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Abnormal Psych 355 > Chapter 11 Schizophrenia > Flashcards

Chapter 11 Schizophrenia Flashcards

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1
Q

What is the prevalence of schizophrenia

A

1%

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2
Q

What is the cost of it and why?

A

62.7 billion
loss of labor, medications, therapy, hospitalization
suspected 10% homeless

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3
Q

What is psychosis

A

lost of contact with reality

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4
Q

How was it once viewed

A

incurable/chronic disorder, but now it is recoverable/improvement

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5
Q

Who is Emil Kraeplin

A

German psychiatrist using the descriptive approach(focused on the description of symptoms he observed in his patients, it was simply physical deteriorations)
created the dementia praecox

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6
Q

What is the dementia praecox

A

intellectual deuteriation(brain damage) + early/premature onset

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7
Q

Who is Eugene Bleuler

A

Process approach (identify psychological processes common across schizophrenia)
Breaking of associative threads
Latent Schizophrenia

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8
Q

What is the breaking of associative threads

A

disruptive thought processes

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9
Q

What is the latent schizophrenia

A

patient has disorder in remission, isn’t showing active symptoms but they can be triggered

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10
Q

Where is there a higher rate

A

immigrants(from African countries)
African Americans,
low SES(poverty is risk factor because of high stress)

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11
Q

What does the higher rate highlight

A

impact of discrimination, environmental stress, stereotypes, and prejudice

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12
Q

What does DSM say about schizophrenia

A

2+ psychotic symptoms of which 1 must be delusions, hallucinations, or disorganized speech; and it impairs life
most commonly diagnosed and most severe

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13
Q

What is a brief psychotic disorder

A

1+ psychotic symptoms, of which at least 1 must be delusions, hallucinations, or disorganized speech between 1 day-1 month
2x more likely in women

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14
Q

What is a schizophreniform disorder

A

2+ psychotic symptoms, of which at least 1 must be delusions, hallucinations, or disorganized speech, between 1-6 months; found in more developing countries

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15
Q

What is delusional disorder

A

1+ delusions for at least one month without other odd behaviors;
Ex. Erotomania, Grandiosity, Jealousy, persecution, somatic complaints, delusions, parasitosis

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16
Q

What is erotomania

A

belief that someone is in love with them

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17
Q

What is Grandiosity

A

one has great unrecognized talent, ability, superiority

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18
Q

What is Jealousy

A

conviction one’s spouse id unfaithful

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19
Q

What is persecution

A

belief one is being conspired/plotted against

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20
Q

What are Somatic complaints

A

body odor, malformity, infestation

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21
Q

What are delusional parasitosis(Morgellons)

A

belief they are being afflicted with living organisms or other pathogens

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22
Q

What is Schizoaffective disorder

A

Psychotic + mood disorder; episode of mania/major depression, concurrent with delusions, hallucinations, or disorganized speech; psychotic symptoms persist after the mood episode ends, more in women

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23
Q

What is Schizophrenia major symptom categories

A

used to describe different classes of symptoms

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24
Q

What is positive symptoms

A

Delusions, capagras syndrome, hallucinations, thought disorder, psychomotor disturbance

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25
Q

What are delusions

A

false belief; protective misinterpretations of reality, disturbances of thought content

26
Q

What some example of delusions

A

grandeur, external source controlling thoughts or feelings, thoughts being shared with the outside world(thought broadcasting), persecutions, you are being referred to by events that have nothing to do with you(reference), someone is stealing thoughts(thought withdrawal

27
Q

What is capgras’ syndrome

A

Delusional existence of doubles who replace SOs, seen most in brief intense psychotic episode

28
Q

What are hallucinations and the types

A

sensory experience in the absence of any environmental stimulus
auditory(most common, usual critical), visual, olfactory(smelling), tactile(feelings), gustatory(tasting)

29
Q

What is thought disorder

A

disturbances in the thinking process/strange use of language

30
Q

What are the types of thought disorder

A

blocking(interruptions in speech), loose associations(cognitive slippage; logical thought/speech), incoherent speech(word salad, disorganized and fragmented), clang associations(illogical assoications in speech baed on sound, rhyming), Neologisms(new words made with no agreed-upon meaning, inability to find real words to describe a thought)

31
Q

What is a psychomotor disturbance

A

disturbances in motor activity; extremes in activity levels, peculiar body movements/posture, strange gestures/grimaces, excited vs. withdrawn catatonia
waxy flexibility=catatonic person can be shaped in strange positions

32
Q

What negative symptoms

A

Avolition(inability to take action), alogia(lack of meaningful speech), asociality(lack of interest in meaningful relationships), restricted affect(little/no emotion), anhedonia(inability to experience pleasure)

33
Q

What is a primary symptom

A

arises from disease itself

34
Q

What is secondary symptoms

A

develops in response to the treatment

35
Q

What are the risk factors for having negative symptoms

A

poor premorbid social functioning, restricted affect, and lack of insight into one’s condition, more common in males

36
Q

What cognitive symptoms

A

often severe impairments, poor executive functioning(ability to organize/sequence things), inability to sustain attention, difficulty retaining learned info

37
Q

What is type 1 schizophrenia

A

mostly positive symptoms; respond better to psychoactive medication, better functioning premorbid histories

38
Q

What is type 2 schizophrenia

A

primarily negative symptoms, more chronic and long-term institutionalized(structural brain damage), 15-25% of schizo, more common in men

39
Q

What is the DSM citerion clusters

A

A: 2+ for significant portion of one month; one must be 123
-delusions
-hallucinations
-disorganized speech
-disorganized/catatonic behavior
-negative symptoms
B: social/occupational dysfunction
C: 6month duration
D: Rule out other psychotic/mood disorder
E: Rule out SUD
F: if there is history of autism, diagnosed only if prominent hallucination delusions for at least 1 month

40
Q

What is the 3 phases for schizo

A

Prodromal—–>active—–> residual

41
Q

What is Prodromal Phase

A

right before active psychotic symptoms start; gradual deterioration of function, can be sudden, deficits in personal hygiene, odd behaviors

42
Q

What is the active phase

A

displays psychotic symptoms; highest risk age is early 20s

43
Q

What is the residual phase

A

After active psychotic phase, complete remission, or return to prodromal symptoms(more common); 2/3 of schizophrenics face relapses(return to active phase) occur when face with life stressors

44
Q

What are favorable factors(protective)

A

fewer negative symptoms, history of good work performance(prior to active phase), ability to live independently, less depression/anxiety, positive peer support

45
Q

What is the biology of etiology for schizophrenia

A

20 genes, 16% mother/son, 4% aunt/niece, 1% general population
Endophenotypes, neuro structures, neurotransmitters, Twin concordance

46
Q

What are endophenotypes

A

quantifiable traits(working memory, executive function, sustained attention, verbal memory)

47
Q

What are neurostructures

A

Smaller cortical structures, enlarged ventricles(the cavities containing cerebral spinal fluid), and differences in brain structure between individuals with/without schizophrenia are relatively small, usually are type 2, and don’t respond as well to medication
abnormalities may result from antipsychotic medication

48
Q

What are neurotransmitters

A

Dopamine Excess theory(type 1 theory)= phenothiazines reduce dopamine levels, amphetamines + amphetamines psychosis: increase dopamine and can cause schizophrenic symptoms

49
Q

What is the twin concordance

A

Less than 50%, nonshared environmental influences also play a role; diathesis stressor model=offspring that had a poor premorbid adjustment and appear to have a higher genetic risk

50
Q

What are the risk/protective factors for schizophrenia

A

severe maternal physical abuse before 12, level of parental warmth/support, severe bullying, negative family relationships, EE

51
Q

What is the expressed emotion(EE)

A

family theory, high levels of expressed verbal criticism + emotional overinvolvement toward schizophrenic members; high EE=likely relapse

52
Q

What are the psychological risk factors

A

cocaine, amphetamines, alcohol, cannabis
unusual beliefs/behaviors preceding onset of psychotic symptoms

53
Q

What are the sociocultural factors

A

earlier in men
shifts in mid 40-50, more women diagnosed(menopause), likely due to estrogen protective effects
risk factors: low parental educational level, low occupational status of father, living in poor residential areas at birth

54
Q

Who is Carol Tamminga

A

psychosis as a learning and memory disorder
looked for a neurobiological basis for thought disorder among active schizophrenics
schizophrenics have hippocampal hyperactivity
anti-psychotic meds decrease dopamine—-> decreased hippocampal activity
exploring direct current stimulation of the hippocampus in active schizophrenics
optimal function is a combination of medication and psychosocial inteventions

55
Q

What is the hippocampal hyperactivity hypothesis

A

leads to false memories/cognitions
hippocampus=episodic memory; consolidates/integrates facts and events
in active schizophrenics, hippocampal tissue deterioration, elevated hippocampal neural activity (compensatory), decreased hippocampal connectivity to the cortex

56
Q

What is the best treatment

A

antipsychotic medication +psycho treatment

57
Q

How good are antipsychotic medication

A

most effective on positive symptoms(type 1), negligible effect on negative symptoms, new drugs not confirmed to work better and are more costly

58
Q

What are the extrapyramidal(side) effects of new and old drugs

A

symptoms: restlessness, involuntary movements, muscular tension
effects: parkinsonism(muscle tremors, shakiness), dystonia(slow contrasting movement), akathesis(motor restlessness), neuroleptic malignant syndrome(muscle rigidity), tardive dyskinesia(rhythmic tongue movement)

59
Q

What are some Inpatient treatments

A

large group psychosocial skills training, behavior function
community group homes: behavioral transitional facilities; token economy

60
Q

What does CBT do for schizophrenics

A

focus on reducing positive/negative symptoms+teach coping skills

61
Q

What does mindfulness training do

A

accepting symptoms/hallucinations in a nonjudgemental manner, enhance self-control, reduce negative symptoms

62
Q

How can the family help

A

normalize the family experience, educate family members, teach the family to cope with symptoms, strengthen communication
emotional reactions to the MI: love, loss, anger, fear

Abnormal Psych 355 (8 decks)

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