Schizophrenia

1
Schizophrenia

• and Schizoaffective Disorder
• DSM-IV-TRTM

American Psychiatric Association Diagnostic and
Statistical Manual of Mental Disorders, Fourth
Edition, Text Revision. Washington, DC, American
Psychiatric Association, 2000

• Russell L. Smith, M.S.,
• LPA, HSP-PA, MAC, CCBT, NCP, FABFCE

2
Subtypes

• 295.30 Paranoid
• 295.10 Disorganized
• 295.20 Catatonic
• 295.90 Undifferentiated
• 295.60 Residual

3
Range of Emotional Cognitive Dysfunction

• Perception
• Inferential thinking
• Language communication
• Behavioral monitoring
• Affect
• Fluency productivity of thought speech
• Hedonic capacity
• Volition drive
• Attention

Associated with impaired occupational or social
functioning
4
Negative Symptoms

• A decrease or loss of normal functions
• Range intensity of emotional expression
• Fluency productivity of thought and speech
• Initiation of goal-directed behavior

5
295.30 Paranoid Type

• Preoccupation with one or more delusions or
  frequent auditory hallucinations.
• None of the following is prominent
• disorganized speech
• disorganized or catatonic behavior
• flat or inappropriate affect.

6
Malingering VS Factitious Disorders

• DSM-IV-TRTM
• American Psychiatric Association Diagnostic and
  statistical Manual of Mental Disorders, Fourth
  Edition, Text Revision. Washington, DC, American
  Psychiatric Association, 2000

• Russell L. Smith, MS,
• LPA, HSP-PA, CCBT, MAC, FABFCE, NCP

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INTENTIONALLY produced physical or psychological
symptoms

• FACTITIOUS DISORDER
• MOTIVATED BY A PSYCHOLOGICAL NEED TO ASSUME THE
  SICK ROLE
• NOT USUALLY AWARE OF THE MOTIVATION
• MALINGERING
• MOTIVATED BY EXTERNAL INCENTIVES
• GOAL IS APPARENT AND THEY CAN STOP WHEN SYMPTOMS
  ARE NO LONGER USEFUL

8
... To Assume the SICK ROLE ...

• SUBJECTIVE COMPLAINTS
• (E.G., PAIN)
• FALSIFICATION OF OBJECTIVE SIGNS
• (E.G., MANIPULATING THERMOMETER)
• SELF-INFLICTED CONDITIONS
• (E.G., INJECTING SALIVA INTO SKIN)
• EXAGERATION OR EXACERBATION OF PEREXISTING
  MEDICAL CONDITION
• (E.G., FAKE SEIZURE)

9
Malingering ... External Incentives

• Positive Reinforcement
• Financial gains
• Drugs
• Social Interaction
• Achieve desired change in placement or services
• simply to gain a meal, a place to sleep, etc.
• simply to manipulate others

• Negative Reinforcement
• Work Avoidance
• Drugs
• To establish mitigating circumstances for court
• To terminate undesirable placement or services
• Avoiding military service