Chapter 11: Schizophrenia Spectrum Disorders

Question 1

Acute onset

Answer 1

Typically develops during late adolescence

Seemingly well-adjusted individual experiences a sudden onset with rapid transformation of personality and behavior.

Question 2

Chronic onset

Answer 2

Typically develops during late adolescence

Characterized by slower, more gradual decline in functioning.

Question 3

Prodromal phase

Answer 3

Characterized by subtle symptoms involving unusual thoughts or abnormal perceptions, decreased interest in social activities, difficulty in daily functioning, and impaired cognition

Question 4

Residual phase

Answer 4

Flagrant psychotic behaviors are absent, but the person is still impaired by significant cognitive, social, and emotional deficits, such as lack of motivation or apathy, and difficulties thinking or speaking clearly, and by holding unusual ideas, such as beliefs in telepathy or clairvoyance

Question 5

Identify the gender differences associated with prevalence and prognosis

Answer 5

Gender differences

Men

• Have slightly higher risk of developing disorder
• Tend to develop disorder at a younger age
• Experience greater cognitive impairment
• Experience more behavioral deficits
• Do not respond as well to drug therapy

Question 6

Positive symptoms

Answer 6

Hallucinations

Delusional thinking

Question 7

Negative symptoms

Answer 7

Lack of emotional responses

Loss of motivation

Loss of pleasure

Lack of social relationships

Limited verbal expression

Question 8

Aberrant forms of thought

Answer 8

Thought disorder: A disturbance in thinking characterized by the breakdown of logical associations between thoughts.

Positive symptoms involving breakdown in organization, processing and control of thoughts and incoherent speech.

• Poverty of speech – slow speech, limited in quantity, vague
• Neologisms – made-up words
• Perseveration – persistent repetition of words
• Clanging – stringing together words that rhyme

Question 9

What does the phrase filtering out extraneous stimuli generally mean?

Answer 9

People with schizophrenia often have difficulty filtering out irrelevant stimuli, making it nearly impossible to focus their attention, organize their thoughts, and filter out unessential information.

Question 10

What does “flat affect” mean in relation to emotional disturbances?

Answer 10

The absence of emotional expression in the face and voice.

Question 11

What are some of the features of catatonia?

Answer 11

Impaired cognitive and motor functioning.

• Maintain fixed or rigid posture
• Be unaware of the environment
• Exhibit odd gestures and bizarre facial expressions
• Become unresponsive
• Show highly excited or wild behavior
• Slow to a state of stupor
• Adopt a fixed posture positioned by others (waxy flexibility)

Question 12

Which neurotransmitter is associated with hallucinations?

Answer 12

Disturbances in brain chemistry of neurotransmitter dopamine

Question 13

Genetic factors of schizophrenia

Answer 13

The closer the genetic relationship between schizophrenia patients and family members, the greater the likelihood family members will also have schizophrenia.

Question 14

First-degree relatives and schizophrenia

Answer 14

First-degree relatives - have about a tenfold greater risk of developing schizophrenia than do members of the general population

Question 15

Identify which twin-group has a higher concordance rate for developing schizophrenia

Answer 15

Concordance rates among MZ twins (48%) is more than twice the rate among DZ twins (17%).

Question 16

Describe the dopamine hypothesis and what is classified as its supportive evidence

Answer 16

Schizophrenia involves overactivity of dopamine transmission in the brain.

Main sources of support:

• Antipsychotic drugs (neuroleptics) inhibit psychotic symptoms by reducing dopamine activity.
• Amphetamines, which increase concentration of dopamine, cause symptoms that mimic paranoid schizophrenia.

Question 17

What part of the brain is thought to influence abnormal functioning and increase risk of schizophrenia? What behavioral components are involved with this part of the brain?

Answer 17

Abnormal functioning in prefrontal cortex

• Higher-order functions, such as regulating attention, organizing thoughts/behavior, prioritizing, formulating goals.

Question 18

What system of the brain is associated with schizophrenia and associated with memory and emotions?

Answer 18

Abnormalities in brain circuitry connecting the prefrontal cortex and lower brain structures.

• Includes parts of the limbic system involved in regulating emotions and memory

Question 19

The stress and protective factors that summarize the contributors to developing schizophrenia. What model is connected to categorizing these factors?

Answer 19

Stress factors

• Prenatal trauma
• Birth complications
• Harsh, critical family environment
• Stressful life experiences

Protective factors

• Healthy communication style within family
• Nurturing family environment
• Low level of life stress
• Coping resources

Diathesis-stress model

Question 20

Antipsychotic medications (neuroleptics)

Answer 20

Helps control the more flagrant behavior patterns of schizophrenia, such as delusional thinking and hallucinations (i.e. positive symptoms), and reduces the need for long-term hospitalization.

Question 21

What are the differences between typical and atypical antipsychotic medications (hint, refer to terms used in class, “old school” and “new school/newer generation”).

Answer 21

First-generation antipsychotics

Associated with increased risk of tardive dyskinesia with long-term use:
- Involuntary movements of the face, mouth, neck, trunk, or extremities

Atypical antipsychotics
Second-generation antipsychotics

• Lower risk of tardive dyskinesia
• Side effects include risk of medical complications such as sudden cardiac death, weight gain, and metabolic disorders

Question 22

Why are atypical antipsychotics preferred over the “old school” medications?

Answer 22

They decrease the risk of tardive dyskinesia

Question 23

Psychosocial rehabilitation

Answer 23

Self-help clubs and rehabilitation centers

• Self-contained communities
• Provide social support
• Help find educational opportunities, employment, and stable housing

Multiservice rehabilitation centers
- Provide skills training

Question 24

Family intervention programs

Answer 24

Focusing on practical aspects of everyday living.

Educating family members about schizophrenia.

Teaching family how to relate to member with schizophrenia.

Training family members in communication skills.

Teaching family members problem-solving and coping skills.

Family interventions have been found to be some of the most effective for schizophrenia, particularly with keeping patients out of the hospital. Such programs have also been found to help patients maintain compliance with taking medications.