Summary Clinical psychopathology Chapter 8

8 Experiencing Psychosis: Schizophrenia Spectrum Problems

LEARNING GOALS 10,11,13
 Recognize the symptoms of schizophrenia, auditory verbal hallucinations in particular
 Apply the theories that may help explain psychosis
 Discuss the interventions available to people with psychotic disorders, in particular an
intervention for family members of people with psychotic disorders


8.1 THE NATURE OF PSYCHOTIC SYMPTOMS

-How is schizophrenia represented in the DSM-5?
positive symptoms (first 4)Characteristics of psychotic symptoms which tend to reflect an excess
or distortion of normal functions.

negative symptoms (5th)Symptoms characteristic of a diminution or loss of normal functions.

schizophrenia spectrum disorderThe name for separate psychotic disorders that range across a
spectrum depending on severity, duration and complexity of symptoms


Delusions= external stimuli

Hallucinations=internal
sensory




 8.1.1 Delusions

-What are the 5 types of illusion? What is their common feature?
DelusionsFirmly held but erroneous beliefs that usually involve a misinterpretation of
perceptions or experiences.

1)persecutory delusionsDelusions in which the individual believes they are being persecuted,
spied upon, or are in danger (usually as the result of a conspiracy of some kind).

2)delusions of controlDelusions where the person believes that his or her thoughts, feelings or
actions are being controlled by external forces (e.g. extra-terrestrial or supernatural beings)

3)delusions of referenceDelusions where the individual believes that independent external
events are making specific reference to him or her.

4)nihilistic delusionsDelusions where individuals believe that some aspect of either the world or
themselves has ceased to exist (e.g. the person may believe that they are in fact dead).

5)erotomanic delusionsRelatively rare psychotic delusions, where an individual has a delusional
belief that a person of higher social status falls in love and makes amorous advances towards

, them.

One common feature
of psychotic thought is that sufferers frequently believe that their thoughts are being interfered
with or controlled in some way, either by being openly broadcast to others or by having thoughts
planted into their mind by external forces
Cognitive deficits
They found that such erroneous beliefs generated higher than normal levels of activation in the
parietal cortex and cerebellum and they suggest that these areas of the brain may be altered
during psychotic episodes so that self-produced actions and thoughts are experienced as external.


 8.1.2 Hallucinations

-Which sensory hallucinations are the most common?
How are hallucinations manifested?
HallucinationsA sensory experience in which a person can see, hear, smell, taste or feel
something that isn’t there.

the most common are auditory hallucinations that are reported by around 70 per cent of sufferers

Research into brain areas
involved in speech generation and the perception of sounds suggests that when sufferers claim to
hear ‘voices’ this is associated with neural activation in these areas of the brain and the sufferer
attributes them to external sources

schizophrenic individuals differed in 2 important ways from non- clinical controls
reality-monitoring deficitWhere an individual has a problem distinguishing between what
actually occurred and what did not occur.

self-monitoring deficitWhere individuals cannot distinguish between thoughts and ideas they
generated themselves and thoughts or ideas that other people generated.




Feed forward Model
 Intending an action-->motor command-->SENSORY MOTOR CORTEX predicts action--
>output
 Sensory motor cortex is less active in HP
 Less able to pick up signals in the brain (self-monitoring deficit)