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• Symptoms of disorganized schizophrenia include incoherent speech, inappropriate mood, hallucinations, and delusional thought patterns. People with disorganized schizophrenia may make no sense when talking and act in a very bizarre way that is inappropriate for the situation (e.g., laughing in the back of the church during a funeral). Silly, childlike behavior is typical.

• Paranoid schizophrenia is characterized by delusions of grandeur, persecution, and reference. The delusions typically form an elaborate network resulting from misinterpretation of reality. For example, people with paranoid schizophrenia often think that they are special and have been selected for exceptional attention (delusions of reference). They often misinterpret occurrences as directly relevant to them, such as lightning being a signal from God. They frequently believe that such attention is because of their specialness, and that they are world leaders (delusions of grandeur). They then think that others are so threatened that these other people plot against them (delusions of persecution). Suffering delusions of persecution, people are fearful and can be a danger as they attempt to defend themselves against their imagined enemies.

• Catatonic schizophrenia is characterized by disordered movement patterns, sometimes immobile stupor or frenzied and excited behaviors. People suffering from this disorder might remain in one position, becoming “statues” with what is called waxy flexibility or holding postures that would normally be impossible to maintain by others.

• Undifferentiated or simple schizophrenia is marked by disturbances of thought or behavior and emotion that do not fit neatly into any of the above categories. One area of dysfunction is noted and yet the person may be perfectly normal in every other aspect of life.

Biological psychologists attribute some positive symptoms of schizophrenia, such as hallucinations and delusions, to excessively high levels of the neurotransmitter dopamine, and some negative symptoms, such as lack of emotion and social withdrawal, to lack of the neurotransmitter glutamate. Brain scans show abnormalities in numerous brain regions of individuals with schizophrenia. These abnormalities may result from teratogens such as viruses or genetic predispositions. The diathesis-stress model holds that people predisposed to schizophrenia are more vulnerable to stressors than other people. Thus, only people who are both predisposed and also stressed are likely to develop schizophrenia. Psychoanalysts attribute schizophrenia to fixation at the oral stage and a weak ego. Behaviorists assume that schizophrenia results from reinforcement of bizarre behavior. Humanists think schizophrenia is caused by lack of congruence between the public self and actual self.

Schizophrenia is NOT split personality! People with schizophrenia experience a split with reality. People with dissociative identity disorder show two or more personalities.

Personality Disorders

People with personality disorders have longstanding, maladaptive thought and behavior patterns that are troublesome to others, harmful, or illegal. Although these patterns impair people’s social functioning, individuals do not experience anxiety, depression, or delusions. DSM-IV classifies personality disorders on Axis II grouped into three clusters: odd/eccentric (including paranoid, schizoid, schizotypal), dramatic/emotionally problematic (including histrionic, narcissistic, borderline, and antisocial), and chronic fearfulness/avoidant (including avoidant, dependent, and obsessive-compulsive).

Table 16.1 Personality Disorders

Developmental Disorders

Disorders of infancy, childhood, and adolescence include attention-deficit hyperactivity disorder, infantile autism, anorexia nervosa, and bulimia nervosa.

• Children with attention-deficit hyperactivity disorder (ADHD) are unable to focus their attention, are easily distracted, and often act impulsively—quickly changing activities,