Abnormal Psychology - Lecture Four Flashcards
Psychotic and Bipolar Disorders
Psychosis
Is not a disorder but a group of symptoms that includes delusions, hallucinations and loss of external reality
Schizophrenia
Is a mental disorder that involves psychoses symptoms
Symptom clusters of psychoses
Positive, negative and disorganised
Current DSM-5 criteria for schizophrenia
Diagnostic criteria for schizophrenia: 2 or more of the following symptoms for 6-months:
Delusions
Hallucinations
Disorganised speech
Grossly disorganised or catatonic behaviour
Negative symptoms
Positive symptoms
Delusions and hallucinations
Delusions
A belief or altered reality that is persistently held despite evidence or agreement to the contrary
Delusions - Persecution
Fixed irrational belief that others are out to harm them
Delusions - Grandeur
Fixed irrational belief that you have special powers e.g. reincarnation of Jesus
Delusions - Reference
When you believe something is irrationally directed to you e.g. the radio/TV is speaking to you
Delusions - Erotomania
Fixed irrational belief that someone is in love with them
Delusions - Somatic
Fixed irrational belief that you have some form of medical illness or something else that is severely wrong with your body, or something that is implanted in your body
Delusions - Nihilistic
The world is about to end or nothing exists
Delusions - Bizzarre vs non-bizzarre
Bizarre are implausible, something that cannot happen. Non-bizarre are plausible, something that can possibly happen but is not true
Hallucinations
Affect all bodily senses
Auditory
Hearing things that are not there. In most cases, they don’t obey the orders but sometimes do.
Most common
Visual
Seeing shapes or distorted reality, but usually do not see other people
Quite rare
Olafactory
Smell things that are not there
Very rare
Gustafactory
Taste things that are not there
Very rare
Tactile
Sensational feeling or tingling
Very rare
Disorganised speech or though
Loose association Neologism Clang associations Echolalia Echopraxia Word salad
Loose association
Person speaks but the sentences are only loosely connected which makes it difficult to follow what they’re saying
Neologism
Words that are made up
Clang associations
Every new sentence rhymes with a previous sentence
Echolalia
Repeating what was said to them
Echopraxia
Imitating movements of another person
Word salad
Speaking in a highly incoherent manner where words are jumbled
Negative symptoms
Remove normal functions, not all present in every patient
Affective flattening
Where persons actual emotions are not expressed strongly or at all - shallow emotions
Alogia
Will not produce much speech - poverty of speech
Thought-blocking
Can’t get their thoughts out in a verbal manner - Thought-blocking
Avolition
Lack of drive/motivation
Anhedonia
Inability to experience pleasure or things that they used to enjoy
Other important diagnostic criteria of psychotic disorders
Temporal criteria
Impairment/deterioration in functioning
Downward drift
Phases of psychotic disorders
Prodromal - phase where person isn’t fully symptomatic but are developing them
Active - phase where person meets full diagnostic for the criteria
Residual - phase where after long period of treatment some symptoms begin to go away but negatives remain present
Other psychotic disorder
Schizophreniform Disorder
Schizoaffective Disorder Delusional Disorder
Schizophreniform Disorder
At least 1-month but less than 6-months with a relatively short duration of symptoms and a good prognosis
Schizoaffective Disorder
Meets full criteria for diagnosis but also a mood disorder, the symptoms of each are independent
Independent symptoms of SZ and mood disorder
Mood disorders with psychotic features
ARE NOT PSYCHOTIC DISORDERS
Delusion Disorder
1-month or more Any hallucinations, if present, directly related to delusion Few or no negative symptoms Less observable impairment Rare Better prognosis
Subtypes of Delusion Disorder
Erotomanic type Grandiose type Jealous type Persecutory type Somatic type Mixed type Unspecified type
Epidemiology of Psychotic Disorders
Occur in all societies, where about 0.7-1.5% of the population suffers/suffered from schizophrenia at some point in their lives and 3/4 of these cases will occur between 15- and 45-years-old
Men’s first psychotic break
Usually between 18 and 25-years-old
Women’s first psychotic break
Usually between 25- and 35-years-old
Schizophrenia is a brain disorder
Neuropsychological deficits
Predisposing Causes
Environmental Causes
Aetiology of Psychotic Disorders
Birth month (winter & spring)
Viral causes → affects brain development
Pregnancy and birth complications
Maternal drug use
Aetiology of schizophrenia
Genetic influences About 50-60% heritability index – Molecular genetics Brain Abnormalities Enlarged ventricles = smaller brains Prefrontal hypometabolism
About 50-60% heritability index – Molecular genetics
DTNBP1, NGR1 – Neurotransmitters; white matter development
COMT, DDNF – Prefrontal functioning
Enlarged ventricles = smaller brains
Reduced bloodflow
Lower brain volume
Prefrontal hypometabolism
Less activity, especially left side
Biological treatment of Psychotic Disorders 1st Generation Anti-psychotics
Reduce positive symptoms
Side effects:
Tardive Dyskinesia
Neuroleptic malignant syndrome
Biological treatment of Psychotic Disorders 2nd Generation Anti-psychotics
Positive and negative symptoms
Cognitive treatment for Psychotic Disorders
Cognitive rehabilitation
Cognitive restructuring
Cognitive rehabilitation
Modify over- & under-attention
Cognitive restructuring
Challenge delusional beliefs
Psychoeducation
Tardive Dyskinesia
Excessive stiffness and trembling in various parts of the body
