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PSY 366 - Psychological Disorders - Test 3 > Chapter 12 - Schizophrenia and Related Disorders > Flashcards

Chapter 12 - Schizophrenia and Related Disorders Flashcards

1
Q

Psychosis

A

a loss of contact with reality

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2
Q

months symptoms have to be present

A

6 months

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3
Q

psychosis most common manifestation

A

schizophrenia

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4
Q

category for the disorders grouped with schizophrenia

A

schizophrenia spectrum disorders

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5
Q

prevalence of schizophrenia

A

1% of population

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6
Q

people worldwide with schizophrenia

A

20 million

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7
Q

people in US with schizophrenia

A

3.2 million

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8
Q

onset for men

A

23 years

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9
Q

onset for women

A

28 years

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10
Q

percent of people with schizophrenia that attempt suicide

A

25%

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11
Q

percent of people with schizophrenia that commit suicide

A

5%

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12
Q

downward drift theory

A

people with schizophrenia fall to a lower socioeconomic level or remain poor because they are unable to function effectively

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13
Q

3 groups of schizophrenia symptoms

A

positive symptoms, negative symptoms, and psychomotor symptoms

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14
Q

positive symptoms

A

excesses of thought, emotion, and behavior

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15
Q

negative symptoms

A

deficits of thought, emotion, and behavior

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16
Q

psychomotor symptoms

A

unusual movements or gestures

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17
Q

examples of positive symptoms

A

delusions, disorganized thinking and speech, heightened perceptions and hallucinations, and inappropriate affect

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18
Q

delusions

A

ideas they believe wholeheartedly but have no basis in fact

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19
Q

kinds of delusions

A

delusions of persecution, of reference, of grandeur, and of control

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20
Q

most common kind of delusion

A

delusions of persecution

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21
Q

delusions of persecution

A

believe they are being plotted against, spied on, slandered, threatened, attacked, or deliberately victimized

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22
Q

delusions of reference

A

attach special and personal meaning to the actions of others or to various objects or events

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23
Q

delusions of grandeur

A

believe themselves to be great inventors, religious saviors, or other specially empowered persons

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24
Q

delusions of control

A

believer their feelings, thoughts, and actions are being controlled by other people

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25
Q

disorganized thinking and speech

A

unable to think logically or may speak in peculiar ways

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26
Q

collective name for disorganized thinking and speech

A

formal thought disorders

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27
Q

examples of formal thought disorders

A

loose associations, neologisms, perseveration, and clang

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28
Q

loose associations

A

shift from one topic to another without any of it making sense

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29
Q

another term for loose associations

A

derailment

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30
Q

perseveration

A

repeat words and statements again and again

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31
Q

neologisms

A

made up words that typically only have meaning for those using them

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32
Q

clang

A

speak in rhymes to express oneself

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33
Q

word salad

A

random words that have no meaning

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34
Q

hallucinations

A

perceptions that a person has in the absence of external stimuli

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35
Q

most common kind of halluctination

A

auditory hallucination

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36
Q

auditory hallucination

A

hearing sounds or voices that are not real

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37
Q

kinds of hallucinations

A

auditory , tactile, somatic, visual, gustatory, olfactory

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38
Q

tactile hallucinations

A

involving touch: tingling, burning, electric shock

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39
Q

somatic hallucinations

A

feel something is happening inside their body

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40
Q

visual hallucinations

A

vague or distinct visions of people or objects

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41
Q

gustatory hallucinations

A

food or drink taste strange

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42
Q

olfactory hallucinations

A

smell odors that no one else smells

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43
Q

Inappropriate affect

A

display of emotions that are unsuited to the situation

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44
Q

examples of negative symptoms

A

poverty of speech, blunted and flat affect, loss of volition, and social withdrawal

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45
Q

poverty of speech also known as

A

alogia

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46
Q

poverty of speech

A

a reduction in speech or speech content

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47
Q

blunted affect

A

display less anger, sadness, joy, and other feelings than most people

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48
Q

flat affect

A

display no emotions at all

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49
Q

loss of volition also known as

A

avolition or apathy

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50
Q

loss of volition

A

feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action

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51
Q

ambivalence

A

conflicting feelings

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52
Q

social withdrawal

A

withdraw from social environment to devote themselves to their own ideas and fantasies

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53
Q

examples of psychomotor symtpoms

A

catatonic stupor, catatonic rigidity, catatonic posturing, catatonic excitement

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54
Q

catatonic stupor

A

stop responding to their environment, remaining motionless and silent for long stretches of time

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55
Q

catatonic rigidity

A

maintain a rigid, upright posture for hours and resist efforts to be moved

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56
Q

catatonic posturing

A

assuming awkward, bizarre positions for long periods of time

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57
Q

catatonic excitement

A

move excitedly, sometimes wildly waving their arms and legs

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58
Q

percent of those with schizophrenia who experience catatonia

A

10%

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59
Q

other disorders that may have catatonia

A

major depressive disorder and bipolar disorder

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60
Q

schizophrenia course

A

late teens and mid-thirties

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61
Q

three phases of schizophrenia course

A

prodromal phase, active phase, residual phase

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62
Q

prodromal phase

A

symptoms are not yet obvious, but deterioration is already beginning

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63
Q

active phase

A

symptoms become more apparent

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64
Q

active phase trigger

A

stress and trauma

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65
Q

residual phase

A

return to a prodromal-like level of functioning

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66
Q

percent of patients who recover completely from schizophrenia

A

25%

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67
Q

times when symptoms are worse

A

times of stress

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68
Q

percent of cases dominated by positive symptoms

A

80-85%

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69
Q

percent of cases dominated by negative symptoms

A

15-20%

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70
Q

name for schizophrenia focused on positive symptoms

A

Type I schizophrenia or excess schizophrenia

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71
Q

name for schizophrenia focused on negative symptoms

A

Type II schizophrenia or deficit schizophrenia

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72
Q

type of patients that were better adjusted before onset and respond to treatment better

A

Type I patients

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73
Q

diathesis-stress relationship

A

people with a biological predisposition will develop schizophrenia only if certain kinds of events or stressors are also present

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74
Q

biological views of schizophrenia

A

genetic factors, biochemical abnormalities, dysfunction brain structures and circuitry, viral problems

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75
Q

genetic factors of schizophrenia

A

more common among relatives and defects on chromosomes 1, 2, 6, 8, 10, 13, 15, 18, 20, and 22 and on the X chromosome

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76
Q

concordant

A

if both members of a pair of twins have a particular trait

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77
Q

kind of twin pair with greater chance of sharing schizophrenia

A

identical twins

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78
Q

biochemical abnormality behind schizophrenia

A

dopamine hypothesis

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79
Q

dopamine hypothesis

A

certain neurons that use the neurotransmitter dopamine fire too often and transmit too many messages

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80
Q

First group of antipsychotic drugs

A

phenothiazines

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81
Q

effect of phenothiazines on schizophrenics

A

Parkinson’s disease- like tremors

82
Q

purpose of phenothiazines

A

to lower dopamine activity

83
Q

receptors that phenothiazines bind the most strongly to

A

D-2 receptors

84
Q

receptors that second-generation antipsychotic drugs bind to

A

D-1 receptors, D-2 receptors, serotonin receptors, glutamate receptors, and GABA receptors

85
Q

Schizophrenia-related circuit

A

prefrontal cortex
hippocampus
amygdala
thalamus
striatum
substantia nigra

86
Q

pairs of structures in schizophrenia-related circuit that have low interconnectivity

A

substantia nigra - prefrontal cortex
striatum - thalamus

87
Q

pairs of structures in schizophrenia-related circuit that have high interconnectivity

A

substantia nigra - striatum
thalamus - prefrontal cortex
hippocampus - prefrontal cortex

88
Q

neurochemical prominent in the schizophrenia-related circuit

A

dopamine

89
Q

viral problems

A

exposure to viruses before birth interferes in brain development, leading to schizophrenia

90
Q

percentage of how much more schizophrenics are born in late winter

A

5-10%

91
Q

Frieda Fromm-Reichmann’s theory

A

cold and un-nurturing mothers set schizophrenia in motion

92
Q

mothers who cause schizophrenia in their children

A

schizophrenogenic mothers

93
Q

cognitive-behavioral explanations for schizophrenia

A

operant conditioning and misinterpreting unusual sensations

94
Q

operant conditioning explanation

A

people not reinforced for proper attention to social cues, so they pay attention to irrelevant cues more often (not much research support)

95
Q

misinterpreting unusual sensations explanation

A

interpretation of unreal sensations distance oneself from reality (not much research support)

96
Q

sociocultural views of schizophrenia

A

multicultural factors, social labeling, and family dysfunction

97
Q

multicultural factors

A

rates of schizophrenia differ between racial and ethnic groups because of overdiagnosis of immigrants and special stressors tied to immigration

98
Q

social labeling

A

features of schizophrenia influenced by the diagnosis itself, causing a self-fulfilling prophecy

99
Q

Family dysfunction

A

schizophrenia often linked to family stress (conflict, difficulty communicating, and too critical or overinvolved parents) and high expressed emotion

100
Q

Brain structure impacted by the schizophrenia-related circuit

A

HPA axis

101
Q

HPA axis

A

hypothalamic-pituitary-adrenal axis

102
Q

What does a dysfunctional schizophrenia-related brain circuit do to the HPA axis?

A

makes HPA axis highly sensitive to stressors, and leads to weaker immune system

103
Q

protein that causes inflammation of brain in schizophrenics

A

pro-inflammatory cytokines

104
Q

prevention techniques for schizophrenia

A

coping skills to correct oversensitive HPA axis

105
Q

treatment for schizophrenia in the first half of the 20th century

A

institutionalization in a public hospital

106
Q

goal of institutionalization

A

restraint and providing essentials (food, clothing, and shelter)

107
Q

physician who developed institutions

A

Philippe Pinel in 1793

108
Q

Pinel’s treatment’s name

A

moral treatment

109
Q

state hospitals

A

public mental institutions established as a requirement of the law

110
Q

by 1955, state hospitals had this problem

A

overcrowding and lack of funding

111
Q

back wards

A

(or chronic wards) where patients who didn’t improve quickly were placed

112
Q

techniques used for schizophrenics in institutions

A

straitjackets, handcuffs, and lobotomy

113
Q

Two new approaches developed in 1950s

A

milieu therapy and token economy program

114
Q

milieu therapy based on

A

humanistic principles

115
Q

token economy program based on

A

behavioral principles

116
Q

milieu therapy

A

give patients opportunities to exercise independence, responsibility, positive self-regard, and to engage in meaningful activities

117
Q

creator of milieu therapy

A

Maxwell Jones

118
Q

token economy program

A

patients rewarded when they behave acceptably and are not rewarded when they behave unacceptably

119
Q

tokens can get you

A

food, cigarettes, hospital privileges, and other desirable items

120
Q

cases where token economy is still used

A

community residences and in mental hospitals along with medication

121
Q

antihistamines

A

developed to fight allergies in the 1940s

122
Q

phenothiazines

A

group of antihistamines that were found to reduce psychotic symptoms

123
Q

man who discovered chlorpromazine reduced psychotic symptoms

A

Henri Laborit

124
Q

chlorpromazine trade name

A

Thorazine

125
Q

first-generation antipsychotic drugs

A

developed in 60s, 70s, and 80s. Had many negative side effects and only reduced positive symptoms

126
Q

another name for first-generation antipsychotic drugs

A

neuroleptic drugs

127
Q

percent who feel reduction in symptoms after taking antipsychotic drug

A

70%

128
Q

period when antipsychotic drugs kick in

A

weeks or up to 6 months after starting to take them

129
Q

extrapyramidal effects

A

uncontrollable movement issues caused by first-generation antipsychotic drugs

130
Q

cause of extrapyramidal effects

A

first-generation antipsychotic drugs target areas of brain that deal with motor control

131
Q

DSM’s term for extrapyramidal effects

A

antipsychotic medication-induced movement disorder

132
Q

Most common extrapyramidal effect

A

Parkinsonian symptoms

133
Q

percent of people who took antipsychotic drugs that experienced muscle tremors

A

about half

134
Q

tardive dyskinesia

A

extrapyramidal effect that appears a while after taking the drug

135
Q

percent of people who develop tardive dyskinesia by taking antipsychotic drugs

A

15%

136
Q

most effective second-generation antipsychotic drug

A

clozapine

137
Q

examples of second-generation antipsychotic drugs

A

clozapine, risperidone, olanzapine, quetiapine, ziprasidone, aripiprazole

138
Q

issue of second-generation antipsychotic drugs

A

1-1.5% Develop agranulocytosis, a fatal drop in white blood cells

139
Q

most helpful forms of psychotherapy for schizophrenia

A

CBT, family therapy, and coordinated specialty care

140
Q

two CBT treatments for schizophrenia

A

cognitive remediation and hallucination reinterpretation and acceptance

141
Q

cognitive remediation

A

improve attention, planning, and memory through cognitive tasks

142
Q

hallucination reinterpretation and acceptance

A

guiding patient to interpret hallucinations accurately, feel more control over their hallucinations, and reduce their delusional ideas

143
Q

aim of new-wave cognitive-behavioral treatment for schizophrenia

A

clients become detached and comfortable observers of their hallucinations

144
Q

impact of cognitive-behavioral therapies of rehospitalization rates for people with schizophrenia

A

50% in rehospitalization rates

145
Q

family therapy

A

provide family members with guidance and psychoeducation on the disorder

146
Q

other forms of family therapy

A

family support groups and family psychoeducational programs

147
Q

family support groups and family psychoeducational programs

A

share their thoughts and emotions, provide mutual support, and learn about schizophrenia

148
Q

coordinated specialty care

A

support clients with their cognitive issues, make sure they take their medications, and help clients find work

149
Q

when should csc be applied

A

as early as possible

150
Q

year that community programs were created

A

1963 with the Community Mental Health Act

151
Q

Community Mental Health Act

A

patients with psychological disorders were to receive a range of mental health services in their communities rather than being moved to institutions far from home

152
Q

number of patients in state institutions today

A

38,000-75,000

153
Q

pattern typical for community approach

A

“revolving door” - patients come in and out repeatedly

154
Q

a leading community approach

A

assertive community treatment

155
Q

assertive community treatment

A

provides much of the same things as csc

156
Q

coordinated services

A

coordination of the different community mental health services available to the client

157
Q

community mental health centers

A

facilities that would supply medication, psychotherapy, and inpatient emergency care to people with sever disturbances

158
Q

those who benefit most from coordination of services

A

clients who display both a severe mental disorder and a substance use disorder

159
Q

another name for condition of having a severe mental disorder and a substance use disorder

A

mentally ill chemical abuse (MICA) or dual diagnosis

160
Q

short-term hospitalization

A

stay in a mental hospital or a general hospital’s psychiatric unit for a few weeks

161
Q

aftercare

A

a general term for follow-up care and treatment in the community

162
Q

partial hospitalization

A

day centers that are in between full hospitalization and outpatient therapy

163
Q

day centers (or day hospitals)

A

all-day programs in which patients return to their homes for the night

164
Q

what happens in day centers

A

daily supervised activities, therapy, and training to improve social skills

165
Q

semihospital or residential crisis center

A

hourses or other structures in the community that provide 24-hour nursing care for people with severe mental disorders

166
Q

supervised residences

A

for people who don’t need hospitalization but cannot live alone/with family

167
Q

examples of supervised residences

A

halfway houses / crisis homes / group homes

168
Q

number of people who stay in halfway houses

A

1-2 dozen people

169
Q

live-in staff of halfway houses

A

paraprofessionals

170
Q

paraprofessionals

A

lay people who receive training and ongoing supervision from outside mental health professionals

171
Q

philosophy of halfway houses

A

milieu therapy philosophy

172
Q

goal of occupational training and support

A

employment brings companionship and order to one’s life

173
Q

sheltered workshop

A

a supervised workplace for employees who are not ready for competitive or complicated jobs

174
Q

state of occupational training in the US

A

not consistently available

175
Q

supported employment

A

vocational agencies and counselors help clients find competitive jobs in the community and provide psychological support while the clients are employed

176
Q

percent of people with severe psychological disorders that are not employed in the competitive job market

A

more than 80%

177
Q

issues with community treatment

A

poor coordination of services and a shortage of services

178
Q

percent of people a year who don’t get treated for their schizophrenia

A

at least 36% of people every year

179
Q

poor coordination of services

A

the various mental health agencies in a community often fail to communicate with one another

180
Q

way in which community therapists address the issue of poor coordination of services

A

community therapists may act as case managers

181
Q

case managers

A

try to coordinate available services, guide clients through the community system, and help protect clients’ legal rights

182
Q

key to success for a community program

A

effective case management

183
Q

shortage of services

A

the number of community programs available to people with severe mental disorders falls short

184
Q

economic reason for the shortage of services

A

plenty of funding for mental health, but it is not directed to community treatment programs

185
Q

brief psychotic disorder

A

schizophrenia symptoms, but lasts less than a month

186
Q

schizophreniform disorder

A

schizophrenia symptoms, but lasts 1-6 months

187
Q

schizoaffective disorder

A

schizophrenia symptoms along with a major depressive episode or manic episode

188
Q

schizoaffective disorder duration

A

at least 6 months

189
Q

delusional disorder

A

delusions without other symptoms of schizophrenia for at least one month

190
Q

reasons why minorities don’t get proper treatment for schizophrenia

A

poverty-linked factors
transportation issues
inadequate health insurance
bias
discrimination
negative attitude toward mental health services by minorities

191
Q

percent who get alternate institutional care

A

8%

192
Q

examples of alternate institutional care

A

nursing home

193
Q

percent who are places in privately run residences that are supervised by untrained staff

A

18%

194
Q

examples of privately run residences

A

foster homes, boardinghouses, and care houses

195
Q

percent who live in totally unsupervised settings

A

34%

196
Q

an example of a totally unsupervised setting that some people with schizophrenia unfortunately live in

A

single-room occupancy hotels (SROs) or rooming houses

197
Q

out of the 565,000 homeless in US, how many have schizophrenia?

A

140,000

198
Q

number of people with sever mental disorders in prison

A

440,000

199
Q

percent of inmates who have schizophrenia or another severe mental disorder

A

20%

200
Q

national interest group in US that advocates for community treatment programs

A

National Alliance on Mental Illness (NAMI)

201
Q

year NAMI was founded

A

1979

202
Q

shared psychotic disorder

A

when two or more persons share a delusion or hallucination

PSY 366 - Psychological Disorders - Test 3 (8 decks)

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