Chapter 12 in class notes Flashcards
3 clusters
1)
2)
3)
1) Positive (adding)
2) Negative (subtracting)
3) Disorganized
“Positive” Symptom Cluster
A) Positive means _
B) ____ even though no trigger
C) ____ = believes something in spite of all evidence
A) “addition” - magnification of normal
B) Hallucinations. Not based in reality
C) Delusions
Hallucination types (Acronym: AVSO)
1) A___
2) V___
3) S___
4) O___
Which is most common?
1) Auditory (voices though no one is there)
2) Visual (sees things though nothing there)
3) Somatic (feels things on skin/in body - i.e. bugs)
4) Olfactory (smell something that doesn’t exist - fire, scent upsetting)
Most common is Auditory. Visual is 2nd.
Delusions (Acronym: PGS)
1) P__
2) G__
3) S__
Which is most common?
1) Persecutory – paranoid. (i.e. Someone is following them. FBI listening to calls etc.)
2) Grandiose – false belief that one has great power (i.e. can control nature/weather)
3) Somatic – belief that some part of body is diseased. (i.e. man who put hand in blender)
Most common: Persecutory
Persecutory delusion
False belief that oneself or one’s loved ones are being persecuted, watched, or conspired against by others.
Delusion of reference
Belief that everyday events, objects or other people have an unusual personal significance
Grandiose delusion
False belief that one has great power, knowledge, or talent or that one is a famous and powerful person
Delusion of being controlled
Belief that one’s thoughts, feelings, or behaviors are being imposed or controlled by an external force
Thought broadcasting
Belief that one’s thoughts are being broadcast from one’s mind for others to hear
Thought insertion
Belief that another person or object is inserting thoughts into one’s mind
Thought withdrawal
Belief that thoughts are being removed from one’s mind by another person or by an object
Delusion of guilt or sin
False belief that one has committed a terrible act or is responsible for a terrible event
Somatic delusion
False belief that one’s appearance or part of one’s body is diseased or altered
“Negative” symptom cluster
A) What does “negative” mean?
B) Spectrum of negative symptoms (4 A’s)
A) absence or insufficiency of normal behavior (less than normal – because the brain is dying)
B)
- Avolition (apathy): no free will, desire, motivation
- Alogia: absence of speech. Mutism. Poverty of speech -shrunken speech. the inability to speak because of mental defect, mental confusion, or aphasia. It is a speech disturbance that can be seen in people with dementia. However, it is often associated with the negative symptoms of schizophrenia. Alogia has been called a poverty of speech, or a reduction in the amount of speech.
- Anhedonia: lack of pleasure/passion. No enjoyment in life
- Affective flattening: vibrancy of emotion significantly reduced
Avolition
a term used to describe the lack of motivation or ability to do tasks or activities that have an end goal, such as paying bills or attending a school function. It occurs most commonly in schizophrenia, depression, and bipolar disorder. … It is considered a negative symptom.
Alogia
the inability to speak because of mental defect, mental confusion, or aphasia. It is a speech disturbance that can be seen in people with dementia. However, it is often associated with the negative symptoms of schizophrenia. It has been called a poverty of speech, or a reduction in the amount of speech.
Anhedonia
Lack of pleasure/passion. reduced motivation or ability to experience pleasure. No enjoyment in life
Affective flattening
Vibrancy of emotion significantly reduced. The person doesn’t have the full range of emotional expression that others do.
Disorganized symptom cluster:
A) S_
B) A_
C) B_
Confused or abnormal speech behavior and emotion
These are all disorganized:
A) Speech: (word salad, tangentiality/loose association)
B) Affect: improper times (i.e. laughing at a funeral)
C) Behavior: (e.g. catatonia - freeze in position)
Word Salad
a confused or unintelligible mixture of seemingly random words and phrases.
Content makes no sense, but is grammatically correct
Catatonia
freeze in position. schizophrenia symptom that sometimes occurs
Tangentiality/loose association
focus on one word and go on a tangent.
i.e. “how was your spring break?” I had a break when I was 12. I broke my leg. Daddy long leg spiders.
Schizophrenia
A pervasive type of psychosis characterized by disturbed thought, emotion, behavior.
Chronic loss of reality.
To diagnose Schizophrenia a person needs
A) 6+ months of a symptom and in at least one of those months need to have 2 symptoms from different categories (delusions, hallucinations)
B) must rule out a mood disorder
C) rule out drug causation
Mood disorder with psychosis
psychosis only shows up in extreme highs and lows. Not schizophrenia.
Psychosis and mood disorder
Psychosis outlasts the mood highs and lows.
If psychosis lasts longer than highs or lows of mood disorders - could be schizophrenia or other psychotic disorder.
Schizophrenia statistics: A) Onset male / female B) Prevalence C) Prognosis D) M:F ratio
A) Males ages 15-28. Females bimodal - 18-20 and then 40-41
B) 1%
C) Chronic
D) 1:1 across lifetimes
Schizophrenia stats - cultural factors
A) Prevalence in __ cultures. More prominent in…
B) recovery in ___ cultures
C) What’s a big factor?
A) more prominent in industrialized individualized societies.
B) Recovery is poor in industrialized individualized societies.
C) Social support. Careers are less specific in collectivist societies - farming communities. Jobs.
No forgiveness for being absent for 6months. Lose home, job, etc.
[exam] Schizophrenia M:F ratio
1:1
courses of schizophrenia
1) P
2) P
3) O
4) C
1) Premorbid
2) Prodromal
3) Onset deterioration
4) Chronic residual
What happens in the premorbid phase of schizophrenia?
and what age?
mild motor, cognitive and social impairments
0 - 12/13
What happens in the prodromal phase of schizophrenia?
and what age?
unusual psychotic-like behaviors
age 13-20
What happens in the onset deterioration phase of schizophrenia?
and what age?
positive, negative, cognitive and mood symptoms
age 20-33
What happens in the chronic residual phase of schizophrenia?
positive negative and cognitive symptoms
age 33+
When is schizophrenia treatment most effective?
When young
[exam] What’s the difference between tangent and disorganized?
tangent - nothing is incorrect. accurate info.
disorganized - not correct
[exam] What percentage of schizophrenia patients attempt suicide?
What percentage complete?
attempt: 40-50%
10-15% complete
Avolition shows up in schizophrenia in what way especially?
lack of care about grooming
Catatonic SZ is
lack of motor control. In some cases can’t stand up even if want to.
Before diagnosing schizophrenia need to rule out
everything else: drugs, medical reasons, medications, etc.
Schizophreniform DO
as soon as they get symptoms that look like schizophrenia this is the label. as soon as they hit 6 months the diagnosis changes to schizophrenia
Brief psychotic disorder
cannot exceed one month. only positive symptoms - hallucinations especially. have to rule out drugs. delusions possible. Visual and auditory
Schizoaffective DO
has psychosis. They could have a mood disorder or severe mood symptoms.
Psychosis has to occur outside of mood symptoms (when the person is at baseline i.e. when they’re bipolar I)
They have to have a mood.
When schizoaffective DO people lose mood, what is happening?
brain is dying off.
Schizoaffective eventually morphs into what DO?
Schizophrenia
Delusional DO
Can last several months to a lifetime. Once they have it, it gets engrained into who they are (confirmation bias).
a generally rare mental illness in which the patient presents delusions, but with no accompanying prominent hallucinations, thought disorder, mood disorder, or significant flattening of affect.
Causes of Schizophrenia: findings from genetic research
A) Family members can inherit ____
B) Relatedness
A) a TENDENCY for schizophrenia
B) Closer relations = higher probability (5th removed aunt not as close as sister/mother)
Twin studies and schizophrenia
A) Monozygotic (identical) twins - if one twin develops, other has ___ chance
B) Fraternal twins - if one twin develops, other has ___ chance
A) 45-50%
B) 15-20%
Separated/adopted twin studies and schizophrenia
A) Adopted monozygotic (identical) - if one gets it & they’re separated
B) If identical twins are adopted and raised in same environment (so not with their schizo parent)
C) dizygotic (fraternal) twin - if one has it the other __
A) Other still has 50% heritability
B) 50% heritability
C) can have increased OR decreased chance
with schizophrenia and environment
if predisposition is really high - environment doesn’t matter. If predisposition is low, environment matters.
SZ: Genetic, Neurological and Behavioral Markers
A) ___ genes associated
B) eye movement
A) Multiple
B) smooth-pursuit eye movement reduced for schizophrenics and relatives. Reduced ability to fluidly track objects with eyes.
smooth-pursuit eye movement
allow the eyes to closely follow a moving object
Marijuana and schizophrenia
increases the risk with already at-risk individuals. Before age of 18.
What are some negative symptoms?
A) Enl____ ____
B) H______
A) Enlarged ventricles (brain dying off)
B) Hypofrontality (less active frontal lobes)
Enlarged ventricles contribute to a___
Alogia (communication)
Hypofrontality
less active frontal lobes (degraded frontal lobe; shrinking, more dead space)
leading to Avolition. Disorganized behavior. Catatonia
What are viral infections associated with schizophrenia and where are they commonly located?
brain eating bacterias.
3rd world countries
[exam] Dopamine hypothesis
drugs increasing dopamine = more schizo symptoms.
drugs decreasing DA (antipsychotic drug to decrease dopamine) = more parkinson’s symptoms
In regards to schizophrenia, stress/anything high in intensity can _______
activate vulnerability. It will not CAUSE schizo.
[exam] Stress can cause a psychotic break in and of itself. What’s the distinction between schizophrenia and PTSD?
PTSD is from a life-threatening trauma.
In regards to families, what is one factor associated with relapse of schizophrenia?
High expressed emotions. Correlational not causal.
schizophrenogenic mother definition
- cold dominating mother
- feelings of guilt/shame and withdrawal from reality
Treatments for Schizophrenia
Antipsychotics (neuroleptics) treat ____
Positive symptoms only. Start with targeting dopamine.
Tardive dyskinesia
side effect of antipsychotic medications. These drugs are used to treat schizophrenia and other mental health disorders.
causes stiff, jerky movements of your face and body that you can’t control.
Schizophrenia compliance with medication
low/poor.
usually on a muscle relaxant - leads to less voluntary motor control
antipsychotic
Are psychosocial treatments alone enough for schizophrenia?
No, they need to be in conjunction with medication
The only psychosocial treatment that helps schizophrenia is ___
behavioral treatments
community care programs help schizophrenia individuals
integrate back into community. Play chess, reading groups. Pace at their level.
Embedded in - get individuals in at least 1x/week to help increase medication compliance, suicide prevention
Social and living skills training for SZ individual
depending on when they developed 1st psychotic break. Sharing, fair play, communication, manage finances, etc.
SZ behavioral family therapy aims to
help individuals integrate back into family life. Help family communicate without being extreme. (low expressed emotions)
SZ vocational rehabilitation
teaching them skills so they can get a job. Animals, peace corp.
[exam] what percentage of crimes are committed by mentally ill?
1%
