Schizophrenia Spectrum and Other Psychotic Disorders:
• Psychosis - unable to tell the difference b/t what is real & what is unreal
➢ Can take many forms – one of the most severe & puzzling is:
o Schizophrenia at times these inds think & communicate clearly, have an accurate view of
reality & function well in daily life &
▪ at other times, during the active phase of their illness, their thinking & speech are
disorganised, they lose touch with reality & they have difficulty caring for themselves
JUST SOME INFO ON SCHIZOPHRENIA (READ)
• Schizophrenia & other psychotic disorders exact a heavy toll, including high medical costs
➢ more than 90% of ppl with psychotic disorders seek treatment in a mental health/general
medicine facility in a given year
• Most ppl who develop psychotic disorders do so in the late teenage/early adult years, when they
are ready to begin contributing to society
➢ instead of pursuing their education, a career/a family, they may need continual services,
including:
o residential care, rehabilitative therapy, subsidised income & the help of social workers to
obtain needed resources
▪ they may need these services for the rest of their lives as schizophrenia tends to be
chronic
• Majority of ppl with schizophrenia live independently/with their family – there are almost as many
people with schizophrenia in jails, prisons, homeless shelters & on the street as there are in
hospitals & nursing homes
➢ CJS & shelters often are repositories for ppl with schizophrenia who don’t have a family to
support them/the resources to receive psychiatric help
Symptoms, Diagnosis & Course
Schizophrenia is a complex diagnosis with psychosis as its core diagnostic symptom
• DSM-5 refers to schizophrenia spectrum = reflects the fact that there are 5 domains of symptoms
that define psychotic
disorders, & their number, severity & duration distinguish psychotic disorders from each other
• Ppl with schizophrenia may show all/just some psychotic symptoms & the disorder can look
different across indivs
• 5 domains of psychotic symptoms:
- delusions,
- hallucinations,
- disorganised thought (speech),
- disorganised/abnormal motor behaviour (including catatonia) &
- negative symptoms (restricted emotional expression/affect)
• Ppl with schizophrenia often show numerous cognitive deficits that RES has shown are linked to
declines in functioning
– not part of diagnostic criteria
Positive Symptoms
Described as positive because they represent overt expressions of unusual perceptions, thoughts
& behaviours
Delusions
- ideas that an indiv believes are true but that are highly unlikely & often simply impossible
• Most ppl occasionally hold beliefs that are likely to be wrong (eg. belief that they will win the
lottery)
o these self-deceptions differ from delusions in at least 3 ways:
1) Self-deceptions are at least possible, whereas delusions often are not
a. EG possible to win the lottery, not possible that body is dissolving
, 2) Ppl harbouring self-deceptions may think about these beliefs occasionally, but ppl with
delusions tend to be preoccupied with them
3) Ppl holding self-deceptions typically acknowledge that their beliefs may be wrong, but ppl
holding delusions often are highly resistant to arguments/compelling facts that contradict
their delusions
a. They may view arguments others make against their beliefs as a conspiracy to silence them &
as evidence of the truth of their beliefs
able above lists more common types of delusions
• Most common = persecutory delusions these ppl may believe they are being watched/
tormented by other ppl they know, or by agenicies or persons in authority with whom they have
never had direct contact (eg. FBI)
• Another common type = delusion of reference ppl believe that random events/comments by
others are directed at them
• Grandiose delusions beliefs that one is a special being/possesses special powers (eg. She
believe she is the most intelligent person on earth)
• Delusions of thought insertion
Delusions can be simple & transient (eg. person with schizophrenia believes pain in stomach is
result of someone shooting a
laser beam at him) BUT
• are often complex & elaborate, with the person clinging to these beliefs for long periods (READ:
Profiles – pg.219)
Delusions also occur in other disorders: indivs with severe forms of depression/bipolar disorder
often have delusions that are consistent with their moods
• When they are depressed they may believe they have committed some unforgiveable sin & when
they are manic they may believe they are a deity
Specific content of delusions can differ across cultures:
• British being controlled by televisions, radios & computers
• Pakistani being controlled by black magic
➢ Differences in content of delusions probably reflect differences in the cultures’ belief systems as
well as differences in the ppl’s environments
• Japanese delusions of being slandered by others & that others know something terrible about
them perhaps due to emphasis on being thought well of by others
• German & Austrians religious delusions of committing a sin, perhaps due to the influence of
ChristianitySome theorists argue that odd/impossible beliefs that are part of a culture’s shared
belief system cannot be considered
delusions
• if the ppl of a particular culture believe that the spirits of dead relatives watch over the living, then
they are not
considered delusional
➢ However, ppl who hold extreme manifestations of their culture’s shared belief systems are
considered
delusional
o EG person who believed that their dead relatives were causing her heart to rot would be
considered delusional
DSM-V changes the definition of delusions to “fixed beliefs that are not amendable to change in
light of conflicting evidence”
from “erroneous beliefs” (as in DSM-IV) because it is often highly difficult to establish the fully false
nature of a belief
• Psychosis - unable to tell the difference b/t what is real & what is unreal
➢ Can take many forms – one of the most severe & puzzling is:
o Schizophrenia at times these inds think & communicate clearly, have an accurate view of
reality & function well in daily life &
▪ at other times, during the active phase of their illness, their thinking & speech are
disorganised, they lose touch with reality & they have difficulty caring for themselves
JUST SOME INFO ON SCHIZOPHRENIA (READ)
• Schizophrenia & other psychotic disorders exact a heavy toll, including high medical costs
➢ more than 90% of ppl with psychotic disorders seek treatment in a mental health/general
medicine facility in a given year
• Most ppl who develop psychotic disorders do so in the late teenage/early adult years, when they
are ready to begin contributing to society
➢ instead of pursuing their education, a career/a family, they may need continual services,
including:
o residential care, rehabilitative therapy, subsidised income & the help of social workers to
obtain needed resources
▪ they may need these services for the rest of their lives as schizophrenia tends to be
chronic
• Majority of ppl with schizophrenia live independently/with their family – there are almost as many
people with schizophrenia in jails, prisons, homeless shelters & on the street as there are in
hospitals & nursing homes
➢ CJS & shelters often are repositories for ppl with schizophrenia who don’t have a family to
support them/the resources to receive psychiatric help
Symptoms, Diagnosis & Course
Schizophrenia is a complex diagnosis with psychosis as its core diagnostic symptom
• DSM-5 refers to schizophrenia spectrum = reflects the fact that there are 5 domains of symptoms
that define psychotic
disorders, & their number, severity & duration distinguish psychotic disorders from each other
• Ppl with schizophrenia may show all/just some psychotic symptoms & the disorder can look
different across indivs
• 5 domains of psychotic symptoms:
- delusions,
- hallucinations,
- disorganised thought (speech),
- disorganised/abnormal motor behaviour (including catatonia) &
- negative symptoms (restricted emotional expression/affect)
• Ppl with schizophrenia often show numerous cognitive deficits that RES has shown are linked to
declines in functioning
– not part of diagnostic criteria
Positive Symptoms
Described as positive because they represent overt expressions of unusual perceptions, thoughts
& behaviours
Delusions
- ideas that an indiv believes are true but that are highly unlikely & often simply impossible
• Most ppl occasionally hold beliefs that are likely to be wrong (eg. belief that they will win the
lottery)
o these self-deceptions differ from delusions in at least 3 ways:
1) Self-deceptions are at least possible, whereas delusions often are not
a. EG possible to win the lottery, not possible that body is dissolving
, 2) Ppl harbouring self-deceptions may think about these beliefs occasionally, but ppl with
delusions tend to be preoccupied with them
3) Ppl holding self-deceptions typically acknowledge that their beliefs may be wrong, but ppl
holding delusions often are highly resistant to arguments/compelling facts that contradict
their delusions
a. They may view arguments others make against their beliefs as a conspiracy to silence them &
as evidence of the truth of their beliefs
able above lists more common types of delusions
• Most common = persecutory delusions these ppl may believe they are being watched/
tormented by other ppl they know, or by agenicies or persons in authority with whom they have
never had direct contact (eg. FBI)
• Another common type = delusion of reference ppl believe that random events/comments by
others are directed at them
• Grandiose delusions beliefs that one is a special being/possesses special powers (eg. She
believe she is the most intelligent person on earth)
• Delusions of thought insertion
Delusions can be simple & transient (eg. person with schizophrenia believes pain in stomach is
result of someone shooting a
laser beam at him) BUT
• are often complex & elaborate, with the person clinging to these beliefs for long periods (READ:
Profiles – pg.219)
Delusions also occur in other disorders: indivs with severe forms of depression/bipolar disorder
often have delusions that are consistent with their moods
• When they are depressed they may believe they have committed some unforgiveable sin & when
they are manic they may believe they are a deity
Specific content of delusions can differ across cultures:
• British being controlled by televisions, radios & computers
• Pakistani being controlled by black magic
➢ Differences in content of delusions probably reflect differences in the cultures’ belief systems as
well as differences in the ppl’s environments
• Japanese delusions of being slandered by others & that others know something terrible about
them perhaps due to emphasis on being thought well of by others
• German & Austrians religious delusions of committing a sin, perhaps due to the influence of
ChristianitySome theorists argue that odd/impossible beliefs that are part of a culture’s shared
belief system cannot be considered
delusions
• if the ppl of a particular culture believe that the spirits of dead relatives watch over the living, then
they are not
considered delusional
➢ However, ppl who hold extreme manifestations of their culture’s shared belief systems are
considered
delusional
o EG person who believed that their dead relatives were causing her heart to rot would be
considered delusional
DSM-V changes the definition of delusions to “fixed beliefs that are not amendable to change in
light of conflicting evidence”
from “erroneous beliefs” (as in DSM-IV) because it is often highly difficult to establish the fully false
nature of a belief
