Week 11 - Schizophrenia Spectrum Disorders PDF

Overview Schizophrenia Patterns Schizophrenia Symptoms Negative Symptoms Positive Symptoms Psychosis Psychomotor Symptoms Catatonia Schizophrenia Causes Dopamine Developmental Psychopathology Schizophrenia Schizophrenia Mental illness characterized by Psycho...

Overview Schizophrenia Patterns Schizophrenia Symptoms Negative Symptoms Positive Symptoms Psychosis Psychomotor Symptoms Catatonia Schizophrenia Causes Dopamine Developmental Psychopathology Schizophrenia Schizophrenia Mental illness characterized by Psychosis (hallucinations and delusions) Overall poor functioning Schizophrenia Sometimes referred to as the “paradigm” mental illness Paradigm = defining or central example of a broader idea Schizophrenia Patterns Late onset Most clients develop symptoms in 20s or early 30s Sudden onset Most clients go from high functioning to extremely poor functioning in a matter of weeks Permanent onset Can be treated with drug and talk therapies, but no long-term cure has ever been developed Schizophrenia Patterns Usually triggered by a severe stressor Older term: to “lose one’s mind” Schizophrenia Diagnosis Extremely high dysfunction Inability to form relationships or maintain a routine is main diagnostic criterion High deviance Behavior usually departs from norms to such a degree that working becomes impossible Moderate danger, moderate distress Both depend on the individual and the nature of the psychosis (hallucinations and delusions) Schizophrenia Stigma Has anyone encountered the word “schizophrenic” used as a metaphor or non- literal description? Schizophrenia Spectrum Disorders Schizophrenia Spectrum Disorders Post-Partum Psychosis Occurs in the weeks after giving birth Probably triggered by Hormonal changes Stress of caring for an infant Loneliness of mothers in nuclear families Lack of sleep Pressure to be “perfect” mother Schizophrenia Spectrum Disorders Shared symptoms Possibly many causes Severe depression Severe anxiety Dissociation and/or PTSD Schizophrenia Symptoms Schizophrenia Symptoms Three broad categories Negative symptoms Loss of normal abilities, loss of volition Positive symptoms Psychosis, speech disorder Psychomotor symptoms Unusual patterns of movement Schizophrenia Symptoms ”Positive” symptoms All refer to addition of some sense or thought pattern when compared to neurotypical controls “Negative” symptoms All refer to subtraction of some sense or thought pattern when compared to neurotypical controls Negative Symptoms Abilities or tendencies lacking in a person with schizophrenia Negative Symptoms Poverty of speech Tendency to have very short utterances, many of which are difficult to understand Some clients show little internal “voice” Some think fluidly, but cannot express that Negative Symptoms Flat affect Affect = emotional expression (different from emotion itself) Person will have neutral facial expression and level voice regardless of their actual emotions May be tied to avoilition Negative Symptoms Avolition Volition = willpower, energy and drive to do things and pursue goals Person has little or no energy, struggles to engage in actions, cannot pursue goals May feel neutral or ambivalent (conflicted) about almost all decisions and subjects Negative Symptoms Social withdrawal Lack of connection to others Loss of basic social skills (e.g. how to converse, how to sit in public) Inability to communicate, often due to differing perceptions Note For positive symptoms, pay attention to how they and negative symptoms can be “two sides of the same coin” Positive Symptoms Tendencies or abilities beyond normal functioning shown by a person with schizophrenia Includes psychosis and disorganized thinking Positive Symptoms Psychosis Umbrella term for perception that does not align to reality Includes hallucinations and delusions Psychosis Has anyone here… felt their phone vibrate in their pocket, only to realize it doesn’t have any notifications? heard a voice or other unexplainable noise while on the verge of falling asleep or waking up? seen something out of the corner of their eye that wasn’t there on a second look? smelled imaginary baking cookies (or another favorite food) when hungry? heard someone call their name while alone in the house? Psychosis Did anyone here… believe something as a kid that seems nonsensical to your adult self? find yourself questioning whether anything you perceive is real? feel like you’re being sent a message by the universe because of eerie coincidences? Psychosis Dysfunction Deviance Distress Danger Psychosis Delusions Deeply held beliefs that do not align to others’ perception of reality Hallucinations Sensory experiences that occur in the absence of any external stimuli Hallucinations Auditory Hallucinations By far the most common type Involve hearing sounds that do not exist in environment MRI studies reveal person’s brain is actually receiving signals of sound existing, despite silence Can be voices, bangs/thumps, or other noises Hallucinations Can affect other senses as well Tactile hallucinations (touch) Gustatory hallucinations (taste) Olfactory hallucinations (smell) Visual hallucinations (seeing) Delusions Believed to be way of explaining discrepancy between own perceptions and those of other people Can reflect real discrimination Delusions Delusion of Persecution Belief one is being spied on, stalked, plotted against, or followed by malicious actors Delusions Delusion of Reference Belief in coded messages being sent to the person through the environment Delusions Delusion of Grandeur Belief one is a savior, superhero, or other important figure Delusions Delusion of Control Belief one’s thoughts or actions are being caused by other people or external forces Disorganized Thinking Common for person to show loose associations Involves jumping from topic to topic in way that is hard for others to follow Results in jumbled speech “I went to the zoo today. Birds are beautiful, but not pigeons. The ducks in the park don’t like bread. If you leave a sourdough starter for too long it won’t rise. My blood pressure increased.” Psychomotor Symptoms Believed to be earliest signal of risk for schizophrenia: unusual or jerky patterns of movement Can include catatonia Psychomotor Symptoms Catatonia Near total absence of movement for several minutes; can last for many hours at a time Discussion How do these symptoms together form a constellation (connected syndrome)? Causes of Schizophrenia Dopamine Neurotransmitter associated with movement, motivation, sensory integration, and rewards Dopamine Antipsychotic drugs Treat symptoms of psychosis Reduce dopamine activity L-dopa Treats Parkinson’s (movement disorder) Increases dopamine activity Overdose causes psychosis Dopamine Hypothesis Theory that schizophrenia caused by dopamine dis-regulation During increases (floods) of dopamine Thoughts interpreted as sensory experiences Senses heightened until hallucinations occur Movement and thought become rapid and erratic Dopamine Hypothesis Theory that schizophrenia caused by dopamine dis-regulation During depletion (drought) of dopamine Thoughts are slow or disorganized Senses are dulled Movement and motivation decrease or disappear Dopamine Hypothesis Suggests there is too much connectivity between key areas of the brain among clients with schizophrenia