Internet Mental Health

SCHIZOAFFECTIVE DISORDER














Internet Mental Health Quality of Life Scale (Client Version)

Internet Mental Health Quality of Life Scale (Therapist Version)

Big 5 Factors Of Mental Illness And Code For This Disorder
(The "6th Big Factor" of Mental Health, "Physical Health", Is Coded Abnormal or Red)

  • Had major depressive or manic episodes associated with a psychosis which failed to meet the diagnostic criteria for either schizophrenia or bipolar I disorder. Either:

    • Unlike schizophrenia, the major depressive or manic episodes lasted longer than 50% of the total duration of the (active + residual) illness.

    • Unlike bipolar I disorder, the the psychosis occurred for at least 2 weeks when not in a major depressive or manic episode.

  • Functioning at usual activities was continuously impaired for at least 1 month.

  • Not due to a medical or substance use disorder.

Psychosis

  • Psychosis is characterized by distortions of thinking and perception, as well as inappropriate or narrowed range of emotions.

  • Incoherent or irrelevant speech may be present.

  • Hallucinations (hearing voices or seeing things that are not there), delusions (fixed, false idiosyncratic beliefs) or excessive and unwarranted suspicions may also occur.

  • Severe abnormalities of behaviour, such as disorganized behaviour, agitation, excitement and inactivity or overactivity, may be seen.

  • Disturbance of emotions, such as marked apathy or disconnect between reported emotion and observed affect (such as facial expressions and body language), may also be detected.

Prediction

    Is either episodic or continuous, lasting for 1 month to years.

Problems

    Occupational-Economic Problems:

    • Causes significant impairment in academic, occupational and/or social functioning.

    • Better prognosis than Schizophrenia but a worse prognosis than Bipolar I Disorder.

    Antagonistic (Low Agreeableness):

    • Irritability and anger occurs during manic phase

    • Uncooperative behavior occurs during manic/depressive episodes

    • May be preceded by:

      • Schizoid Personality Disorder: intimacy avoidance, social withdrawal, lack of emotional expression

      • Schizotypal Personality Disorder: eccentricity, odd beliefs, perceptual distortions

      • Paranoid Personality Disorder: suspiciousness, bearing grudges, feeling victimized

      • Borderline Personality Disorder: harmful impulsiveness, emotional instability, lacks meaningful life purpose & goals, unstable chaotic social life

    • Majority are nonviolent, but overall, like any psychotic disorder, there is an above average risk of physical violence.

    Psychotic (Impaired Intellect):

    • In Schizoaffective Disorder, an individual is irrational (i.e., psychotic) concurrently with a major mood episode which fails to meet the diagnostic criteria for either Schizophrenia or Bipolar I Disorder

    • In Schizophrenia, an individual can have major depressive or manic episodes. However, Schizophrenia is not diagnosed if the total duration of these mood episodes last longer than 50% of the total duration of the (active + residual) illness

    • In Bipolar I Disorder, an individual can become psychotic during a major depressive or manic episode. However, Bipolar I Disorder is not diagnosed if an individual becomes psychotic in the absence of a concurrent major depressive or manic episode

    • If psychotic symptoms occur exclusively during manic/depressive episodes, the diagnosis is Mood Disorder With Psychotic Features

    • Schizoaffective Disorder often develops into pure Mood Disorder (e.g., Major Depressive or Bipolar Disorder) or Schizophrenia

    • Denial of illness: psychotic individuals do not realize that they are psychotic.

    Disinhibited (Disinhibition):

    • Irresponsibility, impulsivity, distractibility, excessive risk taking, hyperactivity, over-talkativeness, and elation occur during the manic phase.

    Negative Emotions (Negative Emotion):

    • Anxiety, depressed mood, and suicidal ideation occur during the depressive phase.

    • 10 to 15% commit suicide (but antipsychotic medication decreases this risk by 75%)



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Click Here For Free Diagnosis

Limitations of Self-Diagnosis

Self-diagnosis of this disorder is often inaccurate. Accurate diagnosis of this disorder requires assessment by a qualified practitioner trained in psychiatric diagnosis and evidence-based treatment.

However, if no such professional is available, our free computerized diagnosis is usually accurate when completed by an informant who knows the patient well. Computerized diagnosis is less accurate when done by patients (because they often lack insight).

Example Of Our Computer Generated Diagnostic Assessment

Schizoaffective Disorder, Bipolar Type, Manic 295.70

This diagnosis is based on the following findings:

  • Had psychotic symptoms (off street drugs) for at least 2 weeks in the absence of prominent mood disturbances

  • Auditory hallucinations (still present)

  • Religious delusion (still present)

  • Disorganized speech (still present)

  • Grossly disorganized or inappropriate behavior (still present)

  • Lack of emotional expression, verbal expression, or motivation (still present)

  • A major mood episode was present for the majority of the total duration of the active and residual portions of the illness

  • Manic episode caused clinically significant distress or disability (still present)

  • Manic episode had abnormally abnormally elevated or expansive mood for at least 1 week (still present)

  • Manic episode had inflated self-esteem or grandiosity for at least 1 week (still present)

  • Manic episode had decreased need for sleep for at least 1 week (still present)

  • Manic episode had unusual talkativeness or pressure to keep talking for at least 1 week (still present)

  • Manic episode had flight of ideas or racing thoughts for at least 1 week (still present)

  • Manic episode had distractibility for at least 1 week (still present)

  • Manic episode had increased goal-directed activity or agitation for at least 1 week (still present)

  • Manic episode had excessive involvement in reckless pleasurable activities for at least 1 week (still present)

TREATMENT GOALS:

  • Goal: prevent auditory hallucinations.
    If this problem worsened: She will continue hearing imaginary things that others can't hear (like noises or someone whispering or talking).

  • Goal: prevent religious delusions.
    If this problem worsened: She will continue to have a false belief that she had a religious experience that others of her religious faith firmly believe is absurd, totally implausible, strange, and false.

  • Goal: prevent disorganized speech.
    If this problem worsened: Her speech will continue to show frequent derailment or incoherence.

  • Goal: prevent grossly disorganized or inappropriate behavior.
    If this problem worsened: Her markedly disheveled appearance, markedly regressed childlike behavior, grossly inappropriate sexual behavior, or unpredictable agitation will continue.

  • Goal: prevent "negative symptoms" of Schizophrenia.
    If this problem worsened: She will continue to have lack of: emotional expression, verbal expression, or motivation.

  • Goal: prevent abnormally elated mood.
    If this problem worsened: Her elevated, unusually good, cheerful, or high mood could lead to unceasing and indiscriminate enthusiasm for interpersonal, sexual, or occupational interactions.

  • Goal: prevent inflated self-esteem or grandiosity.
    If this problem worsened: Her uncritical self-confidence could lead to marked grandiosity. Despite lack of any particular experience or talent, she could embark on writing a novel or seek publicity for some impractical invention or cause. This could develop into grandiose delusions (e.g., having a special relationship to God to some public figure from the political, religious, or entertainment world).

  • Goal: prevent decreased need for sleep.
    If this problem worsened: She could awaken several hours earlier than usual, feeling full of energy. This could progress to going days without sleep and yet not feeling tired.

  • Goal: prevent unusual talkativeness or a pressure to keep talking.
    If this problem worsened: She could have pressured, loud, rapid, and difficult to interrupt speech. This could progress to talking nonstop, sometimes for hours on end, and without regard for others' wishes to communicate. She could become theatrical, with dramatic mannerisms and singing. If her mood was more irritable than expansive, her speech could be marked by complaints, hostile comments, or angry tirades.

  • Goal: prevent flight of ideas or racing thoughts.
    If this problem worsened: Her thoughts could race, often at a rate faster than she could articulate. This could progress to a flight of ideas in which there is a nearly continuous flow of accelerated speech, with abrupt changes from one topic to another. When flight of ideas is severe, speech could become disorganized and incoherent.

  • Goal: prevent distractibility.
    If this problem worsened: She could be unable to screen out irrelevant external stimuli. This could progress to having difficulty differentiating between thoughts that are germane to the topic and thoughts that are only slighly relevant or clearly irrelevant.

  • Goal: prevent abnormally increased goal-directed activity or agitation.
    If this problem worsened: She could have excessive planning of, and excessive participation in, multiple activities (e.g., sexual, occupational, political, or religious). This could involve increased sex drive, fantasies, and sexual behavior. This could progress to increased sociability (e.g., renewing old acquaintances or calling friends or even strangers at all hours of the day or night), without regard to the intrusive, domineering, and demanding nature of these interactions. This could further progress to psychomotor agitation or restlessness (e.g., pacing or holding multiple telephone conversations simultaneously).

  • Goal: prevent excessive involvement in reckless pleasurable activities.
    If this problem worsened: She could have imprudent involvement in pleasurable activities such as buying sprees, reckless driving, foolish business investments, and sexual behavior unusual for her. These activities could have painful consequences. Her unusually increased sexual behavior could include infidelity or indiscriminate sexual encounters with strangers.


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Schizoaffective Disorder F25 - ICD10 Description, World Health Organization
Episodic disorders in which both affective and schizophrenic symptoms are prominent but which do not justify a diagnosis of either schizophrenia or depressive or manic episodes. Other conditions in which affective symptoms are superimposed on a pre-existing schizophrenic illness, or co-exist or alternate with persistent delusional disorders of other kinds, are classified under F20-F29 (schizophrenia, schizotypal and delusional disorders). Mood-incongruent psychotic symptoms in affective disorders do not justify a diagnosis of schizoaffective disorder.

    F25.0 Schizoaffective disorder, manic type

    A disorder in which both schizophrenic and manic symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a manic episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, manic type.

    F25.1 Schizoaffective disorder, depressive type

    A disorder in which both schizophrenic and depressive symptoms are prominent so that the episode of illness does not justify a diagnosis of either schizophrenia or a depressive episode. This category should be used for both a single episode and a recurrent disorder in which the majority of episodes are schizoaffective, depressive type.

    F25.2 Schizoaffective disorder, mixed type

Schizoaffective Disorder - Diagnostic Criteria, American Psychiatric Association

An individual diagnosed with schizoaffective disorder needs to meet all of the following criteria:

  • Active-Phase Symptoms: Two (or more) of the following, each present for a significant portion of time during a 1-month period (or less if successfully treated). At least one of these symptoms must be delusions, hallucinations, or disorganized speech:

    • Delusions.

    • Hallucinations.

    • Disorganized speech (e.g. frequent derailment or incoherence).

    • Grossly disorganized or catatonic behavior.

    • Negative symptoms (i.e., diminished emotional expression or avolition).

  • Concurrent with an uninterrupted period of active-phase symptoms, there is either a manic or major depressive episode:

    • Manic Episode

      • A distinct period of abnormally and persistently elevated, expansive, or irritable mood and abnormally and persistently goal-directed behavior or energy, lasting at least 1 week and present most of the day, nearly every day (or any duration if hospitalization is necessary).

      • During the period of mood disturbance and increased energy or activity, three (or more) of the following symptoms have persisted (four if the mood is only irritable) are present to a significant degree and represent a noticeable change from usual behavior:

        • Inflated self-esteem or grandiosity.

        • Decreased need for sleep (e.g., feels rested after only 3 hours of sleep).

        • More talkative than usual or pressure to keep talking.

        • Flight of ideas or subjective experience that thoughts are racing.

        • Distractibility (i.e., attention too easily drawn to unimportant or irrelevant external stimuli), as reported or observed.

        • Increase in goal-directed activity (either socially, at work or school, or sexually) or psychomotor agitation (i.e., purposeless non-goal-directed activity).

        • Excessive involvement in activities that have a high potential for painful consequences (e.g., engaging in unrestrained buying sprees, sexual indiscretions, or foolish business investments).

      • The mood disturbance is sufficiently severe to cause marked impairment in social or occupational functioning or to necessitate hospitalization to prevent harm to self or others, or there are psychotic features.

      • The episode is not attributable to the direct physiological effects of a substance (e.g., a drug of abuse, a medication, or other treatment) or another medical condition.

        A full manic episode that emerges during antidepressant treatment (e.g., medication, electroconvulsive therapy) but persists at fully syndromal level beyond the physiological effect of that treatment is sufficient evidence for a manic episode.

    • Major Depressive Episode

      • Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning. One of the symptoms must be depressed mood.

        Note: Do not include symptoms that are clearly attibutable to another medical condition.

        • Depressed mood most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad, empty, hopeless) or observation made by others (e.g., appears tearful). (Note: In children and adolescents, can be irritable mood.)

        • Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day (as indicated by either subjective account or observation).

        • Significant weight loss when not dieting or weight gain (e.g., a change of more than 5% of body weight in a month), or decrease or increase in appetite nearly every day. (Note: In children, consider failure to make expected weight gain.)

        • Insomnia or hypersomnia nearly every day.

        • Psychomotor agitation or retardation nearly every day (observable by others, not merely subjective feelings of restlessness or being slowed down).

        • Fatigue or loss of energy nearly every day.

        • Feelings of worthlessness or excessive or inappropriate guilt (which may be delusional) nearly every day (not merely self-reproach or guilt about being sick).

        • Diminished ability to think or concentrate, or indecisiveness, nearly every day (either by subjective account or as observed by others).

        • Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.

      • The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

      • The episode is not attributable to the physiological effects of a substance or to another medical condition.

  • Delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (depressive or manic) during the lifetime duration of the illness.

  • Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.

  • The disturbance is not attributable to the effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.

  • Specify whether:

    • Bipolar type: This subtype applies if a manic episode is part of the presentation. Major depressive episodes may also occur.

    • Depressive type: This subtype applies if only major depressive episodes are part of the presentation.

  • Specify if:

    • With catatonia: The clinical picture is dominated by three (or more) of the following symptoms:

      • Stupor (i.e., no psychomotor activity; not actively relating to environment).

      • Catalepsy (i.e., passive induction of a posture held against gravity).

      • Waxy flexibility (i.e., slight, even resistance to positioning by examiner).

      • Mutism (i.e., no, or very little, verbal response [exclude if known aphasia]).

      • Negativism (i.e., opposition or no response to instructions or external stimuli).

      • Posturing (i.e., spontaneous and active maintenance of a posture against gravity).

      • Mannerism (i.e., odd, circumstantial caricature of normal actions).

      • Stereotypy (i.e., repetitive, abnormally frequent, non-goal-directed movements).

      • Agitation, not influenced by external stimuli.

      • Grimacing.

      • Echolalia (i.e., mimicking another's speech).

      • Echopraxia (i.e., mimicking another's movements).


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Diagnostic Features

Schizoaffective Disorder is a diagnosis midway between the diagnosis of Schizophrenia and Bipolar I Disorder. In Schizoaffective Disorder, an individual has a psychosis which partly overlaps with a major mood episode. The the individual with Schizoaffective Disorder:
  • Has a major mood episode concurrent with Criterion A (psychotic symptoms) of Schizophrenia.

  • Has a major mood episode present for the majority of the disorder (hence would not meet the criteria for Schizophrenia).

  • Has delusions or hallucinations for 2 or more weeks in the absence of a major mood episode (hence would not meet the criteria for Bipolar Disorder).

Schizoaffective Disorder is not due to a drug, medication, or other medical illness. Diagnostic reliability is much lower for Schizoaffective Disorder compared with Schizophrenia, Bipolar Disorder, or Major Depressive Disorder.

Complications

Compared to Schizophrenia, insight is better, and there are less negative symptoms; however (by definition) there are more depressive and manic episodes.

Associated Laboratory Findings

No laboratory or psychometric test is diagnostic of this disorder.

Prevalence

Lifetime prevalence is 0.3% (one-third that of Schizophrenia). The incidence is higher in females than in males (due to increased incidence of the depressive-type in females).

Course

The typical age of onset is early adulthood, although onset can occur anywhere from adolescence to late in life. Schizoaffective Disorder may be preceded by the individual having Borderline, Paranoid, Schizoid or Schizotypal Personality Disorder.

Comorbidity

Schizoaffective Disorder is associated with an increased risk of alcohol and other substance-related disorders.

Several studies have found surprisingly high co-occurrence of Schizophrenia Spectrum Disorder with Dissociative Disorders.

    "Between 9% and 50% of Schizophrenia Spectrum patients also meet diagnostic criteria for a Dissociative Disorder. One study showed that in a sample of patients diagnosed with Dissociative Identity Disorder 74.3% also met diagnostic criteria of a Schizophrenia Spectrum Disorder, 49.5% met diagnostic criteria for Schizoaffective Disorder, and 18.7% met diagnostic criteria for Schizophrenia. In addition, patients with a Dissociative Disorder have often had a previous diagnosis of a Schizophrenia Spectrum Disorder (between 27% and 41%)."

Outcome

The Bipolar (manic) Type of Schizoaffective Disorder is more common in younger patients, whereas the Depressive Type is more common in older patients. Individuals with Schizoaffective Disorder have a somewhat better prognosis than individuals with Schizophrenia but a worse prognosis than individuals with mood disorders.

Outcome of Schizophrenia

Schizoaffective Disorder Recovery At 10-Year Follow-up Compared To Other Disorders

Familial Pattern

Individuals who have a first-degree relative with Schizophrenia, Bipolar Disorder, or Schizoaffective Disorder have a higher risk of developing this disorder.

Effective Therapies

In terms of treatment, the medications used for Schizophrenia and Bipolar I Disorder are also used in Schizoaffective Disorder. Treatment should be lifelong; since this is potentially a very serious illness, with on average a 15- to 20-year reduction in life expectancy. Tragically, 10 to 15% of untreated individuals with this disorder commit suicide, but antipsychotic medication decreases this risk by 75%. For individuals with Schizoaffective Disorder who refuse to take their antipsychotic medication, there is the option of giving them injections of long-lasting antipsychotic medication (that can last one month). The very powerful, but potentially more dangerous, antipsychotic medication, clozapine, is an option for individuals that have failed to respond to two previous antipsychotic medications. Mood stabilizer medications and antidepressants are used in combination with these antipsychotic medications. Effective psychological treatments include: assertive community treatment, supported employment, skills training, token economy interventions, and family-based services. Intensive case management (ICM) reduces hospitalization, improves adherence to care, and improves social functioning.

Ineffective therapies

Cognitive behavioral therapy (CBT) was not effective in reducing symptoms in Schizophrenia, or in preventing relapse in Bipolar I Disorder; thus CBT is unlikely to be effective in Schizoaffective Disorder. Vitamins, dietary supplements, cognitive training and cognitive rehabilitation have all proven to be ineffective in the treatment of psychotic disorders.

A Dangerous Cult

WARNING: Cannabis And Psychosis

Cannabis (pot) has been proven to nearly quadruple the risk of developing schizophrenia.

In 1969-70, Swedish military conscripts (49,321 males representing >97% of the country's male population aged 18-20) were followed for 35 years.

At the start of this study, none of the conscripts had schizophrenia. Over 35 years, those who had used cannabis more than 50 times at the beginning of the study had 3.7 times the normal rate of developing schizophrenia. This association was not explained by use of other psychoactive drugs or personality traits.

Schizophrenia normally occurs in 1% of the population. 86% of individuals with schizophrenia are disabled and unemployed. Thus this research would suggest that legalizing cannabis could triple the incidence of schizophrenia in regular cannabis smokers. This would cause a massive increase in the national unemployment rate.

WARNING: Cannabis And Lung Cancer

Swedish scientists did a 40 year followup study of 97% of all Swedish males, aged 18-20, entering the Swedish army in 1969-70 (a total of 49,321 males). Participants were tracked until 2009 (i.e., age 58-60) for lung cancer using the computerized Swedish national health registry.

For those males entering the army at age 18-20 that reported using cannabis more than 50 times; there was a twofold increase in the rate of lung cancer. It should be noted that most lung cancer occurs after age 60; thus this twofold increase probably underestimates the lifetime cancer risk from smoking cannabis.

For males, lung cancer is the most common form of cancer. Thus this research would suggest that legalizing cannabis could double the incidence of lung cancer in regular cannabis smokers.

WARNING: Legalizing Illicit Drugs

Some people argue that illicit drugs should be legalized to decrease the crime associated with these drugs. Historically, tobacco and alcohol were once illegal drugs.

Tobacco smoking is now the leading cause of death in America, and alcoholism is the third leading cause of death. Thus legalizing illicit drugs does not make them any less medically and socially harmful. In fact the opposite is true; legalizing illicit drugs increases their use and the harm they cause.

The Government of Finland is passing legislation that will gradually ban all tobacco use by 2040.


Scientists Show Link Between Cannabis And Schizophrenia




Cannabis Found To Decrease Brain Connections




New, deadly form of cannabis




Pot is 4 times more potent than in 1970s, and more toxic



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Dr. Jeffrey Gardere: What Is Schizoaffective Disorder?


This Is A Very Honest Story Told By A Very Courageous Woman


Stories

Rating Scales


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World Health Organization Psychosis Treatment Guidelines
(Note: WHO realizes that most of the world can't afford over-priced atypical antipsychotic medication.)











World Health Organization Suicide Treatment Guidelines

Goals of Therapy

Individuals with schizophreniform disorder or schizophrenia and their families have defined that recovery from psychosis should involve:

  • Functional (occupational and social) remission:

    • "Employment/education: Returning to work/school/homemaking."

    • "Fulfilment of duties and responsibilities: Sons or daughters being loving, helping with housework, and attending social gatherings. In addition, husbands financially supporting their families, and wives taking care of their children and doing the expected homemaking."

    • "Independent functioning: Taking care of their personal needs without being dependent on or having the help/assistance of others."

    • "Social functioning: Socializing and having meaningful interpersonal relationships: having social skills (having manners, e.g., greeting others); having friends to talk to or spend time with; attending and participating in family and social functions; getting married; being reunited with or repairing broken relationships with spouses and family members."

  • Symptomatic remission:

    • "Symptom control: Eliminating hallucinations (hearing voices), delusions, negative emotion (fear) and the aches and pains caused by schizophrenia. In addition, their caretakers want elimination of the anger, physical abuse, wandering and inappropriate laughter caused by schizophrenia."

    • "Cognitive ability: Overcoming cognitive impairment: being less confused; being able to remember things and being less forgetful (e.g., with respect to their day to day tasks); being able to concentrate on or pay attention to their work, household tasks or to conversations with other people; and being alert, with a sharp mind."

    • "Activity: Overcoming apathy (a core feature of schizophrenia) by: "not being lazy or sleeping all the time"; following a routine (e.g., waking up/eating on time); exercising and being fit; keeping busy (e.g., pursuing hobbies such as reading or making handicrafts); being engaged in some form of productive tasks (e.g., cooking, cleaning or other housework) and performing these satisfactorily."

    • "Self-care: Taking care of their own health and maintaining good hygiene practices. Examples include taking medicines on their own without being persuaded or reminded to; informing others when feeling unwell; sleeping well and having healthy eating habits (e.g., having a good appetite and eating proper meals); bathing regularly and being clean; taking care of personal and household belongings; not smoking cigarettes or inhaling tobacco; and maintaining a neat and groomed appearance by combing one's hair and dressing appropriately."

    • "Overcoming negative personality traits" (to be less schizoid or paranoid): "Being less socially withdrawn and insensitive; being more self-confident; being less suspicious; not bearing grudges or feeling victimized."

    • "Reduced side-effects: (Antipsychotic medications do differ significantly in their side-effects; hence it is possible to reduce side-effects.)"

    • "Management without medication: (Unfortunately this is not possible because of the high relapse rate off of antipsychotic medication.)"


Treatment Guidelines

  • Schizoaffective Disorder Treatment Guidelines - Google

  • Life in Prison Documentary 2017: US Prisons Are Hell On Earth - USA has 5% of the world's population and 25% of the world's prison inmates. The US prison system has almost no rehabilitation focus, and eventually releases prisoners in worse criminal shape than when they entered prison. There are more severely mentally ill in US prisons than there are in US mental hospitals. Thus gross underfunding of US mental health programs has resulted in prisons becoming the new locked asylums that replace US mental hospitals.

Treatment


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Self-Help Resources For Schizoaffective Disorder


Improving Positive Behavior

Philosophers for the past 2,500 years have taught that it is very beneficial to start the day with goal-setting, and end the day with a brief review.

This habit of planning your day in the morning, and reviewing your day in the evening, is a time-proven technique for more successful living.

Note: When each of the following videos finishes; you must exit YouTube (by manually closing the window) in order to return to this webpage.



Morning Meditation (5-Minute Video)



Afternoon Meditation (Learn How To Have Healthy Relationships)



Evening Meditation (5-Minute Video)



Life Satisfaction Scale (Video)



Healthy Social Behavior Scale (Video)



Mental Health Scale (Video)



Click Here For More Self-Help



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    "In physical science a first essential step in the direction of learning any subject is to find principles of numerical reckoning and practicable methods for measuring some quality connected with it. I often say that when you can measure what you are speaking about and express it in numbers you know something about it; but when you cannot measure it, when you cannot express it in numbers, your knowledge is of a meagre and unsatisfactory kind: it may be the beginning of knowledge, but you have scarcely, in your thoughts, advanced to the stage of science, whatever the matter may be."

    Lord Kelvin (1824 – 1907)


  • The best summary on bad research is given by Laura Arnold in this TEDx lecture. If you read nothing else about research, you owe it to yourself to watch this short video - it is excellent!

  • Canadian researchers who commit scientific fraud are protected by privacy laws: There are criminals in every community - even in the scientific research community (especially if a lot of money is at stake). Criminal researchers can hide their fraud behind outdated privacy laws.

  • The power of asking "what if?"

  • The active placebo effect: 2300 years ago, the Greek Stoic philosophers taught that it is not the objective event, but our subjective judgment about the event, that determines our behavior. The active placebo effect bears witness to this ancient wisdom.

  • Criteria For High Quality Research Studies

  • It is troubling that a recent study found that two-thirds of important psychological research studies couldn't be replicated. High quality research must meet the following criteria:

    • Randomized Controlled Trial:
      Ask: Was the trial randomized? Was the randomization procedure described and was it appropriate? The best research design is to have research subjects randomly assigned to an experimental or control group. It is essential that confounding factors be controlled for by having a control group or comparator condition (no intervention, placebo, care as usual etc.).

    • Representative Sample:
      Ask: Do the research subjects represent a normal cross-section of the population being studied? Many psychological research studies using university students are flawed because their subjects are not representative of the normal population since they are all W.E.I.R.D. (White, Educated, Intelligent, Rich, and living in a Democracy).

    • Single Blind Trial:
      Ask: Was the treatment allocation concealed? It is essential that the research subjects are kept "blind" as to whether they are in the experimental or control group (in order to control for any placebo effects).

    • Double Blind Trial (Better Than Single Blind Trial):
      Ask: Were blind outcome assessments conducted? In a double blind study, neither the research subjects nor the outcome assessors know if the research subject is in the experimental or control group. This controls for both the placebo effect and assessor bias.

    • Baseline Comparability:
      Ask: Were groups similar at baseline on prognostic indicators? The experimental and control groups must be shown to be comparable at the beginning of the study.

    • Confounding Factors:
      Ask: Were there factors, that weren't controlled for, that could have seriously distorted the study's results? For example, research studies on the effectiveness of mindfulness cognitive therapy in preventing depressive relapse forgot to control for whether the research subjects were also simultaneously receiving antidepressant medication or other psychological treatments for depression.

    • Intervention Integrity:
      Ask: Was the research study protocal strictly followed? The research subjects must be shown to be compliant (e.g., taking their pills, attending therapy) and the therapists must be shown to be reliably delivering the intervention (e.g., staying on the research protocol).

    • Statistical analysis:
      Ask: Was a statistical power calculation described? The study should discuss its statistical power analysis; that is whether the study size is large enough to statistically detect a difference between the experimental and control group (should it occur) and usually this requires at least 50 research subjects in the study.

      Ask: Are the results both statistically significant and clinically significant? The results should be both statistically significant (with a p-value <0.05) and clinically significant using some measure of Effect Size such as Standardized Mean Difference (e.g., Cohen's d >= 0.33). The summary statistics should report what percentage of the total variance of the dependent variable (e.g., outcome) can be explained by the independent variable (e.g., intervention). In clinical studies, the study should report the number needed to treat for an additional beneficial outcome (NNTB), and the number needed to treat for an additional harmful outcome (NNTH).

        Number Needed To Benefit (NNTB): This is defined as the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial. (It is defined as the inverse of the absolute risk reduction.) Note: Statistically, the NNTB depends on which control group is used for comparison - e.g., active treatment vs. placebo treatment, or active treatment vs. no treatment.

        Number Needed To Harm (NNTH): This is defined as the number of patients that need to be treated for one of them to be harmed compared with a control in a clinical trial. (It is defined as the inverse of the absolute increase in risk of harm.)

        Tomlinson found “an NNTB of 5 or less was probably associated with a meaningful health benefit,” while “an NNTB of 15 or more was quite certain to be associated with at most a small net health benefit.”

      Ask: Does the researcher accept full responsibility for the study's statistical analysis? The researcher should not just hand over the study's raw data to a corporation (that may have $1,000 million invested in the study) to do the statistical analysis.

    • Completeness of follow-up data:
      Ask: Was the number of withdrawals or dropouts in each group mentioned, and were reasons given for these withdrawals or dropouts? Less than 20% of the research subjects should drop out of the study. The intervention effect should persist over an adequate length of time.

    • Handling of missing data:
      Ask: Was the statistical analysis conducted on the intention-to-treat sample? There must be use of intention-to-treat analysis (as opposed to a completers-only analysis). In this way, all of the research subjects that started the study are included in the final statistical analysis. A completers-only analysis would disregard those research subjects that dropped out.

    • Replication of Findings:
      Ask: Can other researchers replicate this study's results? The research study's methodology should be clearly described so that the study can be easily replicated. The researcher's raw data should be available to other researchers to review (in order to detect errors or fraud).

    • Fraud:
      Ask: Is there a suspicion of fraud? In a research study, examine the independent and dependent variables that are always measured as a positive whole number (e.g., a variable measured on a 5-point Likert-type scale ranging from "1 = definitely false to 5 = definitely true" etc.). For each of these variables, look at their sample size (n), mean (M) and standard deviation (SD) before they undergo statistical analysis. There is a high suspicion of fraud in a study's statistics:

      • If the M is mathematically impossible (online calculator): This is one of the easiest ways to mathematically detect fraud. The mean (M) is defined as "the sum (Sum) of the values of each observation divided by the total number (n) of observations". So: M = Sum/n. Thus: (Sum) = (M) multiplied by (n). We know that, if a variable is always measured as a positive whole number, the sum of these observations always has to be a whole number. For these variables to test for fraud: calculate (M) multiplied by (n). This calculates the Sum which MUST be a positive whole number. If the calculated Sum isn't a positive whole number; the reported mean (M) is mathematically impossible - thus the researcher either cooked the data or made a mistake. A recent study of 260 research papers published in highly reputable psychological journals found that 1 in 2 of these research papers reported at least one impossible value, and 1 in 5 of these research papers reported multiple impossible values. When the authors of the 21 worst offending research papers were asked for their raw data (so that its reliability could be checked) - 57% angrily refused. Yet such release of raw data to other researchers is required by most scientific journals. (Here is an example of a research paper filled with mathematically impossible means.)

      • If the SD is mathematically impossible (online calculator): When researchers fraudulently "cook" their data, they may accidently give their data a mean and standard deviation that is mathematically impossible for a (normally distributed) strictly positive variable (because the "cooked" M and SD would mathematically require the strictly positive variable's range of data to include negative numbers). For a normally distributed sample of size of 25-70, this occurs when the SD is greater than one-half of the M; for a sample size of 70+, this occurs when the SD is greater than one-third of the M [using these formulas].

      • If the SD/M is very small (i.e., the variable's standard deviation is very small compared to the mean suggesting data smoothing).

      • If the SD's are almost identical (i.e., the variables have different means but almost identical standard deviations).

      • If the 4th digit of the values of the variables aren't uniformly distributed - since each should occur 10% of the time (Benford's Law).

      • If the researcher is legally prevented from publishing negative findings about a drug or therapy because that would violate the "nondisclosure of trade secrets" clause in the research contract (i.e., it is a "trade secret" that the drug or therapy is ineffective - hence this can not be "disclosed"). Approximately half of all registered clinical trials fail to publish their results.

      • If the researcher refuses to release his raw data to fellow researchers (so that they can check its validity). In order to be published in most scientific journals, a researcher must promise to share his raw data with fellow researchers. Thus a researcher's refusal to do so is almost a sure indicator of fraud.

      • If the research study's data contradicts the study's own conclusions - surprisingly, this often occurs.

  • Calling Bullshit In The Age of Big Data - "Bullshit is language, statistical figures, data graphics, and other forms of presentation intended to persuade by impressing and overwhelming a reader or listener, with a blatant disregard for truth and logical coherence." Reading the syllabus of this university course should be required reading for every student of mental health. This syllabus is absolutely fantastic!

  • Statistical Methods in Psychology Journals: Guidelines and Explanations - American Psychologist 1999

  • Not All Scientific Studies Are Created Equal - video

  • The efficacy of psychological, educational, and behavioral treatment

  • Estimating the reproducibility of psychological science

  • Psychologists grapple with validity of research

  • Industry sponsorship and research outcome (Review) - Cochrane Library

  • 'We've been deceived': Many clinical trial results are never published - (text and video)

  • Junk science misleading doctors and researchers

  • Junk science under spotlight after controversial firm buys Canadian journals

  • Medicine with a side of mysticism: Top hospitals promote unproven therapies - Are some doctors becoming modern witchdoctors?

  • When Evidence Says No, But Doctors Say Yes


  • Cochrane Collaboration - the best evidence-based, standardized reviews available

Research Topics


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Which Behavioral Dimensions Are Involved?

Research has shown that there are 5 major dimensions (the "Big 5 Factors") of personality disorders and other mental disorders. There are two free online personality tests that assess your personality in terms of the "Big 5 dimensions of personality". Although not computerized online, the Big Five Inventory (BFI) is a 44-item test often used in personality research.

This website uses these 5 major dimensions of human behavior to describe all mental disorders. (This website adds one more dimension, "Physical Health", but our discussion will focus on the first 5 major dimensions.)

These major dimensions of human behavior seem to represent the major dimensions whereby our early evolutionary ancestors chose their hunting companions or spouse. To maximize their chance for survival, our ancestors wanted companions who were agreeable, conscientious, intelligent, sociable, emotionally stable, and physically healthy.

    Dimensions of Human Behavior That Are Impaired in Schizoaffective Disorder

    THE POSITIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THE NEGATIVE SIDE OF THE "BIG 5" PERSONALITY DIMENSIONS THIS DISORDER
    Agreeableness Antagonism       Antagonism
    Conscientiousness Disinhibition       Disinhibition
    Intellect Decreased Intellect       Decreased Intellect (Psychotic)
    Sociability (Extraversion) Detachment       Detachment
    Emotional Stability Negative Emotion       Negative Emotion

    (Note: The behavior of individuals between mood and psychotic episodes is normal.)

The 5 Major Dimensions of Mental Illness

The Big 5 Factors or dimensions of mental illness each has a healthy side and an unhealthy side. Thus the Big 5 Factors are: (1) Agreeableness vs. Antagonism, (2) Conscientiousness vs. Disinhibition, (3) Intellect vs. Decreased Intellect, (4) Sociability (Extraversion) vs. Detachment (Introversion), and (5) Emotional Stability vs. Negative Emotion.

The Following Will Only Discuss The Dimensions of Mental Illness That Are Abnormal In This Disorder

The problems that are diagnostic of this disorder are highlighted in   Pink  . Other problems that are often seen in this disorder are highlighted in   Yellow  .



Treatment Goals for Individuals With Antagonism

AGREEABLENESS VS. ANTAGONISM
.
AGREEABLENESS
.
Description: Agreeableness is synonymous with compassion and politeness. Compassion reflects empathy, sympathy, and caring for others. Politeness reflects respect for others. Agreeable people are interested in others, and they make people feel comfortable. The Agreeableness dimension measures the behaviors that are central to the concept of JUSTICE and equality (fair, honest, and helpful behavior - living in harmony with others, neither harming nor allowing harm). Justice is then the public manifestation of love. High agreeableness is associated with better: longevity, helping others, giving to charity, job [team] performance, and marital success. (This dimension appears to measure the behaviors that differentiate friend from foe.)
Descriptors: Compassionate, polite, warm, friendly, helpful, unselfish, generous, modest.
Language Characteristics: Pleasure talk, agreement, compliments, empathy, few personal attacks, few commands or global rejections, many self-references, few negations, few swear words, few threats, many insight words.
Research: Higher scores on Agreeableness are associated with deeper relationships. *MRI research found that Agreeableness was associated with increased volume in regions that process information about the intentions and mental states of other individuals.
"I am helpful and unselfish with others."
"I have a forgiving nature."
"I am generally trusting."
"I am considerate and kind to almost everyone."
"I like to cooperate with others."
"I don't find fault with others."
"I don't start quarrels with others."
"I am not cold and aloof."
"I am not rude to others."
"I feel other's emotions."
"I inquire about others' well-being."
"I sympathize with others' feelings."
"I take an interest in other people's lives."
"I like to do things for others."
"I respect authority."
"I hate to seem pushy."
"I avoid imposing my will on others."
"I rarely put people under pressure."
.
ANTAGONISM
.
Description: Antagonism is synonymous with competition and aggression. Antagonistic people are self-interested, and do not see others positively.
Descriptors: Manipulative, deceitful, grandiose, callous, disrespectful, unfriendly, suspicious, uncooperative, malicious.
Language Characteristics: Problem talk, dissatisfaction, little empathy, many personal attacks, many commands or global rejections, few self-references, many negations, many swear words, many threats, little politeness, few insight words.
.
* Callousness:
"It's no big deal if I hurt other people's feelings."
"Being rude and unfriendly is just a part of who I am."
"I often get into physical fights."
"I enjoy making people in control look stupid."
"I am not interested in other people's problems."
"I can't be bothered with other's needs."
"I am indifferent to the feelings of others."
"I don't have a soft side."
"I take no time for others."
.
* Deceitfulness:
"I don't hesitate to cheat if it gets me ahead."
"Lying comes easily to me."
"I use people to get what I want."
"People don't realize that I'm flattering them to get something."
.
* Manipulativeness:
"I use people to get what I want."
"It is easy for me to take advantage of others."
"I'm good at conning people."
"I am out for my own personal gain."
.
* Grandiosity [When Manic]:
"I'm better than almost everyone else."
"I often have to deal with people who are less important than me."
"To be honest, I'm just more important than other people."
"I deserve special treatment."
.
* Suspiciousness:
"It seems like I'm always getting a “raw deal” from others."
"I suspect that even my so-called 'friends' betray me a lot."
"Others would take advantage of me if they could."
"Plenty of people are out to get me."
"I'm always on my guard for someone trying to trick or harm me."
.
* Hostility [When Manic]:
"I am easily angered."
"I get irritated easily by all sorts of things."
"I am usually pretty hostile."
"I always make sure I get back at people who wrong me."
"I resent being told what to do, even by people in charge."
"I insult people."
"I seek conflict."
"I love a good fight."
.
("Agreeableness vs. Antagonism" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.



Treatment Goals for Individuals With Disinhibition

CONSCIENTIOUSNESS VS. DISINHIBITION
.
CONSCIENTIOUSNESS
.
Description: Conscientiousness is synonymous with being self-disciplined, industrious and orderly. The Conscientiousness dimension measures the behaviors that are central to the concept of SELF-CONTROL - organizing and controlling one's behavior in order to achieve one's goals. This involves traits like paying attention, controlling impulses, and delaying gratification. High conscientiousness is associated with better: longevity, health, school and job performance. (This dimension appears to measure the behaviors that differentiate behavioral order and inhibition from chaos and disinhibition.)
Descriptors: Industrious, self-disciplined, rule-abiding, organized
Language Characteristics: Many positive emotion words (e.g. happy, good), few negative emotion words (e.g. hate, bad), more perspective, careful to check that information is conveyed correctly, straight to the point, formal, few negations, few swear words, few references to friends, few disfluencies or filler words, many insight words, not impulsive.
Research: Higher scores on Conscientiousness predict greater success in school and at work. *MRI research found that Conscientiousness was associated with increased volume in the lateral prefrontal cortex, a region involved in planning and the voluntary control of behavior.
"I do a thorough job. I want everything to be 'just right'. I want every detail taken care of."
"I am careful."
"I am a reliable hard-worker."
"I am organized. I follow a schedule and always know what I am doing."
"I like order. I keep things tidy."
"I see that rules are observed."
"I do things efficiently. I get things done quickly."
"I carry out my plans and finish what I start."
"I am not easily distracted."
.
Rigid Perfectionism
.
"Even though it drives other people crazy, I insist on absolute perfection in everything I do."
"I simply won't put up with things being out of their proper places."
"People complain about my need to have everything all arranged."
"People tell me that I focus too much on minor details."
"I have a strict way of doing things."
"I postpone decisions."
.
DISINHIBITION
.
Description: Disinhibition is synonymous with being distractible, impulsive and disorganized.
Descriptors: Distractible, impulsive, irresponsible, disorganised, unreliable, careless, forgetful
Language Characteristics: Few positive emotion words, many negative emotion words, less perspective, less careful, more vague, informal, many negations, many swear words, many references to friends (e.g. pal, buddy), many disfluencies or filler words, few insight words, impulsive.
.
* Irresponsibility [When Manic]:
"I've skipped town to avoid responsibilities."
"I just skip appointments or meetings if I'm not in the mood."
"I'm often pretty careless with my own and others' things."
"Others see me as irresponsible."
"I make promises that I don't really intend to keep."
"I often forget to pay my bills."
.
* Impulsivity [When Manic]:
"I usually do things on impulse without thinking about what might happen as a result."
"Even though I know better, I can't stop making rash decisions."
"I feel like I act totally on impulse."
"I'm not good at planning ahead."
.
* Distractibility [When Manic]:
"I can't focus on things for very long."
"I am easily distracted."
"I have trouble pursuing specific goals even for short periods of time."
"I can't achieve goals because other things capture my attention."
"I often make mistakes because I don't pay close attention."
"I waste my time ."
"I find it difficult to get down to work."
"I mess things up."
"I don't put my mind on the task at hand."
.
* Reckless Risk Taking [When Manic]:
"I like to take risks."
"I have no limits when it comes to doing dangerous things."
"People would describe me as reckless."
"I don't think about getting hurt when I'm doing things that might be dangerous."
.
* Hyperactivity [When Manic]:
"I move excessively (e.g., can't sit still; restless; always on the go)."
"I'm starting lots more projects than usual or doing more risky things than usual."
.
* Over-Talkativeness [When Manic]:
"I talk excessively (e.g., I butt into conversations; I complete people's sentences)."
"Often I talk constantly and cannot be interrupted."
.
* Elation [When Manic]:
"I feel very happy or exhilarated."
"I'm feeling a rush of good feelings."
.
("Conscientiousness vs. Disinhibition" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.



Treatment Goals for Individuals With Decreased Intellect

INTELLECT VS. DECREASED INTELLECT
.
INTELLECT (OPEN-MINDED)
.
Description: Intellect (or "Openness To Experience") is synonymous with being open-minded and creative. The Intellect dimension measures the behaviors that are central to the concept of WISDOM - having curiosity, experience, knowledge, and good judgment. (This dimension appears to measure the behaviors that differentiate open-minded from close-minded individuals.) Open-minded people are usually creative, sophisticated, intellectual, curious and interested in art. Their curiosity propels them to try new things, and ask novel questions. High intellect is associated with better: longevity, school and creative performance.
Descriptors: Receptive to new ideas, curious, imaginative, creative, unconventional
Language Characteristics: Many positive emotion words (e.g. happy, good), high meaning elaboration, more perspective, politeness, few self-references, complex sentence constructions, few causation words, many inclusive words (e.g. with, and), few third person pronouns, many tentative words (e.g. maybe, guess), many insight words (e.g. think, see), few filler words and within-utterance pauses, stronger uncommon verbs.
Research: Higher scores on Intellect are associated with greater creativity and general intelligence. *MRI research found that Intellect did not have any significant correlation with the volume of any localized brain structure.
Relationship To General Intelligence: Research has shown that Intellect can be separated into 2 factors: Openness and Intellect. Intellect was independently associated with general intelligence (g) and with verbal and nonverbal intelligence about equally. Openness was independently associated only with verbal intelligence.
Example: This video shows how we see what we want to see. What we pay attention to (or what we believe about the world) blinds us to reality. (Exit YouTube after first video.)
"I am original, and come up with new ideas."
"I am curious about many different things."
"I am quick to understand things."
"I can handle a lot of information."
"I like to solve complex problems."
"I have a rich vocabulary."
"I think quickly and formulate ideas clearly."
"I enjoy the beauty of nature."
"I believe in the importance of art."
"I love to reflect on things."
"I get deeply immersed in music."
"I see beauty in things that others might not notice."
"I need a creative outlet."
.
DECREASED INTELLECT (CLOSED-MINDED)
.
Description: Decreased Intellect (or "Closed To Experience") is synonymous with being closed-minded and uncreative. Decreased Intellect is associated with narrow-mindedness, unimaginativeness and ignorance.
Descriptors: Narrow-minded, conservative, ignorant, simple
Language Characteristics: Few positive emotion words, low meaning elaboration, less perspective, less politeness, few positive emotion words, many self-references, simple sentence construction, many causation words (e.g. because, hence), many third person pronouns, few tentative words, few insight words, many filler words and within-utterance pauses, milder verbs.
.
"I prefer work that is routine."
"I have difficulty understanding abstract ideas."
"I think slowly."
"People find it hard to follow my logic or understand my thoughts."
"I avoid philosophical discussions."
"I avoid difficult reading material."
"People find it hard to follow my logic or understand my thoughts."
"I have few artistic interests."
"I seldom notice the emotional aspects of paintings and pictures."
"I do not like poetry."
"I seldom get lost in thought."
"I seldom daydream."
.
COGNITIVE IMPAIRMENT
.
* Memory Impairment:
"I have difficulty learning new things, or remembering things that happened a few days ago."
"I often forget a conversation I had the day before."
"I often forget to take my medications, or to keep my appointments."
.
.
* Impaired Reasoning [When Severely Ill]:
"My judgment or ability to solve problems isn't good."
"I have difficulty understanding abstract ideas."
"I think slowly."
"People find it hard to follow my logic or understand my thoughts."
.
PSYCHOTICISM
.
Description: Psychoticism is the state of being psychotic or of being predisposed to develop psychosis.
Descriptors: Unusual beliefs and experiences, eccentricity, perceptual dysregulation.
.
* Eccentricity [When Severely Ill]:
"I often have thoughts that make sense to me but that other people say are strange."
"Others seem to think I'm quite odd or unusual."
"My thoughts are strange and unpredictable."
"My thoughts often don’t make sense to others."
"Other people seem to think my behavior is weird."
"I have several habits that others find eccentric or strange."
"My thoughts often go off in odd or unusual directions."
.
* Unusual Beliefs and Experiences [When Severely Ill]:
"I often have unusual experiences, such as sensing the presence of someone who isn't actually there."
"I've had some really weird experiences that are very difficult to explain."
"I have seen things that weren’t really there."
"I have some unusual abilities, like sometimes knowing exactly what someone is thinking."
"I sometimes have heard things that others couldn’t hear."
"Sometimes I can influence other people just by sending my thoughts to them."
"I often see unusual connections between things that most people miss."
.
* Perceptual Dysregulation [When Severely Ill]:
"Things around me often feel unreal, or more real than usual."
"Sometimes I get this weird feeling that parts of my body feel like they're dead or not really me."
"It's weird, but sometimes ordinary objects seem to be a different shape than usual."
"Sometimes I feel 'controlled' by thoughts that belong to someone else."
"Sometimes I think someone else is removing thoughts from my head."
"I have periods in which I feel disconnected from the world or from myself."
"I can have trouble telling the difference between dreams and waking life."
"I often 'zone out' and then suddenly come to and realize that a lot of time has passed."
"Sometimes when I look at a familiar object, it's somehow like I'm seeing it for the first time."
"People often talk about me doing things I don't remember at all."
"I often can't control what I think about."
"I often see vivid dream-like images when I’m falling asleep or waking up."
.
("OPENNESS TO EXPERIENCE vs. BEING CLOSED TO EXPERIENCE" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.



Treatment Goals for Individuals With Detachment

SOCIABILITY (EXTRAVERSION) VS. DETACHMENT
.
SOCIABILITY
.
Description: Sociability (Extraversion) is synonymous with being enthusiastic and assertive. Assertiveness encompasses traits relating to leadership, dominance, and drive. Enthusiasm encompasses both sociability and the tendency to experience and express positive emotion. Extraverts tend to engage in social interaction; they are enthusiastic, risk-taking, talkative and assertive. The Extraversion dimension measures the behaviors that are central to the concept of SOCIABILITY - seeking and enjoying companionship. High sociability is associated with better: longevity, leadership, job [sales] performance. (This dimension appears to measure the behaviors that differentiate approach from avoidance.)
Descriptors: Sociable, gregarious, reward-seeking, talkative.
Language Characteristics: Many topics, higher verbal output, think out loud, pleasure talk, agreement, compliment, positive emotion words, sympathetic, concerned about hearer (but not empathetic), simple constructions, few unfilled pauses, few negations, few tentative words, informal language, many swear words, exaggeration (e.g. "I'm really smart" ), many words related to humans (e.g. "man", "pal"). poor vocabulary.
Research: Higher scores on Sociability (extraversion) are associated with greater happiness and broader social connections. *MRI research found that Sociability (extraversion) was associated with increased volume of medial orbitofrontal cortex, a region involved in processing reward information.
"I'm talkative"
"I'm not reserved."
"I'm full of energy."
"I generate a lot of enthusiasm."
"I'm not quiet."
"I have an assertive personality."
"I'm not shy or inhibited."
"I am outgoing and sociable."
"I make friends easily."
"I warm up quickly to others."
"I show my feelings when I'm happy."
"I have a lot of fun."
"I laugh a lot."
"I take charge."
"I have a strong personality."
"I know how to captivate people."
"I see myself as a good leader."
"I can talk others into doing things."
"I am the first to act."
.
Attention Seeking
.
"I like to draw attention to myself."
"I crave attention."
"I do things to make sure people notice me."
"I do things so that people just have to admire me."
"My behavior is often bold and grabs peoples' attention."
.
DETACHMENT
.
Description: Detachment is synonymous with being reserved and quiet.
Descriptors: Withdrawn, anhedonic (pleasureless), intimacy avoiding, detached, shy, passive, solitary, moody
Language Characteristics: Single topic, doesn't think out loud, problem talk, dissatisfaction, negative emotion words, not sympathetic, elaborated sentence constructions, many unfilled pauses, formal language, many negations, many tentative words (e.g. maybe, guess), few swear words, little exaggeration, few words related to humans, rich vocabulary.
.
* Social Withdrawal [When Depressed]:
"I don’t like to get too close to people."
"I don't deal with people unless I have to."
"I'm not interested in making friends."
"I don’t like spending time with others."
"I say as little as possible when dealing with people."
"I keep to myself."
"I am hard to get to know."
"I reveal little about myself."
"I do not have an assertive personality."
"I lack the talent for influencing people."
"I wait for others to lead the way."
"I hold back my opinions."
.
* Intimacy Avoidance [When Depressed]:
"I steer clear of romantic relationships."
"I prefer to keep romance out of my life."
"I prefer being alone to having a close romantic partner."
"I'm just not very interested in having sexual relationships."
"II break off relationships if they start to get close."
.
* Anhedonia (Lack of Pleasure) [When Depressed]:
"I often feel like nothing I do really matters."
"I almost never enjoy life."
"Nothing seems to make me feel good."
"Nothing seems to interest me very much."
"I almost never feel happy about my day-to-day activities."
"I rarely get enthusiastic about anything."
"I don't get as much pleasure out of things as others seem to."
.
* Restricted Emotions [When Depressed]:
"I don't show emotions strongly."
"I don't get emotional."
"I never show emotions to others."
"I don't have very long-lasting emotional reactions to things."
"People tell me it's difficult to know what I'm feeling."
"I am not a very enthusiastic person."
.
("Sociability vs. Detachment" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.



Treatment Goals for Individuals With Negative Emotion

EMOTIONAL STABILITY VS. NEGATIVE EMOTION
.
EMOTIONAL STABILITY
.
Description: Emotional Stability is synonymous with being calm and emotionally stable. The Emotional Stability dimension measures the behaviors that are central to the concept of COURAGE - having calm composure and endurance when confronting adversity. High emotional stability is associated with better: longevity, leadership, job [team] performance, and marital success. (This dimension appears to measure the behaviors that differentiate safety from danger.)
Descriptors: Calm, even-tempered, peaceful, confident
Language Characteristics: Pleasure talk, agreement, compliment, low verbal productivity, few repetitions, neutral content, calm, few self-references, many short silent pauses, few long silent pauses, many tentative words, few aquiescence, little exaggeration, less frustration, low concreteness.
"I am relaxed, and I handle stress well."
"I am emotionally stable, and not easily upset."
"I remain calm in tense situations."
"I rarely get irritated."
"I keep my emotions under control."
"I rarely lose my composure."
"I am not easily annoyed."
"I seldom feel blue."
"I feel comfortable with myself."
"I rarely feel depressed."
"I am not embarrassed easily."
.
NEGATIVE EMOTION
.
Description: Degree to which people experience persistent anxiety or depression and are easily upset. (This could be thought of as high threat sensitivity or low stress tolerance.)
Descriptors: Emotionally unstable, anxious, separation-insecure, depressed, self-conscious, oversensitive, vulnerable.
Language Characteristics: Problem talk, dissatisfaction, high verbal productivity, many repetitions, polarised content, stressed, many self-references, few short silent pauses, many long silent pauses, few tentative words, more aquiescence, many self references, exaggeration, frustration, high concreteness.
Research: Lower scores on Emotional Stability are associated with unhappiness, dysfunctional relationships, and mental health problems. *MRI research found that Low Emotional Stability (= Negative Emotion or Neuroticism) was associated with increased volume of brain regions associated with threat, punishment, and negative emotions.
.
* Emotional Instability [When Manic]:
"I get emotional easily, often for very little reason."
"I get emotional over every little thing."
"My emotions are unpredictable."
"I never know where my emotions will go from moment to moment."
"I am a highly emotional person."
"I have much stronger emotional reactions than almost everyone else."
"My emotions sometimes change for no good reason."
"I get angry easily."
"I get upset easily."
"I change my mood a lot."
"I am a person whose moods go up and down easily."
"I get easily agitated."
"I can be stirred up easily."
.
* Anxiety:
"I worry about almost everything."
"I'm always fearful or on edge about bad things that might happen."
"I always expect the worst to happen."
"I am a very anxious person."
"I get very nervous when I think about the future."
"I often worry that something bad will happen due to mistakes I made in the past."
"I am filled with doubts about things."
"I feel threatened easily."
"I am afraid of many things."
.
* Separation Insecurity:
"I fear being alone in life more than anything else."
"I can't stand being left alone, even for a few hours."
"I’d rather be in a bad relationship than be alone."
"I'll do just about anything to keep someone from abandoning me."
"I dread being without someone to love me."
.
* Submissiveness:
"I usually do what others think I should do."
"I do what other people tell me to do."
"I change what I do depending on what others want."
.
* Perseveration:
"I get stuck on one way of doing things, even when it's clear it won't work."
"I get stuck on things a lot."
"It is hard for me to shift from one activity to another."
"I get fixated on certain things and can’t stop."
"I feel compelled to go on with things even when it makes little sense to do so."
"I keep approaching things the same way, even when it isn’t working."
.
* Depressed Mood [When Depressed]:
"I have no worth as a person."
"Everything seems pointless to me."
"I often feel like a failure."
"The world would be better off if I were dead."
"The future looks really hopeless to me."
"I often feel just miserable."
"I'm very dissatisfied with myself."
"I often feel like nothing I do really matters."
"I know I'll commit suicide sooner or later."
"I talk about suicide a lot."
"I feel guilty much of the time."
"I'm so ashamed by how I've let people down in lots of little ways."
"I am easily discouraged."
"I become overwhelmed by events."
.
("Emotional Stability vs. Negative Emotion" modified from "PID-5" by Kreuger RF, Derringer J, Markon KE, Watson D, Skodol AE and Between facets and domains: 10 aspects of the Big Five)
*MRI Research: Testing predictions from personality neuroscience. Brain structure and the big five.




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