Chapter 12: Schizophrenic Disorders

Question 1

What are disorders on the schizophrenic spectrum?

Answer 1

Involve psychosis, hallucinations and delusions, impaired cognitive processes, unusual or disorganized motor behavior, and uncommon behaviors affecting social interactions

Question 2

What is anosognosia?

Answer 2

An inability of those living with schizophrenia and related disorders to recognize their own mental confusion

Question 3

What are the four categories of schizophrenic spectrum disorder symptoms?

Answer 3

Positive symptoms
Psychomotor abnormalities
Cognitive symptoms
Negative symptoms

Question 4

What are the positive symptoms of schizophrenic spectrum disorders?

Answer 4

Delusions
Hallucinations
Disordered thinking
Incoherent communication
Peculiar behavior

Question 5

What are delusions?

Answer 5

False personal beliefs that are consistently held despite evidence or logic

Question 6

What are the themes of delusion?

Answer 6

Grandeur
Control
Thought broadcasting
Persecution
Reference
Thought withdrawal

Question 7

What is capgras delusion?

Answer 7

A belief in the existence of identical doubles who replace significant others

Question 8

What is pseudocyesis?

Answer 8

Women wrongly believe they are pregnant

Question 9

What are hallucinations?

Answer 9

Perception of a nonexistent or absent stimulus

Question 10

What are the cognitive symptoms of schizophrenic spectrum disorders?

Answer 10

Disorganized thinking, communication, and speech
Thought blocking: Train of thought trails off
Loosening of associations (word salad)
Continual shifting from topic to topic without apparent logical or meaningful connection between thoughts
Response to words or phrases in a very concrete manner
Moderately severe to severe impairment in executive functioning

Question 11

What are the psychomotor abnormalities in schizophrenic spectrum disorders?

Answer 11

Catatonia: extremes in activity level

Question 12

What is withdrawn catatonia?

Answer 12

Peculiar body movements or postures
May persistently resists attempts to change their positions
May exhibit a waxy flexibility, allowing their bodies to be arranged in almost any position

Question 13

What is excited catatonia?

Answer 13

Agitated, hyperactive, and lack inhibition
Loud, inappropriate laughter
Sleep little and are continually on the go

Question 14

What are the negative symptoms of schizophrenic spectrum disorders?

Answer 14

Decreased ability to initiate actions or speech, express emotions, or feel pleasure
Avolition, alogia, asociality, anhedonia, diminished emotional expression: facial expression, voice intonation, and gestures

Question 15

What is avolition?

Answer 15

Inability to take action or become goal-oriented

Question 16

What is alogia?

Answer 16

Lack of meaningful speech

Question 17

What is asociality?

Answer 17

Minimal interest in social relationships

Question 18

What is anhedonia?

Answer 18

Reduced ability to experience pleasure

Question 19

What is required to diagnose schizophrenia?

Answer 19

At least two of the following symptoms:
Delusions, hallucinations, disorganized speech, gross motor disturbance, negative symptoms
Deterioration from a previous level of functioning
Symptoms must be present most of the time for at least 1 month, and the disturbance must persist for at least 6 months

Question 20

What are the phases of schizophrenia?

Answer 20

Prodromal phase:
Teenage years usually
Onset and buildup of symptoms
Active phase:
Full-blown symptoms
Residual phase:
Symptoms no longer prominent

Question 21

What are the factors associated with a positive long-term outcome for schizophrenia?

Answer 21

Gender (women have a better outcome)
Higher levels of education
Higher level of premorbid functioning Obvious onset
Absence of family history
Short symptom duration
Positive symptoms

Question 22

What is the dopamine hypothesis?

Answer 22

Schizophrenia may results from excess dopamine activity in certain brain areas
Supported from research with three drugs
Phenothiazines: block dopamine receptor sites
L-dopa: increases dopamine levels and sometimes produces schizophrenic-like symptoms
Amphetamines: increase dopamine availability and produces symptoms similar to acute paranoid schizophrenia in non-schizophrenics

Question 23

What is used to treat schizophrenia?

Answer 23

Medications
Cognitive-behavioral therapies
Cognitive enhancement therapy

Question 24

What kind of medication is used to treat schizophrenia?

Answer 24

Antipsychotics can reduce intensity of symptoms
For example: Thorazine, First-generation antipsychotics, Atypical antipsychotics

Question 25

What are some side effects of antipsychotics?

Answer 25

Weight gain, feelings of restlessness, or excessive sedation
Enhanced risk of cardiovascular conditions
Increased risk of metabolic syndrome
Mixed effects on cognitive functioning and motivation
Extrapyramidal Symptoms: Parkinsonism (muscle tremors, shakiness, immobility), Dystonia (involuntary muscle contraction in limbs and tongue), Akathesia (motor restlessness)
Neuroleptic malignant syndrome: muscle rigidity
Tardive dyskinesia: involuntary and rhythmic tongue movement, chronic condition

Question 26

What does psychotherapeutic work with individuals with schizophrenia focus on?

Answer 26

Direct teaching of conversational, behavioral, and social skills
Social cognition and interaction training (SCIT)

Question 27

What is Work-Focused Cognitive Behavioral Therapy?

Answer 27

Increasing positive attitudes toward work, bolstering coping and problem-solving skills, and improving social interaction skills

Question 28

What is cognitive enhancement therapy?

Answer 28

Aims to ameliorate the neurocognitive deficits found in individuals with schizophrenia

Question 29

What does CBT for schizophrenia teach?

Answer 29

Teach coping skills that allow clients to manage their positive and negative symptoms
Psychoeducation and engagement
Assessment and normalization
Cognitive restructuring and identification of negative beliefs
Normalization
Collaborative analysis of symptoms
Development of alternative explanations

Question 30

What is integrated psychological therapy?

Answer 30

A computer-based program that specifically targets deficits: basic impairments in neurocognition, deficits in social cognition, impaired interpersonal skills, difficulties solving day-to-day problems
Neurocognitive and social focus results in
improvements in overall functioning, appears to help prevent return of serious illness

Question 31

What is delusional disorder?

Answer 31

Persistent delusions that are not accompanied by other unusual or odd behaviors
Common themes involved in delusional disorders include the following: Erotomania, Grandiosity, Jealousy, Persecution, Somatic complaints

Question 32

What is brief psychotic disorder?

Answer 32

Presence of one or more psychotic symptoms, including at least one symptom involving delusions, hallucinations, or disorganized speech, that continue for at least 1 day but lasts less than 1 month

Question 33

What is schizophreniform disorder?

Answer 33

Two or more of the following symptoms: delusions, hallucinations, disorganized speech, gross motor disturbances, or negative symptoms. At least one of these symptoms must involve delusions, hallucinations, or disorganized speech. This condition lasts between 1 month and 6 months

Question 34

What is schizoaffective disorder?

Answer 34

Psychotic symptoms that meet the diagnostic criteria for schizophrenia combined with symptoms of a major depressive or manic episode