lesson 2 & 3 - schizophrenia and its symptoms

introduction to schizophrenia and its symptoms

1. Schizophrenia Ms. Asma Waheed

2. What we need to know Symptoms & Diagnostic criteria (ICD-11) Explanations and causes Treatment approaches

3. 1. Intro Most severe form of psychotic disorder; disturbance in thoughts, feelings, behaviors and experience. Key symptoms . Persistent delusions False beliefs Persistent hallucinations False sensory experiences Thought disorder Inability to think Experiences of influence, passivity or control

4. Positive Symptom-distortion Negative symptom-fall below normal Tip Positive adds in a normal symptom While negative is towards reduction side such as flattened affect symptoms must persist for another month

5. Types of delusions Persecutory delusion Belief you are in danger Grandiose delusion Superhero Delusion of reference Referring any information with self

6. Guess my symptom: I saw a lady running towards me to hit —--------- Who is the lady behind the door —-------- Why there is so much noise in a quiet room —------ Meaningless talk —------- I cant stop thinking about a cat i found dead on street 20 years back—--------- I didn't mean what i said, it's the alien who forced me to do so —---

7. Example study; Aneja et al Early onset Case study 1-before age 18 Divorced parents, voices, muttering to himself, SHOUTING, on medications. Types of delusions Persecutory delusion Grandiose delusion Delusion of reference

8. Paper 3 Research Method—case study (increased validity, with low reliability and generalizability) S trengths : Detailed investigation of single case-idiographic Long term investigation to follow up progression Insight from multiple perspectives Ecological validity-real life circumstances Weakness: Unique circumstances-generalised Subjective observations, interpretations

9. Individual VS situational Individual with long face and ears shows neurological damage, situational is parents divorce Holistic approach Study however does not explore boy’s school factors. Environmental factors and emergence of disorder at an early age. Issues and Debates—ethical issues Well being and consent of child Potential harmful for further psychological damage Limited vocabulary to assess hallucinations Small sample size, age, gender

10. 5 Key studies For each of the key studies, candidates should show knowledge and understanding of: • the context of the study and relationship to other studies • the main theories/explanations included in the study • the aim(s) and hypotheses of the study [if stated] • the design of the study, including all methodology as appropriate, such as the research method(s) used, sample size and demographics [if known] and sampling technique [if known], procedure, technique for data collection • the results, findings and conclusions of the study • the main discussion points of the study. For each key study candidates should be able to: • describe and evaluate research methods used in and methodological concepts included in the study • describe and evaluate the psychological issues and debates

11. 2. Key study; Freeman VR in early 2000, research resource such as spatial awareness, treatment of different phobias Main theory & explanation Persecutory ideation in non clinical individuals Aim Link persecutory ideation with emotional distress and paranoia Design; library scene with avatars, questionnaire to record experience BSI

12. Aims To investigate whether nonclinical individuals have persecutory thoughts in virtual reality; To investigate cognitive factors that predict the occurrence of persecutory ideation in virtual reality, with a particular focus on emotional processes. Brief Symptom Inventory ( BSI ): A 53-item self-report measure to assess 9 symptom dimensions over the past 7 days ; 9 dimensions include Somatization, Obsessive-Compulsive, Interpersonal Sensitivity, Depression, Anxiety, Hostility, Phobic Anxiety, Paranoid Ideation, and Psychoticism; Each item is rated on a 5-point distress scale (0–4) ; Total score obtained is the Global Severity Index. 2. Paranoia Scale : A 20-item self-report scale to measure paranoia in college students; Measures both ideas of persecution and reference ; Each item is rated on a 5-point scale ; Scores range from 20 to 100 , with higher scores indicating greater paranoid ideation.

13. 3. Spielberger State Anxiety Questionnaire : A 20-item self-report measure of state anxiety; Each item is rated on a 1–4 scale ; Scores range from 20 to 80 , with higher scores indicating higher levels of anxiety. 4. VR-Paranoia Questionnaire : A 15-item self-report questionnaire specifically devised for the study ; Assesses participants’ views of the avatars in the virtual environment; 3 areas assessed – persecutory thoughts about the avatars (VR-Persecution), ideas of reference about the avatars (VR-Reference), and positive beliefs about the avatars (VR-Positive) Each item is rated on a 4-point scale (0–3) ; Scores can range from 0 to 15 for each subscale , with higher scores indicating greater endorsement of items. 5. Sense of Presence Questionnaire : Assesses the extent to which participants experience a sense of being in the virtual world ; Consists of 6 questions rated on a scale of 1 to 7 ; Higher numbers indicate greater reported presence; A score of 6 or 7 on a question is coded as 1, while all other scores are coded as 0; Total score can range between 0 and 6 .

14. Design Sample size: age 26, 24 students and admin staff, paid voluntary basis through advertising Procedure; Consent obtained, not informed of examination, Equipment training, library scenario with avatars, 5 minutes to form impression about the people, explore env Data; questionnaire to test symptoms, closed ended Qs , half completed before and after , semi structured interviews to assess thoughts and feelings BSI Brief symptom inventory, 53 item self-report measure, assess 9 symptoms Interpersonal sensitivity, depression, anxiety

15. Results & Conclusion Moderate sense of presence Anxiety levels did not increase No correlation with paranoia scale Higher levels of interpersonal sensitivity with higher levels of anxiety and higher levels of persecutory ideation Non clinical individuals have persecutory thoughts in virtual reality The cognitive and emotional processes of paranoia and anxiety predict the occurence of persecutory ideation. Predictors of Persecutory Ideation in VR: VR Persecution did not significantly correlated with scores on the Paranoia Scale ; Higher levels of interpersonal sensitivity and anxiety were associated with higher levels of persecutory ideation in virtual reality.

16. Research Method—correlational study Strengths: sampling technique, equal gender, recognized and validated tools, semi structured interviews & ratings, multiple measures Week areas: Reduced ecological validity , limited generalisability–sample size Papert 4 Issues and Debates Knowledge of study was not clear, individual & situational explanations, qualitative and quantitative data (idiographic and nomothetic)

17. Research Method (Correlational Study) Strengths Study used multiple measures like surveys, interviews, and observations to understand worry and sadness, increasing validity; Study looks at how personality and emotions relate to persecutory thoughts, offering new insights for research Weaknesses Only 24 people were part of the study, who were not mentally ill. Results may not apply widely; Participants weren’t randomly assigned for different groups, making it harder to conclude that paranoia causes

18. Issues and Debates; I ndividual and Situational Explanations Individual Explanation Paranoia as explaining persecutory ideation Situational Explanation VR environment explaining persecutory ideation Strengths of Individual Explanation Encourages treatment of paranoia to stop persecutory delusions; Encourages delusional patients to take responsibility for reducing their paranoid thinking. Weaknesses of Individual Explanation Use of self-report methods to understand paranoid thinking, subject to social desirability, reducing validity Separating the influence of individual and situational factors is difficult – whether VR environment causes persecutory ideation or paranoia Strengths of Situational Explanation The study used a special computer room with lifelike characters to simulate real-life situations , increasing ecological validity ; Psychologists indirectly encouraged to look at behaviours of people around a patient also while diagnosing and treating schizophrenia, increasing social responsibility Weaknesses of Situational Explanation People only used the virtual world for 5 minutes , so it may not show long-term effect of situation; The study didn’t compare virtual experiences with real-life situations , which could confirm paranoid thoughts in the real world.

19. Idiographic versus Nomothetic Idiographic Approach Study included individual comments (qualitative data) to understand unique experiences and subjective perspectives of participants; Nomothetic Approach Study examined correlations (quantitative data) between variables to identify general patterns and trends applicable to a broader population. Strengths of Idiographic Approach Provided rich qualitative data through semi-structured interviews, capturing individual experiences and perceptions; Allowed for personalized assessment of persecutory thoughts and beliefs, providing a detailed understanding of participants’ unique perspectives Weaknesses of Idiographic Approach Subjectivity in scoring and interpreting qualitative data may introduce bias and affect the reliability of the findings; Limited generalizability due to the small sample size and specific characteristics of the participants from one university. Strengths of Nomothetic Approach Provides quantitative data for statistical analysis, allowing for generalization and comparison between participants; Allows for identification of correlations between variables, such as persecutory thoughts and emotional distress. Weaknesses of Nomothetic Approach Limited depth of understanding due to reliance on quantitative measures, potentially missing nuanced experiences and perspectives; Lack of contextual information and individual variability might overlook important factors influencing persecutory thoughts and emotional distress.

20. What do you think? Write one weak area– What’s looking challenging Rate your lesson out of 5 with 5 being highest score… Write one strength— what’s helping you to learn