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Abnormal Psychology > Chapter 13 > Flashcards

Chapter 13 Flashcards

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1
Q

Psychosis

A

significant loss of contact with reality

– Hallmark of schizophrenia

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2
Q

Epidemiology schizophrenia

A
  • Lifetime prevalence just under 1%
  • Onset: ages 18-30
  • More common and more severe in men
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3
Q

Delusions

A

are an erroneous belief that is fixed and firmly

held despite clear contradictory evidence

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4
Q

hallucination

A

A hallucination is a sensory experience that seems real
to the person having it, but occurs in the absence of any
external perceptual stimulus
– Can occur in any sensory modality
– Auditory are most common

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5
Q

Disorganized Speech

A

• Disorder in thought form
– Delusions are a disorder of thought content
• Fail to make sense even though they are using language
in a conventional way

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6
Q

Catatonia

A

• Catatonia involves almost no movement at all,
sometimes in an unusual posture
• Catatonic stupor a virtual absence of all movement and
speech

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7
Q

Disorganized Behavior

A

• Impairment of goal-directed activity
• Occurs in areas of daily functioning
– Examples: hygiene, silliness or unusual dress

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8
Q

Positive symptoms

A

excess or distortion in normal

behavior and experience

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9
Q

Negative symptoms

A

reflect an absence or deficit of
normally present behaviors
– Two domains:
– Reduced expressive behavior and Reductions in motivation or experience of pleasure
– Presence of negative symptoms is not a good sign

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10
Q

Avolition

A

the inability to initiate or persist in goal-directed activity

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11
Q

Reduced expressive behavior

A

▪ Voice, facial expression, speech

▪ Blunted or flat affect, or alogia (little speech)

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12
Q

Reductions in motivation or experience of pleasure

A

includes Avolition

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13
Q

Schizoaffective Disorder

A
  • Features of schizophrenia and severe mood disorder

* Diagnostic criteria revised in DSM-5 to improve reliability

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14
Q

Schizophreniform Disorder

A
  • Schizophrenia-like psychoses lasting at least 1 month but less than 6 months
  • Do not warrant a schizophrenia diagnosis
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15
Q

Delusional Disorder

A

• Delusional beliefs with otherwise normal behavior

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16
Q

Brief Psychotic Disorder

A

Sudden onset of psychotic symptoms or disorganized

speech or catatonic behavior

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17
Q

Genetic Factors schizophrenia

A

• Disorders of the schizophrenia type are “familial”—tend
to run in families
– The prevalence of schizophrenia in the first-degree relatives
(parents, siblings, and offspring) is 10 percent
– Second-degree relatives who share only 25 percent of their
genes is closer to 3 percent

TWIN STUDIES
• Schizophrenia concordance rates for identical twins (28%) are
higher than those for fraternal twins or ordinary siblings (6%)
– If only genetic, the rate would be 100% between identical twins
– Genes are not the whole story
ADOPTION STUDIES
• Higher rates of schizophrenia among adopted children of
schizophrenic biological parents

18
Q

other biological factors schizophrenia

A

Prenatal Exposures
VIRAL INFECTION

RHESUS INCOMPATIBILITY

PREGNANCY AND BIRTH COMPLICATIONS

EARLY NUTRITIONAL DEFICIENCY

MATERNAL STRESS

A Neurodevelopmental Perspective
• The stage is set for schizophrenia early in life
– Problems may not appear until the brain is mature
• Research focuses on those showing prodomal—very
early signs of schizophrenia

19
Q

VIRAL INFECTION schizophrenia

A

• Elevated rates of schizophrenia in children born to
mothers who had been in their second trimester of
pregnancy at the time of the influenza epidemic

20
Q

RHESUS INCOMPATIBILITY

A

• Mechanism involves oxygen deprivation, or hypoxia—risk
for schizophrenia linked to birth complications
• Rh-incompatibility between the mother and fetus may
increase the risk of brain abnormalities

21
Q

PREGNANCY AND BIRTH COMPLICATIONS

A

• Many delivery problems (breech delivery, prolonged
labor, or the umbilical cord around the baby’s neck) affect
the newborn’s oxygen supply

22
Q

EARLY NUTRITIONAL DEFICIENCY

A

• Schizophrenia might be caused or triggered by

environmental events

23
Q

MATERNAL STRESS

A

• Extremely stressful event late in 1st trimester/early in 2nd
trimester of pregnancy increases schizophrenia risk

24
Q

A Neurodevelopmental Perspective

A

• The stage is set for schizophrenia early in life
– Problems may not appear until the brain is mature
• Research focuses on those showing prodomal

25
Q

prodomal

A

very

early signs of schizophrenia

26
Q

Neurocognition: schizophrenia

A

• Cognitive impairment is a core feature of schizophrenia

– Apparent even before there is a diagnosable illness

27
Q

Social Cognition

A

• Social cognition: how we recognize, think about, and

respond to social information, including the emotions and intentions of others

28
Q

social cognition: schizophrenia

A

• People with schizophrenia show significant impairments
in social cognition
– Failure to spot the kinds of subtle (or not so subtle) social hints
– Difficulty recognizing emotion in faces and emotion being
conveyed in speech

29
Q

brain volume: schizophrenia

A

Patients with schizophrenia have enlarged brain
ventricles
– Males more affected than females
– Indicator of a reduction in brain tissue
• Decrease in brain volume is present very early in the
illness
• Progressive brain deterioration continues for many years

30
Q

affected brain areas schizophrenia

A

Reductions in the volume of regions in the frontal and
temporal lobes
– More specifically, in the volume of medial temporal areas: the
amygdala, the hippocampus, and the thalamus

31
Q

white matter problems schizophrenia

A

White matter is crucially important for the connectivity of the brain
– White matter abnormalities have been shown to be correlated
with cognitive impairments
• Patients have reductions in white matter volume as well
as structural abnormalities in the white matter itself
– Abnormalities are found in first-episode patients and in people
at genetic high risk for the disorder

32
Q

Brain Functioning schizophrenia

A

Some patients show abnormally low frontal lobe
activation (known as “hypofrontality”) when they are
involved in mentally challenging tasks
• Impaired functioning of the frontal lobes is found in
patients in the early stages of schizophrenia and in
people at high risk for developing the disorder

33
Q

cytoarchitecture

A

the overall organization of cells

in the brain

34
Q

cytoarchitecture schizophrenia

A

If cells fail to migrate properly, the brain’s cytoarchitecture will be compromised
– Increase in neuronal density in some areas of the brains of patients
with schizophrenia
• Abnormalities in the distribution of cells in the cortex and hippocampus
• Patients with schizophrenia are missing “inhibitory
interneurons”
– May be less able to regulate or dampen down overactivity in certain
neural circuits

35
Q

Neurochemistry schizophrenia

A

• Alterations in brain chemistry may be associated with
abnormal states
• Dopamine: a neurotransmitter linked to schizophrenia
– Chlorpromazine blocks dopamine receptors and help patients
– Amphetamines produce excess dopamine and mimic a
psychotic state that looks like schizophrenia
– L-DOPA treated patients display psychotic symptoms
• Glutamate: an excitatory neurotransmitter
– When glutamate receptors are blocked it creates schizophrenic like symptoms

36
Q

Families and Relapse schizophrenia

A

Expressed emotion (EE): a measure of the family
environment
• Three main elements: criticism, hostility, and emotional
overinvolvement (EOI)
• High-EE home environment more than doubles the
chance of a relapse
– Especially strong for chronically ill patients

37
Q

Clinical Outcome schizophrenia

A

• Around 38% of patients have a favorable outcome and
can be thought of as being recovered 15 to 25 years after
development of the disorder
• Around 12 percent of patients need long-term
institutionalization
• Around one-third show signs of continued negative
symptoms

38
Q

Pharmacological Approaches

A 
FIRST-GENERATION ANTIPSYCHOTICS
• Block the action of dopamine
SECOND-GENERATION ANTIPSYCHOTICS
• Fewer extrapyramidal symptoms
OTHER APPROACHES
• Researching the role of estrogen
39
Q

THE PATIENT’S PERSPECTIVE

A

• Not all patients benefit from antipsychotic medications
• May show clinical improvement but still need help
• Side effects may lead patients to discontinue taking the
medication
• Some patients may try to avoid taking medications
because, to them, needing to take medications confirms
that they are mentally ill

40
Q

Treatments and Outcomes

A 
CASE MANAGEMENT
FAMILY THERAPY
PSYCHOEDUCATION
SOCIAL-SKILLS TRAINING
COGNITIVE REMEDIATION
COGNITIVE-BEHAVIOR THERAPY

Abnormal Psychology (7 decks)

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