Hockenbury Discovering Psychology 5th txtbk

566 CHAPTER 13 Psychological DisordersTable 13.9Types of SchizophreniaParanoid Type• Well-organized delusional beliefs reflectingpersecutory or grandioseideas• Frequent auditory hallucinations,usually voices• Little or no disorganized behavior,speech, or flat affectCatatonic Type• Highly disturbed movements or actions,such as extreme excitement,bizarre postures or grimaces, or beingcompletely immobile• Echoing of words spoken by others,or imitation of movements of othersDisorganized Type• Flat or inappropriate emotional expressions• Severely disorganized speech andbehavior• Fragmented delusional ideas andhallucinationsUndifferentiated Type• Display of characteristic symptomsof schizophrenia but not in a waythat fits the pattern for paranoid,catatonic, or disorganized typeTypes of SchizophreniaFigure 13.5 shows the frequency of positive and negative symptoms at the time ofhospitalization for schizophrenia. These symptoms are used in diagnosing the particularsubtype of schizophrenia. DSM-IV-TR includes three basic subtypes ofschizophrenia: paranoid, catatonic, and disorganized (see Table 13.9).The paranoid type of schizophrenia is characterized by the presence of delusions,hallucinations, or both. However, people with paranoid schizophrenia show virtuallyno cognitive impairment, disorganized behavior, or negative symptoms. Instead,well-organized delusions of persecution or grandeur are operating. Auditoryhallucinations in the form of voices talking about the delusional ideas are also oftenevident. Convinced that others are plotting against them, these people react withextreme distrust of others. Or they may assume an air of superiority, confident in thedelusional belief that they have “special powers.” The paranoid type is the mostcommon type of schizophrenia.The catatonic type of schizophrenia is marked by highly disturbed movements oractions. These may include bizarre postures or grimaces, extremely agitated behavior,complete immobility, the echoing of words just spoken by another person, orimitation of the movements of others. People with this form of schizophrenia willresist direction from others and may also assume rigid postures to resist beingmoved. Catatonic schizophrenia is often characterized by another unusual symptom,called waxy flexibility. Like a wax figure, the person can be “molded” into anyposition and will hold that position indefinitely. The catatonic type of schizophreniais very rare.The prominent features of the disorganized type of schizophrenia are extremelydisorganized behavior, disorganized speech, and flat affect. Delusions and hallucinationsare sometimes present, but they are not well-organized and integrated, likethose that characterize paranoid schizophrenia. Instead, people with the disorganizedtype experience delusions and hallucinations that contain fragmented, shiftingthemes. Silliness, laughing, and giggling may occur for no apparent reason. In short,the person’s behavior is very peculiar. This type of schizophrenia was formerly calledhebephrenic schizophrenia, and that term is still sometimes used.Finally, the label undifferentiated type is used when an individual displays somecombination of positive and negative symptoms that does not clearly fit the criteriafor the paranoid, catatonic, or disorganized types.100908081%85%7065%Percentage60504058%Figure 13.5 Presence of Symptoms inSchizophrenia This graph shows how oftenspecific positive and negative symptomswere present in a study of over 100 individualsat the time they were hospitalizedfor schizophrenia. Delusions were the mostcommon positive symptom, and avolition,or apathy, was the most common negativesymptom.3020100Delusions22%30%Hallucinations Disorganized Flat affect Alogia/thoughtspovertyof speechAvolition/apathySource: Based on data reported in Andreasen & Flaum(1991).Positive symptomsNegative symptoms