ABNORMAL PSYCHOLOGY

MODULE 5
CATATONIA
Catatonia is a group of symptoms that usually involve a lack of movement and
communication, and also can include agitation, confusion, and restlessness.
Catatonia is a neuropsychiatric syndrome that can occur in various psychiatric
and medical conditions. It is characterized by a range of motor abnormalities
and behavioral disturbances. Some of the common symptoms of catatonia
include:
1. Motor Symptoms:
- Stupor: Immobility and lack of responsiveness to external stimuli.
- Catalepsy: Sustained, rigid posture against attempts to be moved.
- Waxy Flexibility: Maintaining a limb or posture in the position it is placed
by another person.
- Negativism: Resistance to instructions or attempts to be moved.
- Mutism: Limited or absent verbal responses.

2. Behavioral Symptoms:
- Echolalia: Repetition of words or phrases spoken by others.
- Echopraxia: Mimicking the movements of others.

3. Affective Symptoms:
- Flat Affect: Lack of emotional expression.
- Inappropriate Affect: Expressing emotions that are not contextually
appropriate.

4. Psychomotor Symptoms:
- Hyperactivity or Hypoactivity: Unusual levels of motor activity, either
excessive or reduced.
5. Regulatory Disturbances:
- Disturbed Sleep Patterns: Insomnia or hypersomnia.
- Loss of Appetite: Significant reduction in food intake.
- Catatonic Excitement: Agitation and hyperactivity.

SCIZOPHRENIA
(What is Schizophrenia)
Schizophrenia is defined as a psychotic disorder in which personal, social,
and occupational functioning deteriorate as a result of strange perception,
disturbed thought processes, unusual emotions and motor abnormalities.
 People with schizophrenia experience Psychosis, which refers to a state in
which a person loses contact with reality.
 Their ability to perceive and respond to the environment becomes so
disturbed that they may not be able to function at home, with friends, in
school or at work.
 They may have hallucinations (false sensory perceptions) or delusions (false
beliefs), or they may withdraw into a private world.
 (Important) In 1911, the Swiss psychiatrist Eugen Bleuler coined a new term
“Schizophrenia” by combining Greek words that mean “Split Mind”. Bleuler
meant to imply
1. A fragmentation of thought process
2. A split between thoughts and emotions
3. A withdrawal from reality
(Onset of Schizophrenia)
1. Approximately 1 out of 100 people in the world have suffered from
Schizophrenia at some point in their lives.
2. Although Schizophrenia appears in all socioeconomic groups, it is found
more frequently in the lower levels of economy leading some theorists to
believe that the stress of poverty is itself a cause of the disorder. However, it
could be that schizophrenia causes its victims to fall from a higher to a lower
socioeconomic level or to remain poor because they are unable to function
effectively. This is sometimes called the downward drift theory.
(Symptoms of Schizophrenia)
The symptoms can be grouped into three categories:
1. Positive symptoms (excess of thought, emotion and behavior)
2. Negative symptoms (deficits of thought, emotion and behavior)
3. Psychomotor symptoms
Men display more negative symptoms than women but both genders display
positive symptoms to the same degree.
POSITIVE SYMPTOMS
Positive symptoms are ‘pathological excess’, or bizarre additions to a person’s
behavior. Delusions, disorganized thinking and speech, hallucinations, and
inappropriate effect are the ones most often found in schizophrenia.
 DELUSIONS: Many people with schizophrenia develop delusions, ideas that
they believe wholeheartedly but have no basis in fact.
Delusions of persecution are the most common in schizophrenia. People with
such delusions believe that they are being plotted or discriminated against,
spied on, slandered, threatened, attacked, or deliberately victimized.
Delusions of reference are also experienced by people with Schizophrenia;
they attach special and personal meaning to the actions of others or to
various objects or events.
People who experience delusions of grandeur believe themselves to be great
inventors, religious saviors or other specially empowered persons.
Those with delusions of control believe their feelings, thoughts and actions
are being controlled by other people.
 DISORGANIZED THINKING AND SPEECH: People with schizophrenia
may not be able to think logically and may speak in peculiar ways. These
formal thought disorders can cause the sufferer great confusion and make
communication extremely difficult. Often they take the form of positive
symptoms (pathological excesses) as in loose associations, neologisms,
perseveration, and clang.
People with loose associations, or derailment (the most common formal
thought disorder) rapidly shift from one topic to another, believing that their
incoherent statements make sense. A single, perhaps unimportant word in
one sentence becomes the focus of the next.
Some people with schizophrenia use neologisms, made up words that
typically have meaning only to the person using them.
 Others may display the formal thought disorder of perseveration, in which
they repeat the same statement/their words again and again.
Finally, some use clang or rhyme to think or express themselves.
 HEIGHTENED PERCEPTIONS AND HALLUCINATIONS:
Laboratory studies have repeatedly found problems of perception and
attention among people with schizophrenia. In many studies, subjects with
this disorder have also demonstrated deficiencies have also demonstrated
deficiencies in smooth pursuit eye movement, weakness that may be related
again to attention problems.
The various perception and attention problems in schizophrenia may develop
years before the onset of the actual disorder. Such problems also contribute
to memory impairment, another difficulty found among many individuals
with the disorder.
Another kind of perceptual problem in schizophrenia consists of
hallucinations, which can be defined as experiencing sights, sounds or
other perceptions that occur in the absence of external stimuli. Types of
hallucinations are:
o Auditory hallucinations: The most common type of hallucination
found in schizophrenia. The person hears sounds and voices that
seem to come from outside their head. The voices may talk directly
to the hallucinator, perhaps giving commands or warnings of
danger, or they may be experienced as overheard.
o Tactile hallucinations: These take the form of tingling, burning, or
electric shock sensations.
o Somatic hallucinations: Somatic hallucinations feel as if something
is happening inside the body, such as a snake crawling inside one’s
stomach.
o Visual hallucinations: These may produce vague perceptions of
colors or clouds or distinct visions of people or objects.
o Gustatory hallucinations: People with gustatory hallucinations
regularly find that their food or drink tastes strange
o People with olfactory hallucinations smell odors that no one else
does, such as the smell of poison or smoke.

 INAPPROPRIATE EFFECT: Many people display inappropriate effect,

NEGATIVE SYMPTOMS
Negative symptoms are those that seem to be ‘pathological deficits’,
characteristics that are lacking in an individual. Poverty of speech, blunted and
flat affect, loss of volition and social withdrawal are commonly found in
schizophrenia.
 POVERTY OF SPEECH
People with schizophrenia often display alogia, or poverty of speech, a
reduction in speech or speech content. Some people with this negative kind
of formal thought disorder think and say very little. Others say quite a bit but
manage to convey very little meaning. These speech problems do not
necessarily carry over to the realm of writing.
 BLUNTED AND FLAT AFFECT
- Many people with schizophrenia have blunted affect; they show less
anger, sadness, joy and other feelings than most people.
- Some show no emotion at all. This is known as flat effect. Their faces are
still, their eye contact poor, and their voices monotone.
- In some cases, people with these problems may have anhedonia, a
general lack of pleasure or enjoyment.
- In other cases, however, blunted or flat effect may reflect an inability to
express emotions as others do.
 LOSS OF VOLITION
Many people with schizophrenia experience avolition, or loss of volition.
This refers to apathy or feeling drained of energy and of interest in normal
goals and unable to start or follow through any course of action. This
problem is particularly common in people who have had schizophrenia for
many years as if they have been worn down by it. Similarly, individuals with
the disorder may play ambivalence or conflicting feelings about most things.
 SOCIAL WITHDRAWAL
People with schizophrenia may withdraw from their social environment and
attend only to their own ideas and fantasies. Because their ideas are illogical
and confused, the withdrawal has the effect of distancing themselves farther
from reality. The social withdrawal seems to break down social skills,
including the ability to recognize other people’s needs and emotions
accurately.
PSYCHOMOTOR SYMPTOMS

I’m tired okay, study from the damn textbook. Here, the page is um – yeah, page
11 of the PDF, start from ‘What is the course of Schizophrenia’.
You have to:
 Skip that (READ)
 Diagnosis
 Biological view (focus on biochemical abnormalities on page 18 of pdf)
 Psychological view
 Sociocultural view
Congrats you’re done
DELUSIONAL DISORDER
Q) Define delusional disorder. Describe its clinical features
Delusional disorder is a psychiatric condition characterized by the presence of
persistent, non-bizarre delusions in the absence of other significant psychotic
symptoms. Delusions are false beliefs that are firmly held despite being
contradicted by reality or rational argument. Unlike schizophrenia, individuals
with delusional disorder generally do not experience significant impairment in
overall functioning and may maintain good cognitive and social functioning
apart from the specific delusional beliefs.
Clinical features of delusional disorder include:
1. Delusions: The hallmark feature of delusional disorder is the presence of one
or more delusions. These delusions are typically non-bizarre, meaning that they
involve situations that could occur in real life. Common themes include
persecutory (believing one is being targeted or mistreated), jealous (believing a
partner is unfaithful), erotomanic (believing someone of higher social status is
in love with them), grandiose (having an exaggerated sense of self-importance),
somatic (related to bodily functions or sensations), or mixed themes.
2. Duration: The delusions persist for at least one month or longer. The
individual may not exhibit any other psychotic symptoms, such as
hallucinations or disorganized thinking.
3. Functioning: In general, individuals with delusional disorder maintain good
social and occupational functioning. Their daily activities are not significantly
impaired by the delusions, and they may be able to hold down a job and have
relationships.
4. Insight: Unlike individuals with some other psychotic disorders, those with
delusional disorder often have good insight into other aspects of their lives.
They may recognize that their delusional beliefs are unusual or not widely
accepted, but they maintain a firm conviction in the truth of these beliefs.
5. Emotional Disturbance: Individuals with delusional disorder may experience
mood disturbances, such as depression or anxiety, but these are typically
secondary to the delusional content.

Q) Differentiate between delusion and illusion

1. Delusion:
- Definition: A delusion is a fixed, false belief that is resistant to reasoning or
contrary evidence and is not consistent with the individual's cultural or religious
background.
 - Nature: Delusions are often symptoms of psychiatric disorders, such as
schizophrenia, delusional disorder, or bipolar disorder. They can involve various
themes, such as paranoia, grandiosity, jealousy, or somatic concerns.
- Perception of Reality: Individuals experiencing delusions firmly hold these
false beliefs, even when confronted with evidence to the contrary. Delusions are
internal and personal, and the person is generally unaware that their beliefs are
not grounded in reality.
2. Illusion:
- Definition: An illusion refers to a misinterpretation or distortion of sensory
stimuli, leading to a perception that does not match the physical reality of the
stimulus.
- Nature: Illusions can occur in various sensory modalities, including vision,
hearing, touch, and taste. They are not necessarily indicative of a mental
disorder and can be experienced by anyone under certain conditions.
- Perception of Reality: Unlike delusions, individuals experiencing illusions
may be capable of recognizing the discrepancy between their perception and
actual reality once the conditions causing the illusion are understood or
removed. Illusions are external distortions in perception and are often shared
among individuals in the same perceptual environment.

In summary, delusions are false beliefs that are resistant to contrary evidence
and are often associated with psychiatric disorders, while illusions are
misinterpretations of sensory stimuli that result in perceptual distortions.
Delusions involve beliefs, thoughts, and interpretations that are not shared by
others, while illusions involve misperceptions that can be shared in specific
environmental contexts.