Schizophrenia Thomas G Bowers Ph D Penn State

Schizophrenia Thomas G. Bowers, Ph. D. Penn State Harrisburg 2000 1/20/2022 Copyright, 1996 © Dale Carnegie & Associates, Inc.

Schizophrenia • Concept is old • Noted by Kraepelin and Bleuler 1/20/2022

Schizophrenia • Bleuler - Four A’s – Affect - inappropriate – Ambivalence - difficulty choosing – Association - loosening – Autism - odd, peculiar behavior 1/20/2022

Schizophrenia • America expanded the concept – Schizoaffective disorder – Pseudoneurotic schizophrenia – Process-reactive distinction – Pre-morbid state 1/20/2022

Schizophrenia • Currently – Brief reactive psychosis (2 weeks) – Schizophreniform disorder – Schizophrenia 1/20/2022

Schizophrenia • Types – 1. Disorganized (hebephrenic) – 2. Catatonic – 3. Paranoid (delusional) – 4. Undifferentiated 1/20/2022

Schizophrenia • Theories of Schizophrenia • Jung: Toxin X • Difficulties in research – Schizophrenic individuals take many medications – Smoke, drink coffee heavily, poor diet, inactive 1/20/2022

Schizophrenia • Theories of Schizophrenia – Excessive dopamine theory – Parkinsons Disease • Deficient dopamine levels – Phenothiazines manage schizophrenia, but induce pseudoparkinsonianism 1/20/2022

Schizophrenia • Theories of Schizophrenia – Amphetamines raise dopamine levels – With chronic high dose use, yield toxic psychosis – Amphetamines make schizophrenic individuals much worse 1/20/2022

Schizophrenia • Theories of Schizophrenia – Early efforts to research this directly faced difficulties – Murphy & Wyatt (1972) compared 33 schizophrenic subjects with 22 normal controls • Found lower MAO levels • MAO can lower dopamine • Not found in later studies 1/20/2022

Schizophrenia • Theories of Schizophrenia – Like in depression, there appears to be a disjunction between psychopharmacological effects and behavioral effects 1/20/2022

Schizophrenia • Theories of Schizophrenia – Attempts to directly evaluate DA levels have been unsuccessful – Over possibilities • DA receptors over responsive • Post mortem findings indicate more DA receptors than expected • Many confounds 1/20/2022

Schizophrenia • Theories of Schizophrenia – CT/MRI Scans • Enlarged ventricles • Suggest limbic or diencephalic pathology 1/20/2022

Schizophrenia • Theories of Schizophrenia – Neuropsychological Findings • Halstead-Reitan - Many “false positives” • Luria-Nebraska - Fewer false positive, less sensitive, positive findings with enlarged ventricles 1/20/2022

Schizophrenia • Theories of Schizophrenia – Familial Theories • Schizophrenogenic mother • “Double mand” • Shouts “I love you” • May confuse cause and effect 1/20/2022

Schizophrenia • Theories of Schizophrenia – Cognitive theories • Input dysfucntion • Overinclusive thinking • Inability to preserve conceptual boundaries • Thinking becomes more abstract • E. G. “pen” versus “pen” 1/20/2022

Schizophrenia • Theories of Schizophrenia – Chapman • Rejected early psychoanalytical view • Focused on disruption of the reticular system 1/20/2022

Schizophrenia • Theories of Schizophrenia – Learning theory - Mednick • High drive and arousal state disturbs central cortical processes 1/20/2022