoke in a monotone voice, did not smile or use facial expressions, and appeared emotionally disconnected. Finally Ronald might have exhibited cationic behaviour, which includes either excessive, purposeless movement or complete immobility. Rory may have noticed him pacing repetitively or, conversely, remaining rigid in odd postures, resisting attempts to move. These behaviours would seem bizarre but are recognised symptoms of schizophrenia.