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Nolen-Hoeksema Solutions Manual


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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
© 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.
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
© 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.
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

© 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.
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.)
© 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.
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.
© 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.
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
© 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.
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.

© 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.
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:
© 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.
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)

© 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.
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
© 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.
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
http://www.mhhe.com/socscience/psychology/psychonline/general.html.

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:
http://www.learner.org/resources/series150.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.

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:
http://www.learner.org/resources/series142.html or through the McGraw Hill
© 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.
Higher Education General Resources for Students and Faculty Annenberg / CPB
projects link
http://www.mhhe.com/socscience/psychology/psychonline/general.html.

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:
http://www.learner.org/resources/series54.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

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,
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distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in
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,
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distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in
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.

© 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.
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

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distribution in any manner. This document may not be copied, scanned, duplicated, forwarded, distributed, or posted on a website, in
whole or part.
Chapter 8
Schizophrenia and Related Psychotic Disorders

© 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.

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