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Process vs. reactive schizophrenia
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Process schizophrenia refers to schizophrenia that has a gradual onset.
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Reactive schizophrenia refers to schizophrenia symptoms that have a sudden
onset, usually following a stressor.
Positive signs vs. negative signs
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The negative signs of schizophrenia are the symptoms where something has
"decreased or been taken away." Examples of negative signs include loss
of volition, flatness of affect, social withdrawal, and poverty of thought
content.
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The positive signs of schizophrenia are the symptoms where something has
been added. Examples are things like hallucinations and delusions and emotional
turmoil, where something "extra" is happening.
Symptoms of Schizophrenia
Disturbance of language and communication
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previously disturbance in thought form
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loose associations - - the most common type of thought disorder,
in which people rapidly shift from one topic to another. The statements
they make are inconsequential and incoherent, although the patient apparently
believes they make sense
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neologisms - - are made up words that have meaning only to
the person using them.
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perseveration - - repetition of words or phrases again and
again
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clang associations - - using rhyme as a guide to formulate
thoughts and statements.
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blocking - - involves thoughts disappearing midstream - a
person will just end midway through a thought, and have the experience
of losing the thought.
Disturbance of thought content (delusions)
there are 4 main types of delusions
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some people have delusions of persecution, in which they
believe they are being plotted or discriminated against, spied on, slandered,
threatened, attacked, or deliberately victimized
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some people have delusions of reference, in which they attack
special, personal significance to the actions of others, or to various
objects or events (messages on t.v., radio, or in the newspaper meant especially
for you, messages from the way things are arranged around you)
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delusions of grandeur are beliefs about being someone very
special, famous, or competent, or about personally having very special
or important powers or abilities. So the person may believe themselves
to be a messiah, religious savior, a person from history such as Napoleon,
or simply feel that they have extra special powers and abilities
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delusions of control are beliefs that one’s impulses, feelings,
thoughts, and actions are being controlled by other people.
Disruption of perception (hallucinations)
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sometimes a heightened sensitivity to sounds and sight, feel "flooded"
e.g. "I’m too alert, everything is super vivid, and I can’t seem to block
anything out"
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others show sensory blunting -a significant reduction in the strength of
their physical sensations. It is possible that this blunting is actually
a reaction to heightened sensitivity - an over-compensation
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hallucinations - the most severe perceptual disturbance - can occur in
any modality
Disturbance of affect and emotion
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blunted of flat affect - - they may manifest less anger,
sadness, joy, etc. than other people. Some show little or no emotion at
all.
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inappropriate affect - - emotional reactions that are unsuited
to the situation. e.g. may smile when saying something very serious, laughing
at a funeral, but not from nervousness
Confused sense of self
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often have an altered sense of persona agency - may be part of control
delusions
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sometimes have the experience of being somehow connected with the supreme
being, and acting as an agent of that being
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often the boundaries between me and not-me become blurred
Disrupted volition
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a negative sign of schizophrenia
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often fail to take care of themselves, make decisions, engage in even minimally
planful behavior
Retreat to an inner world
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active disengagement from the environment
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may retreat into an inner world of fantasy ("I Never Promised You a Rosegarden")
Disturbed motor behavior
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often show a loss of spontaneous movement, becoming very still, or may
adopt odd grimaces, gestures, and mannerisms
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in an extreme form, this is called catatonia
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catatonic stupor - - people become totally unresponsive to
their environment, remaining motionless and silent for long stretches of
time
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catatonic rigidity - - occurs when the person remains very
rigid, in an upright posture for hours at a time, resisting all efforts
to be moved
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catatonic posturing - - involves assuming awkward, bizarre
positions for long periods of time (may show "waxy flexibility")
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catatonic excitement - - the opposite of other forms of catatonia,
involving the excited movement of limbs, waving arms and legs wildly