What is Psychosis? An Interview with Staff Psychologist Dr. Jeremy Ridenour (Part 1 of 3)
Q: What does psychosis look like? What are some of the symptoms?
JR: Symptoms of psychosis are often categorized into “positive,” “disorganized,” and “negative” categories:
- Hallucinations – sensory experiences without sensory input (i.e., hearing voices other people can’t hear, seeing visions other people can’t see, having tactile experiences other people can’t feel)
- Delusions – fixed beliefs that are not amenable to change in light of conflicting evidence (often paranoid or grandiose ideas)
- Cognitive Disorganization – tangential speech (the use of words in ways that are scrambled or unclear) or making up new words (neologisms)
- Disorganized Behavior – for example, laughing, walking, or moving in certain ways that are hard to understand, becoming catatonic (frozen motor movements or not moving much at all)
The “negative” symptoms are characterized by an absence of something – that are generally grouped into two categories (Strauss & Cohen, 2017)
- Reduced Volition – lack of motivation, anhedonia (lack of pleasure), asociality (lack of engagement with others)
- Impoverishment of expression – expressing limited emotions, an inability to name feelings, alogia (lack of spontaneous speech)
Psychosis is a broad term for a cluster of symptoms that can occur in various disorders. For example, someone with post-traumatic stress disorder (PTSD) might have hallucinations (hear voices). Someone with major depression could develop delusional ideas that they are the worst person in the world or that everyone hates them – or they can hear voices expressing similar ideas. Generally, though, schizophrenia is one of the most severe psychotic disorders.
Strauss, G. P., and A.S. Cohen, “A transdiagnostic review of negative symptom phenomenology and etiology.” Schizophrenia Bulletin 43, no. 4 (2017): 712-719. doi: 10.1093/schbul/sbx066.
Exploring psychotic spectrum disorders with Jane G. Tillman, PhD, ABPP, Evelyn Stefansson Nef Director of the Erikson Institute for Education and Research of the Austen Riggs Center and member of the Riggs clinical staff.