Professional Documents
Culture Documents
What is Depersonalization?
(Depersonalization is the third most common
psychological experience)
Depersonalization is a sense that things around you aren't
real, or the feeling that you're observing yourself from
outside your body.
Many people have a passing experience of
depersonalization at some point. But when feelings of
depersonalization keep occurring, or never completely go
away, it's considered depersonalization disorder.
Persistent of recurrent experiences of feeling
detached from, and as if one is an outside observer
of, ones mental processes or body (e.g., feeling like
one is in a dream).
During the depersonalization experience, reality
testing remains intact.
The depersonalization causes clinically significant
distress or impairment in social, occupational, or
other important areas of functioning.
The depersonalization experience does not occur
exclusively during the course of another mental
disorder, such as Schizophrenia, Panic Disorder,
Acute Stress Disorder, or other Dissociative Disorder,
and is not due to the direct physiological effects of a
substance (e.g., drug abuse, a medication) or a
general medical condition (e.g., temporal lobe
epilepsy).
Continuous or recurring feelings that you're an
outside observer of your thoughts, your body or parts
of your body
Numbing of your senses or responses to the world
around you
Feeling like a robot or feeling like you're living in a
dream or in a movie
The sensation that you aren't in control of your
actions, including speaking
Awareness that your sense of detachment is only a
feeling, and not reality
Differential diagnosisTemporal Lobe Seizures
( epilepsy )
Atypical forms of Migraine and Headache
Schizophrenia
Panic disorder
Acute stress
Fugue
DID
Drug abuse
Begin with no apparent trigger
Start after a life-threatening event, such as an
accident or assault
Be triggered by fear of having another
depersonalization experience
Lack of sleep
Severe stress
Has a history of childhood emotional, physical or
sexual abuse
Counseling
Medications
While there are no medications specifically approved to
treat depersonalization disorder, a number of medications
generally used to treat depression and anxiety may help.
Some examples that have been shown to relieve
symptoms include fluoxetine (Prozac), clomipramine
(Anafranil) and clonazepam (Klonopin).
Two-thirds of the patients are women. The onset is often
in adolescence or early adult life, with the condition
starting before the age of 30 in about half the cases
SCHIZOPHRENIC DISORDERS
SCHIZOPHRENIA
A severe form of abnormal behavior = madness
Different kinds of psychotic symptoms indicating that
the person has lost touch with reality.
Officially defined by various combinations of
psychotic symptoms in the absence of other forms of
disturbance, such as mood disorders, substance
dependence, delirium, or dementia.
THREE PHASES OF SCHIZOPHRENIA
Prodormal phase
others perceive a change in personality
peculiar behaviors, unusual perceptual
experiences, outbursts of anger, increased
tension, restlessness
social withdrawal, indecisiveness, lack of
willpower
Active phase
hallucinations, delusions, disorganized speech
Residual phase
symptoms akin to those in the prodromal phase
most dramatic symptoms of psychosis have
improved, but negative symptoms remain
pronounced
SYMPTOMS
Can be divided into three (3) dimensions:
Positive symptoms
- hallucinations, delusions
Negative symptoms
- blunted affect, anhedonia, apathy, avolition, alogia
Disorganization
- disorganized speech/thought disorder, catatonia,
inappropriate affect
DSM - IV - TR DIAGNOSTIC CRITERIA FOR
SCHIZOPHRENIA
A. Characteristic symptoms: Two (or more) of the
following, each present for a significant portion of time
during a one-month period (or less if successfully
treated):
Delusions
Hallucinations
Disorganized speech (such as frequent derailment or
incoherence)
Grossly disorganized or catatonic behavior
Negative symptoms (such as affective flattening,
alogia, or avolition)
Social impairment
Incoherence of speech
Delusions/hallucinations are not wellorganized
Paranoid
Characterized by systematic delusions with
persecutory or grandiose content.
Preoccupation with frequent auditory hallucinations.
* Patients who exhibit disorganized speech, disorganized
behavior, flat or inappropriate affect, or catatonic behavior
are excluded from a diagnosis of paranoid schizophrenia and
would fall into one of the other subtypes.
Undifferentiated
ATTENTION DYSFUNCTION
o
Biogenic Psychoses
Process Schizophrenia onset is gradual: result of
an abnormal psychological process
(neurophysiologic abnormalities), less responsive to
psychoactive drugs
Bad Premorbid prior poor functioning (social,
sexual and occupational adjustment) , early onset,
worse prognosis (unremitting course)
Negative Symptoms absence of something
normally present (i.e. poverty of speech, flat affect,
withdrawal, apathy or attention impairment >
deficit symptoms endure across all stages of
schizophrenia unlike non-deficit symptoms :
negative symptoms due to medication ). Performs
poorly on test s that involve visual stimuli. Symptoms
may develop to positive symptoms or vice-versa.
Non-Paranoid - TYPE 2 SCHIZOPHRENIA
Risks & Influencing Factors
Culture influences symptoms and prognosis
Police vs. Sorcerer Delusions or Paranoia
Less industrialized nations (stable family
structures) have better prognosis than more
industrialized nations (emphasis on
competition and self-reliance)
Individual differences affect schizophrenia
likely to be experienced by people
who have low IQs, are
unemployed, unmarried, live in the
city and are of African American
descent (vs. European Americans)
Schizophrenia normally strikes in adolescence or
early adulthood
Men have it in their Mid20s
Women have it in Late20s
Gender plays an important role too
Men are 1.5 times more vulnerable than
women (could be due to the presence of
estrogen)
Men tend to exhibit negative symptoms due
to brain abnormalities and acquire Type 2
Schizophrenia. This is contrary to women.
Cognitive Therapy
Process Approach: Cognitive Rehabilitation
Give patient tasks that call upon their defective
cognitive skills memory, attention, social
perception and build them by means of
instruction, training, prompting and even
monetary rewards
Content Approach: Cognitive Therapy
Therapists leads patient to question their
thoughts, hallucinations and delusions and teaches
them to use efficient coping devices for dealing
with unwelcomed thoughts
Interpersonal Perspective
High levels of Expressed Emotion (EE) based on
two factors : level of criticism and emotional
overinvolvement - is the best predictor for relapse (3
to 4 times more)
Negative and emotionally charged family atmosphere
may be related to both the onset and the course of
schizophrenia
Communication Deviance (CD) --Double-bind
Communication (no-win interchange with mutually
contradictory messages wherein one is always the
loser) also contributes to Schizophrenia
Family Treatment
Step-by-step method for working out problems, from
planning a dinner menu to coping with major crises
(brief about schizophrenia and symptoms). More
effective in underdeveloped countries than in western
industrialized countries, contributes to lower risk of
relapse.
Behavioral Perspective
Bizarre behaviors elicit a reinforcing response
(attention, sympathy, release from responsibilities )
responses become habitual. Wherein Crazy
behaviors sometimes reap rewards.
Goal of behavioral treatment is to relearn behavior.
Sociocultural Perspective
Short term cure for schizophrenia. It is a longterm multifaceted support programs within the
community.
Staff maintain daily contact with the patients
calling them, dropping by, offering suggestions
and generally helping them.
Assertive Community Treatment (ACT) improves
social functioning and facilitate independent
living.
Personal Therapy one-on -one case, designed to
fit emotional needs of patient , focus on
management of emotions avoid the kind that
causes relapse. Stress and Emotion Management
3 years.
Unitary Theories: Diathesis and Stress
Cannot be entirely controlled by genes, 81% have no
schizophrenic parent or sibling, both genetic and
environmental causes.
What stresses are likely to convert to schizophrenia?
Feelings of clumsiness and a sense of being different
as a result of attention deficits
Increase dependence on parents as a result of being
impaired
Poor academic performance and poor coping skills,
because of impairment
Stressful family interaction, high EE levels
Communication deviance in family leading to
difficulty in communicating with others hence
isolation
Frequent hospitalization of a parent or other family
member
DISSOCIATIVE DISORDERS
CAUSES
These are mental disorders in which the normally wellintegrated functions of memory, identity, perception, and
consciousness are separated (dissociated).
Psychological
Dissociative Identity
Dissociative Fugue
Dissociative Amnesia
DISSOCIATIVE AMNESIA
Dissociative Depersonalization
Benzodiazepine tranquilizers
Tricyclic antidepressants
Selective serotonin reuptake inhibitors
SYMPTOMS
- emotional numbing
- changes in visual perception
- altered experience of one's body
CHARACTERISTICS
ETIOLOGY
The word fugue stems from the Latin word for flight
fugere .
ETIOLOGY
-unknown
-sever and prolonged Traumatic event in childhood
-4 causative factors
Causes
EPIDEMIOLOGY
SYMPTOMS
Depression
mood swings
phobias
Diagnosis
headaches
panic attacks
eating disorders