Abnormal Psychology

Criteria of abnormality:
1. Statistical deviation  unusual
2. Social norm violation
3. Maladaptive behaviour self/other
4. Personal distress
Schizophrenia:
1 in 100 will develop Schizophrenia statistically
Demonic possession  in medieval times, saw Schizophrenia as demonic
possession and people use to trepan the skull to release it.
Diagnostic criteria for Schizophrenia: two of the following, each present for
a significant portion of time during a 1-month period…
 Delusions:
 Hallucinations
 Disorganised speech and behaviour
 Negative symptoms

Delusions:
 A false belief
 Held on to despite evidence
 Foreign to most members of the culture* examinable
 May be bizarre
Refers to a belief that would be seen by most members of society as a
misrepresentation of reality, often referred to as a disorder of thought
content. Delusions are often called the basic characteristics of madness.
Two types of theories are used to explain delusions: motivational theories
see delusions as a means of dealing with anxiety and stress, or a way of
making sense of the world; deficit theories see brain dysfunction as the
cause of delusions. Types of delusions include:
 Delusions of grandeur, or the belief that one is particularly famous or
important.
 Delusions of persecution refer to a common belief that other people are
out to get or harm the person.
 Capgras syndrome, the belief that someone a person knows has been
replaced by a double. E.g. belief that family members have been
kidnapped and replaced by identical looking imposters.
 Cotard’s syndrome, where the person believes he or she is dead.
 Fregoli’s delusion, the belief that a persecutor adopts different
appearances.
 Lycanthropy, the belief that one is a werewolf.

Major sub-types of delusions:

 Paranoid – most common of delusions.
 Grandiose – delusions that focus on your having special powers.
 Somatic – delusions that surround body image.
 Erotomanic – usually takes two forms dependent on gender. Women
believe people in society usually of higher social ranking is in love with
her. Men stalk people – become obsessed with this figure.

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Hallucinations: What’s the different between an illusion and hallucinations.
A false perception  There isn’t anything there
Illusion there is an actual stimulus, just distorting way it is viewed, whereas
hallucinations there is nothing there.
 Auditory
 Visual
 Tactile
 Olfactory
Hallucinations refer to the experience of sensory events without any input
from the surrounding environment. Hallucinations can involve any of the
senses; though auditory hallucinations (i.e., hearing things that are not
there) are most common in persons with schizophrenia.
 a. Hallucinations are related to the concept of metacognition, or thinking
about one’s thinking. Auditory hallucinations are thought by some to be
intrusive thoughts, which are perceived as coming from someone else.
They then worry about these thoughts.
 b. Single photon emission tomography (SPECT) has been used to study
cerebral blood flow in schizophrenic patients during their auditory
hallucinations. The part of the brain most active during auditory
hallucinations is Broca’s area (i.e., the area involved in speech
production), not Wernicke's area (i.e., the area involved in understanding
and language comprehension). This research supports the idea that
auditory hallucinations do not involve hearing voices of others, but rather
patients listening to their own thoughts or their own voices, and a failure
to recognize the difference.

Disorganized symptoms of schizophrenia include rambling speech, erratic

behavior or catatonic behavior, and inappropriate affect. Neologisms (made
up words) and negative symptoms i.e. attentive flattering.
1. Disorganized speech refers to several often frustrating forms of
communication problems in persons with schizophrenia. Examples include:

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a. Cognitive slippage often manifests as illogical and incoherent speech
where the person jumps from one topic to the next.
b. Tangentially manifests as “going off on a tangent” rather than
answering a question directly.
c. Loose associations or derailment refers to changing a conversational
topic in unrelated areas.

Positive symptoms = things that schizophrenic people have that we do not

have – additional characteristics and associations that affect schizophrenic
patients.
1. Delusions
2. Hallucinations
3. Disorganised speech
4. Disorganised behaviour

Negative symptoms of schizophrenia indicate the absence or insufficiency of

normal behavior and include emotional or social withdrawal, apathy, and
poverty of thought or speech. Approximately 25% of people with
schizophrenia experience these symptoms.
1. Avolition or apathy refers to the inability to initiate and persist in
activities. Persons with this feature show little interest in performing even
the most basic daily functions, such as personal hygiene
2. Alogia refers to the relative absence of speech. This feature may manifest
as brief replies to questions with little content, delayed comments or slowed
responses to questions, or as disinterest in conversation. This feature is
thought to reflect a negative thought disorder, not inadequate
communication skills.
3. Anhedonia refers to a lack of pleasure, or indifference to activities that
would normally be considered pleasurable, including eating, social
interactions, and sexual activities.

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4. Affective flattening, or flat affect, occurs in about two-thirds of persons
with schizophrenia, and refers to an absence of normally expected
emotional responses. Persons with flat affect show little change in facial
expression, but not the experience of appropriate emotions. This work
suggests that flat affect in schizophrenia may represent difficulty in
expressing emotion, not an inability to feel emotion. Lack of expressed
affect may be important in the development of schizophrenia. For example,
children who later develop schizophrenia show less positive and more
negative affect than normal siblings.

Schizophrenia with few negative symptoms is associated with…

o Good premorbid functioning
o Acute onset
o Better prognosis  the more symptoms you have

Schizophrenia with many negative symptoms is associated with:

o poor premorbid functioning
o insidious onset
o poor prognosis
o in most cases a chronic course leading to permanent impairment.

Paranoia predominates in some people. A type in which the following

criteria is met: preoccupation with one or more delusions or frequent
auditory hallucinations of a persecutory nature. With none of the following
characteristics prominent
a) Disorganised speech
b) Disorganised or catatonic behaviour.
c) Persons with the paranoid type of schizophrenia stand out because of
their hallucinations and delusions. Such persons have relatively intact
cognitive skills and affect and do not generally show disorganized

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 speech or flat affect. The paranoid type is associated with the best
prognosis.
d) Delusions and hallucinations usually have a theme of grandeur or
persecution.
e) DSM-IV-TR criteria specify a preoccupation with one or more delusions
or auditory hallucinations but without marked display of disorganized
speech, disorganized or catatonic behavior, or flat or inappropriate
affect.
f) Persons with the undifferentiated type do not neatly fit into any of
the other subtypes and include people with major symptoms of
schizophrenia but who do not meet criteria for paranoid, disorganized,
or catatonic types.
g) Persons with the residual type have had at least one episode of
schizophrenia but are no longer displaying major symptoms.
Such persons often display residual symptoms, such as negative
beliefs, unusual or bizarre ideas, social withdrawal, inactivity, or flat
affect.

Waxy flexibility  in the exam