Simulate the Process: Schizophrenia Overview

            Screen 1: Schizophrenia Overview: Schizophrenia is characterized by an array of desires symptoms including extreme oddities in perception, thinking, action, sense of self, and manner of relating to others. This exercise will be reviewing the symptoms and types of schizophrenia.

            Screen 2: Schizophrenia positive symptoms: One way that the type of schizophrenic symptoms are differentiated is to classify them as positive symptoms are negative symptoms. Positive symptoms include delusions, hallucinations, disordered behavior, and disorganized speech. Most of us here some sort of voice in our heads most of the time. We replay conversations, have an inner dialogue etc. but these seem to be qualitatively different from what schizophrenics describe. Their voices are usually louder, more insistent, less controllable, and are perceived as “real.” For most of us, if attention is drawn to our voices, we can clearly recognize that they are fantasies or memories.

            Screen 3: Schizophrenia Negative Symptoms: Negative symptoms include flat affect (appears to be without a motion), alogia (brief, slow, empty replies to questions), and avolition (inability to initiate goal-director behavior). Some researchers refer to schizophrenia in which positive symptoms are predominant as Type I schizophrenia and Type II for a condition in which negative symptoms are the most common. Some suggest that the symptoms may be two different disorders with different causes. Others see these conditions as different points along a spectrum that may include other disorders, such as bipolar disorder and certain types of personality disorders or even certain variations of major or unipolar depression. Even if schizophrenia is seen as one of disorder the DSM-IV-TR recognizes that it can take on considerable different manifestations.

            Screen 4: Schizophrenia Various Classifications: The Diagnostic and Statistical Manual, Fourth Edition, Text Revised, the DSM IV TR, recognizes several categories of the general diagnosis Schizophrenia:

            Catatonic: The central feature is pronounced motor symptoms, of either an excited or a stuporous type, which sometimes make for difficulty in differentiating this condition from a psychotic to the disorder.

            Disorganized: Usually begins at an earlier age and represents a more severe disintegration of the personality than in other types of schizophrenia.

            Paranoid: A person is increasingly suspicious, has severe difficulties in interpersonal relationships, and experiences absurd, a logical, and often changing delusions.

            Residual: People who have experienced a schizophrenic episode from which they have recovered enough to not show prominent symptoms but are still manifesting some mild signs of their past disorder.

             Undifferentiated: A person meets the usual criteria for being schizophrenic—including (in varying combinations) delusions, hallucinations, thought disorder, and bizarre behavior—but does not clearly fit into one of the other types because of a mixed symptom picture.

            Screen 5: Case Study #1: View the video considering what types of symptoms (positive or negative) disease are being displayed. Then click next answer questions on this video.

            [Video]

            Interviewer: Hello, Jim. I am Dr. Conklin. Jim, can I get you anything to drink?

            Client: No.

            Interviewer: How long have you been here at the Institute? How do you feel about            being here?

            Client: Okay.

            Interviewer: I understand you’re going to participate in a sweat lodge tomorrow?

            Client: I guess.

            Interviewer: Is that something you are looking forward to?

            Client: Yes.

            Screen 6: Questions on Case Study #1: In the previous video, Jim is displaying _________: A: Positive symptoms; B: Negative symptoms.

            A: Positive symptoms: Incorrect. Jim is presenting a typical set of negative symptoms: booze very little, engages in communication minimally, his voice is flat and lacks any emotional content, and his body posture is rigid and also portrays no motivation or motion.

            B: Negative symptoms: Correct! Jim is presenting a typical set of negative symptoms: moves very little, engages in communication minimally, his voice is flat and lacks any emotional content: and his body posture is rigid and also portrays no motivation or emotion.

            Screen 7: Case Study sign 2: View the video considering what types of symptoms (positive or negative) the fees are being displayed. Then click next to answer questions on this video.

            [Video]

            Interviewer: Good afternoon.

            Client: Hi, doctor.

            Interviewer: I understand that you have been reporting a voice that you hear quite a bit.

            Client: That’s right. I hear my cousin most of the time.

            Interviewer: Is your cousin male or female?

            Client: Wendy, her name is Wendy.

            Interviewer: Do you hear Wendy now?

            Client: Oh, yeah, all the time. I have to listen to you carefully to what you say so I can hear you over what she is saying.

            Interviewer: And what is she saying?

            Client: Oh, just stuff. She says I should get out of here. That this place isn’t good for me, that you’re pretty stupid, that the air in here is really dirty.

            Interviewer: Does her voice have a location?

            Client: Sure, she’s just behind me on my right side. If I turn towards her, she moves behind me so I can’t see her.

            Interviewer: Do you think she’s there behind you?

            Client: No, she’s in Toronto.

            Interviewer: But is it her speaking?

            Client: Yeah.

            Interviewer: How is that possible?

            Client: I guess it isn’t.

            Interviewer: So what is it really?

            Client: Oh, it’s her! I recognize her voice, and she knows things that only she would know. It’s not bad right now, but usually very insistent. She’s very insistent.

            Screen 8: Questions on Case Study #2: In the previous video, Carla is displaying _______ A: Positive symptoms; B: Negative symptoms?

            A: Correct! Although most patients exhibit both positive and negative symptoms, Carlos hallucinations are positive symptoms.

            B: Incorrect. Although most patients exhibit both positive and negative symptoms, Carla’s hallucinations are positive symptoms.

            Screen 9: Case Study #3: View the video considering what type of schizophrenia is being displayed. Then click next to answer questions on this video.

            [Video]

            Interviewer: Hello Helen, nice to see you today.

            Client: I don’t know about that. They’ve been at it again, you know. I guess you do know, know-it-all that you are. They keep trying to get at me. I notice you keep the TV focused on the channel they use. I guess that makes it easier for them to get it me, to find me, you know? They keep playing the news reports that are aimed at me, you know?

            Interviewer: So you are still viewing the TV as a means of getting at you?

            Client: Oh yeah, TV, radio, newspapers. They stack the crosswords, you know? Did you do the crossword today? I can do them in three seconds usually because they are aimed at me. I can decipher the clues better than anyone because they are meant for me.

            Interviewer: What is the gist of the message, Helen?

            Client: Like you don’t know! They want me to go away. I can save the earth, but they don’t want me to do that, do they?

            Interviewer: Who is they?

            Client: The big drug companies, the oil companies, the tobacco companies… I know what they are up to. Phony wars to make money, but they won’t tell us the truth, won’t publish our letters to the newspapers.

            Screen 10: Questions on Case Study sign 3: In the previous video, Helen could be diagnosed with which of the following types of schizophrenia? A: Catatonic; B: Disorganized; C: Paranoid; D: Residual; E: Undifferentiated?

            A: Catatonic: Incorrect. Did you notice Helen’s delusions and suspicions? These symptoms are common in paranoid schizophrenics.

            B: Disorganized: Incorrect: Did you notice Helen’s delusions and suspicions? The symptoms are common in paranoid schizophrenics.

            C: Paranoid: Correct! Helen’s delusions and suspicions could be evidence of a paranoid schizophrenic.

            D: Residual: Incorrect. Did you notice Helen’s delusions and suspicions? These symptoms are common in paranoid schizophrenics.

            E: Undifferentiated: Incorrect. Did you notice Helen’s delusions and suspicions? These symptoms are common in paranoid schizophrenics.

            Screen 11: Schizophrenia Summary:

            Current understanding: Schizophrenia is, in many ways, the prototypical mental disorder. It is vivid, debilitating and progressive. Currently, we have no real cure for this disorder and our attempts at treatment are mainly methods of relieving symptoms.

            Directions for Future Research: As research progresses, we will be able to explain the cause of these different types of symptoms and the different clusters of symptoms. Directions for research include:

• Some individuals diagnosed with schizophrenia eventually go into remission or are symptom-free; research into this process is very important when searching for true treatments.
• We need to refine our ability to diagnose it and look into the possibility that is in fact a number of disorders with different origins.
• We also need to look into the possibility that schizophrenia shares a common cause with some forms of depression, bipolar disorder, and various personality disorders.
• Current research is focusing on the genetics of this disorder, the correlation with several viral infections, the regions of the brain that appeared to lose neurons as the illness progresses, and the various neurotransmitters involved.