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Chapter 8
Schizophrenia Spectrum and Other Related
Psychotic Disorders
Teaching Objectives
After reading and studying this chapter and participating in lecture and discussion,
students should be able to:
1. Describe the prevalence of schizophrenia and how it varies by gender and

ethnicity.
2. Define and describe delusions and hallucinations, as well as the different types of
delusions and hallucinations, and how they do and do not vary across cultures.
3. Describe the disorganized thought and speech that occurs with schizophrenia.
4. Distinguish between disorganized and catatonic behavior.
5. Describe common negative symptoms of schizophrenia.
6. Discuss the history of diagnostic criteria for schizophrenia, as well as the current
criteria for schizophrenia and disorders that are similar to it.
7. Distinguish between Type I and Type II symptoms, as well as between prodromal

and residual symptoms.
8. Identify the key features of each of the five subtypes of schizophrenia: paranoid,
disorganized, catatonic, undifferentiated, and residual.
9. Describe the prognosis for an individual with schizophrenia, and how it might
vary according to the gender and age of the affected individual.
10. Discuss the evidence for a genetic transmission of schizophrenia, and which
people are most at risk for developing schizophrenia.
11. Discuss the brain areas implicated in schizophrenia, as well as their functions,
and be able to discuss how they are different in the brains of people with
schizophrenia compared to people without schizophrenia.
12. Discuss both past and recent hypotheses of how dopamine is believed to affect
the development and treatment of schizophrenia.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or distribution in any
manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in whole or part.
13. Discuss the psychosocial factors associated with schizophrenia and the evidence
for them.
14. Discuss the drug therapies most commonly prescribed for schizophrenia, their
side effects, which symptoms they treat most effectively, and which ones they do
not.
15. Discuss the psychological and social interventions designed for people with
schizophrenia.
Chapter Outline
I. Symptoms, Diagnosis, and Course

A. Positive Symptoms
1. Delusions
a. Persecutory Delusions
b. Delusions of Reference
c. Grandiose Delusions
d. Delusion of Being controlled
e. Though Broadcasting
f. Thought Insertion
g. Thought Withdrawal
h. Delusion of Guilt or Sin
i. Somatic Delusion
5. Delusions across culture
2. Hallucinations
a. Auditory
b. Tactile
c. Somatic
3. Disorganized Thought and Speech
a. Loose associations
b. Word salad
4. Disorganized or Catatonic Behavior
a. Catatonia
B. Negative Symptoms
1. Restricted Affect
a. Anhedonia
2. Avolition / Asociality
C. Cognitive Deficits
1. Attention Focusing and Maintaining
2. Memory Deficits
D. Diagnosis
1. Prodromal Symptoms
2. Residual Symptoms
E. Prognosis
1. Gender and Age Factors
2. Sociocultural Factors
F. Other psychotic disorders
1. Schizoaffective Disorder
2. Schizophreniform Disorder
3. Brief Psychotic Disorder
4. Delusional Disorder
5. Schizotypal Psychotic Disorder
II. Biological Theories
A. Genetic Contributors to Schizophrenia
1. Family Studies
2. Adoption Studies
3. Twin Studies
B. Structural Brain Abnormalities
1. Enlarged Ventricles
2. Prefrontal Cortex and Other Key Areas
3. Damage to the Developing Brain
a, Birth Complications
b. Prenatal viral exposure
C. Neurotransmitters
1. Dopamine Theory of Schizophrenia
III. Psychosocial Perspectives
A. Social Drift and Urban Birth
B. Stress and Relapse
C. Schizophrenia and the Family
D. Cognitive Perspectives
E. Cross-Cultural Perspectives
IV. Treatment
A. Biological Treatments
1. Insulin Coma Therapy
2. Electroconvulsive Therapy (ECT)
3. Warehousing
4. Drugs
5. Typical Antipsychotic Drugs
a. Chlorpromazine (Thorazine)
b. Butyrophenones (Haladol)
c. Side Effects
ii. Tardive Dyskinesia
6. Atypical Antipsychotic
a. Clozapine
B. Psychological and Social Treatments
1. Behavioral, Cognitive, and Social Treatments
2. Family Therapy
3. Assertive Community Treatment Programs
4. Cross-Cultural Treatments: Traditional Healers
V. Chapter Integration
Key Terms
psychosis residual symptoms

schizophrenia schizoaffective disorder
schizophrenia spectrum schizophreniform disorder
positive symptoms brief psychotic disorder
delusions schizotypal personality disorder
persecutory delusion phenothiazines
delusion of reference neuroleptics
grandiose delusions mesolimbic pathway
delusions of thought insertion social drift
hallucinations expressed emotion
formal thought disorder chlorpromazine
catatonia tardive dyskinesia
negative symptoms atypical antipsychotics
restricted affect assertive community treatment
avolition programs
prodromal symptoms
Key Concepts
• The positive (or Type I) symptoms of schizophrenia include delusions

(ideas the individual believes are true but are certainly false),
hallucinations (unreal perceptual experiences), thought disturbances
(incoherent thought and speech), and grossly disorganized or catatonic
behavior.
• The negative (or Type II) symptoms include affective flattening, alogia
(poverty of speech), and avolition (the inability to initiate and persist in
goal-directed activities). Prodromal and residual symptoms are mild
versions of the positive and negative symptoms that occur before and
after episodes of acute symptoms.
• Estimates of the prevalence of schizophrenia in various countries range
from about 0.1 percent to 2.0 percent, but most estimates are between 0.5
and 1.0 percent. There are some slight ethnic differences in rates of
schizophrenia, but these may be due to differences in socioeconomic
status.
• The content of delusions and hallucinations changes somewhat across
cultures, but the form of these symptoms remains similar across cultures,
and many clinicians and researchers believe schizophrenia can be reliably
diagnosed across cultures.
• Men may be more prone to schizophrenia than are women, and there are
some differences in symptoms between genders.
• Biological theories of schizophrenia have focused on genetics, structural
abnormalities in the brain, and neurotransmitters. There is clear evidence
for a genetic transmission of schizophrenia, although genetics do not fully
account for the disorder.
• Stressful events probably cannot cause schizophrenia in people who do
not have a vulnerability to the disorder, but they may trigger new episodes
of psychosis in people with the disorder.
• Early psychodynamic theories argued that caregivers who are demanding
and excessively harsh toward their children, so-called schizophrenogenic
mothers, might cause the children to regress to infantile stages, resulting
in schizophrenia. These theories have not been supported.
• Several theories have suggested that family communication patterns play
a role in schizophrenia.
• Cognitive theories suggest that some schizophrenic symptoms are
attempts by the individual to understand and manage cognitive deficits.
Behavioral theories suggest that schizophrenic behaviors are operantly
conditioned.
• Drugs known as phenothiazines, introduced in the 1950s, brought relief to
many people with schizophrenia. The phenothiazines reduce the positive
symptoms of schizophrenia but are often not effective with the negative
symptoms. Major side effects include tardive dyskinesia.
© 2014 by McGraw-Hill Education. This is proprietary material solely for authorized instructor use. Not authorized for sale or
distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in
whole or part.
• Newer drugs called atypical antipsychotics seem to induce fewer side
effects and are effective in treating both the positive and the negative
symptoms of schizophrenia in many people.
• Psychological and social therapies for schizophrenia focus on helping
people with schizophrenia reduce stress, improve family interactions, learn
social skills, and cope with the impact of the disorder on their lives.
• People in developing countries tend to show a more positive course of
schizophrenia than do people in developed countries. Women tend to
have a more positive course than do men.
ONLINE LEARNING CENTER RESOURCES

Lecture Suggestions and Class Activities
Concept Reviews
Positive Symptoms of Schizophrenia

Negative Symptoms of Schizophrenia
Biological Theories of Schizophrenia
Psychosocial Perspectives on Schizophrenia
Lecture Suggestions
A Vulnerability-Stress Model of Schizophrenia: Neurodevelopmental
Disruption
Research concerning causal factors in the development of schizophrenia

provides an excellent opportunity to illustrate and discuss emerging integrative
models of psychological disorders. Several lines of research lead to the
interaction of genetic factors and environmental stressors, which result in
neurodevelopmental disruption and subtle defects in the brain. Later in
development, additional environmental factors can either exacerbate or mitigate
the expression of these defects. Family, twin, and adoption studies indicate that,
while there is a substantial genetic component to schizophrenia, environmental
factors play an important role in the development and expression of the disorder.
Weinberger and others propose an integrative model, hypothesizing that
schizophrenia develops from "a subtle defect in cerebral development that
disrupts late-maturing, highly evolved neocortical functions, and fully manifests
itself years later in adult life" (Lipska & Weinberger, 1997). These
neurodevelopmental dysfunctions may be a product of a pre- or neonatal injury to
the brain due to viral central nervous system infections, poor nutrition, delivery
complications, or genetic transmission. (Students are encouraged to consult
Chapter 4: “Adults and Mental Health” of the Surgeon General's Report on
Mental Health [1999], which provides a current view of scientific research in the
study of mental health and mental disorders and includes an excellent summary
and references pertaining to a neurodevelopmental model of schizophrenia.)
whole or part.
Debate: The Case For and Against Deinstitutionalization
Assign students, in advance, to prepare to discuss one side or the other of the
issue of deinstitutionalization of the seriously mentally ill, a population dominated
by individuals diagnosed with schizophrenia. The case against
deinstitutionalization might include the following key points (adapted from
Gralnick, 1985):
• The rate of mental illness has not declined.

• The acutely ill are neglected in the context of community-based care
models and often do not receive the treatment they need until or unless
they become dangerous to themselves or others.
• Patients who never become dangerous may never become hospitalized
and therefore, may never receive treatment.
• Many patients who manage to receive treatment without or before
presenting a threat to themselves or others are only seen in an advanced
stage in the course of their disorder and when they have less chance to
recover.
• A small percentage of patients discharged from hospitals continue in
community aftercare.
• Many patients discharged from hospitals discontinue taking medications.
• Increasing numbers of mentally ill persons who have no families live in
nursing homes, jails, on the streets, and in public shelters.
• Research on the causes and treatment of serious mental illnesses is
made more difficult due to the decline of the public hospital system.
• A reformed and reconstructed state hospital system would serve patients
better than any expansion of community services.
The case for deinstitutionalization might include these arguments (adapted from
Okin, 1985):
• Treatment usually works best in an environment that minimizes coercion

and encourages contact with family members and the rest of society
• Most patients will eventually live in the community and therefore, they
should learn the needed skills in the place where they will be used.
• Given adequate services, many severely ill people prefer to live i4n the
community rather than in state hospitals.
• Reform is unlikely to remedy the basic deficiencies of state-supported
hospitals.
• State hospitals are isolated and isolating.
• Family therapy, in conjunction with medication, can be effective in
reducing the need for rehospitalization and reduces the burden on
families.
• The visibility of the mentally ill in the community compels increased public
awareness and allocation of resources to their needs.
whole or part.
Data and Schizophrenia
Remind students that this is a disorder that affects approximately 1% of the

population. And then out of that 1% how many individuals give data and follow up
data? There also appears to be a class distinction. For many years it appeared
that rich people didn’t get schizophrenia. Why? What kinds of hypothesis can
students generate for this finding? If a rich person shows some of these
behaviors are they more likely to be viewed as “eccentric” than the poor showing
those same behaviors?
Changes Between DSM IV-TR and DSM 5
There were a few changes in this chapter between DSM 4TR and DSM 5. For a
diagnosis of schizophrenia spectrum disorder, patients now need at least one
positive symptom. The subtypes were eliminated completely due to poor validity
and questionable reliability.
Classroom Activities
Virtual Voices: http://eikonprofessionals.com/Virtual-Voices.html — see if you can

arrange a training or a demonstration.
Role-Play
Description: Students play the role of a person with schizophrenia and answer
questions about what it is like to have that disorder.
Time Needed: At least 30 minutes, probably more with discussion.
Materials Needed: Copies of a first-person account by a person with

schizophrenia, describing the experience of the disorder. For example, Janice C.
Jordan's article, “Schizophrenia: Adrift in an Anchorless Reality,” is available at:
http://www.mentalhealth.org and describes the course of her disorder.
Procedure: Group students in pairs, and provide one student in each pair with a
first-person account by a person with schizophrenia. Instruct the student to
assume the role of the person in the account. The other student in the pair is
instructed to assume the role of the first student's prospective roommate. The
role-play proceeds with the actor in the role of the person with schizophrenia
introducing himself/herself to the other person and describing his/her disorder
and how it impacts his/her life. The other actor is instructed to ask questions in
an attempt to learn what it might be like to enter the mind of and empathize with
a person with this disorder. Following the role-play, the instructor may lead the
whole or part.
students in a debriefing discussion with probes designed to evoke their feelings
about the role they played. The actors playing the person with schizophrenia
might be queried about how they felt disclosing their experiences, whether they
felt stigmatized, and how difficult it was to assume the role of a person with this
disorder. Questions directed to the other actors might include whether they were
able to comprehend the impact of the disorder on a person's life, and whether
they were able to see the person as separate from the disorder. If time allows,
the exercise may be repeated, this time pairing students with different students
and assigning them to assume the opposite role.
Project Suggestion
Distinguishing Between the Positive and Negative Symptoms of
Schizophrenia
Using the chart in Handout 8.1, assign students to groups, and instruct them to
fill in the cells concerning the nature of symptoms, likely causes, most effective
treatments, prognostic outcomes, and responsiveness to medication for positive
and negative symptoms in schizophrenia.
Connect, Learnsmart and Faces Interactive
Please take an opportunity to look at “Connect” (connect.mgraw-hill.com) as well

as (LearnSmart learnsmartadvantage.com) for several videos available in the
McGraw Hill library. LearnSmart is an adaptive learning tool that maximizes
productivity and identifies the most important learning objectives for each student
to master at a given point in time. Data-driven reports, found in the Reports tab
under LearnSmart reports, highlight the concepts with which individual students
are — or the entire class is — struggling. The tool is proven to improve academic
performance, including higher retention rates and better grades. There are more
videos and learning assets available on the website
(http://www.mhhe.com/nolen6e). The instructor website provides access to CPS /
clicker questions, faces interactive guides, images, and many other resources.
McGraw Hill also has an extensive database of video clips available in the
McGraw-Hill's Visual Assets Database for Life-Span Development (VAD 2.0)
(http://www.mhhe.com/vad). This is an online database of videos for use in the
developmental psychology classroom created specifically for instructors. You can
customize classroom presentations by downloading the videos to your computer
and showing the videos on their own or inserting them into your course cartridge
or PowerPoint presentations. All of the videos are available with or without
captions.
McGraw-Hill also offers other video and multimedia materials, ask your local
representative about the best products to meet your teaching needs.
whole or part.
Faces Interactive (www.mhhe.com/faces)
Faces Interactive, created by Arthur J. Kohn of Portland State University, is a
unique web-based learning environment that provides students with an
opportunity to observe and interact with real patients through a series of case
studies on twelve different psychological disorders. Each case study takes
students through five stages of a patient’s experience: the diagnosis, case
history, an interview, treatment, and assessment. Students are able to explore
diagnostic processes, improve their understanding of clinical practice, and gain
experience documenting their findings in a case study report project. After using
Faces Interactive students will have a wealth of information about, and a
humanistic outlook on, these disorders. (http://www.mhhe.com/faces).
The Faces Interactive Module contains an interview with an individual diagnosed

with Paranoid Schizophrenia.
PARANOID SCHIZOPHRENIA
Schizophrenia is a psychotic disorder that involves distortions of thought,

behavior, perceptions, and mood, symptoms, which can have devastating effects
in all aspects of a person’s life. The DSM –IV-TR identifies five subtypes of
schizophrenia. Paranoid schizophrenia, which is profiled in this segment,
involves marked delusions, either of persecution or grandeur, and auditory
hallucinations that are either related to themes of persecution or of grandeur.
Case of Valerie
Valerie has suffered from paranoid schizophrenia for more than 20 years. In the
first segment, she describes her early psychotic episodes, and she describes her
confusion and fear when she was first committed to a psychiatric hospital. Her
first episode involved her delusional belief that people were infiltrating her church
and trying to destroy their community. She began to suffer episodes of violent
behavior, including an attempt to smother her roommate in the hospital. The
feelings of anxiety and tensions she suffered felt like torture.
Suggested Classroom Activities
A) Direct students to Ian Chovil’s Experience of Schizophrenia page:

(http://www.chovil.com). Have students discuss the challenges he faced
regarding the legal system and getting appropriate treatment. What could the
government do to insure that people with schizophrenia get the appropriate
treatment instead of going to jail or becoming homeless?
B) Have students compare and contrast the following case studies: Valerie from
the Faces Interactive Schizophrenia case and Ian from the Web link:
whole or part.
http://www.chovil.com. Compare the courses of their schizophrenia, their
treatments, and their prognosis.
Videos
A Beautiful Mind (2001) stars Russell Crowe in a human drama about the
struggle of a true genius, inspired by events in the life of John Forbes Nash, Jr.,
and in part based on the biography A Beautiful Mind by Sylvia Nasar. A
mathematical genius, John Forbes Nash, Jr. (Crowe) made an astonishing
discovery early in life and stood on the brink of international acclaim. But the
handsome and arrogant Nash soon found himself on a painful and harrowing
journey of self-discovery once he was diagnosed with schizophrenia. After many
years of struggle, he eventually triumphed over this tragedy, and finally, late in
life, received the Nobel Prize.
Benny & Joon (1993) is a bittersweet comedy about a mentally ill artist who
finds love with a quirky outsider, much to her guardian's chagrin.
David and Lisa (1962) (Keir Dullea and Janet Margolin) are adolescents
hospitalized in the same mental institution. Lisa can communicate only through
rhyme (which students should recognize as "clanging") and demonstrates the
classic cognitive, behavioral, and social symptoms. This most touching of films,
based on a real case history, provides insight into the patients, as well as one
family (David's). The bond David forges with Lisa is so powerful that it brings
hope for her eventual passage out of her isolated world.
I Never Promised You a Rose Garden (1977) is a TV movie based on the

autobiographical novel by Joanne Greenberg. The book and movie both put the
viewer into the mind—and the world—of a young schizophrenic woman,
complete with visual and auditory hallucinations, and the language she uses to
communicate with the cruel other worldly creatures who dominate her life. We
also become involved in the successful psychoanalytic treatment, which has
(beyond the scope of the film) led to Ms. Greenberg's complete and healthy
functioning as a mother, renowned author, speaker, volunteer firefighter, and
teacher for over 40 years.
Abnormal Psychology: Inside and Out is a two-part series. Part I features ten
clinically focused DSM-IV interviews with real clients who suffer from major
depressive disorders, sexual dysfunction, panic disorder, obsessive-compulsive
disorder, bipolar disorder, schizophrenia, amnestic disorder, antisocial
personality disorder, substance dependence, and anorexia nervosa. (Insight
Media, #43AJ3678, 137 min., 1994)
whole or part.
Dark Voices: Schizophrenia shows how schizophrenia affects the lives of
patients and their families. Part of the series “Fires of the Mind.” (Films for the
Humanities and Sciences, #BVL29221, 53 minutes, 2001)
Preventing Relapse in Schizophrenia. As of now, there is no cure for

schizophrenia, but with a combination of proper medication, therapy, and group
support, sufferers can gain more control over their lives. In this program, two
psychiatric experts discuss the elusive nature of this devastating illness, as well
as the various treatments available to prevent relapse. Both the benefits and side
effects of new antipsychotic drugs are weighed by doctors. Schizophrenia victims
offer personal insights into how they avoid relapse, and how new treatment
options, including the new medications, are helping them lead relatively normal
lives. (21 min., Films for the Humanities & Sciences, #BVL7398, 1996)
Schizophrenia: New Definitions, New Therapies. Using interviews with

medical authorities and outstanding computer animation of the brain, this
program provides an update on the causes and latest treatments of
schizophrenia. NewsHour correspondent Susan Dentzer focuses on a young
Philadelphia man trying desperately to control this devastating disorder. Although
new atypical antipsychotic drugs such as Olanzapine, Risperidone, and
Quetiapine are proving helpful—to those who can afford them—experts agree
that a strong community support program is also essential to achieve lasting
recovery. (29 min., Films for the Humanities & Sciences, #BVL10045, 1998,
color)
The Teenage Brain is the 3rd part of The Secret Life of the Brain series.
Included in this part is an excellent discussion of recent research on
schizophrenia. (PBS Home Video, #SELB904, 2002)
The Torment of Schizophrenia provides computer animations of the brain, case

studies, and expert commentary to promote a better understanding of
schizophrenia. The phases of a psychotic episode are described. Approaches to
mainstreaming patients are addressed. (Films for the Humanities and Sciences,
BVL11024, 53 minutes, 2000)
Unchaining the Mind: Advances in Schizophrenia Research outlines the

function of neurotransmitters and the development of antipsychotic drugs. The
video discusses newer medication and the use of cognitive therapy in long-term
treatment. (Films for the Humanities and Sciences, 36 min., # BVL34261, 2004)
Understanding Schizophrenia. Schizophrenia is the most severe of the serious

mental illnesses, and it is more common than diseases such as cystic fibrosis,
diabetes, or Alzheimer’s disease. This program explains recent research on the
disease, speaking with leading medical researchers to explore what we do and
don’t know about schizophrenia. The program profiles an individual with
schizophrenia and explains how the disease has affected his and his family’s life
whole or part.
and how they cope. (21 min., Films for the Humanities & Sciences, #BVL5827,
1994)
The World of Abnormal Psychology
Of particular relevance to this chapter are Looking at Abnormal Behavior,

Psychological Treatments, and The Schizophrenias.
“The World of Abnormal Psychology” is a video series that covers a wide range
of topics such as ADHD, conduct disorders, autism, and separation disorders
and can be found at: http://www.learner.org/resources/series60.html or through
the McGraw Hill Higher Education General Resources for Students and Faculty
Annenberg / CPB projects link
http://www.mhhe.com/socscience/psychology/psychonline/general.html.
Discovering Psychology: Updated Edition
Cognitive Neuroscience is on overview of cognition and the brain.
“Discovering Psychology: Updated Edition” is a general series with several clips

that can be used in a human development course and can be found at:
http://www.learner.org/resources/series138.html or through the McGraw Hill
Higher Education General Resources for Students and Faculty Annenberg / CPB
projects link
The Mind
Treating Depression: Electroconvulsive Therapy
“The Mind” is a series that looks at myriad factors relevant to cognitive,

biological, and developmental psychology. The entire series can be found at:
projects link
The Brain: Teaching Modules
Schizophrenia: Symptoms
Schizophrenia: Etiology
Schizophrenia: Pharmacological Treatment
“The Brain” is a series that looks at myriad factors relevant to cognitive,

biological, and developmental psychology. The entire series can be found at:
whole or part.
projects link
Seasons of Life
“Seasons of Life” is a series that covers various stages of life and is wonderful for
a human development class. The series can be found at:
projects link
http://www.mhhe.com/socscience/psychology/psychonline/general.html
Online Learning Center Resources

The Online Learning Center can be found at: http://www.mhhe.com/nolen6e.
Novels, Biographies, and Nonfiction Titles of Note
Greenberg, Joanne (1964). I Never Promised You a Rose Garden. New York:
Holt, Rinehart and Winston.
Chronicles the three-year battle of a mentally ill, but perceptive, teenage

girl against a world of her own creation, emphasizing her relationship with
the doctor who gave her the ammunition of self-understanding with which
to help herself.
Holley, Tara Elgin, & Holley, Joe (contributor) (1998). My Mother's Keeper: A
Daughter's Memoir of Growing up in the Shadow of Schizophrenia. New
York: William Morrow & Co.
The author, who as a young girl was made responsible for her
schizophrenic mother and forced to deal with the incomprehensible
changes that happen to her due to her sickness, reflects on the
experience with a greater understanding of her mother's illness and her
family's legacy of schizophrenia.
Neugeboren, Jay (1998). Imagining Robert: My Brother, Madness, and Survival:

A Memoir. New York: Henry Holt & Company.
Novelist Neugeboren has written a detailed, exquisitely painful and always

thoughtful account of his younger brother's long struggle with mental
illness. He includes scenes from their Brooklyn childhood of constantly
warring parents, extremes of love and hatred, of holding on too tightly and
rejecting too absolutely. Robert Neugeboren, who was born in 1943,
whole or part.
suffers from a variety of disorders, all roughly grouped together under
schizophrenia. He has needed long periods of restraint and multiple
hospital stays. His thirty-year battle has coincided frighteningly with
numerous changes in our attitudes toward and treatment of such illness.
Shuttled from doctor to doctor, Robert has been dosed with almost every
polysyllabic wonder drug that has surfaced. Some worked; some didn't.
None offered the "magic bullet" that the author hoped and prayed for.
Neither did such bizarre fads as putting patients into insulin-induced
comas. The narrative touches on the author's parallel life as a writer,
academic, divorcee and father of two and is shot through with an
understandable sense of guilt. Could the family have done more? Would
greater financial resources have changed Robert's chances for a normal
life? The blatant dysfunction of the New York State mental health
establishment is horrifying in this portrayal, yet, to most readers of the
daily newspaper, totally expected. Nothing is solved here, but
Neugeboren's account may bring understanding to those who can barely
imagine such horrors and comfort to those who have and have felt alone
(Publishers Weekly, Dec. 30, 1996).
Neugeboren, Jay (1999). Transforming Madness: New Lives for People Living
with Mental Illness. New York: William Morrow & Co.
Neugeboren surveys the mental health care system, discussing what he

sees as its faults and the possibilities for the future. Because his brother
suffers from mental disease, it's no academic matter for the author. The
problems Neugeboren found go beyond the social stigmas attached to
mental illness. He argues, among other things, that many treatment
programs incorrectly separate the mentally ill from society, to the
detriment of patient, family, and community. Using the testimony of
patients and mental health professionals, he concludes that drug
treatment, though at times the best option is frequently overused. But
Neugeboren also discovered innovative, successful programs. One, for
example, places increasing responsibility on the mentally ill for getting
better and making them an active part of the process. The case histories
and stories of his brother's struggle to get better create a compassionate
overview of an issue the U.S. is just beginning to look at squarely (Brian
McCombie, Booklist, May 1, 1999).
Schiller, Lori, & Bennett, Amanda (contributor) (1994). Quiet Room: A Journey
out of the Torment of Madness. New York: Warner Books.
In the bestselling tradition of The Bell Jar and I Never Promised You a
Rose Garden, this is the electrifying story of one woman's descent into
madness—and her courageous, triumphant struggle to rejoin the real
world. To recreate Lori's harrowing story, coauthor Bennett drew from
Lori's personal diaries as well as intimate interviews with relatives, friends,
whole or part.
and doctors.
Sheehan, Susan (1983). Is There No Place on Earth for Me? New York: Vintage
Books.
This is the unforgettable true story of Sylvia Frumkin and her dramatic
regress from a highly intelligent grade-school student to a schizophrenic
who has spent much of the last 17 years in mental institutions.
Simon, Clea (1997). Mad House: Growing up in the Shadow of Mentally Ill
Siblings. New York: Doubleday.
Combining the story of her brother's and sister's schizophrenia with those
of other siblings who likewise watched the tragic consequences that
mental illness wreaked on their families, this is the first book to
comprehensively address the issues "well" children face.
Vonnegut, Mark (2002). The Eden Express: A Classic Account of Schizophrenia.

New York: Praeger.
Mark Vonnegut graduated from Swarthmore College in 1969. Ambivalent

about the academy and suspicious of his father's new literary fame, he
traveled to British Columbia to build an ideal community. On Valentine's
Day, 1971, he was committed to Vancouver's Hollywood Psychiatric
Hospital as a schizophrenic. The Eden Express is his account of his life
with schizophrenia. Winner of the American Library Association Notable
Book Award, Mark Vonnegut's honest, thoughtful and moving account of
the illness of schizophrenia features a foreword by his father, literary
grandmaster Kurt Vonnegut.
References
Gralnick, A. (1985). Build a better state hospital: Deinstitutionalization has failed.

Hospital and Community Psychiatry, 36, 738-741.
Okin, R. L. (1985). Expand the community care system: Deinstitutionalization can

work. Hospital and Community Psychiatry, 36, 742-745.
whole or part.
Handout 8.1:
Distinguishing Between the Positive and Negative Symptoms of Schizophrenia
Positive (Type I) Symptoms Negative (Type II)

Symptoms
Description of symptoms
Likely causes
Most effective treatments
Prognostic outcomes
Responsiveness to
medication
whole or part.
Chapter 8
Schizophrenia and Related Psychotic Disorders
whole or part.
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der Eber noch den Boden aufwühlt und der Hirsch mit den
gewaltigen Stangen den Buchenwald durchästet“ (Mehlis).
Abb. 58. Schloß Rheinstein. (Zu Seite 50.)

Bis südlich von Lorch (Abb. 62), das schmuck
auf dem rechten Ufer bald vor uns auftaucht, Lorch.
während links das langgestreckte Dorf
Niederheimbach und die Heimburg grüßen, bauen sich die Talwände
aus Taunusquarzit auf. Es war ein mühevolles Werk, das der
Rheinstrom beim Einsägen in dieses harte Gestein auszuführen
hatte. Noch hat er es nicht ganz vollendet, noch lauern überall
Quarzriffe unter seinem Wasserspiegel, besonders bei niedrigem
Wasserstande die Schiffahrt sehr gefährdend. An vielen Stellen
mußten, wie am Binger Loch, umfangreiche Sprengungen
vorgenommen werden, um diese überhaupt möglich zu machen. Auf
der folgenden Strecke, auf der der Rhein den Hunsrückschiefer zu
durchfurchen hatte, war das Werk wohl leichter. Aber manche harte
Felsbänke durchsetzen auch dort den Strom und lassen ihn wild
aufbrausen, so am Wilden Gefährt bei Bacharach, ferner bei Caub,
wo die Pfalz, eine kleine Burg, auf einem Felsen mitten im Strom
erbaut ist, sowie besonders auf der Strecke zwischen dem
Kammereck und der Lorelei. Mit dem Eintritt in den Hunsrückschiefer
geht zugleich eine große Veränderung in dem Gepräge der
Landschaft vor sich. Während der Quarzit eine ziemlich gleichmäßig
zusammengesetzte Gesteinsmasse bildet, ist der Schiefer in seinen
einzelnen Lagen oft sehr verschieden beschaffen und von ungleicher
Härte. Infolgedessen sind die Formen, die die Verwitterung und die
gewaltsame Zerstörung durch den Strom und der einmündenden
Bäche entstehen ließen, mannigfaltiger, und malerischer ist das Bild
der Felswände, die ihre wuchtige Gesamterscheinung durch einen
reichen Wechsel zwischen beleuchteten kleinen Vorsprüngen und
dunkeln Klüften beleben können.
Abb. 59. Aßmannshausen. (Zu Seite 50.)
Zwischen trotzigen Schieferwänden geht also die Fahrt weiter.

Schon gleich die Ruinen der hinter dem Städtchen Lorch
aufragenden Burg Nollich zeigen sich uns auf zackigem
Schieferberge. Ein scharfer Felsgrat tritt aus dessen südwestlichem
Abhange heraus, die Teufelsleiter genannt. Ein Ritter von Lorch soll
einst an dieser Stelle hinaufgeritten sein, um durch diese kühne Tat
die Hand eines Edelfräuleins zu erringen. Lorch selbst ist ein sehr
alter Ort. Schon 844 wird es als Lorecha erwähnt. Im Mittelalter
wohnten daselbst viele Adlige, die, nach dem Wortlaut einer
Urkunde, ein „Leben wie im Paradiese“ führten. Auch heute hat
Lorch noch manche historisch interessante Gebäude. Die aus dem
dreizehnten bis fünfzehnten Jahrhundert stammende Martinskirche,
die sich durch ihr herrliches Geläute auszeichnet, enthält mehrere
bemerkenswerte Grabdenkmäler, so das Denkmal des Ritters
Johann Hilchen von Lorch, eines Waffengenossen Sickingens, der
„in den Zügen gegen den Erbfeind, den Dürcken, und den König zu
Francreich in den Jahren 1543 und 1544 oberster Veltmarschalck“
war. Auch das fünfstöckige Wohnhaus dieses Ritters wird in Lorch
noch gezeigt.
Bei Lorch mündet das Wispertal in das Rheintal. Kalte Winde
führt es diesem zu, Bergwinde, die die im Rheintale aufsteigende
warme Luft zu ersetzen suchen und dem Weinbau viel Schaden
zufügen.
Abb. 60. Die Falkenburg (Schloß Reichenstein). (Zu Seite 52.)
Von Lorch und Burg Nollich wenden wir den Wispertal.

Blick ab und schauen nach links auf die Fürstenberg.
gegenüberliegende Bergwand, die den kalten Bacharach.
Windhauch des Wispertales empfängt. Von der
Höhe grüßen uns die Ruinen der Burg Fürstenberg. Einst fuhr ein
neugewählter deutscher Kaiser, Adolf von Nassau war es, hier
vorbei, auf dem Wege zur Krönung nach Aachen. Da gebot die
pfälzische Besatzung dieser Burg seinem Schifflein Halt und forderte
trotzig den Rheinzoll. So geschehen im Jahre 1292. Noch sinnen wir
nach über eines solchen Kaisers Herrlichkeit, der seine Kaiserwürde
verzollen mußte, da taucht, schimmernd im Lichtglanze des Tages,
das alte ehrwürdige Städtchen Bacharach (2000 Einw.) (Abb. 63)
aus den Fluten vor uns auf. Malerisch überragen es die roten
Sandsteinbogen einer gotischen Kirchenruine und die weitläufigen
Mauertrümmer der oft und heiß umstrittenen Burg Stahleck. Das
Schiff mäßigt die Fahrt, um an der Landebrücke anzulegen, und in
Muße können wir das Bild betrachten, dessen einzelne Züge so viele
historische Erinnerungen in uns wecken. Die mittelalterlichen
Stadtmauern, die von der Burg herabkommen und noch fast die
ganze Stadt umschließen, machen uns schon klar, daß diese eine
lange Geschichte zu erzählen weiß. Im Mittelalter wurde kaum ein
Ort mehr genannt als Bacharach, und auch in der weiten Welt war
es überall bekannt. Kamen doch von dort die herrlichsten Weine, wie
Widtmanns musikalisches Kurzweil aus dem Jahre 1632 uns meldet,
worin es heißt:
Zu Klingenberg am Main,
Zu Würzburg an dem Stein,
Zu Bacharach am Rhein,
Hab’ ich in meinen Tagen
Gar oftmals hören sagen,
Soll’n sein die besten Wein’!
Abb. 61. Schloß Sooneck.
Nach einer Photographie von Sophus Williams in Berlin. (Zu Seite 52.)
Wohl haben Bacharachs Rebengehänge eine Bacharach.

günstige Lage; denn unterhalb der Stadt macht der Stahleck.
Rhein eine Biegung, so daß auf dieser Strecke die
linke Bergwand mehr Sonnenbestrahlung und den warmen Hauch
von Süden empfängt. Aber dennoch ist die Lage nicht so
hervorragend günstig, und es sind nur mittelmäßige Weine, die bei
Bacharach und in der Umgegend, so im Blüchertal, das den
beliebten Steeger liefert, wachsen. Der hohe Ruf der Weine von
Bacharach in früherer Zeit hatte einen anderen Grund. Im Mittelalter
war die Stadt der Stapelplatz für die meisten Weine, die im oberen
Rheintal und in dem angrenzenden Rheingau, der besten
Weingegend Deutschlands, wuchsen. Die zahlreichen Felsklippen
im Rhein machten nämlich die Schiffahrt zwischen Bacharach und
Bingen fast unmöglich. Die herrlichen Rheingauer Weine mußten auf
Fuhren nach Bacharach gebracht werden und wurden dort erst auf
die Schiffe verladen. So galten sie als Bacharacher Weine. Die
frühere Bedeutung hat Bacharach mit der Erweiterung der
Rheinschiffahrt und dem Ausbau des Eisenbahnnetzes verlieren
müssen. Doch besitzt es noch immer einige Bedeutung auf dem
Gebiete des Weinhandels. Denn in den Tälern von Steeg, von
Oberdiebach und Manubach wächst eine Fülle von Wein. Im Innern
macht Bacharach einen altertümlichen Eindruck. Noch viele alte
Fachwerkbauten, Giebelhäuser mit weit vorstehendem und dadurch
schwerfällig überhängendem Obergeschoß engen die Straßen ein.
Ein altberühmtes Fachwerkhaus mit turmartigem Erker, das aus dem
Jahre 1568 stammt, wurde 1897 zum Teil auf Staats- und
Provinzialkosten neu hergestellt. Hinter der spätromanischen
Peterskirche steigt auf einer kleinen Anhöhe der auch als
Mauerruine noch schöne Bau der ehemaligen Wernerskirche vor uns
auf. In zierlichem gotischem Stil war diese 1293 in Form eines
Kleeblattes erbaut worden; das Maßwerk in den Fensteröffnungen,
in denen nun der Wind sein Spiel treibt, veranschaulicht noch die
edlen Formen des Baues. Nun hinauf zur Burg Stahleck! An der
Einmündung des breiten Steeger- oder Blüchertales, das den
Zugang zur Hochfläche des Hunsrück bildet und auch von Blücher
als Marschroute auf dem Zuge nach Frankreich gewählt wurde,
gelegen, war sie ein strategisch wichtiger Punkt. Nicht weniger als
achtmal wurde sie im Dreißigjährigen Krieg, zwischen 1620 und
1640, nebst der Stadt von den Franzosen erobert, die sie auch 1689
zerstörten.
Von Eindrücken, die frühere oftmalige Einkehr
im alten Bacharach zurückgelassen hatte, durfte Die Pfalz. Caub.
ich in Kürze erzählen. Nur zu schnell setzt sich Oberwesel.
unser Schiff „Lohengrin“ wieder in Bewegung, und neue Bilder
verdrängen die alten. Die zierliche Pfalz, mitten im Strome gelegen
und von dessen Wogen oft wild umbraust, läßt uns vorübergleiten,
und rechts begleitet uns die lange Häuserreihe von Caub, überragt
von der Burg Gutenfels, die vor kurzem ausgebaut wurde. Am Ufer
steht, der Pfalz gegenüber, seit 1894 ein Denkmal Blüchers (Abb.
65). Es ist die Stelle, wo dieser mit einem preußischen und einem
russischen Armeekorps in der Neujahrsnacht 1813/14 den Rhein
überschritt. Mit Hilfe der Cauber Schiffer wurde die Pontonbrücke
geschlagen, für die die Felsklippe der Pfalz einen vortrefflichen
Stützpunkt darbot. Bei Caub wird der beste rheinische Dachschiefer
gewonnen. In dem schwärzlichen Gestein, dessen Farbe die
Sonnenstrahlen stärker auf sich sammelt, gedeiht auch vortrefflich
die Rebe.
Mit freudigem Staunen wenden wir uns dann dem prächtigen
Bilde zu, das am linken Stromesufer im Rahmen einer der schönsten
Landschaften des Rheintales erscheint, dem mit Kirchtürmen,
Ringmauern und zinnengekrönten Türmen reich geschmückten
Städtchen Oberwesel (2800 Einw.) (Abb. 64). Von der Bergeshöhe
schaut ernst die in Trümmern liegende Schönburg hinab auf die
freundlichen Gärten im Tale, aus denen schmuck die zahlreichen
Landhäuser Oberwesels herauslugen.
Abb. 62. Lorch.
Abb. 63. Bacharach und Burg Stahleck. (Zu Seite 54.)
Die Lorelei.
Bei Oberwesel beginnt die schönste Strecke
des Rheintales. Hinter der hochragenden Felsmasse des Roßsteins
stürmt der Rhein, in seinem Laufe umbiegend, in die enge
Felsenspalte des Kammereck hinein, und bei einer neuen Biegung
des Stromes fällt unser Blick auf eine andere trotzige Felsklippe, die
unmittelbar aus dem Strome, 132 m über dessen Spiegel,
emporsteigt. Es ist der sagenumwobene Loreleifelsen (Abb. 66). Die
zackig auslaufenden Schichten seines schiefrigen Gesteins steigen
zum Strome hin an, so daß man das Gefühl bekommt, als ob der
Bergkoloß im Begriff wäre, sich aus den Fluten herauszuheben. Wer
das Glück hat, beim Sonnenuntergang, wenn die Abendröte die
Bergesspitze golden bemalt, oder im Mondenschein, wenn
gespensterhafte Schatten den schroffen Berg umspielen, den
Anblick des Lurleifelsens zu genießen, der glaubt auf dem hohen
Bergesgipfel die schöne Jungfrau, von der die Sage erzählt, zu
schauen. Auch den Schiffer kann er sehen. Zum Fischfange fährt er
hinaus auf den Strom. In dem kühlen, wenig von der Sonne
erwärmten Wasser am Loreleifelsen hält sich mit Vorliebe der Salm,
der beste, schmackhafteste und teuerste aller Rheinfische, auf. Dort
lockt den Fischer ein guter Gewinn, und mancher mag beim
Fischfange die verborgenen Felsklippen nicht genug beachtet
haben. Aber die Sage vergoldet, gleich dem Abendrot, das golden
die Spitze des Loreleifelsens malt, in einem sinnigen Bilde den
ernsten Zug des Fischerlebens. Sie läßt den jungen Fischer
lauschen auf das liebliche Singen, das geheimnisvoll, mit gewalt’ger
Melodei, von der umgoldeten Bergesspitze hernieder klingt.
Die schönste Jungfrau sitzet

Dort oben wunderbar,
Ihr gold’nes Geschmeide blitzet,
Sie kämmt ihr goldenes Haar.
Sie kämmt es mit goldenem Kamme
Und singt ein Lied dabei,
Das hat eine wundersame,
Gewalt’ge Melodei.
Dem Schiffer im kleinen Schiffe
Ergreift es mit wildem Weh,
Er schaut nicht die Felsenriffe,
Er schaut nur hinauf in die Höh’.
Ich glaube, am Ende verschlingen
Die Wellen noch Schiffer und Kahn,
Und das hat mit ihrem Singen
Die Lorelei getan.
(H e i n e .)
Die Abstammung des Wortes Lorelei ist nicht völlig aufgeklärt.
Die einen wollen es, an das schöne Echo, das vom Berge
widerklingt, erinnernd, als „lauter Fels“ deuten. In der
Bibelübersetzung Luthers wird „lören“ in dem Sinne von „heulen, laut
jammern“ gebracht. Die Übersetzung „Totengesangfelsen“ würde zu
der mit der Lorelei verknüpften Sage passen.
Abb. 64. Oberwesel.

Abb. 65. Blücherdenkmal in Caub und Burg Gutenfels.
Nach einer Photographie von Stengel & Co. in Berlin. (Zu Seite 56.)
Von den steilen Bergwänden, die sich bis auf 165 m einander
nähern, während die Breite des Rheines bei Rüdesheim 830 m
beträgt, eingeengt, mußte der gefesselte Strom mit um so größerer
Gewalt sich an den Felsen brechen, die in seinem Bette aufragten.
Bis zu einer Tiefe von 27 m hat er dasselbe ausgefurcht. Tiefdunkel
sind daher seine Fluten, in die aber früher hier und da einzelne
härtere Felsklippen höher, gefahrdrohend für die Schiffahrt,
hinaufragten, bis Sprengungen sie beseitigten. Der helle
Sonnenschein, der unserer Rheinfahrt lacht, gibt nicht das rechte
Stimmungsbild in diesem engsten, schluchtartigen Teile des
Rheintals. Wenn Gewitterwolken über dem Strome sich ballen oder
die Rheinnebel durch das Tal wallen, wenn aus dem Wolkengrau,
dem weißen Nebelschleier wie schwarze Mauern die trotzigen
Bergwände mit den Trümmerresten der Burgen herausschauen,
dann erst entsteht eine Stimmung, die in diese Landschaft
hineinpaßt und uns ein düsteres Fjordbild von Norwegens felsiger
Küste vortäuschen könnte.
Abb. 66. Die Lurlei.
Abb. 67. St. Goar und Rheinfels.
Unterhalb des Loreleifelsens wird der Rhein St. Goar.

wieder breiter, und bei St. Goarshausen, dem das Rheinfels. Katz
alte Städtchen St. Goar (Abb. 67) gegenüberliegt, und Maus. Die
fand sich sogar Raum genug zur Anlage eines Brüderburgen.
Sicherheitshafens, in dem die Schiffe zur Winterzeit vor dem
Eisgange oder zu anderen Jahreszeiten vor plötzlich eintretendem
Hochwasser Schutz suchen können. Während über
St. Goarshausen der hohe Turm der 1393 erbauten Burg Katz (Abb.
68) emporragt, ist St. Goar durch die Ruinen der umfangreichen
Burg Rheinfels (Abb. 69), die mehr als 100 Jahre älter ist, malerisch
geschmückt. Die Besitzer dieser beiden Burgen waren die Grafen
von Katzenelnbogen, die eine Stunde landeinwärts auch die Burg
Reichenberg (Abb. 70) besaßen. Spottweise nannten diese eine
andere Burg, die wenig unterhalb von der rechten Talwand
herniederschaut, die Maus. Dann erscheinen auf derselben Seite,
nach einer längeren Strecke, auf wildgerissenen Felsen die Trümmer
der beiden „Brüderburgen“ Liebenstein und Sterrenberg. Eine tiefe
Schlucht trennt die beiden Burgen voneinander, über die die
Geschichte wenig Verbürgtes zu melden weiß. Gesprächiger ist die
Sage. Sie erzählt von zwei Brüdern, die, nachdem sie ihre blinde
Schwester bei der Erbschaftsteilung betrogen haben, selbst
miteinander in heftigen Streit geraten und sich gegenseitig töten.
Anders berichtet Horn die Sage. Zwei Brüder liebten eine Maid —
Gräfin Laura nennt Heine sie — und gerieten darüber in Streit.
„Wehe! Wehe! Blut’ge Brüder!

Wehe! Wehe! Blut’ges Tal!
Beide Kämpfer stürzen nieder,
Einer in des andern Stahl.“
(H e i n e .)
Abb. 68. St. Goarshausen und Ruine Katz.

Abb. 69. Ruine Rheinfels, mit Durchblick nach St. Goarshausen.
Abb. 70. Burg Reichenberg bei St. Goarshausen.
Gegenüber den beiden Brüderburgen und dem Salzig.

Kloster Bornhofen, einem vielbesuchten
Wallfahrtsort, liegt, umschattet von Hunderten von Kirschbäumen,
das Dörfchen Salzig. Im Frühling entfalten die Kirschenhaine einen
Blütenschmuck, daß das Auge, wie schon Wolfram von Eschenbach
sang, „schier trunken wird ob solcher Pracht“. Im Juni aber, wenn die
Kirschenernte stattfindet, fließt ein reicher Goldsegen in den
berühmten Kirschenort. In kleinen Körbchen wandern die
rotbackigen süßen Früchte auf den Kirschenmarkt nach Coblenz, wo
zahlreiche Händler aus allen Städten des Niederrheins, sowie aus
Holland und England sich einfinden. Bei guter Ernte soll Salzig einen
Erlös von 200000 Mark aus seinen Kirschen machen. Auch die
Rheinorte, die weiter unterhalb vom baumgeschmückten Strand
grüßen, wie Camp, das Städtchen Boppard, ferner Filsen,
Osterspay, Ober- und Niederspay, treiben neben dem Weinbau
einen bedeutenden Obstbau. Im Frühling sind diese Ortschaften von
dem weißen Blütenmeer der Kirschbäume, in dem hier und da, wie
ein duftiger Strauß, das liebliche Rosa eines Pfirsichbaumes
erscheint, umrahmt.
Zwar lacht nicht des Frühlings Blütenpracht bei
der Ankunft unseres Schiffes, des stolzen Boppard.
„Lohengrin“, im gastlichen Boppard (6600 Einw.)
(Abb. 71). Aber der Schmuck der schönen Gärten, die die
zahlreichen Villen umgeben, erfreut unser Auge und lockt mehr noch
die, welche mit ihrem Reisebündel bereit stehen, das Schiff zu
verlassen. Genußreiche Wanderungen werden sie hinauf führen zur
Bergeshöhe, wo der Landschaft Pracht zu ihren Füßen liegt, zum
Vierseenplatz, wo sie den sich krümmenden Rheinlauf vierfach
zwischen den Bergen aufblitzen sehen, oder in das anmutige Mühltal
(Abb. 72). So heiter lacht des Lebens, der Gegenwart frischer Reiz,
und fast vergessen wir, den Geist in die lange Geschichte zu
versenken, von der Boppard zu erzählen weiß. Von den Kelten
wurde das alte Bodobriga gegründet. Die Römer errichteten daselbst
ein Wurfmaschinendepot (balistarii Bodobricae). Im vierten Jahrhundert
n. Chr. wurde der Ort von ihnen von neuem stark befestigt.
Bedeutende Reste dieser spätrömischen Festungsanlage sind noch
erhalten. Es konnte festgestellt werden, daß dieselbe ein Rechteck
von etwa 300 m Länge und halber Breite bildete und von einer 3 m
dicken und 8 m hohen Ringmauer, in der sich vier runde Ecktürme
und 24 halbrunde Mauertürme befanden, umgeben war. Im
dreizehnten Jahrhundert wurde Boppard, das seit dem zwölften
Jahrhundert freie Reichsstadt gewesen war, zusammen mit
Oberwesel an den Erzbischof von Trier verpfändet. Von
mittelalterlichen Gebäuden sind besonders die in der Mitte der Stadt
gelegene spätromanische Pfarrkirche, deren alte Malereien 1894
und 1895 sorgfältig erneuert wurden, die gotische Karmeliterkirche
und die ehemalige kurtriersche Burg, die jetzt als Amtsgericht dient,
zu nennen.
Abb. 71. Boppard und Filsen von „Alte Burg“ aus gesehen.
Nach einer Photographie der Neuen Photographischen Gesellschaft in Berlin-Steglitz.
(Zu Seite 64.)
Von dem freundlichen Bilde Boppards müssen Die Bopparder

zu schnell wir wieder scheiden. Weiter geht die Hamm.
Fahrt, und auf eine hochragende steile Bergwand, Marksburg.
die Bopparder Hamm genannt, steuert unser Schiff
los. Quer ist diese dem Strome vorgelagert, der vor ihr nach Osten
umbiegen muß. Keine Bergwand im ganzen Rheintal, abgesehen
vom Rüdesheimer Berg, hat eine solche günstige Lage nach Süden
wie die Bopparder Hamm. Ein vorzüglicher Wein wächst auf
derselben. Bis hoch hinauf ist sie mit Reben bepflanzt. Beim
Vorbeifahren müssen wir den Kopf weit zurück in den Nacken legen,
um zu den obersten Weinbergen hinaufschauen zu können. Zur
rechten Hand begleitet uns dagegen eine kleine Niederung, die dicht
mit Bäumen bepflanzt ist. Der Gegensatz zwischen der
hochragenden, steilen Felswand zur Linken, auf der der Winzer

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Abnormal Psychology An Integrated Approach 6th Edition

1. Describe the prevalence of schizophrenia and how it varies by gender and

4. Distinguish between disorganized and catatonic behavior.

5. Describe common negative symptoms of schizophrenia.

7. Distinguish between Type I and Type II symptoms, as well as between prodromal

I. Symptoms, Diagnosis, and Course

psychosis residual symptoms

• The positive (or Type I) symptoms of schizophrenia include delusions

ONLINE LEARNING CENTER RESOURCES

Positive Symptoms of Schizophrenia

Research concerning causal factors in the development of schizophrenia

• The rate of mental illness has not declined.

• Treatment usually works best in an environment that minimizes coercion

Remind students that this is a disorder that affects approximately 1% of the

Changes Between DSM IV-TR and DSM 5

Virtual Voices: http://eikonprofessionals.com/Virtual-Voices.html — see if you can

Time Needed: At least 30 minutes, probably more with discussion.

Materials Needed: Copies of a first-person account by a person with

Connect, Learnsmart and Faces Interactive

Please take an opportunity to look at “Connect” (connect.mgraw-hill.com) as well

The Faces Interactive Module contains an interview with an individual diagnosed

Schizophrenia is a psychotic disorder that involves distortions of thought,

Suggested Classroom Activities

A) Direct students to Ian Chovil’s Experience of Schizophrenia page:

I Never Promised You a Rose Garden (1977) is a TV movie based on the

Preventing Relapse in Schizophrenia. As of now, there is no cure for

Schizophrenia: New Definitions, New Therapies. Using interviews with

The Torment of Schizophrenia provides computer animations of the brain, case

Unchaining the Mind: Advances in Schizophrenia Research outlines the

Understanding Schizophrenia. Schizophrenia is the most severe of the serious

The World of Abnormal Psychology

Of particular relevance to this chapter are Looking at Abnormal Behavior,

Discovering Psychology: Updated Edition

Cognitive Neuroscience is on overview of cognition and the brain.

“Discovering Psychology: Updated Edition” is a general series with several clips

Treating Depression: Electroconvulsive Therapy

“The Mind” is a series that looks at myriad factors relevant to cognitive,

The Brain: Teaching Modules

“The Brain” is a series that looks at myriad factors relevant to cognitive,

Online Learning Center Resources

Novels, Biographies, and Nonfiction Titles of Note

Chronicles the three-year battle of a mentally ill, but perceptive, teenage

Neugeboren, Jay (1998). Imagining Robert: My Brother, Madness, and Survival:

Novelist Neugeboren has written a detailed, exquisitely painful and always

Neugeboren surveys the mental health care system, discussing what he

Vonnegut, Mark (2002). The Eden Express: A Classic Account of Schizophrenia.

Mark Vonnegut graduated from Swarthmore College in 1969. Ambivalent

Gralnick, A. (1985). Build a better state hospital: Deinstitutionalization has failed.

Okin, R. L. (1985). Expand the community care system: Deinstitutionalization can

Positive (Type I) Symptoms Negative (Type II)

Most effective treatments

Abb. 58. Schloß Rheinstein. (Zu Seite 50.)

Zwischen trotzigen Schieferwänden geht also die Fahrt weiter.

Abb. 60. Die Falkenburg (Schloß Reichenstein). (Zu Seite 52.)