Chap12 Flashcards
Schizophrenia
Disorder characterized by severely impaired cognitive processes, personality disintegration, disturbance, and social withdrawal
Schizophrenia spectrum
Group of disorders that range and severity and that have similar clinical features including some degree of reality distortion
Psychosis
Condition involving lost contact with or distorted view of reality
Four categories of symptoms of schizophrenia spectrum disorders
Positive symptoms cycle motor abnormalities cognitive symptoms and negative symptoms
Positive symptoms of schizophrenia spectrum disorders
Delusions hallucinations disordered thinking incoherent communication and bizarre behavior
Poor insight
Failing to recognize the symptoms of one’s own mental illness. Common among those with severe symptoms and among those who had difficulties functioning before the onset of their mental illness. Common with people who have positive symptoms. Lack of awareness of psychotic symptoms highest with asociology, Delusions and restricted affect
Delusions
Falls personal believes that are firmly and consistently held despite disconfirming evidence or logic. Lack of insight particularly common among individuals experience illusions
Delusional themed
Grandeur, control, thought broadcasting, thought with drawl, persecution, reference, paranoid ideation
Paranoid ideation
Suspiciousness about the actions or motives of others
Persecutory delusions
Believes of being targeted by others or that people are plotting against them talking about their morale to harm them in someway. Accompanied by high levels of anxiety and worry as well as in reactions
Does confirmatory evidence
Information that contradicts the delusional belief. Often people with delusions of persecution avoid dangerous situations.Safe behaviors such as this may prevent them from encountering just confirmatory evidence.
Recovery model
A move away from the view that schizophrenia is a chronic disorder with an inevitability poor prognosis. If you schizophrenia is a chronic medical conditions such as diabetes or heart disease which may interfere with an optimal functioning, but does not define the individual
Capgras delusion
Where delusion involving a believe in the existence of identical doubles will replace significant others. Most common with Bree forms of psychosis that develop after an emotionally distressing event
Hallucination
Perception of a nonexistent or absent stimuli sensory miss perception. Maybe any one of the sensors
Cognitive symptoms of schizophrenia spectrum
Disordered thinking and communication speech. Loosening of associations. are not related to the conversation having no hierarchical structure organization. May also demonstrate difficulty with abstractions and thusrespond to words or phrases in concrete manner. Also over inclusiveness. Attention and memory problems and difficulty making decisions.Poor executive functioning such as deficits in inability to sustain attention, to absorb and interpret information and tomake decisions based on recently learned information. Cognitive symptoms are generally present before the onset of the first psychotic episode and persist even with treatment. Also found in nonpsychotic relatives of individuals with schizophrenia
Loosening of associations
Also called cognitive slippage another characteristic of disorganized thinking. Involves a continual shifting from topic to topic without any apparent logical or meaningful connection between thoughts
Over inclusiveness
Abnormal categorization in thinking
Grossly disorganized or abnormal psycho motor behavior
Experiencing bizarre and extremely distressing motor behavior. Could be a period of catatonia.
Catatonia
Condition involving market disturbance in motor activity, either extreme excitement or motoric inability. Include social withdrawal you to some pastoring negativism cataplexy which is Viccs posture, muscle rigidity waxy flexibility compulsive moments and cycle motor excitement
Excited catatonia
Very disorganized Haviar maybe aggressive agitated hyper active and left in the missions. May talk constantly and shout moving or running until they drop from exhaustion
Withdrawn catatonia
Extremely unresponsive for a long periods of stupor and mutism maintaining strange pastors or waxy flexibility
Waxy flexibility
Allowing their bodies to be arranged in almost any position and then remaining in the position for long periods
Negative symptoms
Inability or decrease ability to initiate actions or speech, express emotions or feel pleasure. May include avolition,alogia a sociology and a hedonism and diminished emotional expression. Common in individuals with schizophrenia spectrum disorders. Negative symptoms are more common man and are associated with poor social functioning and progress
Avolition
Lack of motivation, inability to take action or become goal oriented
Alogia
Lack of meaningful speech
Asociality
Minimal interest in social relationships
Diminished emotional expression
Reduce display of observable verbal and nonverbal behaviors to communicate internal emotions
DSM five diagnosis of schizophrenia
Presence of two of the following: delusions hallucinations disorganize speech gross motor disturbances or negative symptoms symptoms. At least one symptom must be either delusions hallucinations or disorganized speech. Additionally requires a deterioration from a previous level of function and in areas such as work, interpersonal relationships, or self-care. Symptoms must be present most of the time for at least one month and the disturbance must persist for at least six months. May or may not have a psychosocial stress summer. Psychotic symptoms are gradual. Occasional returned premorbid functioning. Higher prevalence Among family members.
Premorbid functioning
Impairment Present in most cases of schizophrenia. Individuals often showed some abnormalities before the onset of major symptoms. Most people with schizophrenia recover gradually rather than suddenly. Schizophrenia consists of three phases prodromal active and residual
Prodromal phase
Ansell and build up of schizophrenic symptoms. Social isolation, peculiar behavior’s, inappropriate affect, poor communication patterns and neglect of personal grooming. Excessive demands on the individual or other psychosocial stressors in the prodromal phase result in the onset of prominent psychotic symptoms or the active phase
Active phase
Full-blown symptoms of schizophrenia including severe disturbances in thinking and marked deterioration and social relationships and restricted or markedly inappropriate affect
Residual phase
Symptoms no longer prominent severity of psychotic behavior and symptoms decline. Many people with schizophrenia can live productive lives although complete recovery is Rare
Recovery rates
Majority of participants improve over time whereas minority appear to deteriorate. 40% should one or more periods of substantial recovery and 15 year follow up study. Positive outcome factors: women, education level, being Married,hire premorbid level of functioning fewer negative symptoms, prior history of good work performance and ability to live independently, lower levels of depression and aggression. Early intervention
Attenuated psychosis syndrome
Proposed diagnostic category involves distressing or disabling delusions hallucinations or disorganize speech that have emerged to become progressively worse over the previous year and a current lease once per week. Less severe and more transient then symptoms experienced by individuals with schizophrenia. Person stays in touch with reality
Causes of schizophrenia
Emotional or sexual abuse, cannabis use, and trauma are all hypothesize to affect open mean levels general cognitive functioning in those susceptible to schizophrenia
Biological causes
Interactions among a large number of different genes. Closer blood relatives of individuals diagnosed with schizophrenia run a greater risk of developing it. Monozygotic twins, if one twin receives diagnosis risk of second twin isless than 50%. Low birth weight delivery complications also increases risk
Endo phenotypes in schizophrenia
Irregularities in working memory, executive function, sustained attention, and verbal memory
Neuro structures
Decreased volume in the cortex and other areas of the brain, ventricular enlargement this is also present in healthy siblings. Striking loss of brain cells in cortex over six years among young people with schizophrenia. Loss of gray matter in parietal frontal and temporal areas of the brain. Siblings also show similar cortical lossMay lead in with connectivity between brain regions and reductions in integrative functioning and impaired processing leading to cognitive symptoms, positive and meg symptoms
Bio chemical influence and schizophrenia
Dopamine serotonin GABA and glutamate linked to schizophrenia. And excess dopamine as evidenced by phenothiazines l-dopa and amphetamines.
Dopamine hypothesis
Schizophrenia may result from excess dopamine activity in certain areas of the brain as evidenced from phenothiazines l-dopa and amphetamines criticism is that schizophrenia involves multiple natural chemicals and brain regions and one magical medication will not treat all forms
Effect of illegal drugs and alcohol and schizophrenia
Cocaine amphetamines alcohol in the specially cannabis increase the chances of developing a psychotic disorder. Meth and feta mean may result in five fold increase of psychotic symptoms during intoxication. Cannabis users who develop schizophrenia have a three-year earlier onset. Marijuana increases risk of psychosis by 40%. Not due to transitory effects of intoxication. 14% of cases of psychosis might not of occurred
Affect of estrogen in schizophrenia
Men develop schizophrenia earlier. Women develop later and that’s due to the protective effects of estrogen. Estrogen increase cause improvements in cognitive functioning. Psychotic symptoms improve during the luteal phase of menstrual cycle.
Psychological dimension and schizophrenia
Deficits in empathy, tendency to focus on one’s own thoughts and feelings, gesture less when speaking and nod less frequently when listening. May interfere with interpersonal functioning, during adolescence this predicted bizzare experiences, perceptual abnormalities and persecutory ideation
Theory of mind
The ability to recognize that others have emotions believes and desires that may be different from one’s own. Deficits and this may cause poor communication problems and lack of insight and schizophrenia
Characteristics that sharply increased likelihood of developing schizophrenia
Genetic risk, recent deterioration in functioning especially social withdrawal, increasing frequency of unusual Thoughts , high levels of suspiciousness and paranoia, social Impairment, and substance abuse.
Early life indications
Infant to later develop schizophrenia or slower to smile, and with their heads, city, Bro, and walk compared to infants who did not. LOL cognitive ability test scores in childhood and adolescence project of the presence of psychotic like experiences and psychosis and middle-age. Young man with a decline in for both the hottie between 13 and 18 associated with increased risk of developing a psychotic disorder. They may have less cognitive reserve and reduce the opportunity for the brain to bounce back from neurological insult
Becks theory of schizophrenia
Bicitra fusions for negative attitudes can lead to or maintain psychotic symptoms such as delusions. Limited motivation and restricted affect maybe do two individuals beliefs that they are worthless and their condition is hopeless. Low expectancy for pleasure and success combined with low motivation may maintain negative symptoms.
Restricted at five
Severely diminished or limited emotional responsiveness
Social dimension of schizophrenia
Research is failed to substantiate hypothesized causal link between family dysfunction and the etiology of schizophrenia. Social factors associated with increased vulnerability: maltreatment during childhood and bullying by peers risk magnified among those exposed to both. Being in a Trumatic accident was associatedwith only slightly higher risk.
Expressed emotion
A negative communication pattern found him on some relatives of individuals with schizophrenia. Associated with higher relapse rate includes critical comments made by relatives status of this like a resentment toward the schizophrenic my family members and statements reflecting over concern overprotectiveness or over-involvement not sure which is caused which is effect. It’s a fact had less meaning in different cultures or different meaning
Socio-cultural dimensions
African-Americans 2 to 3 times more likely to receive a diagnosis of schizophrenia compared to European Americans. Maybe due to discriminatory experiences or clinician bias .or actual differences in the disorder
Social risk factors which are risk factors for schizophrenia
Laura educational level of parents, lower occupational status of fathers, and residing in poor areas at birth. When combined with other risk factors these produce a threefold increase in risk of developing schizophrenia compared to those not exposed to these. Migration is a risk factor I’m on first and second generation immigrants to the UK living I’m on one’s own ethnic group reduces the risk. Maybe cost to access dopamine release that occurs in response to chronic stress
Prefrontal lobotomy
Surgical procedure in which the frontal lobe’s are disconnected from the remainder of the brain
Antipsychotic medications and schizophrenia
Medicine develop to counteract symptoms of psychosis. Can reduce the intensity of symptoms and have side effects and dosage levels need to be carefully monitored. First generation antipsychotics reduce dopamine levels in the brain also called conventional or typical antipsychotics such as stores in the first one. Atypical antipsychotics are newer antipsychotic medications that are chemically different and less likely to produce side effects associated with the first generation ones
Atypical antipsychotics
Risperidone/ Risperdal olanzapine or Zyprexa, quietispine or Seroquel, aripiprazole orAbilify and lurasidone/Latuda act on both dopamine and serotonin receptors. Less side effects such as rigidity persistent muscle spasms, tremors and restlessness.conventional in a typical both reduce severity a positive symptoms but give a little relief from negative symptoms, and a large group do not benefit at all. Too many side effects main reason why people stop taking the medicine
Extrapyramidal symptoms
Side effects such as restlessness involuntary movements and muscular tension produced by antipsychotics medication. Including parkinsonism, dystonia or muscle contractions of limbs and tongue, akathisia or motor restlessness, and neuroleptic malignant syndrome including muscle rigidity and autonomic instability.
Tardive dyskinesia
More chronic or permanent condition, a side effect of antipsychotics. Involves involuntary and rhythmic movements of tongue, chewing, lipsmacking another facial movements, and jerking movements of the limb.
Metabolic syndrome
Increased risk when taking antipsychotics. A condition associated with obesity diabetes high cholesterol and hypertension
Most effective treatment for schizophrenia
Medication and therapy. Continuous medication may not be needed for some individuals who remain stable after 6 to 10 months. Off medication. Antipsychotic medication have a negative impact on brain anatomy and bio chemical functioning I can affect cognitive functioning. Dose reduction is another option
Psychosocial therapy
Psychotherapeutic work including direct teaching of social skills including conversational skills to reduce eccentric cities in the parents a tire and communication patterns.
Milieu therapy and behavioral inpatient therapy.
Hospital setting operates as a community within which schizophrenics exercise wide range of responsibilities and help make decisions. Also psycho social skills training including appropriate self-care behaviors conversational skills and job skills. Undesirable behavior such as crazy talk her social isolation or decrease your reinforcement in modeling techniques.
Cognitive behavioral therapy
Major advances in this may help delusions hallucinations delusions of reference paranoid delusions. Includes engagement or collaborative message, assessment and which clients are encouraged to discuss fears and anxietiesand make sense of them, identifies negative believes and help them re-interpret, normalization to decatastrophize the psychotic experiences, collaborative analysis of symptoms and development of alternative explanations for maladaptive assumptions
Mindfulness training for schizophrenia
Clients learn to let go of and we are fearful responses to psychotic symptoms are taught to let the psychotic symptoms, consciousness without reacting. And Hanses going to self-control and significantly reduce his negative symptoms
integrated psychological therapy
Form of cognitive therapy specifically targets deficits found it individuals with schizophrenia such as basic impairments and neurocognitive deficits in social cognition and interpersonal communication. It is an effective rehabilitation approach
Family communication interventions in schizophrenia
Siblings may display variety of emotional reactions to the mental illness such as love loss and her guilt and shame and fear. Family intervention programs reduce relapse rates and lower the cost of care. Beneficial for families with and without negative communication patterns
Best psychotherapy include
CBT, family counseling, and social skills training produce most positive results plus use of medication. Recent research suggests a substantial portion of people with the illness will recover completely and many more will regain good social functioning
Other schizophrenia spectrum disorders
Delusional disorder schizoaffective disorder schizophreniform disorder and brief psychotic disorder
Delusional disorder
Persistent delusions that are not accompanied by other unusual or odd behaviors. Tactile and olfactory hallucinations related to the delusions may be present. Delusions must persist for at least one month and have no other evidence of psychosis. Absence of additional disturbances in thoughts or perceptions.common themes are erotomania, grandiosity Jealousy persecution or somatic complaints. Delusional disorder is equally common in men and women. Higher in suspicious people, or hearing impairment in adolescents. Genetic relationship between delusional disorder and schizophrenia
Shared delusions
Sometimes referred to as folly all do more prevalent among those that are socially isolated. Involves a family member or a partner acquiring the delusional believe from the dominant individual. The other individuals often younger highly suggestable,more passive and lower self-esteem
Brief psychotic disorder
Requires the presence of one or more psychotic symptoms including at least one symptoms involving delusions hallucinations or disorganize speech to continue for one day but less less than one month. Can be produced by psychological trauma. Usually a significant stressor proceeds onset of symptoms but not in all cases. 9% of individuals who seek help for first time psychotic symptoms. Twice is common in women. Often for return to normal functioning after episode. Abrupt onset of psychotic symptoms.
Schizophreniform disorder
Requires the presence of two or more of the following symptoms:delusions, hallucinations,disorganize speech gross motor disturbances or negative symptoms. At least one of the two must involve delusions hallucinations or disorganized speech. Last between one and six months. Usually a psychosocial stressors of an abrupt symptoms possible return the premorbid functioning increased risk of schizophrenia among family members
Schizoaffective disorder
symptoms of both schizophrenia and a major depressive or manic symptoms. The depression or manic episodes continue for the majority of time that the schizophrenic symptoms are present. The psychotic features must sometimes continue for at least two weeks after symptoms of the manic or depressed episode have subsided. Individuals with mood disorders do not have psychotic symptoms in the absence of a major mood episode. Relatively rare; more prevalent in women; younger people tend to have bipolar type, older more likely to have depressive subtype. prognosis better then schizophrenia but somewhat worse than for bipolar or depressive. treatment includes antipsychotic medication combined with mood stabilizers and individual and group psychotherapies
