Psychopathology and treatment

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Psychopathology and treatment

• To study the abnormal is the best way of knowing
  the normal W. James

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Schizophrenia
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What is schizophrenia?

• Medical model
• Delusions
• Hallucinations
• Flat Affect
• Incoherent thinking (word salad)

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Types of Schizophrenia

• Paranoid
• Catatonic
• Disorganized
• Undifferentiated

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We now classify on the basis of..

• Type of Symptoms
• Positive
• Negative
• Severity

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Whos crazy here anyway?

• The Social Model
• drapetomania

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Line between

• Mental health professionals determine (judge)
  where on the continuum behavior lies
• Which criteria to use?
• Bizarreness of Behavior
• Persistence of Behavior
• Social Deviance
• Subjective Distress
• Psychological Handicap
• Effect on Functioning

Normal Abnormal
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Role of Expectations

• Thunk

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Schizophrenia throughout the ages..

• What causes schizophrenia??
• How should we treat schizophrenia?

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Historical Therapies for Madness

• Caused by evil spirits
• Trephining

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Middle Ages

• Witchcraft, demonic possession, full moon,
  supernatural forces
• Exorcism, torture, primitive surgery,
  bloodletting, bitter poisons, starvation.

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Schizophrenia the 19th Century

• Cause trauma in infancy
• Therapy spinning chairs, drowning therapy, cold
  packs

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The 20th century therapiesLobotomy
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Electroshock therapy
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Anti-psychotic medications

• aka phenothiazines, neuroleptics
• The Dopamine Hypothesis

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Evidence against the dopamine hypothesis
I know theres something disturbing me but I
couldnt care less.
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What else might cause schizophrenia?

• Glutamate
• Brain lesions
• Genetic mutation
• Drug abuse
• Environmental causes?

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Side effects of antipsychotics

• Tardive dyskinesia

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Schizophrenia and the third world

• In the third world (1970)
• After 2 and 5 years, 64 were asymptomatic
• In the US and other developed countries
• After 2 and 5 years, 18 were asymptomatic

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Do they work?
When I was discharged from the hospital I was
told I had an incurable disease called
schizophrenia. The doctor told my family that my
chances of being rehospitalized were very high.
is medical orders were directed at my parents,
not me, and stated wit an absolute authority that
discouraged any challenge. He predicted a
lifetime in the back ward of a state hospital if
his orders were not followed."He will need to
take medication for the rest of his life. For
now, you need to bring him to the hospital weekly
for outpatient treatment and he must not see any
of his old friends."
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• The shoe that fits one person pinches another
  there is no recipe for living that suits all
  cases.
• Carl Jung

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How to help a schizophrenic?

• Your son Joe has schizophrenia with strong
  delusions.
• Today, he was bumped into on the subway. He
  tells you This is a government plot to harass
  me! The government thinks that if they keep this
  up, I will not tell about their plans
• What should YOU say?

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The man who thought he was the Terminator

• http//www.thislife.org/
• 4/16/04 Desperate Measures

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Antisocial personality disorder

• C - cannot follow law
• O - obligations ignored
• R - remorselessness
• R - recklessness
• U - underhandedness
• P - planning deficit
• T - temper

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3. Dissociative Identity Disorder

• Dissociation

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Skeptical?

• 1817-1970 lt 75 cases
• 1970-2006 gt 40,000 cases
• Other cultures
• Repressed memories

"I began to add a few things up and realized
there was no way I could come from a little town
in Iowa, be eating 2,000 people a year, and
nobody said anything about it."
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Beware!

• Medical Students Disorder is prevalent among
  psych students
• Psychological disorders are just exaggerations of
  tendencies that all of us have
• Being sad, anxious, or proud does not mean we are
  suffering from depression, narcissism, anxiety
  disorder or schizophrenia