Schizophrenia Chapter 12 Psychosis Psychosis a loss of
![Schizophrenia Chapter 12 Schizophrenia Chapter 12](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-1.jpg)
![Psychosis • Psychosis: a loss of contact with reality • A change in your Psychosis • Psychosis: a loss of contact with reality • A change in your](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-2.jpg)
![Schizophrenia • • Prevalence: 1% (about 2. 5 million Americans) Little variability in prevalence Schizophrenia • • Prevalence: 1% (about 2. 5 million Americans) Little variability in prevalence](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-3.jpg)
![Diagnosing Schizophrenia • The DSM-5 calls for a diagnosis of schizophrenia only after symptoms Diagnosing Schizophrenia • The DSM-5 calls for a diagnosis of schizophrenia only after symptoms](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-4.jpg)
![Three Types of Symptoms • There are three kinds of symptoms of schizophrenia: • Three Types of Symptoms • There are three kinds of symptoms of schizophrenia: •](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-5.jpg)
![Positive Symptoms • Positive symptoms include: • Hallucinations – false perceptions • Most common Positive Symptoms • Positive symptoms include: • Hallucinations – false perceptions • Most common](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-6.jpg)
![Positive Symptoms • Types of delusions • Persecutory • Referential • Somatic • Religious Positive Symptoms • Types of delusions • Persecutory • Referential • Somatic • Religious](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-7.jpg)
![Positive Symptoms • Disorganized Thinking and Speech: • Loose associations (derailment): • “Kyra serves Positive Symptoms • Disorganized Thinking and Speech: • Loose associations (derailment): • “Kyra serves](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-8.jpg)
![Positive Symptoms • Other positive symptoms include: • Heightened perceptions • People may feel Positive Symptoms • Other positive symptoms include: • Heightened perceptions • People may feel](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-9.jpg)
![Negative Symptoms • Poverty of speech (alogia) • Flat affect or blunted affect poor Negative Symptoms • Poverty of speech (alogia) • Flat affect or blunted affect poor](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-10.jpg)
![Psychomotor Symptoms • Catatonic stupor – stop responding to environment, motionless and mute • Psychomotor Symptoms • Catatonic stupor – stop responding to environment, motionless and mute •](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-11.jpg)
![The Course of Schizophrenia • Type I and Type II schizophrenia • Type I The Course of Schizophrenia • Type I and Type II schizophrenia • Type I](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-12.jpg)
![Explaining Schizophrenia: Biology • Lots of proposed explanations for schizophrenia • Biological explanations have Explaining Schizophrenia: Biology • Lots of proposed explanations for schizophrenia • Biological explanations have](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-13.jpg)
![Biological Views: Genetic • There is a big genetic risk in schizophrenia • The Biological Views: Genetic • There is a big genetic risk in schizophrenia • The](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-14.jpg)
![Biological Views: Genetic • Genetic factors may lead to the development of schizophrenia through Biological Views: Genetic • Genetic factors may lead to the development of schizophrenia through](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-15.jpg)
![Biological Views: Biochemical Abnormalities • The Dopamine Hypothesis • Certain neurons using dopamine fire Biological Views: Biochemical Abnormalities • The Dopamine Hypothesis • Certain neurons using dopamine fire](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-16.jpg)
![Biological Views: The Dopamine Hypothesis • Antipsychotics/neuroleptics are dopamine antagonists: bind to dopamine receptors Biological Views: The Dopamine Hypothesis • Antipsychotics/neuroleptics are dopamine antagonists: bind to dopamine receptors](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-17.jpg)
![Biological Views: The Dopamine Hypothesis • Biochemical abnormalities • Research since the 1960 s Biological Views: The Dopamine Hypothesis • Biochemical abnormalities • Research since the 1960 s](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-18.jpg)
![Antipsychotics work. . . Antipsychotics work. . .](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-19.jpg)
![. . . but have serious and disabling side effects . . . but have serious and disabling side effects](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-20.jpg)
![Biological Views: Antipsychotics • Used to be given antipsychotics like thorazine. • Now, new Biological Views: Antipsychotics • Used to be given antipsychotics like thorazine. • Now, new](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-21.jpg)
![Biological Views: Abnormal Brain Structures • Abnormal brain structures have been found: • Enlarged Biological Views: Abnormal Brain Structures • Abnormal brain structures have been found: • Enlarged](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-22.jpg)
![Biological Views: Viral • Correlational research: • More people who were born in the Biological Views: Viral • Correlational research: • More people who were born in the](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-23.jpg)
![Psychological Views • Research on biology of this disorder is strong, many abandoned psychological Psychological Views • Research on biology of this disorder is strong, many abandoned psychological](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-24.jpg)
![Psychological Views: Psychodynamic • The psychodynamic explanation • Freud believed that schizophrenia develops from Psychological Views: Psychodynamic • The psychodynamic explanation • Freud believed that schizophrenia develops from](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-25.jpg)
![Psychological Views: Cognitive • The cognitive view • Cognitive theorists agree that biological factors Psychological Views: Cognitive • The cognitive view • Cognitive theorists agree that biological factors](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-26.jpg)
![Sociocultural Views • 3 main sociocultural influences • Multicultural factors • Prevalence higher in Sociocultural Views • 3 main sociocultural influences • Multicultural factors • Prevalence higher in](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-27.jpg)
![How Are Schizophrenia and Other Severe Mental Disorders Treated? • For much of human How Are Schizophrenia and Other Severe Mental Disorders Treated? • For much of human](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-28.jpg)
![Institutional Care in the Past • For more than half of the 20 th Institutional Care in the Past • For more than half of the 20 th](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-29.jpg)
![Institutional Care Takes a Turn for the Better • In the 1950 s, clinicians Institutional Care Takes a Turn for the Better • In the 1950 s, clinicians](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-30.jpg)
![Institutional Care Takes a Turn for the Better • Milieu therapy • The guiding Institutional Care Takes a Turn for the Better • Milieu therapy • The guiding](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-31.jpg)
![Institutional Care Takes a Turn for the Better • The token economy • Based Institutional Care Takes a Turn for the Better • The token economy • Based](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-32.jpg)
![Institutional Care Takes a Turn for the Better • The token economy • Researchers Institutional Care Takes a Turn for the Better • The token economy • Researchers](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-33.jpg)
![Antipsychotic Drugs • While milieu therapy and token economies helped improve treatment outcomes, it Antipsychotic Drugs • While milieu therapy and token economies helped improve treatment outcomes, it](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-34.jpg)
![Antipsychotic Drugs • Antipsychotic drugs developed throughout the 1960 s, 1970 s, and 1980 Antipsychotic Drugs • Antipsychotic drugs developed throughout the 1960 s, 1970 s, and 1980](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-35.jpg)
![How Effective Are Antipsychotic Drugs? • Research has repeatedly shown that antipsychotic drugs reduce How Effective Are Antipsychotic Drugs? • Research has repeatedly shown that antipsychotic drugs reduce](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-36.jpg)
![How Effective Are Antipsychotic Drugs? • Antipsychotic drugs, particularly the conventional ones, reduce the How Effective Are Antipsychotic Drugs? • Antipsychotic drugs, particularly the conventional ones, reduce the](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-37.jpg)
![The Unwanted Effects of Conventional Antipsychotic Drugs • The most common unwanted effects produce The Unwanted Effects of Conventional Antipsychotic Drugs • The most common unwanted effects produce](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-38.jpg)
![Unwanted Effects of Conventional Antipsychotic Drugs • A more difficult side effect of conventional Unwanted Effects of Conventional Antipsychotic Drugs • A more difficult side effect of conventional](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-39.jpg)
![Unwanted Effects of Conventional Antipsychotic Drugs • Since learning of the unwanted side effects Unwanted Effects of Conventional Antipsychotic Drugs • Since learning of the unwanted side effects](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-40.jpg)
![New Antipsychotic Drugs • Recently, new drugs have been developed • Called “atypical” because New Antipsychotic Drugs • Recently, new drugs have been developed • Called “atypical” because](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-41.jpg)
![Psychotherapy • Before the discovery of antipsychotic drugs, psychotherapy was not an option for Psychotherapy • Before the discovery of antipsychotic drugs, psychotherapy was not an option for](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-42.jpg)
![Psychotherapy • Insight therapy • A variety of insight therapies have been used to Psychotherapy • Insight therapy • A variety of insight therapies have been used to](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-43.jpg)
![Psychotherapy • Family therapy • About 25% of persons recovering from schizophrenia live with Psychotherapy • Family therapy • About 25% of persons recovering from schizophrenia live with](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-44.jpg)
![The Community Approach • The community approach is the broadest approach for the treatment The Community Approach • The community approach is the broadest approach for the treatment](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-45.jpg)
![What Are the Features of Effective Community Care? • People recovering from schizophrenia and What Are the Features of Effective Community Care? • People recovering from schizophrenia and](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-46.jpg)
![How Has Community Treatment Failed? • There is no doubt that effective community programs How Has Community Treatment Failed? • There is no doubt that effective community programs](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-47.jpg)
![What Are the Consequences of Inadequate Community Treatment? • When community treatment fails, many What Are the Consequences of Inadequate Community Treatment? • When community treatment fails, many](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-48.jpg)
![](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-49.jpg)
![What Are the Consequences of Inadequate Community Treatment? • Finally, a great number of What Are the Consequences of Inadequate Community Treatment? • Finally, a great number of](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-50.jpg)
![The Promise of Community Treatment • Today community care is a major feature of The Promise of Community Treatment • Today community care is a major feature of](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-51.jpg)
- Slides: 51
![Schizophrenia Chapter 12 Schizophrenia Chapter 12](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-1.jpg)
Schizophrenia Chapter 12
![Psychosis Psychosis a loss of contact with reality A change in your Psychosis • Psychosis: a loss of contact with reality • A change in your](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-2.jpg)
Psychosis • Psychosis: a loss of contact with reality • A change in your ability to perceive and respond to the environment • Can be substance-induced – but most due to schizophrenia. 2
![Schizophrenia Prevalence 1 about 2 5 million Americans Little variability in prevalence Schizophrenia • • Prevalence: 1% (about 2. 5 million Americans) Little variability in prevalence](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-3.jpg)
Schizophrenia • • Prevalence: 1% (about 2. 5 million Americans) Little variability in prevalence cross culturally Equal rates across men and women More frequently found among low SES • “downward drift” theory • At greater risk for suicide and to be victims of crime 3
![Diagnosing Schizophrenia The DSM5 calls for a diagnosis of schizophrenia only after symptoms Diagnosing Schizophrenia • The DSM-5 calls for a diagnosis of schizophrenia only after symptoms](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-4.jpg)
Diagnosing Schizophrenia • The DSM-5 calls for a diagnosis of schizophrenia only after symptoms of psychosis continue for six months or more • Individuals must also show a deterioration in their work, social relations, and ability to care for themselves 4
![Three Types of Symptoms There are three kinds of symptoms of schizophrenia Three Types of Symptoms • There are three kinds of symptoms of schizophrenia: •](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-5.jpg)
Three Types of Symptoms • There are three kinds of symptoms of schizophrenia: • Positive symptoms – “Pathological Excesses” • (e. g. , hallucinations) • Negative symptoms • (e. g. , flat affect) • Psychomotor symptoms • (e. g. , catatonic postures) 5
![Positive Symptoms Positive symptoms include Hallucinations false perceptions Most common Positive Symptoms • Positive symptoms include: • Hallucinations – false perceptions • Most common](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-6.jpg)
Positive Symptoms • Positive symptoms include: • Hallucinations – false perceptions • Most common are auditory • Can involve ANY of the 5 senses – olfactory, tactile, visual • Delusions – faulty interpretations or beliefs • Lots of kinds of delusions https: //www. youtube. com/watch? v=Gv. F 4 C 1 Eu. JU 6
![Positive Symptoms Types of delusions Persecutory Referential Somatic Religious Positive Symptoms • Types of delusions • Persecutory • Referential • Somatic • Religious](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-7.jpg)
Positive Symptoms • Types of delusions • Persecutory • Referential • Somatic • Religious • Grandiose • Thought withdrawal • Thought insertion 7
![Positive Symptoms Disorganized Thinking and Speech Loose associations derailment Kyra serves Positive Symptoms • Disorganized Thinking and Speech: • Loose associations (derailment): • “Kyra serves](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-8.jpg)
Positive Symptoms • Disorganized Thinking and Speech: • Loose associations (derailment): • “Kyra serves drinks at a bar. I love candy bars. I went to Hershey, PA when I was five years old. ” • Neologisms (made-up words): • “butterflower” • Perseveration • Patients repeat their words and statements again and again • “Let’s go to supper at the supper club, with the supper, supper” • Clang (rhymes): • How are you? “Well, hell, it’s well to tell” 8
![Positive Symptoms Other positive symptoms include Heightened perceptions People may feel Positive Symptoms • Other positive symptoms include: • Heightened perceptions • People may feel](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-9.jpg)
Positive Symptoms • Other positive symptoms include: • Heightened perceptions • People may feel that their senses are being flooded by sights and sounds, making it impossible to attend to anything important • Inappropriate affect – emotions that are unsuited to the situation https: //www. youtube. com/watch? v=n 7 BEO xj 81 f. M 9
![Negative Symptoms Poverty of speech alogia Flat affect or blunted affect poor Negative Symptoms • Poverty of speech (alogia) • Flat affect or blunted affect poor](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-10.jpg)
Negative Symptoms • Poverty of speech (alogia) • Flat affect or blunted affect poor eye contact monotonous voice face appears to lack emotion • Loss of volition (avolition or apathy) lack of initiation or follow through • Social withdrawal 10
![Psychomotor Symptoms Catatonic stupor stop responding to environment motionless and mute Psychomotor Symptoms • Catatonic stupor – stop responding to environment, motionless and mute •](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-11.jpg)
Psychomotor Symptoms • Catatonic stupor – stop responding to environment, motionless and mute • Catatonic rigidity – rigid posture, resisting movement • Catatonic posturing – awkward positions • Catatonic excitement – “wild waving of arms &legs” 11
![The Course of Schizophrenia Type I and Type II schizophrenia Type I The Course of Schizophrenia • Type I and Type II schizophrenia • Type I](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-12.jpg)
The Course of Schizophrenia • Type I and Type II schizophrenia • Type I schizophrenia is dominated by positive symptoms • Better adjustment prior to the disorder • Later onset of symptoms • Greater likelihood of improvement • Tied more closely to biochemical abnormalities in the brain • Type II schizophrenia is dominated by negative symptoms • Tied largely to structural abnormalities in the brain 12
![Explaining Schizophrenia Biology Lots of proposed explanations for schizophrenia Biological explanations have Explaining Schizophrenia: Biology • Lots of proposed explanations for schizophrenia • Biological explanations have](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-13.jpg)
Explaining Schizophrenia: Biology • Lots of proposed explanations for schizophrenia • Biological explanations have received the most research support • Biological theories: • • Genetic Biochemical Abnormalities Abnormal Brain Structure Viral problems • Diathesis-stress relationship • People have a biological risk for schizophrenia (diathesis) • Might only develop symptoms if they experience certain kinds of stress 13
![Biological Views Genetic There is a big genetic risk in schizophrenia The Biological Views: Genetic • There is a big genetic risk in schizophrenia • The](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-14.jpg)
Biological Views: Genetic • There is a big genetic risk in schizophrenia • The closer you are related to a person with the disorder, the more likely you are to get it. • 1% risk with no family hx • 17% risk for dizygotic twins • 48% risk for monozygotic twins • (Not 100%! Stress plays a role. ) 14
![Biological Views Genetic Genetic factors may lead to the development of schizophrenia through Biological Views: Genetic • Genetic factors may lead to the development of schizophrenia through](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-15.jpg)
Biological Views: Genetic • Genetic factors may lead to the development of schizophrenia through two kinds of (potentially inherited) biological abnormalities: • Biochemical abnormalities • Abnormal brain structure 15
![Biological Views Biochemical Abnormalities The Dopamine Hypothesis Certain neurons using dopamine fire Biological Views: Biochemical Abnormalities • The Dopamine Hypothesis • Certain neurons using dopamine fire](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-16.jpg)
Biological Views: Biochemical Abnormalities • The Dopamine Hypothesis • Certain neurons using dopamine fire too often, producing symptoms of schizophrenia • This theory was discovered accidentally • Antipsychotic drugs (which increase dopamine) were tested as allergy pills • They failed in that role – but they were found to increase dopamine 16
![Biological Views The Dopamine Hypothesis Antipsychoticsneuroleptics are dopamine antagonists bind to dopamine receptors Biological Views: The Dopamine Hypothesis • Antipsychotics/neuroleptics are dopamine antagonists: bind to dopamine receptors](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-17.jpg)
Biological Views: The Dopamine Hypothesis • Antipsychotics/neuroleptics are dopamine antagonists: bind to dopamine receptors (D 2), thus preventing dopamine from binding, and preventing neurons from firing. • Extrapyramidal side effects: muscular tremors, uncontrollable shaking, similar to symptoms of Parkinson’s 17
![Biological Views The Dopamine Hypothesis Biochemical abnormalities Research since the 1960 s Biological Views: The Dopamine Hypothesis • Biochemical abnormalities • Research since the 1960 s](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-18.jpg)
Biological Views: The Dopamine Hypothesis • Biochemical abnormalities • Research since the 1960 s has supported and clarified this hypothesis • Example: patients with Parkinson’s disease develop schizophrenic symptoms if they take too much L-dopa, a medication that raises dopamine levels • Example: people who take high doses of amphetamines, which increase dopamine activity in the brain, may develop amphetamine psychosis – a syndrome similar to schizophrenia 18
![Antipsychotics work Antipsychotics work. . .](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-19.jpg)
Antipsychotics work. . .
![but have serious and disabling side effects . . . but have serious and disabling side effects](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-20.jpg)
. . . but have serious and disabling side effects
![Biological Views Antipsychotics Used to be given antipsychotics like thorazine Now new Biological Views: Antipsychotics • Used to be given antipsychotics like thorazine. • Now, new](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-21.jpg)
Biological Views: Antipsychotics • Used to be given antipsychotics like thorazine. • Now, new atypical antipsychotics • Clozapine, risperidone, olanzapine… • More effective (85% vs. 65%) • Few extrapyramidal effects • No tardive dyskinesia effects. • But, 1% risk of agranulocytosis (drop in white blood cells) -- need frequent blood tests
![Biological Views Abnormal Brain Structures Abnormal brain structures have been found Enlarged Biological Views: Abnormal Brain Structures • Abnormal brain structures have been found: • Enlarged](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-22.jpg)
Biological Views: Abnormal Brain Structures • Abnormal brain structures have been found: • Enlarged ventricles • Smaller temporal/frontal lobes • Smaller amounts of grey matter 22
![Biological Views Viral Correlational research More people who were born in the Biological Views: Viral • Correlational research: • More people who were born in the](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-23.jpg)
Biological Views: Viral • Correlational research: • More people who were born in the winter have schizophrenia • Possible increased exposure to viruses? • More direct research: • Mothers of those with schizophrenia more likely to have had the flu • Antibodies for certain viruses more commonly found in those with schizophrenia. 23
![Psychological Views Research on biology of this disorder is strong many abandoned psychological Psychological Views • Research on biology of this disorder is strong, many abandoned psychological](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-24.jpg)
Psychological Views • Research on biology of this disorder is strong, many abandoned psychological views • Two main psychological theories of schizophrenia: • Psychodynamic • Cognitive 24
![Psychological Views Psychodynamic The psychodynamic explanation Freud believed that schizophrenia develops from Psychological Views: Psychodynamic • The psychodynamic explanation • Freud believed that schizophrenia develops from](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-25.jpg)
Psychological Views: Psychodynamic • The psychodynamic explanation • Freud believed that schizophrenia develops from two processes: • Regression to a pre-ego stage (due to cold, un-nurturing parents) • Efforts to re-establish ego control • Frieda Fromm-Reichmann theorized the schizophrenogenic mothers theory • Proposed that mothers of people with schizophrenia were cold, domineering, and uninterested in their children’s needs • These theories are not supported by research. 25
![Psychological Views Cognitive The cognitive view Cognitive theorists agree that biological factors Psychological Views: Cognitive • The cognitive view • Cognitive theorists agree that biological factors](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-26.jpg)
Psychological Views: Cognitive • The cognitive view • Cognitive theorists agree that biological factors produce symptoms • They argue: some symptoms develop because of faulty interpretation • Example: a man experiences auditory hallucinations and approaches his friends for help; they deny the reality of his sensations; he concludes that they are trying to hide the truth from him; he begins to reject all feedback and starts feeling persecuted • There is little direct research support for this view 26
![Sociocultural Views 3 main sociocultural influences Multicultural factors Prevalence higher in Sociocultural Views • 3 main sociocultural influences • Multicultural factors • Prevalence higher in](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-27.jpg)
Sociocultural Views • 3 main sociocultural influences • Multicultural factors • Prevalence higher in some minority groups – is it because of SES? • Social labeling • Rosenhan’s “pseudo-patient” study • Family dysfunction • Parents higher in “expressed emotion” – more critical, overly involved • Higher “expressed emotion” – 4 x greater chance of relapse! 27
![How Are Schizophrenia and Other Severe Mental Disorders Treated For much of human How Are Schizophrenia and Other Severe Mental Disorders Treated? • For much of human](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-28.jpg)
How Are Schizophrenia and Other Severe Mental Disorders Treated? • For much of human history, people with schizophrenia were considered beyond help and without hope • Though schizophrenia is still hard to treat, the discovery of antipsychotic drugs has enabled people with the disorder to think clearly and profit from psychotherapies • A historical perspective of treatment allows the best understanding of the nature, problems, and promise of modern approaches
![Institutional Care in the Past For more than half of the 20 th Institutional Care in the Past • For more than half of the 20 th](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-29.jpg)
Institutional Care in the Past • For more than half of the 20 th century, people with schizophrenia were considered insane and were institutionalized in public mental hospitals • Because patients failed to respond to traditional therapies, the primary goals of the hospitals were to restrain them and give them food, shelter, and clothing
![Institutional Care Takes a Turn for the Better In the 1950 s clinicians Institutional Care Takes a Turn for the Better • In the 1950 s, clinicians](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-30.jpg)
Institutional Care Takes a Turn for the Better • In the 1950 s, clinicians developed two institutional approaches that brought some hope to chronic patients: • Milieu therapy • Based on humanistic principles • Token economies • Based on behavioral principles • These approaches particularly helped improve the personal care and self-image of patients, problem areas that were worsened by institutionalization
![Institutional Care Takes a Turn for the Better Milieu therapy The guiding Institutional Care Takes a Turn for the Better • Milieu therapy • The guiding](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-31.jpg)
Institutional Care Takes a Turn for the Better • Milieu therapy • The guiding principle is that institutions can help patients make clinical progress by creating a social climate (“milieu”) that promotes productive activity, self-respect, and individual responsibility • Milieu programs have been set up in institutions throughout the Western world with moderate success • Research has shown that patients with schizophrenia in milieu programs often leave the hospital at higher rates than patients receiving custodial care
![Institutional Care Takes a Turn for the Better The token economy Based Institutional Care Takes a Turn for the Better • The token economy • Based](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-32.jpg)
Institutional Care Takes a Turn for the Better • The token economy • Based on operant conditioning principles, token economies are used in institutions to change the behavior of patients with schizophrenia • Patients are rewarded when they behave in socially acceptable ways and are not rewarded when they behave unacceptably • Immediate rewards are tokens that can later be exchanged for food, cigarettes, privileges, and other desirable objects • Acceptable behaviors likely to be targeted include care for oneself and one’s possessions, going to a work program, and showing self
![Institutional Care Takes a Turn for the Better The token economy Researchers Institutional Care Takes a Turn for the Better • The token economy • Researchers](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-33.jpg)
Institutional Care Takes a Turn for the Better • The token economy • Researchers have found that token economies help change psychotic and related behavior • However, questions have been raised about such programs: • Are such programs ethical and legal? Aren’t all humans entitled to basic rights, some of which are compromised in a strict token economy system? • Are such programs truly effective? For example, patients may change overt behaviors but not underlying psychotic beliefs
![Antipsychotic Drugs While milieu therapy and token economies helped improve treatment outcomes it Antipsychotic Drugs • While milieu therapy and token economies helped improve treatment outcomes, it](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-34.jpg)
Antipsychotic Drugs • While milieu therapy and token economies helped improve treatment outcomes, it was the discovery of antipsychotic drugs in the 1950 s that revolutionized treatment for those with schizophrenia • It was discovered that one group of antihistamines, phenothiazines, could be used to calm patients about to undergo surgery • Psychiatrists tested one of the drugs, chlorpromazine, on six patients with psychosis and observed a sharp reduction in their symptoms
![Antipsychotic Drugs Antipsychotic drugs developed throughout the 1960 s 1970 s and 1980 Antipsychotic Drugs • Antipsychotic drugs developed throughout the 1960 s, 1970 s, and 1980](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-35.jpg)
Antipsychotic Drugs • Antipsychotic drugs developed throughout the 1960 s, 1970 s, and 1980 s are now referred to as “conventional” antipsychotic drugs • Drugs developed in recent years are known as “atypical” antipsychotics
![How Effective Are Antipsychotic Drugs Research has repeatedly shown that antipsychotic drugs reduce How Effective Are Antipsychotic Drugs? • Research has repeatedly shown that antipsychotic drugs reduce](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-36.jpg)
How Effective Are Antipsychotic Drugs? • Research has repeatedly shown that antipsychotic drugs reduce schizophrenia symptoms in the majority of patients • In direct comparisons, drugs appear to be more effective than any other approach used alone • In most cases, the drugs produce the maximum level of improvement within the first six months of treatment • Symptoms may return if patients stop taking the drugs too soon
![How Effective Are Antipsychotic Drugs Antipsychotic drugs particularly the conventional ones reduce the How Effective Are Antipsychotic Drugs? • Antipsychotic drugs, particularly the conventional ones, reduce the](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-37.jpg)
How Effective Are Antipsychotic Drugs? • Antipsychotic drugs, particularly the conventional ones, reduce the positive symptoms of schizophrenia more completely, or at least more quickly, than the negative symptoms • Although the use of such drugs is now widely accepted, patients often dislike the powerful effects of the drugs, and some refuse to take them
![The Unwanted Effects of Conventional Antipsychotic Drugs The most common unwanted effects produce The Unwanted Effects of Conventional Antipsychotic Drugs • The most common unwanted effects produce](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-38.jpg)
The Unwanted Effects of Conventional Antipsychotic Drugs • The most common unwanted effects produce Parkinsonian symptoms, reactions that closely resemble the features of the neurological disorder Parkinson’s disease, including: • Muscle tremor and rigidity • Dystonia (bizarre movements of the face, neck, tongue, and back) • Akathisia (great restlessness, agitation, and discomfort in the limbs)
![Unwanted Effects of Conventional Antipsychotic Drugs A more difficult side effect of conventional Unwanted Effects of Conventional Antipsychotic Drugs • A more difficult side effect of conventional](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-39.jpg)
Unwanted Effects of Conventional Antipsychotic Drugs • A more difficult side effect of conventional antipsychotic drugs appears up to one year after starting the medication • This reaction, called tardive dyskinesia, involves involuntary movements, usually of the mouth, lips, tongue, legs, or body • It affects more than 10% of those taking the drugs • It can be IRREVERSIBLE!
![Unwanted Effects of Conventional Antipsychotic Drugs Since learning of the unwanted side effects Unwanted Effects of Conventional Antipsychotic Drugs • Since learning of the unwanted side effects](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-40.jpg)
Unwanted Effects of Conventional Antipsychotic Drugs • Since learning of the unwanted side effects of conventional antipsychotic drugs, clinicians have become more careful in their prescription practices: • They try to prescribe the lowest effective dose • They gradually reduce or stop medication weeks or months after the patient begins functioning normally
![New Antipsychotic Drugs Recently new drugs have been developed Called atypical because New Antipsychotic Drugs • Recently, new drugs have been developed • Called “atypical” because](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-41.jpg)
New Antipsychotic Drugs • Recently, new drugs have been developed • Called “atypical” because their biological operation differs from that of conventional antipsychotics • They appear more effective than conventional drugs, especially for negative symptoms • They cause few extrapyramidal side effects (i. e. , movement disorders) • Examples: Clozaril, Risperdal, Zyprexa, Seroquel, Geodon, and Abilify
![Psychotherapy Before the discovery of antipsychotic drugs psychotherapy was not an option for Psychotherapy • Before the discovery of antipsychotic drugs, psychotherapy was not an option for](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-42.jpg)
Psychotherapy • Before the discovery of antipsychotic drugs, psychotherapy was not an option for people with schizophrenia • Most were simply too far removed from reality to profit from psychotherapy • Today, psychotherapy can be very helpful when used in combination with medication • The most helpful forms of psychotherapy include insight therapy and two broader sociocultural therapies: family therapy and social therapy • These approaches are often combined
![Psychotherapy Insight therapy A variety of insight therapies have been used to Psychotherapy • Insight therapy • A variety of insight therapies have been used to](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-43.jpg)
Psychotherapy • Insight therapy • A variety of insight therapies have been used to treat schizophrenia • Studies suggest that the orientation of therapist is less important than their experience with schizophrenia • In addition, the most successful therapists are those who take an active role, set limits, express opinions, and challenge the patients’ statements
![Psychotherapy Family therapy About 25 of persons recovering from schizophrenia live with Psychotherapy • Family therapy • About 25% of persons recovering from schizophrenia live with](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-44.jpg)
Psychotherapy • Family therapy • About 25% of persons recovering from schizophrenia live with family members • This creates significant family stress • Those who live with relatives who display high levels of expressed emotion are at greater risk for relapse than those who live with more positive or supportive families • Family therapy attempts to address such issues, create more realistic expectations, and provide psychoeducation about the disorder
![The Community Approach The community approach is the broadest approach for the treatment The Community Approach • The community approach is the broadest approach for the treatment](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-45.jpg)
The Community Approach • The community approach is the broadest approach for the treatment of schizophrenia • In 1963, Congress passed the Community Mental Health Act, which said that patients should be able to receive care within their own communities, rather than being transported to institutions far from home • This led to massive deinstitutionalization of patients with schizophrenia • Unfortunately, community care was (and is) inadequate for their care • The result is a “revolving door” syndrome
![What Are the Features of Effective Community Care People recovering from schizophrenia and What Are the Features of Effective Community Care? • People recovering from schizophrenia and](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-46.jpg)
What Are the Features of Effective Community Care? • People recovering from schizophrenia and other severe disorders need medication, psychotherapy, help in handling daily pressures and responsibilities, guidance in making decisions, training in social skills, residential supervision, and vocational counseling • This combination of services sometimes is called assertive community treatment
![How Has Community Treatment Failed There is no doubt that effective community programs How Has Community Treatment Failed? • There is no doubt that effective community programs](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-47.jpg)
How Has Community Treatment Failed? • There is no doubt that effective community programs can help people with schizophrenia recover • However, fewer than half of all people who need them receive appropriate community mental health services • In any given year, 40% to 60% of all people with schizophrenia receive no treatment at all • Two factors are primarily responsible: • Poor coordination of services • Shortage of services
![What Are the Consequences of Inadequate Community Treatment When community treatment fails many What Are the Consequences of Inadequate Community Treatment? • When community treatment fails, many](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-48.jpg)
What Are the Consequences of Inadequate Community Treatment? • When community treatment fails, many people with schizophrenia receive no treatment at all • Some return to their families and receive medication and perhaps emotional and financial support, but little else in the way of treatment
![](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-49.jpg)
![What Are the Consequences of Inadequate Community Treatment Finally a great number of What Are the Consequences of Inadequate Community Treatment? • Finally, a great number of](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-50.jpg)
What Are the Consequences of Inadequate Community Treatment? • Finally, a great number of people with schizophrenia become homeless • Approximately one-third of the homeless people in America have a severe mental disorder, commonly schizophrenia
![The Promise of Community Treatment Today community care is a major feature of The Promise of Community Treatment • Today community care is a major feature of](https://slidetodoc.com/presentation_image/366af56b05026ffaa499f0c923715ccc/image-51.jpg)
The Promise of Community Treatment • Today community care is a major feature of treatment for people recovering from schizophrenia in countries around the world • Both in the U. S. and abroad, varied and well coordinated community treatment is seen as an important part of the solution to the problem of schizophrenia
Normal loss treatment in process costing
Chapter 31 schizophrenia and other psychoses
Chapter 12 schizophrenia spectrum disorders
Is schizophrenia on a spectrum
Psychosis and ptsd
Schizophrenia types
Mild psychosis
Culture bound syndrome examples
Types of psychosis and neurosis
Dr angel rodriguez-chevres
Types of psychosis and neurosis
Psychological disorders
Dopamine hypothesis psychosis
Geiteams
First episode psychosis
Margaret schlosser autopsy photos
Post ictal phase
Psychosis vs neurosis
Psychosis
Difference between psychosis and neurosis
Autoplastic defense
Mahler symbiotic psychosis
Thomas jansen abs
Psychosis
Neuroses
Psychomotor activity in mse
Brief psychotic disorder
Signs of schizophrenia in children
Humanistic approach to schizophrenia
Eugen beuler
First-line treatment for schizophrenia
Hebephrenic schizophrenia
Genain sisters
Donnie darko schizophrenia
Types of schizophrenia
Hebephrenic schizophrenia
Sel tmu
Schizophrenia disorganized behavior
Example of loose associations in schizophrenia
Hebephrenic schizophrenia
Phases of schizophrenia
Double bind
Negative explanatory style
Psychodynamic causes of schizophrenia
Associative looseness
Example of loose associations in schizophrenia
Motivational interviewing schizophrenia
Axis 1-5 mental health
Module 68: schizophrenia
Prevalence of schizophrenia
Complications of schizophrenia
Dsm 5 vs dsm 4