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PSYCH 239 > Chapter 10: Schizophrenia Spectrum Disorders > Flashcards

Chapter 10: Schizophrenia Spectrum Disorders Flashcards

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1
Q

Schizophrenia

A

a chronic psychotic disorder characterized by acute episodes involving a break with reality, as manifested by such features as delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behavior

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2
Q

Four A’s

A

in Bleuler’s views, the primary characteristics of schizophrenia

loose associations, blunted or inappropriate affect, ambivalence, and autism

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3
Q

Looseness of Associations

A

ideas are strung together with little or no relationship among them

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4
Q

Affect

A

the behavioral expression of emotions

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5
Q

First-Rank Symptoms

A

in Kurt Schneider’s view, the primary features of schizophrenia, such as hallucinations and delusions, that distinctly characterize the disorder

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6
Q

Second-Rank Symptoms

A

in Schneider’s view, symptoms associated with schizophrenia that also occur in other psychological disorders

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7
Q

Prodromal Phase

A

(1) stage in which the early features or signs of a disorder become apparent

(2) in schizophrenia, the period of decline in functioning that precedes the development of the first acute psychotic episodes

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8
Q

Acute Episode

A

in schizophrenia, the phase in which psychotic symptoms develop, such as hallucinations, delusions, and disorganized speech and behavior

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9
Q

Residual Phase

A

in schizophrenia, the phase of the disorder that follows an acute phase, characterized by a return to a level of functioning typical of the prodromal phase

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10
Q

Thought Disorder

A

disturbances in thinking characterized by various features, especially a breakdown in logical associations between thoughts

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11
Q

Neologisms

A

type of disturbed thinking associated with schizophrenia involving the coining of new words

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12
Q

Perservation

A

persistent repetition of the same thought or train of thought

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13
Q

Clanging

A

in people with schizophrenia, the tendency to string words together because they rhyme or sound alike

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14
Q

Blocking

A

(1) disruption of self-expression of threatening or emotionally laden material

(2) in people with schizophrenia, a condition of suddenly becoming silent with loss of memory for what they have just discussed

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15
Q

Catatonia

A

gross disturbances in motor activity and cognitive functioning

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16
Q

Stupor

A

state of relative or complete unconsciousness in which a person is not generally aware pf or responsive to the environment, as a catatonic stupor

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17
Q

Waxy Flexibility

A

feature of catatonia involving adopting a fixed posture into which people with schizophrenia have been positioned by others

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18
Q

Positive Symptoms

A

the more flagrant features of schizophrenia characterized by the presence of abnormal behavior, such as hallucinations, delusions, thought disorder, disorganized speech, and disorganized behavior

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19
Q

Negative Symptoms

A

features of schizophrenia characterized by the absence of normal behavior, negative symptoms are deficits or behavioral deficiencies, such as social-skills deficits, social withdrawal, flattened affect, poverty of speech and thought, psychomotor retardation, or failure to experience pleasure in pleasant activities

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20
Q

Blunted Affect

A

significant reduction in emotional expression

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21
Q

Flat Affect

A

absence of emotional expression

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22
Q

Cross-Fostering Study

A

method of determining heritability of a trait or disorder by examining differences in prevalence among adoptees reared by either adoptive parent or biological parents who possessed the trait or disorder in question

evidence that the disorder followed biological rather than adoptive parentage favors the heritability of the trait or disorder

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23
Q

Dopamine Theory

A

biochemical theory of schizophrenia that proposes schizophrenia involves the action of dopamine

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24
Q

Hippocampus

A

one of a pir of structures in the limbic system involved in processes of memory

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25
Q

Amygdala

A

one of a pair of structures in the limbic system involved in emotion and memory

26
Q

Schizophrenogenic Mother

A

type of mother, described as cold but also overprotective, who was believed to be capable of causing schizophrenia in her children

research has failed to support the validity of this concept

27
Q

Double-Blind Communications

A

pattern of communication involving the transmission of contradictory or mixed messages without acknowledgement of the inherent conflict; posited by some theorists to play a role in the development of schizophrenia

28
Q

Expressed Emotions

A

a form of disturbed family communication in which the family members of the individual with schizophrenia have a tendency to be hostile, critical, and unspportive

29
Q

Tardive Dyskinesia

A

movement disorder characterized by involuntary movements of the face, mouth, neck, trunk, or extremities caused by long-term use of antipsychotic medications

30
Q

What is schizophrenia?

A

schizophrenia is among the most puzzling and disabling clinical syndromes

schizophrenia touches every facet of an afflicted person’s life

acute episodes are characterized by delusions, hallucinations, illogical thinking, incoherent speech and bizarre behavior

between episodes, people may still be unable to think clearly and may lack appropriate emotional responses to people and events in their lives

31
Q

What was Emil Kraeplin’s (1856-1926) perspective on schizophrenia?

A

dementia praecox (losing their mental capacities before old age)

“the loss of inner unity of thought, feelings, and acting”

progressive disease process (develops early in life)

hallucinations, motor abnormalities, delusions

32
Q

What was Eugen Bleuler’s (1857-1939) perspective on schizophrenia?

A

Four A’s: associations (jumping from one topic to another without correlation), affect (withdraw socially), ambivalence (no form of strong decisions), autism (withdraw into internal delusions)

introduced the term “schizophrenia”, “split brain”

recognized variability in the course of the disorder

33
Q

What was Kurt Schneider’s (1887-1967) perspective on schizophrenia?

A

thought the four A’s overlapped too much with other disorders and wanted better differential criteria

first rank and second rank symptoms

34
Q

What are first rank symptoms?

A

central to diagnosis of Sz, initially thought to be unique to Sz

ABCD: auditory hallucinations, broadcasting of thought, controlling of thought (echo, insertion, withdrawal), delusions

35
Q

What are second rank symptoms?

A

things that are often present but not exclusively

frequently associated with Sz, but not exclusively

mood problems

non-auditory hallucinations (visual, olfactory, haptic, gustatory)

36
Q

What is the prevalence of schizophrenia?

A

1% of the population; fifth leading cause of disability

social isolation

early adult onset, few cases spontaneously enter remission permanently

consequences can be devastating in virtually all main functional areas

37
Q

Why is homelessness and victimization common in schizophrenia?

A

properly treated, individuals with Sz are no more harmful than members of the general population

often suspicious of family and professionals, so avoid Tx

delusions may lead to fear that medications are poison or thought control agents

medication side effects can be nasty

poor compliance with social services and out reach workers make permanency planning difficult

may be reluctant to allow others into their residence to assess safety of home environment

about 20x as likely as members of the general population to complete suicide

38
Q

What are the phases of schizophrenia?

A

prodromal phase: deterioration of self-care

acute phase: positive symptoms start

residual phase: still have some features, retain the belief that some delusions have merit, even if they acknowledge they are false

39
Q

What are major features of schizophrenia?

A

disturbances of thought and speech

disturbances in the content of thought

delusions of persecution, being controlled, grandeur

40
Q

What are common forms of delusions?

A

thought broadcasting

thought insertion

thought withdrawal

41
Q

What are disturbances in the form of thought?

A

neologisms: terms they make up that don’t make sense

preservations: keep using same phrases, words, or topics of conversation over and over

clanging: non-sensical rhyming

blocking: stopping mid-sentence

42
Q

What are attentional deficiencies in schizophrenia?

A

hypervigilance: looking over shoulder, immediately suspicious of anyone who enters the room

43
Q

What are perceptual disturbances in schizophrenia?

A

auditory hallucinations and self-talk (sub-vocal speech)

auditory hallucinations in 60% of cases

command hallucinations

44
Q

What are the emotional disturbances in schizophrenia?

A

flatness of affect

inappropriate affect

often in facial expression

45
Q

What are the previous subtypes of schizophrenia that are no longer in the DSM-5?

A

disorganized: sat around and giggled, act drunk but no motor impairment

catatonic: without movement
waxy flexibility: can be moved
rigid: can’t be moved

paranoid: term that trumped everything else

undifferentiated: features are evenly distributed between all three

46
Q

What are Type I and Type II schizophrenia?

A

positive symptoms and negative symptoms

premorbid functioning: poorer in type II

47
Q

What is the DSM-5 criteria of schizophrenia?

A

two (or more) of the following: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

level of functioning in one or more areas is markedly below the level achieved prior to the onset

continuous signs of the disturbance persist for at least 6 months, may include period of prodromal or residual symptoms

schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out

if there is a history of ASD or a communication disorder, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations

48
Q

What are the specifiers of schizophrenia?

A

first episode, currently in acute episode

first episode, currently in partial

multiple episodes, currently in acute episode

multiple episodes, currently in full remission

continuous

unspecified

with catatonia

49
Q

What is the DSM-5 criteria for schizoaffective disorder?

A

an uninterrupted period of illness during which there is a major mood episode

delusions or hallucinations for 2 or more weeks in the absence of a major mood episode

50
Q

What are differentials of schizophrenia?

A

mood disorder with psychotic features

brief psychotic disorder

delusional disorder: positive symptoms in the absence of others

substance-induced psychotic disorder

schizophreniform disorder: Sz. except the time period has not been met

schizotypal personality disorder: positive symptoms
schizoid personality disorder: negative symptoms

the boundaries between these can be so unclear that many scholars have argued for the removal of separate diagnostic categories

51
Q

What are the psychodynamic perspectives on schizophrenia?

A

primary narcissism

Harry Stack Sullivan: ego defenses are completely overwhelmed, when defense collapses fully they will revert to oral phase, perceives delusions of the Id as being real, don’t have distinction between themselves and the environment

mother-child relationships: arise from moms who do not meet the child’s emotional needs, so they retreat into themselves for social stimulation, cause social withdrawal

52
Q

What are the learning perspectives on schizophrenia?

A

Ulmann and Krasner: arose from environment where social reinforcement is hard to come by, then they partake in unusual, attention-seeking behavior to gain reinforcement, increase behavior to increase attention

reinforcement for behaving in a manner consistent with Sz.

secondary gains: inadvertent reinforcement of bizarre behavior

53
Q

What are the biological perspectives on schizophrenia?

A

genetic factors: cross-fostering studies

biochemical factors: dopamine theory, neuroleptic drugs

viral infections

brain abnormalities: hippocampus, amygdala

54
Q

What is the research evidence supporting the diathesis-stress model?

A

acute stress tends to predict onset: people who have already had a psychotic break

people with COMT gene more likely to develop psychosis with cannabis

genetic liability

55
Q

What is a schizophrenogenic mother?

A

cold, aloof, withholding affection

child withdraws, foreclosing on opportunities to socialize

retreats into a fantasy world and begins to behave according to that imagined

56
Q

What is double-bind communications theory?

A

children being shaped to say what they think parents “want” to hear

learned that if they speak up they will get in trouble, being shaped to speak in a way the authority figure wants

incompatible with true feelings

57
Q

What is communication deviance?

A

mimicking unclear, vague, communication modelled by others, especially parents

58
Q

What are biological approaches to the treatment of schizophrenia?

A

antipsychotic drugs

59
Q

What are the psychoanalytic approaches to the treatment of schizophrenia?

A

personal therapy

Freud was of the opinion that psychoanalysis was not helpful in the treatment of Sz.

60
Q

What are the learning based approaches to the treatment of schizophrenia?

A

social skills training

lots of evidence speaking to social maladjustment

social rejection and lack of support worsen outcomes

61
Q

What are the psychosocial rehabilitation approaches to the treatment of schizophrenia?

A

focuses on functional practical adaptation

public transportation

job skills (often in a sheltered environment)

appointment of a public guardian/trustee

62
Q

What are the family intervention program approaches to the treatment of schizophrenia?

A

education: educate family, tell them it’s not their fault

early intervention is critical

PSYCH 239 (12 decks)

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