Abnormal Psychology

Schizophrenia and Other Psychotic Disorders 523

words. For example, a patient might say something like “Pots dog small is tabled.”

Another type of disorganized speech involves many neologisms, or words that the

patient makes up:

That’s wish-bell. Double vision. It’s like walking across a person’s eye and refl ecting

personality. It works on you, like dying and going to the spiritual world, but landing in

theVella world.

(Marengo et al., 1985, p. 423)

In this case, “wish-bell” is the neologism; it doesn’t exist, nor does it have an obvi-

ous meaning or function as a metaphor.

Disorganized Behavior

Another positive symptom (and recall that positive in this context means “present,”

not “good”) of schizophrenia is disorganized behavior, behavior that is so unfo-

cused and disconnected from a goal that the person cannot successfully accomplish

a basic task, or the behavior is inappropriate in the situation. Disorganized behavior

can range from laughing inappropriately in response to a serious matter or mas-

turbating in front of others, to being unable to perform normal daily tasks such

as washing oneself, putting together a simple meal, or even selecting appropriate

clothes to wear.

Hester Genain had symptoms of schizophrenia that began in childhood, includ-

ing disorganized behavior: “Hester did a lot of strange things. Once Mrs. Genain

bought each girl four pairs of new panties, and Hester put on all four pairs over the

dirty one she was wearing” (Rosenthal, 1963, p. 52).

The category of disorganized behavior also includes catatonia(also referred

to as catatonic behavior), which occurs when an individual remains in an odd

posture or position, with rigid muscles, for hours. For example, during her early

20s, Iris Genain’s symptoms included standing in the same position for hours

each evening.

These positive symptoms—hallucinations, delusions, disorganized speech, and

disorganized behavior—constitute four of the fi ve DSM-IV-TR symptom criteria for

schizophrenia; the fi fth criterion is any negative symptom (discussed in the follow-

ing section). DSM-IV-TR requires that a person have a total of two—out of the

fi ve—of these symptoms (see Table 12.1) to be diagnosed with schizophrenia. In

order to receive such a diagnosis, then, an individual must have a least one positive

symptom.

Negative Symptoms

In contrast to positive symptoms, negative symptoms are marked by the absenceor

reduction of normal mental processes, mental contents, or behaviors. DSM-IV-TR

specifi es three types of negative symptoms: fl at affect, alogia, and avolition. Each of

these refl ects the lack of a normal mental process, expression of feeling, or behavior,

but they differ in what—specifi cally—is lacking. Let’s look more closely at these

negative symptoms.

Flat Affect: Muted Expression

Some people with schizophrenia exhibit fl at affect, which occurs when a person

does not display a great range of emotion and hence often seems emotionally neu-

tral. Such people may not express or convey much information through their facial

expressions or body language, and they tend to refrain from making eye contact

(although they may smile somewhat and do not necessarily come off as “cold”).

Although people with schizophrenia may not display much emotion, that doesn’t

necessarily mean that they don’t experience much emotion. Studies suggest that their

experience of emotion is much like that of other people (Aghevli, Blanchard, &

Horan, 2003; Chattopadhyay, 2005; Myin-Germeys, Delespaul, & deVries, 2000).

However, this is not apparent from casual observation.

Catatonia

A condition in which an individual remains

in an odd posture or position, with rigid

muscles, for hours.

Negative symptoms

Symptoms of schizophrenia that are marked

by the absence or reduction of normal mental

processes, mental contents, or behaviors.

Flat affect

A lack of, or considerably diminished,

emotional expression, such as occurs when

someone speaks robotically and shows little

facial expression.