Chapter 10: Schizophrenia Flashcards
Acute Schizophrenia episodes are characterized by:
delusions, hallucinations, illogical thinking, incoherent speech, bizarre behaviour
Emil Kraeplin (1856-1926)
Dementia Praecox
- out (dementia) of ones mind (praecox)
Eugen Bleuler
Associations: relationships among thoughts become disturbed
Affect: emotional responses become flattened and inappropriate
Ambivalence: hold conflicting feelings towards others
Autism: withdrawal into a private fantasy wold that is not bound by principles of logic
Kurt Schneider
First rank symptoms
- central to the diagnosis
- hallucinations and delusions (not specific to schizophrenia)
Second-rank symptoms
- symptoms associated with schizophrenia that occur in other psychological conditions
- disturbances of mood and confused thinking
Phases of Schizophrenia
Prodromal phase
Residual phase
Prodromal phase
waning interest in social activities and increasingly difficulty in meeting the responsibilities of daily living
residual phase
behavioural returns to the level that was characteristic in functioning prior to the first acute phase
behaviour may not return fully to normal
Schizophrenia occurs when?
late teens/early 20s
drug induced/stress induced
can come on fast (acute onset) or gradual onset
Major features of schizophrenia
disturbances of thought and speech other common forms of delusions disturbances in the form of thought Attentional deficiencies perceptual deficiencies emotional disturbances oter types of impairment
Disturbances of thought and speech
Delusions of persecution
Delusions of reference
Delusions of being controlled
Delusions of grandeur
Common forms of delusions
Thought broadcasting
thought insertion
thought withdrawal
Disturbances in the form of thought
Thought disorder Neologisms Perseveration Clangling Blocking
thought disorder
breakdown in the organization, processing, and control of thoughts
Neologisms
words made up by the speaker that have little or no meaning to the others
perseveration
inappropriate but persistent repetition of the sane words or train of thought
Clanging
stringing together of words or sounds on the basis of rhyming
Blocking
involuntary abrupt interruption of speech or thought
Younger individuals with schizophrenia vs. older individuals
younger: talk a lot
older: have poverty of speech
Hypervigilance
acute sensitivity to extraneous sounds, esp. during the early stages of the disorder
attentional deficiency
Perceptual disturbances
Auditory hallucinations and self-talk
- auditory hallucinations in 60% of cases
- commmand hallucinations
Causes of hallucinations
too much dopamine
- therefore they are easy to treat with medication
Emotional disturbances
flat affect
Stupor
state of relative or complete unconsciousness in which a person is not generally aware of or responsive to the environment
Schizophrenia can be either ______ or ______
type 1
type 2
Type 1 Schizophrenia
Positive symptoms (something is added)
- acute onset
- presence of abnormal behaviour such as hallucinations, delusions, thought disorders, disorganized speech and inappropriate affect
Type 2 Schizophrenia
Negative symptoms (something is removed) - gradual onset
-absence of normal behaviour, such as social skill deficits, social withdrawal, flattened affect, poverty of speech and thought, psychomotor retardation, failure to experience pleasure in pleasant activities
premorbid functioning
poorer in type 2
psychodynamic perspective
Primary narcissism
- person regresses to an early period in the oral stage
Harry Stack Sullivan
- mother-child relationships
- anxious and hostile interactions between parent and child can lead the child to take refuge in a private fantasy world
learning perspective
Ulmann and Krasner
- reinforcement
- children may grow up in non-reinforcing environments and never learn to respond appropriately to social stimuli
Biological perspective
genetic factors
- cross-fostering studies: method of determining heritability of a trait or disorder by examining differences in prevalence among adoptives reared by adoptive parents or biological parents
Biochemical factors
- DA theory: do not appear to produce more dopamine but have a greater than normal # of receptors in their brains or have receptors that are overly sensitive to DA
- Neuroleptic drugs: block DA receptors
Theoretical perspective
Viral infections
- slow acting virus that attacks the developing brain of a fetus or newborn child
Brain abnormalities
- hippocampus: impairs memory
- amygdala: impairs emotions
Diathesis-stress model of schizophrenia
diathesis + stress factors -> + potential protective factors -> schizophrenia
family theories
Schizophrenogenic mother
- cold, aloof, overprotective, domineering
Double-bind communication
- the transmission of contradictory or mixed messages
Communication deviance
- unclear, vague, disruptive, or fragmented parental communication
Expressed emotion
- hostile, critical, and unsupported of the schizophrenic family member
- high levels of expressed emotion is BAD
Family factors: causes or sources of stress
- increase risk is disturbed communication and emotional interaction
Biological approaches
antipsychotic drugs
sociocultural factors in treatment
Phenothiazines; Haloperidol
antipsychotic
help with hallucinations and delusions
treats tardive dyskinesia (TD)
Tardive dyskinesia (TD)
movement disorder characterized by involuntary movements of the face, mouth, neck, trunk, or extremities
- treated with phenothiazines, haloperidol
psychoanalytic approaches
personal therapy, not well suited to treatment
Learning based approaches
selective reinforcement
toke economy systems
social skills training
psychosocial rehabilitation
self help groups: ran by non-professionals or people with schizophrenia
community programs: housing, jobs, education
Family intervention programs
practical aspects of daily living educating members teaching family members how to relate in a less hostile way improving communication problem solving skills
Early intervention programs
reduced disruption of activities
reduced disruption of family and social relationships
reduced likelihood of hospitalization
reduced disability and fewer relapses
reduced risk of suicide
improved capacity to maintain self-identity and self-esteem
faster and more complete recovery
