PSYC 223 EXAM 3 STUDY GUIDE
Schizophrenia
1. Know what differentiates a neurotic versus psychotic disorders.
Neurotic disorders: involve distressing symptoms that are not typically delusional or
hallucinatory, such as anxiety disorders or obsessive-compulsive disorder (OCD)
Psychotic disorders: involve significant disruptions in thinking, perception, and behavior,
including hallucinations, delusions, and disorganized thoughts.
● involve severe impairment in individuals' perception and understanding of reality
● Symptoms include:
○ Delusional thought content (i.e. believing the FBI is after you)
○ Abnormalities in sensory perception (i.e. auditory hallucinations)
2. Know the difference between positive and negative symptoms in Schizophrenia, as well
as define the various positive and negative symptoms discussed in class.
Schizophrenia: behavioral manifestations of structural abnormalities in the brain and their
various consequences; characterized by severe impairment in several areas of functioning:
● Positive symptoms: the presence of symptoms indicative of psychosis (break with
reality); symptoms that are in excess to normal behavior
○ Thought content - is what you’re thinking and saying making sense to the general
population? e.g. delusions - a false belief that meets the following criteria:
■ Certainty - held with absolute conviction
■ Incorrigibility - Not changeable by compelling counterargument or proof
to the contrary
■ Preoccupation - the delusional belief is the focus of all thought and action
■ Impossibility or falsity of content - Implausible or patently untrue
■ Bizarre and Non-bizarre Delusions: Non-bizarre: Theoretically possible
but clearly untrue; Bizarre: Violate the accepted laws of nature
○ Perception (hallucinations and illusions)
■ e.g. hallucination: a false perception of objects or events involving the
senses; you’re seeing something that is not there; e.g. “There’s someone in
the corner looking at me” (there is no one in the corner)
● Auditory (most common): usually negative and insulting;
commanding - voices telling you to do things
● Visual: e.g. Shadowy figures, bugs crawling over the ground
● Tactile: e.g. Bugs crawling on your skin; feelings of electricity
shooting around your body
● Olfactory: e.g. Smelling rotting flesh
, ● Somatic: e.g. Feel like they can feel their kidney rotting inside of
them; physically feeling something terrible happening to their body
● Gustatory: e.g. Tasting different weird sensations/tastes
■ Hallucinations are fairly common in the general population: e.g., Ohayon
(2000) found that 38% of the sample (N = 13,057) experienced some
hallucination, with only .6% being strongly related to psychosis.
■ Illusion: seeing something that is there but it’s warped (more common)
● e.g. “the lights in here are blinding” (there are lights in there, but
they’re not blinding)
○ Form of thought: e.g., vague, unfocused, and seemingly pointless discourse;
deficits in working memory; not being able to hold information in your memory
● Negative symptoms: loss of normal traits or abilities; things that normally people have
but are lost in schizophrenia
○ Affect (how you feel): e.g., flat affect (you just won the lottery! No response),
mood lability (excessive variation in affect, often inappropriate to the situation)
○ Volition (the power of using one’s will): e.g., loss of drive or motivation
○ Impairment in interpersonal relationships: e.g., social withdrawal
○ Identity: e.g., confusion about personal identity and confused boundaries between
the internal and external world; Built up over time; in schizophrenia, there are
impairments that lead to a breakdown of the self-other boundaries
○ Psychomotor behavior: e.g., hyperactivity (the person is super energetic),
catatonic rigidity (the person doesn’t move; is stationary)
3. Know the difference between the various subtypes of Schizophrenia.
Subtypes of Schizophrenia
Paranoid subtype: characterized by preoccupation with persecutory delusions or auditory
hallucinations
● Delusional beliefs that they cannot be convinced of otherwise
Disorganized subtype: exhibits prominent disorganized speech and behavior (broader breakdown
of executive function)
● Prominent disorganized speech and behavior: struggles to connect their sentences fluently
(Mattson’s personal experience of seeing schizophrenic patients who were
institutionalized for long periods appeared to fall more into the disorganized subtype)
○ Possible hypothesis for this is that they didn’t get the proper medication for
treatment
● Flat or inappropriate emotional expressions
, Catatonic subtype: involves motor immobility or excessive motor activity like waxy flexibility
(can be moved into peculiar positions and that’s how they would stay); Catatonic is rare
4. Be able to identify the changes in the Schizophrenia diagnosis across the DSM-IV to
DSM-V.
Changes in DSM-V
DSM-V requires a greater number of symptoms for diagnosis
● Two (as opposed to one) of the following: delusions, hallucinations, disorganized speech,
behavior, and negative symptoms.
● The intent behind this was to make the criteria higher for one to be classified as
schizophrenic
● Individual must have one of the most blatant symptoms: delusions, hallucinations, or
disorganized speech
Subtypes were removed due to lack of research support or clinical evidence (more recently we
have not seen the breakdown for these subtypes)
A dimensional approach was introduced to rate the severity of schizophrenic symptoms
● Mattson’s experience with this has been low reliability across multiple clinicians
classifying the same patient on the degree of severity
5. Know the main neurotransmitters thought to be involved in Schizophrenia, as well as the
brain areas that are implicated in the disorder.
Structural Abnormalities
● Schizophrenia patients show increased lateral ventricular areas volume (caused by brain
degeneration in this area)
● Decreased frontal, temporal, and whole brain volume affects cognitive processes and
memory formation.
○ Frontal lobe: Higher-order cognitive processes
○ Hippocampus: Long-term memory formation
● Aside: there are some early signs from people who are likely to develop schizophrenia
through signs of irregular eye movement patterns while reading
Research suggests an interplay of neurotransmitters like dopamine and glutamate in
schizophrenic symptoms.
● Dopamine (reward-circuitry) (different theories)
○ increased brain levels of dopamine underlie schizophrenic symptoms
○ Increased number of receptors for dopamine: it’s not the level of dopamine but
the number of receptors that is causing the symptoms in schizophrenia
Schizophrenia
1. Know what differentiates a neurotic versus psychotic disorders.
Neurotic disorders: involve distressing symptoms that are not typically delusional or
hallucinatory, such as anxiety disorders or obsessive-compulsive disorder (OCD)
Psychotic disorders: involve significant disruptions in thinking, perception, and behavior,
including hallucinations, delusions, and disorganized thoughts.
● involve severe impairment in individuals' perception and understanding of reality
● Symptoms include:
○ Delusional thought content (i.e. believing the FBI is after you)
○ Abnormalities in sensory perception (i.e. auditory hallucinations)
2. Know the difference between positive and negative symptoms in Schizophrenia, as well
as define the various positive and negative symptoms discussed in class.
Schizophrenia: behavioral manifestations of structural abnormalities in the brain and their
various consequences; characterized by severe impairment in several areas of functioning:
● Positive symptoms: the presence of symptoms indicative of psychosis (break with
reality); symptoms that are in excess to normal behavior
○ Thought content - is what you’re thinking and saying making sense to the general
population? e.g. delusions - a false belief that meets the following criteria:
■ Certainty - held with absolute conviction
■ Incorrigibility - Not changeable by compelling counterargument or proof
to the contrary
■ Preoccupation - the delusional belief is the focus of all thought and action
■ Impossibility or falsity of content - Implausible or patently untrue
■ Bizarre and Non-bizarre Delusions: Non-bizarre: Theoretically possible
but clearly untrue; Bizarre: Violate the accepted laws of nature
○ Perception (hallucinations and illusions)
■ e.g. hallucination: a false perception of objects or events involving the
senses; you’re seeing something that is not there; e.g. “There’s someone in
the corner looking at me” (there is no one in the corner)
● Auditory (most common): usually negative and insulting;
commanding - voices telling you to do things
● Visual: e.g. Shadowy figures, bugs crawling over the ground
● Tactile: e.g. Bugs crawling on your skin; feelings of electricity
shooting around your body
● Olfactory: e.g. Smelling rotting flesh
, ● Somatic: e.g. Feel like they can feel their kidney rotting inside of
them; physically feeling something terrible happening to their body
● Gustatory: e.g. Tasting different weird sensations/tastes
■ Hallucinations are fairly common in the general population: e.g., Ohayon
(2000) found that 38% of the sample (N = 13,057) experienced some
hallucination, with only .6% being strongly related to psychosis.
■ Illusion: seeing something that is there but it’s warped (more common)
● e.g. “the lights in here are blinding” (there are lights in there, but
they’re not blinding)
○ Form of thought: e.g., vague, unfocused, and seemingly pointless discourse;
deficits in working memory; not being able to hold information in your memory
● Negative symptoms: loss of normal traits or abilities; things that normally people have
but are lost in schizophrenia
○ Affect (how you feel): e.g., flat affect (you just won the lottery! No response),
mood lability (excessive variation in affect, often inappropriate to the situation)
○ Volition (the power of using one’s will): e.g., loss of drive or motivation
○ Impairment in interpersonal relationships: e.g., social withdrawal
○ Identity: e.g., confusion about personal identity and confused boundaries between
the internal and external world; Built up over time; in schizophrenia, there are
impairments that lead to a breakdown of the self-other boundaries
○ Psychomotor behavior: e.g., hyperactivity (the person is super energetic),
catatonic rigidity (the person doesn’t move; is stationary)
3. Know the difference between the various subtypes of Schizophrenia.
Subtypes of Schizophrenia
Paranoid subtype: characterized by preoccupation with persecutory delusions or auditory
hallucinations
● Delusional beliefs that they cannot be convinced of otherwise
Disorganized subtype: exhibits prominent disorganized speech and behavior (broader breakdown
of executive function)
● Prominent disorganized speech and behavior: struggles to connect their sentences fluently
(Mattson’s personal experience of seeing schizophrenic patients who were
institutionalized for long periods appeared to fall more into the disorganized subtype)
○ Possible hypothesis for this is that they didn’t get the proper medication for
treatment
● Flat or inappropriate emotional expressions
, Catatonic subtype: involves motor immobility or excessive motor activity like waxy flexibility
(can be moved into peculiar positions and that’s how they would stay); Catatonic is rare
4. Be able to identify the changes in the Schizophrenia diagnosis across the DSM-IV to
DSM-V.
Changes in DSM-V
DSM-V requires a greater number of symptoms for diagnosis
● Two (as opposed to one) of the following: delusions, hallucinations, disorganized speech,
behavior, and negative symptoms.
● The intent behind this was to make the criteria higher for one to be classified as
schizophrenic
● Individual must have one of the most blatant symptoms: delusions, hallucinations, or
disorganized speech
Subtypes were removed due to lack of research support or clinical evidence (more recently we
have not seen the breakdown for these subtypes)
A dimensional approach was introduced to rate the severity of schizophrenic symptoms
● Mattson’s experience with this has been low reliability across multiple clinicians
classifying the same patient on the degree of severity
5. Know the main neurotransmitters thought to be involved in Schizophrenia, as well as the
brain areas that are implicated in the disorder.
Structural Abnormalities
● Schizophrenia patients show increased lateral ventricular areas volume (caused by brain
degeneration in this area)
● Decreased frontal, temporal, and whole brain volume affects cognitive processes and
memory formation.
○ Frontal lobe: Higher-order cognitive processes
○ Hippocampus: Long-term memory formation
● Aside: there are some early signs from people who are likely to develop schizophrenia
through signs of irregular eye movement patterns while reading
Research suggests an interplay of neurotransmitters like dopamine and glutamate in
schizophrenic symptoms.
● Dopamine (reward-circuitry) (different theories)
○ increased brain levels of dopamine underlie schizophrenic symptoms
○ Increased number of receptors for dopamine: it’s not the level of dopamine but
the number of receptors that is causing the symptoms in schizophrenia
