Ch 14&15-Psychotic disorders Flashcards
The psychoses
A set of disorders involving alterations of perception, thought, consciousness
Positive symptoms of schizophrenia
Presence or Addition of behaviors
hallucinations, delusions, strange speech, unusual motor behaviors
Negative symptoms of schizophrenia
Absence of behavior
flat affect (little emotion), lack of motivation, social withdrawal
Acute Schizophrenia (Type I)
- more sudden onset of sx’s
- more positive sx’s
Chronic schizophrenia (Type II)
- More prolonged onset & prolonged history of withdrawal from functioning
- more negative sx’s
Hallucinations
false perceptions
*auditory most common
Delusions
deeply entrenched false beliefs
Most common: persecution, thought-broadcasting, thought-insertion, delusions of reference
Loosening of association
topics shift quickly without meaning
-product of disordered thinking
odd speech
“word salad”
“clanging”
incomprehensible mix of words
inappropriate emotion
emotions inappropriate to the environment/to what is currently happening
Loss of ego boundaries
sense of merging with one’s environment/others
strange motor behaviors
hyperactivity OR hypoactivity
-purposeless motor activities
lack of motivation
everything seems to slow down
inappropriate social behavior
incapable of picking up on social cues
Catatonia cluster of schizophrenia
- bizarre/unusual body movements
- lack of movement (rigidity)
- “waxy flexibility”
- lots of NEGATIVE sx’s
Disorganized cluster of schizophrenia
- Most bizarre & obvious sx’s
- incoherent communications
- inappropriate affect
- no coherent themes to their delusions/hallucinations
Paranoid cluster of schizophrenia
- all delusions/hallucinations related to persecution themes
- more functional overall
- delusions more coherent
- sx’s respond better to current treatment
undifferentiated cluster of schizophrenia
sx’s are mixed & don’t fit into other categories
Prodromal Phase of schizophrenia
- Period of progressive deterioration of behavior
- social withdrawal, decreased performance, change in personal grooming, increase in odd behaviors
Active phase of schizophrenia
Period of prominent intense symptoms
-Duration: typically at least 1 month
Residual phase of schizophrenia
continuing symptoms of disturbance, but less intense
Neuroleptics
anti-psychotic drugs
-most widely used in US
Tardive Dyskinesia
IRREVERSIBLE movement disorder after using neuroleptics
Neuroleptic malignant syndrome
- high fever
- increase in white blood cells
- kidney problems
- liver problems
- difficulty swallowing
Psychodynamic therapy for schizo
not effective, may even worsen symptoms
CBT for schizo
may be useful
ACT for schizo
can be effective
- does not reduce sx’s
- ->decreases hospitalizations (better functionality)
Behavioral therapy for schizo
- social training in social skills
- behavior modification using operant conditioning/positive reinforcement
Causes of positive sx’s
- Respond better to meds that act on Dopamine
- (too much dopamine at synapse)
Dopamine hypothesis
schizophrenia caused by excess of dopamine at synapse
- related more to positive sx’s
- more stongly effected by current meds
Causes of negative sx’s
- do not respond as well to meds
- enlarged ventricles in the brain (cortical atrophy)
- may represent a deterioration of brain tissue
Culture & display of schizophrenia sx’s
Western: more depressive sx’s, thought broadcasting, thought insertion
-more COGNITIVE & AFFECTIVE sx’s
Non-western: more visual & auditory hallucinations telling them to do something
culture & how sx’s interpreted in schizophrenia
schizophrenia diagnosed more often among Asians, Blacks, Hispanics
Schizoaffective disorder
- overlap b/w schizophrenia & mood disorder
- sx’s of schizo & depression/mania (mood disorder prominent)
*psychotic sx’s must be present even in absence of mood disorder
-better prognosis than schizophrenia
BUT worse than bipolar/depression
Brief psychotic disorder (formerly nervous breakdown)
- delusions, hallucinations, disorganized speech, prominent affective sx’s
- sx’s must last at least 1 day, but less than 1 month
- specifiers: with/without marked stressors
schizophreniform disorder
- bridge b/w brief psychotic disorder & schizophrenia
- sx’s: same as schizophrenia BUT sx’s last 1-6 months
Delusional disorders
- single striking delusion-could conceivably be true
- typically remain functional
erotomania
delusion that one of higher status is in love or infatuated with you, or potentially could be
grandiose delusional disorder
delusion of inflated worth/power
jealous delusional disorder
delusion that one’s partner is unfaithful
persecutory delusional disorder
delusion that one’s being persecuted or plotted against
somatic delusional disorder
delusion about the body
ex: having body odor
shared psychotic disorder
one or more people develop psychotic sx’s from their close association with a psychotic individual
“buying into someone else’s delsuions”
-ex: cults
Causes of psychotic disorders
genetic links
dopamine hypothesis
enlarged ventricles
unusual family relations
enlarged ventricles
evidence towards cortical atrophy
-more associated with negative sx’s
MRI studies of psychotic disorders
decreased functioning in areas associated with attention, planning, and volition
unusual family relations/communications
schizophrenic families: families with a member experiencing psychotic sx’s
-negativity, emotionally expressive, intrusive, fragmented communication styles
diathesis stress model for psychotic disordes
vulnerability + major stressor–>onset of psychotic sx’s
schizophrenic spectrum disorders
more likely to occur in families of individuals with schizophrenia:
- schizotypal PD
- schizoid PD
- paranoid PD
- schizophreniform disorder
- delusional disorder
- schizoaffective disorder
Positive prognostic signs for schizophrenia
- married/stable sexual/social
- fewer negative sx’s
- family history not schizo
- presence of affective response in acute stage
- onset later
- higher SES
- competence socially
- no history of ECT
