Abnormal Psychology Notes

3/15/99

1. Disorders of perception

1. Running Commentary

• patient states that voices tell her that she’ll never have a job, she’s a bad mother, negative things
• voices comment on her location and thoughts

1. Voices Converse

• argument about patient, saying things about her husband, female voice wants her to die

1. Disorder of affect

1. Flat Affect

• monotone, no facial expressions
• no reaction to statements made

1. Inappropriate Affect

• in the middle of talking about a job, starts randomly giggling when talking about a hard time

1. Motor Behavior

• patient begins to rock in his seat
• unusual way of holding pencil

1. Catatonic Behavior

• boy doesn’t react to therapist, but catches ball when thrown to him

1. Tardive dyskinesia

• crosses arms, taps fingers
• sticks tongue out

Disorganized Schizophrenia

1. Frequent Incoherence
2. Absence of Systematized Delusions
3. Blunted, Inappropriate or Silly Affect

• preoccupation with breaking words up
• delusion that father wanted to put blemish on his face to make him less pure
• changed his name because he doesn’t want to commit suicide; feels that suicide is when your name matches the one on an ID card
• parents were too feminine, drank too much coffee, trying to think of "fee" and what it means
• tries to find the meaning of parts of words instead of the meaning of the whole word

Paranoid Schizophrenia

1. Persecutory Delusions
2. Grandiose Delusions
3. Delusional Jealousy
4. Hallucinations with persecutory or grandiose content

• could recognize some of the voices as his friends’ voices, were saying that they wanted to kill him and his family
• voices make him do dangerous things to himself = perverted thoughts
• lost a brother 2 years before the voices began, said it was suicide, but patient investigated who actually killed him; feel that this has compromised him
• voices say that they will get rid of him too

Prof made the statement: is mental illness a myth?

• school of psychiatrists 25 years ago felt that it was actually a myth started by Pinel
• schizophrenics are the ones who are well adjusted and the rest of the culture is poorly adjusted

In spite of all of the research, no cure or prevention has been found

Is it a homogeneous disorder?

Schizophrenic Spectrum

1. Schizoid personality à loner, withdrawn
2. Schizotypal personality à some symptoms at a highly reduced level
3. ?? paranoia à island of decompensation surrounded by intact personality; high functioning

Dimensions:

1. paranoid vs. non paranoid
2. acute vs. chronic
3. reactive vs. process
4. good premorbid personality vs. poor premorbid personality

Prognosis:

1. If patient was married, disorder occurred at a later time – reactive – good
2. If patient held a job for more than 2 years – reactive – good
3. If patient had academic or vocational training – reactive – good
4. Gang/clique membership – poor
5. Dated steadily as a teenager (cultural) – good
6. Like physical education – good
7. Tell anyone that they were deeply in love – good
8. Short jobs – poor
9. Purchased a house – good
10. Sudden life changes – poor
11. Long term hospitalization – poor

text: environment and genetics both play roles; diathesis stress model

autointoxication hypothesis à generates substances that are intoxicating; byproduct of metabolic process

• supported due to tranquilizer modulated the positive symptoms
• tranquilizers were not developed in a logical way; empirical, not deductive

Genetics

• single gene?
• not a homogeneous disorder – probably at least 2 genes, otherwise concordance rate between monozygotic twins should be around 95%

3/17/99

Personality Disorders:

• psychopathology because it’s in the DSM IV
• can’t be justified otherwise
• close association with substance abuse

personality à character; enduring; begins early in life

views:

1. personality is determine by environment (situational)
2. personality is determined by traits occurring early in life

• if you use situational view, individual is reacting to situations they are put into which is not psychopathology

French: moral mania à character defect à antisocial personality disorder

certain disorders have been taken in and out over the years; catchall for disorders that did not fit in elsewhere in the DSM

• at one time included: sexual deviance, paraphilias, fingernail biting, narcolepsy, tics

Antisocial Personality Disorder:

• willingly violates the rights of others
• no anxiety, guilt, concern for others
• amoral
• rejects authority
• doesn’t profit from experiences
• poor interpersonal skills
• most likely to be a male

research has shown deficiency in emotional arousal – stimulation seeker, risk taker

Paranoid Personality Disorder:

• suspiciousness, hypersensitive, envious, argumentative

Schizoid Personality Disorder:

• loner, lack of social interest, cold, distrustful, solitary, poor relationship skills

Schizotypal Personality Disorder:

• eccentric in communication, oversensitive, reality and orientation is good, likely to overinterpret a chance occurrence