Week 4: Disorganized and Undifferentiated Schizophrenia
In Ward No. 6 we were introduced to paranoid schizophrenia, particularly the delusions and breakdown of rational thought involved in the disorder. Now we look at two other forms of schizophrenia through two famous works of literature, William Shakespeare's "Hamlet" and F. Scott Fitzgerald's Tender is the Night. Since the background information on schizophrenia has already been presented (you can check out Week 2 again if you need to refresh your memory), we'll proceed right on to this lesson...

In our first stoy, "Hamlet," Ophelia is suffering from what is now called disorganized schizophrenia. This disorder used to be called hebephrenic schizophrenia, and is discussed in the reading as such. The DSM-IV outlines the following symptoms for someone to be diagnosed with disoragnized schizophrenia:
  • delusions
  • hallucinations
  • disorganized (or incoherent) speech and behavior
  • inappropriate emotional responses
  • silliness and laughter not associated with the content of speech
  • inability to perform daily activities (showering, dressing or preparing meals)
  • behaviors include grimacing, mannerisms and other oddities of behavior

OPTIONAL: Listen to a case study on disorganized schizophrenia and notice the extent of the childlike, incoherent behaviors. Read through all the following instructions before proceeding to the taped case study.

Next, we get to our first reading passage. Ophelia, suffering from the death of her father, has fallen into mental distress. She has lost touch with reality and is wandering around the castle singing.

    1. What is the most typical symptom of disorganized schizophrenia?
    2. The king says, "...poor Ophelia, Divided from herself and her fail judgment, Without the which we are pictures or mere beasts." What does he mean by this?
    3. Whose death does Ophelia keep referring to in her ramblings?
Our second story is Tender is the Night. Nicole, a sixteen-year-old girl, is suffering from undifferentiated schizophrenia. Undifferentiated schizophrenia involves general symptoms of schizophrenia but don't meet the criteria for any one subtype: paranoid, disorganized or catatonic schizophrenia. The DSM-IV outlines the following symptoms for someone to be diagnosed with undifferentiated schizophrenia:
  • delusions
  • hallucinations
  • disorganized (or incoherent) speech and behavior
  • flattened affect (lack of emotional dynamics)

OPTIONAL: Listen to a case study on undifferentiated schizophrenia and notice the extent of the childlike, incoherent behaviors. Read through all the following instructions before proceeding to the taped case study.

Now on the our second reading passage. The character being studied is Nicole, Devererux Warren's sixteen-year-old daughter. She never speaks or is observed directly in this passage. Her behaviors are relayed by her father, Mr. Warren to Dr. Dohmler. The cause of her lapse into undifferentiated schizophrenia is revealed at the end of this reading passage.

  • Tender is the Night is already included in the download of "Hamlet."
  • Answer the following questions. Title these "Tender is the Night Questions" (worth 5 points each):
    1. Who did Mr. Warren tell the doctor had made "indecent advances" toward Nicole and was promptly dismissed for the incident.
    2. What delusion did Nicole have when Mr. Warren stated she got "crazier and crazier?"
    3. What did Dr. Dohmler think about Mr. Warren intitial report on Nicole?
    4. What had Mr. Warren done to his daughter? Does her earlier paranois of men make sense now?
    5. Why did Nicole "freeze up" right away after the incident?

    When you've finished paste your work into an e-mail titled "Week 4 Homework." Then e-mail your work to me at aeaptl@gmail.com.

Week 4 homework is to be completed by 3:00 pm
Monday, March 16
for full credit. It will accepted after that date for half credit.

Reminder:
When e-mailing your work, be sure to paste your work INTO your e-mail.
Do NOT include your work as an attachment.

Lesson Copyright ©2009 Clay Sisman