Abnormal Psych Final

• Psychosis

  A broad term, it can mean hallucinations, delusions, etc.
• Schizophrenia


  One of the many psychotic disorders
• Positive symptoms


  An extra thing that people who are not psychotic do not have
• Delusions


  Thoughts that do not have a basis in reality; generally refer to symptoms around distorted reality
• Approximately 70% of people with schizophrenia experience delusions
• Delusions

  • Delusions of grandeur: a mistaken belief that the person is famous or powerful
  • Delusions of persecution: the belief that others are out to get them/sabotage them
• Motivational view of delusions


  Beliefs as an attempt to deal with and relieve anxiety and stress
• Deficit view of delusions


  Beliefs resulting from brain dysfunction that creates these disordered cognitions or perceptions
• Hallucinations


  Experience of sensory events without environmental input
• Between 60% and 80% of people with schizophrenia experience hallucinations
• Hallucinations


  • Can involve all senses but auditory hallucinations are the most common
• Metacognition


  Phrase to describe examining your own thoughts
• People who have hallucinations appear to have intrusive thoughts, but they believe they are coming from somewhere or someone else
• The part of the brain active the most during hallucinations was Broca's area
• Negative symptoms


  Deficits in normal behavior
• The 5 A's

  • Avolition (or apathy) - lack of initiation, persistence, and motivation
  • Alogia - relative absence or poverty of speech
  • Anhedonia - lack of pleasure
  • Affective flattening - little emotion expressed
  • Asociality - severe impairment in social relationships
• People with schizophrenia often lack awareness that they have a problem
• Disorganized speech


  • Cognitive slippage - illogical and incoherent
  • Tangentiality - "going off on a tangent"
  • Loose associations - conversation in unrelated directions
• Disorganized affect

  Inappropriate emotional behavior (laughing or crying at inappropriate times)
• Disorganized behavior

  • Includes a variety of unusual behaviors
  • Catatonia - awake but does not respond to people or the environment; alternating immobility and excited agitation (waxy flexibility), frozen
• Brief Psychotic Disorder

  Symptoms have persisted between 1 day and 1 month
• Schizophreniform

  Symptoms have lasted between 1 month and 6 months
• Schizophrenia

  Symptoms have lasted over 6 months
• Schizoaffective Disorder

  • Symptoms of schizophrenia and mood episodes
  • Both disorders are independent of one another
  • Psychotic symptoms occurs at times in the absence of mood swings
  • Prognosis is similar for people with schizophrenia
  • No major depressive or manic episodes have occurred concurrently with the active-phase symptoms OR if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness
  • Precipitated by extremely stressful situations
• Delusional Disorder


  • Delusions are present for at least one month
  • Erotomanic - thinking another person is in love with them, person is usually of higher status
  • Grandiose - believing in one's inflated worth, power, knowledge, identity, or special relationship to a deity or famous person
  • Jealous - believes partner is cheating on them
  • Persecutory - believing oneself (or someone close) is being malevolently treated in some way (ex. being spied on)
  • Somatic - person feels afflicted by a physical defect or general medical condition
  • Has never met criteria for schizophrenia
  • Better prognosis than schizophrenia
  • Delusions differ from the more bizarre types found in people with schizophrenia because in delusional disorder the imagined events could be happening but aren't (ex. mistakenly believing you are being followed). However, in schizophrenia, delusions tend to fall into the bizarre category (ex. believing your brain waves broadcast your thoughts to other people around the world)
  • The DSM-5 allows for one bizarre delusion, which separates it from a diagnosis of schizophrenia, which requires more than one delusion to be present
• About 1% of the population has schizophrenia
• Often develops in early adulthood for men and later in life for women
• Can emerge at any time, childhood cases are rare (1 in 10,000)
• Children show early clinical features such as mild physical abnormalities, poor motor coordination, and mild cognitive and social problems (sometimes not specific enough)
• About 20% of people with schizophrenia attempt suicide and 5-6% die
• 85% of people who later develop schizophrenia go through a prodromal stage: a 1 to 2-year period before the serious symptoms where less severe yet unusual symptoms occur
• In the US, proportionately more African Americans receive the diagnosis of schizophrenia than European Americans (research shows this could be due to bias)
• Twin studies

  • Monozygotic twins - risk for schizophrenia is 48-50% if one twin has it
  • Fraternal (dizygotic) twins - rate drops to 17%
• Adoption studies → risk remains high in cases where a biological parent has schizophrenia
• Genes are responsible for making some individuals vulnerable to schizophrenia that can be passed onto offspring, even when they do not show signs of the disorder themselves
• A person can have genes that predispose them to schizophrenia that can be passed onto offspring, even when they do not show signs of the disorder themselves
• A gene-environment interaction was observed in this study, with a good home environment reducing the risk of schizophrenia
• Stress all by itself cannot cause schizophrenia, but can cause relapse
• You can't get schizophrenia without a genetic predisposition, but not everyone with a biological predisposition have it, it runs in the family
• Dopamine Hypothesis

  • Drugs that increase dopamine (agonists) result in schizophrenic-like behavior
  • Drugs that decrease dopamine (neuroleptics/antagonists) reduce schizophrenic-like behavior by blocking the brain's use of dopamine
  • Possible that the dopamine system is too active in people with schizophrenia