Chapter 91. Symptoms of Schizophrenia

Learning Objectives

catatonia
disturbance in a person’s movement produced by a person’s mental state; often involves a trance-like stupor with rigid limbs
delusions
beliefs that do not match reality
disorganized behavior
in schizophrenia, repetitive, purposeless actions, or behaviors that don't fit the situation
disorganized speech
in schizophrenia, illogical or incoherent statements that jump from topic to topic
dopamine
neurotransmitter involved in movement and motivation; excessively high levels may produce distortions in perception or thinking
emotion
a conscious mental state or feeling that arises spontaneously as a reaction to events
flat affect
absence of normal, expected emotional reactions
hallucinations
false sensory experiences or distortions in perception
negative symptoms
in schizophrenia, the absence of normal emotions or typical behaviors
neurotransmitters
chemical messengers released by the axon terminal into the synaptic gap between neurons
paranoia
a distortion in thinking characterized by excessive suspicion and fear of other people
perception
organizing and interpreting information from the senses to understand its meaning
positive symptoms
in schizophrenia, the occurrence of unusual thoughts or behaviors, such as hallucinations, delusions, disorganized speech, or repetitive movements
psychological disorder
a disturbance in a person’s thinking, behavior, or emotions serious enough to cause distress
schizophrenia
a psychological disorder characterized by disturbed, irrational thinking and inappropriate emotional behavior
stimulus
an external event, such as a light or sound, detected by our senses
Concept Formation
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Illustration: Monochrome illustration similar to reference images; show young male or female in center, with hands on head or face, indicating confusion and fear; show human hands and robotic hands or claws reaching toward person from multiple positions
Learning Objectives:

Describe the major symptoms of schizophrenia.

Contrast positive and negative symptoms of schizophrenia.

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1. The term schizophrenia comes from the Greek words for "split mind." It is considered one of the most serious psychological disorders because it involves a break with reality severe enough to impair functioning and cause a person to experience difficulties in relationships, at school, and/or at work.

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The figure is a tree diagram. Schizophrenia is at the middle of the diagram with an arrow pointing to the left and to the right. The arrow to the left leads to negative symptoms, which include passive and withdrawn behavior. The arrow to the right leads to positive symptoms, which include active and unusual behavior. An arrow representing dopamine leads to the positive symptoms.

2. The symptoms of schizophrenia are often divided into positive symptoms and negative symptoms. Positive symptoms are active, unusual behaviors that demonstrate distortions in perception or thinking. These symptoms are associated with high levels of the neurotransmitter called dopamine. Negative symptoms are harder to notice, because they represent the absence of normal, expected behaviors.

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3. Hallucinations are perceptions of stimuli that are not really present. The most common hallucination is hearing voices. Some individuals with schizophrenia experience visual hallucinations (such as seeing blood dripping down the walls) or tactile hallucinations (such as feeling insects crawling on their skin).

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4. Delusions are beliefs that do not match reality. Some individuals with schizophrenia have delusions of grandeur, believing that they are some famous or powerful person. Others experience paranoia and have delusions of persecution, believing that someone or something is trying to harm them.

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Illustration: Representation of disorganized thinking; show front view of torso/head of young male or female, with hand or hands on temple/head in a pose suggesting deep thought; show thought bubble rising from head; inside thought bubble, show scribbles indicating chaotic, incoherent thinking

5. Other positive symptoms include disorganized speech (containing illogical or incoherent statements) or disorganized behavior (such as repetitive, purposeless actions, or behaviors that don’t fit the situation). Some individuals with schizophrenia also display catatonia, holding a rigid, motionless pose for hours at a time.

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6. The main negative symptom of schizophrenia is flat affect, an absence of normal emotional reactions. (Affect, with accent on the first syllable, is another word for mood or emotion.) Some individuals with schizophrenia also display social withdrawal, cutting off contact with friends and family.

Practice 1: Exploring Schizophrenic Symptoms

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Practice 1: Exploring Schizophrenic Symptoms

Roll over the images to see some of the symptoms associated with schizophrenia.

Symptoms:

Flat affect: absence of normal, expected emotional reactions (such as showing no sadness at the funeral of a close friend)

Disorganized speech: illogical or incoherent statements

Disorganized behavior: repetitive, purposeless actions, or behaviors that don't fit the situation (such as wearing a heavy coat on a hot summer day)

Hallucinations: false sensory experiences or distortions in perception

Delusions: beliefs that do not match reality

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Practice 2: Hallucinations and Delusions

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Practice 2: Hallucinations and Delusions

Select the PLAY button to hear this woman describe her symptoms.

These symptoms of schizophrenia indicate that the person has lost touch with reality. Hallucinations can occur in any of the senses, but they are usually auditory. People who experience auditory hallucinations may hear voices talking about them or giving commands, such as telling them to kill their family members. Often, the hallucinations are related to the person’s delusions.

People with delusions of persecution have paranoid thoughts that others are "out to get me." People with delusions of grandeur are convinced they have special powers or status, such as the ability to control other people’s thoughts.

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Practice 3: Disorganized Thinking and Behavior

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Practice 3: Disorganized Thinking and Behavior

Select the PLAY button to hear this man talk about his symptoms.

People who suffer from schizophrenia sometimes exhibit bizarre disorganized behavior—repetitive, purposeless movements or rigid immobility. Some schizophrenic patients repeatedly twirl their hair or shake their feet continuously for no apparent reason.

Another symptom is disorganized speech—a disturbed pattern of speech, perhaps filled with made-up words and sentence fragments, separated with long pauses. The person jumps from one topic to the next in a disorganized, incoherent manner.

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Quiz 1

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Quiz 1

Drag each term for a symptom of schizophrenia to the gray area near the appropriate scenario. When all the terms have been placed, select the CHECK ANSWER button.

Select the NEXT button and move to Quiz 2.
Perhaps you should go back to review the symptoms of schizophrenia.

Hikaru said, “The voices told me to stop taking my medications.”

Jenny refused to get onto the bus because “Cleopatra only rides in chariots.”

Maria’s face was expressionless and her voice was a monotone as she described winning the lottery.

Samuel said, “She put on her head and then became respectable. Stands up himself and eats it.”

After Kyle fell off his bike, he laughed uncontrollably when he saw that his leg was bleeding.

flat affect
disorganized speech
hallucinations
disorganized behavior
delusions

Quiz 2

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Quiz 2

Drag one of the terms for a symptom category to the gray area in front of each specific symptom of schizophrenia. When all the terms have been placed, select the CHECK ANSWER button.

Select the NEXT button and move to the Conclusion.
Perhaps you should go back to review the symptoms of schizophrenia.
positive symptom
positive symptom
positive symptom
negative symptom
negative symptom
negative symptom

hallucinations

flat affect (lack of emotions)

delusions

poor social functioning

low energy, apathetic

disorganized speech

Conclusion

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Illustration: Monochrome illustration similar to reference images; show young male or female in center, with hands on head or face, indicating confusion and fear; show human hands and robotic hands or claws reaching toward person from multiple positions
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