Ch. 11

Question 1

prodromal phase

Answer 1

Charaterized by subtle syptoms involving unsual thoughts or abnormal perceptions (but not outright delsuions or hallucinations), as well as waning interest in social activities, difficult meeting responsibilites of daily living, and impaired cognitive functioning involving problems with memory and attention use of language, and ability to plan and organize one’s activities

Question 2

residual phase

Answer 2

“1. Following acute episodes, behavior returns to the level of the prodromal phase
2. Flagrant psychotic behavior are absnet, but the perso is still impaired by sig. cognitive, social, and emotional deficits such as a deep sense of apathy and diffciulties in thinking or speaking clearly, and by harboring unusal ideas, such as beliefs in telepathy or clairvoyance”

Question 3

prevalence of Schizophrenia

Answer 3

1% of US population

.3 to .7% of the global population

Question 4

Gender differences

Answer 4

“1. Men have slightly higher risk than women

2. Men develop at an earlier age (early to mid twenties for men, late twenties for women)
3. Men have more cognitive impairment, greater behavioral deficits, and a poorer resonse to drug therapy”

Question 5

Positive symptoms

Answer 5

Involve a break with reality, as represented by the appearance of hallucinations and delusionsal thinking

Question 6

Negative symptoms

Answer 6

“1. Lack of emotions or emotional expression

2. Loss of motivation
3. Loss of pleasure in normally pleasant activities
4. Social withdrawal or isolation, and limited output of speech”

Question 7

Criterion A

Answer 7

“Two (or more of the following, each present for a sig. portion of time during a 1-month period (or less if successfully treated). At least one these must 1, 2, or 3

1. Delusions
2. Hallucinations
3. Disorganized speech
4. Grossly disorganized or catatonic behavior
5. Negative symptoms”

Question 8

Criterion B

Answer 8

For a sig. portion of the time sice the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset

Question 9

Criterion C

Answer 9

Continuous sign of the disturbance persists for at least 6 months This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (ie. Active-phase symptoms,) and may include periods of prodromal or residual symptoms. During these prodromal or resiual periods , the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g. odd beliefs, unusual perceptual experiences)

Question 10

Criterion D

Answer 10

Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either

1. No major depressive or manic episodes have occurred concurrently with the active-phase symptoms or
2. if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness

Question 11

Criterion E

Answer 11

The disturbance is not attribuatable to the physiological effects of a substnace or another medical condition

Question 12

Criterion F

Answer 12

If there is a hisotry of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is mode only if prominent delusions or hallucinations, in addition to the other required symptoms of schizophrenia, are also present for at least 1 month (or less if successfully treated)

Question 13

Thought disorder

Answer 13

1. Positive symptom involving a breakdown in the organization, processing, and control of thoughts.
2. Looseness of association is cardinal sign of thought disorder
3. Poverty of speech: speech that is coherent but so slow, limited in quantity, or vague that little info is conveyed
4. Perseveration: inappropriate but persistent repetition of the same words or train of thought
5. Clanging: stringing together words or sounds on the basis of rhyming
6. Blocking: involuntary, abrupt interruption of speech or thought”

Question 14

Signs in childhood

Answer 14

1. Delays in reaching certain developmental milestones

Question 15

Attentional deficiencies

Answer 15

Hyper-vigilant to extraneous sounds

Question 16

Eye Movement dysfunction

Answer 16

“1. Difficulty tracking slow-moving target across their field of vision

2. Common in people with schizophrenia and first-degree relatives
3. Suggests it might be a genetically transmitted trait, or biomarker
4. Not entirely unique to schiophrenia (also seen in bipolar)”

Question 17

Abnormal Event-Related Potentials

Answer 17

“1. Brain wave patterns in response to external stimuli such as sounds and flashes of light

2. Normally, sensory gating mechanism allows brain to disregard irrelevant stimuli
3. With Schizophrenia, experience sensory overload
4. Also show weaker ERPs”

Question 18

Hallucinations

Answer 18

1. Most common form of perceptual disturbance

Question 19

Psychodynamic Perspectives

Answer 19

“1. Represents the overwhelming of the ego by the drives or impulses from the id: threaten ego and give rise to intrapsychic conflict

2. Person regresses to an early period in the oral stage: Primary Narcissism
3. Infant has not yet learned that the world is distinct from itself
4. Breakdown in ego function is what accounts for the datchment from reality (Input from the id cannot be filtered correctly)”

Question 20

Harry Stack Sullivan

Answer 20

“1. Placed more emphasis on interpersonal than intrapsychic factors (as Freud did)
2. Emphasized that impaired mother-child relationship can set the stage for gradual withdrawl from other people”

Question 21

Environment vs Genetic

Answer 21

“1. Highly related to presence of schizophrenia in biological parent
2. High risk-children raised in better environments are at less of risk than when raised in low ses homes”

Question 22

Cross-fostering study

Answer 22

Compares the incidence of schizophrenia among children whose biological parents either had or didn’t have schizophrenia an who were reared by adoptive parents who either had or didn’t have it

Question 23

Gene Research

Answer 23

“1. No single gene is responsible for schizophrenia

2. Children of older fathers have higher risk of schizo and autism (sperm are more prone to mutation)
3. No risks of genetic mutations are found in older mothers”

Question 24

Dopamine Hypothesis

Answer 24

“1. Involves overactivity of dopamine transmission in the brain

2. Evidence comes from the effects seen in the use of antipsychotic drugs (neuroleptics) - most common are phenothiazines
3. Neuroleptics block dopamine receptors, reduce level of dopamine activity, inhibit excessive transmission of neural impulses that may give rise to symptomatic behavior
4. Large amounts of amphetamines result in more dopamine, blocking reuptake, cause symptoms that mimic paranoid schizophrenia
5. Not that there is too much dopamine, but that the dopamine system is overactive or too responsive to stimulation of dope receptors”

Question 25

Viral Cause

Answer 25

1. Research shows a sevenfold greater risk for individuals exposed to influenze in the first 3 months of prenatal development

Question 26

Brain Abnormalities

Answer 26

"1. Loss of brain tissue (gray matter) as compared to normal controls 2. Abnormally enlarged ventricles (hollow spaces in the brain) 3. Abnormal functioning and loss of brain tissues in the prefrontal cortex (imaging shows lower level of neural activity compared to healthy controls) - showed less activation while performing arithmetic operations"

Question 27

Family Theories

Answer 27

1. Discredited theory of the schizophrenogenic mother: cold, aloof, overprotective, and domineering mother without a father figure to adequately counterbalance

Question 28

Communication Deviance

Answer 28

"1. Pattern of unclear, vague, disruptive, or fragmented communicaiton that is often found among parents and family members of schizophrenia patients 2. CD is speech that is hard to follow and from which it is difficult to extract any shared meaning 3. Difficulty focusing on what their children are saying 4. Verbally attack their children rather than offer constructive criticism 5. Causual pathway may work in both directions"

Question 29

Expressed Emotion

Answer 29

"1. Pattern of responding to the individual in hostile, critical, and unsupportive ways 2. Patients living high EE family environment have more than twice the risk of of suffering a relapse as those living in low EE families 3. High EE families are more common in industrial countries"

Question 30

EE Cultural Differences

Answer 30

"1. High EE families (mex-american, anglo-american, chinese families) view psychotic behavior of a family member with schizophrenia as within the person's control 2. High EE linked to more negative outcomes in Anglo-American families, but not Mexican American 3. Mex-American linked family warmth, not EE, was related to more positive outcomes (Not true for Anglo-Americans) 4. High EE in African-American were associated with better outcomes (intrustive critical comments perceived as signs of caring and concern rather than rejection) "

Question 31

Endophentoypes

Answer 31

"1. Measurable process or mechanism unseen by the unaided human eye, explains how genetic instructions encoded in an organism's DNA influence an observable characteristic of the organism or phenotype 2. One example involves brain circuitry as a possile endophenotype: breakdowns lead to positive features e.g. hallucinations, delusions, and thought disorder"

Question 32

Antipsychotic drugs

Answer 32

Major tranquilizers or neuroletpics revolutionized the treatment of schizophrenia and helped spur deinstitutionalization

Question 33

Tardive Dysknesia

Answer 33

"1. Major side-effect of antipsychotics (disorder can persist when medication is withdrawn) 2. Most common among older people and among women"

Question 34

Atypical antipsychotics

Answer 34

"1. Second generation of antipsychotics (Clozapine, risperidone, olanzapine) 2. Fewer neurological side-effects, lower risk of TD 3. Side effects: cardiac death, substantial weight gain, and metabolic disorders 4. Clozapine causes body to produce inadequate supplies of white blood cells"

Question 35

Psychodynamic Therapy

Answer 35

"1. Freud did not believe that traditional psychoanalysis was well suited 2. Harry Stack Sullivan and Frieda Fromm-Reichmann adapted PA techniques specifically for schizophrenia 3. No research to establish effectiveness of PA with s"

Question 36

Learning-Based Therapies

Answer 36

"1. Selective reinforcement of behavior: providing attention for appropriate bahavior and extinguishing bizarre verbalization through withdrawal of attention 2. Token economy (has fallen out of favor in recent years -very time and staff-intensive) 3. Social skills training (incorporates role-playing within a group format) 4. CBT as adjunct to drug therpay"

Question 37

Psychosocial Rehab

Answer 37

Clubhouses (self-help clubs) have sprung up becaue mental health agencies often failed to provide comparable services

Question 38

Brief Psychotic Disorder

Answer 38

"1. Applies to a psychotic disorder that last from a day to a month and is characterized by at least one of the following: delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior) and then a full return to prior level of functioning 2. Often linked to signifcant stressor"

Question 39

Schizophreniform Disorder

Answer 39

"1. Abnormal behaviors identical to those in schizophrenia, persisted for at least one month, but less than 6 months 2. Some cases have good outcomes, or after six months, disoder is reclassified as schizophrenia or schizoaffective disorder"

Question 40

Delusional Disorder

Answer 40

"1. Applies to people who hold persistent, clearly delusional beliefs, often involving paranoid themes 2. Rare, affecting 20 in 10,000 3. Apart from the delusion, the individual's behavior may not show evidence of obviously bizarre or odd behavior"

Question 41

Schizoaffective Disorder

Answer 41

1. (mixed bag) Includes psychotic behaviors associated with schizophrenia occurring at the same times as a major mood disorder 2. Delusions or hallucinations must have occurred for a peiod of at least two weeks without the presence of a major mood disorder