ch 8 review Flashcards
what are the positive and negative symptoms of schizophrenia
Positive:
- delusions
- hallucinations
- disorganized thought and speech
- disorganized behavior
Negative:
- restricted affect
- anhedonia
- avolition
Definition of delusions
- false, unshakeable beliefs held despite contradictory evidence
- Contrary to reality and highly unlikely
4 Types of delusions and definitions
- persecutory delusions: being persecuted, watched, or tormented by others
- Grandiose delusions: One has a special identity or possesses special powers
- Delusion of reference: Random events are directed at them
- Delusions of thought insertion: One’s thoughts are being controlled by outside forces
Definition of hallucinations
- Perceptual experiences that occur without a stimulus
- Can affect any of the five senses
4 Types of hallucinations and definitions
- Frequent, persistent, and complex
2. Auditory: hearing things; Most common
3. Visual: Usually with auditory hallucinations
4. Tactile: Something is happening to the outside of the body
5. Somatic: Something is happening to the inside of the body
Disorder with Disorganized Thought and Speech:
Formal thought disorder: Slip from one topic to an unrelated topic with little coherent transition
Definition of Disorganized behavior and an example
- unpredictable and untriggered agitation
- Catatonia: decreased or excessive and peculiar motor activity
What are the three kinds of Negative symptoms of schizophrenia and their definitions?
- Restricted affect: Severe reduction in or absence of emotional expression
- Anhedonia: loss of the ability to experience pleasure
- Avolition: Inability to initiate or persist at goal-directed activities
what is the definition of Cognitive deficits in schizophrenia and what does this mean?
o Deficits in attention, memory and processing speed
o Early marker for schizophrenia
Criteria for diagnosis of schizophrenia:
- the DSM states:
- at least two symptoms of psychosis
- present for at least 1 month
- some symptoms for at least 6 months that impair functioning
- Prodromal symptoms: Before the acute phase
- Residual symptoms: After the acute phase
Prognosis for schizophrenia:
- 3 years after 1st episode:
- 40% employed or in school
- 37% recovered a good level of functioning
- Negative symptoms
- Linked to poor functioning
- Less responsive to medication
- Rehospitalization rates: 50-80%
- Life expectancy 10 years shorter
- More infectious and circulatory diseases
- 5-10% commit suicide
- Stabilize after the first episode within 5 to 10 years
Schizoaffective disorder symptoms:
Mix of schizophrenia and a mood disorder
Schizophreniform disorder: criteria and symptoms
- Criteria of A, D, and E for schizophrenia
- at least 2 symptoms present
- schizoaffective, depressive, and bipolar disorder ruled out
- not due to substance abuse
- symptoms last only 1-6 months
- 2/3 will develop schizophrenia or schizoaffective disorder
Brief psychotic disorder: criteria and symptoms
- Sudden onset of delusions, hallucinations, disorganized speech, and/or disorganized behavior
- between 1 day and 1 month
- Emerge after a stressor
Delusional disorder: criteria and symptoms
- Delusions for at least 1 month, regarding situations that occur in real life
- No other psychotic symptoms
Genetic theories of schizophrenia:
- Genes: strongest risk factor
- Family studies: Genetic similarity increases risk
- Twin studies
- Higher concordance rate in MZ (46%) twins than DZ twins (14%)
- Genainquadruplets
- Adoption studies
- Parent with schizophrenia creates a stressful environment
- Genetic predisposition interacts with biological and environmental factors
Biological brain theories of schizophrenia:
- Reduced gray matter in cortex: Medial, temporal, superior temporal, and prefrontal areas
- Low prefrontal cortex activity: Deficits in cognition, emotion, and social interactions
- Hippocampus: Abnormal activity and Abnormal volume and shape
- Reductions and abnormality in white matter
- Enlarged ventricles: Reduction in brain volume
Biological theories of schizophrenia; birth
Birth complications
- Perinatal hypoxia (oxygen deprivation)
- Interacts with genetic vulnerability
Prenatal Illness Exposure
- Maternal viral infection increases risk
- Second trimester
Biological theories of schizophrenia: neurotransmitters
Excess levels of dopamine?
- Neuroleptics block action of dopamine
- Drugs that increase dopamine increase positive symptoms
- Neuroimaging studies
- More dopamine receptors and higher levels of dopamine
Excess dopamine in Mesolimbic pathway
- Processing of salience and reward
- Positive symptoms
Low dopamine activity in prefrontal brain area
- Negative symptoms
Serotonin neurons regulate dopamine neurons in the mesolimbic system
Psychosocial theories of schizophrenia:
Social drift
- Tendency to drift downward in social class
Birth in a large city (due to stress)
What predicts relapse?
- Stress
- Families
- Expressed emotion: Shown by family members are associated with multiple episodes and relapse
Cognitive perspectives of schizophrenia
Use biases to understand overwhelming sensory information
- Delusions
- trying to explain strange perceptual experiences
- Hallucinations
- Hypersensitivity to perceptual input
- attribute experiences to external sources
- Negative symptoms
- Expect social interactions to be aversive and so conserve scarce cognitive resources
what are two kinds of biological treatments for schizophrenia?
- typical antipsychotics
- atypical antipsychotics
Typical antipsychotics and side effects
- Chlorpromazine (Thorazine)
- Bind to D2 dopamine receptors
- Work best for positive symptoms
- Not effective for 25% of patients
Side effects - drowsiness, dry mouth, weight gain
- Tardive dyskinesia
- Neurological disorder involving involuntary movements of the mouth and face
Atypical antipsychotics and side effects
- Bind to the D4 dopamine receptor
- Influence other neurotransmitters like serotonin
- Clozapine (Clozaril)
Side effects - Dizziness, nausea, sedation
- Agranulocytosis: life threatening drop in white blood cells
Psychological treatments for schizophrenia:
Comprehensive approach
- Behavioral: Social learning theory and operant conditioning
- Cognitive: Recognize and change demoralizing attitudes
- Social: Support groups; Problem-solving skills for common social situations
Family Therapy:
- Basic education of the illness
- Communication skills training of family members
- Effective when combined with drug therapy
