Chapter 14 - schizophrenia and related disorders Flashcards

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1
Q

Schizophrenia

A
  • Though they previously functioned well or at least acceptably, deteriorate into an isolated wilderness of unusual perceptions, odd thoughts, disturbed emotions and motor abnormalities
  • 1 out of every 100 people in the world have schizophrenia
  • 21 mil people world wide
  • 3.6 mil in the U.S.
  • 25% attempt suicide : 5 % die from suicide
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2
Q

Psychosis

A

A loss of contact with reality
- Their ability to perceive and respond to the environment becomes so disturbed that they may not be able to function at home, with friends, in school, or at work

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3
Q

What are the three categories of symptoms for Schizophrenia

A
  • Positive Symptoms
  • Negative Symptoms
  • Psychomotor Symptoms
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4
Q

Positive Symptoms

A
  • “Pathological Excess”
  • Bizzare additions to a person’s behavior
  • Delusions
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5
Q

Delusions

A

Ideas that they believe wholeheartedly but that have no basis in fact

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6
Q

Formal thought disorders

A

Can cause the sufferer great confusion and make communication extremely difficult

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7
Q

Loose Associations or Derailment

A
  • The most common formal thought disorder

- Rapidly shift one topic to another, believing that their incoherent statements make sense

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8
Q

Neologisms

A

Made up words that typically have meaning only to the person using them

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9
Q

Hallucinations

A

Perceptions that a person has in the absence of external stimuli

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10
Q

Auditory Hallucinations

A
  • The most common
  • Hear sounds and voices that come from outside of their heads that may talk directly to them or may be “overheard”
  • When having these hallucinations, there is more blood flow in their Broca’s area
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11
Q

Tactile Hallucinations

A

May take form of tingling, burning or electric-shock sensations

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12
Q

Somatic Hallucinations

A

Feel as if something is happening inside of the body

- ex: rats chewing behind someone’s eyeballs so they stab themselves in the eye with an icepick

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13
Q

Visual Hallucinations

A

May produce vague perceptions of colors or clouds or distinct visions of people or objects

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14
Q

Gustatory Hallucinations

A

Regularly find that their food and drink tastes strange

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15
Q

Olfactory hallucinations

A

Smell odors that no one else does, such as the smell of poison or smoke

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16
Q

Inappropriate Affect

A

Emotions that are unsuited to the situation

- ex: crying at something that should make you happy

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17
Q

Negative Symptoms

A
  • “pathological deficits”

- Characteristics that are lacking in a person

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18
Q

What are they types of Negative Symptoms

A
  • Poverty of speech
  • Blunted and flat affect
  • Loss of volition
  • Social withdrawal
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19
Q

Poverty of Speech

A

A reduction in speech or speech content

- these people believe they have nothing or little to say or say quite a bit but convey little meaning

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20
Q

Blunted Affect

A

They display less anger, sadness, Joy and other feelings than most people

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21
Q

Flat Affect

A

Show no emotion at all

- Faces are still, eye contact is poor, and their voices are monotone

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22
Q

Loss of Volition

A
  • “avolition” or “apathy”
  • Feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action
  • People who have this have typically had schizophrenia for a while and are drained by it
  • Can also feel “ambivalence”: conflicting feelings - this makes daily ordeals like getting dressed difficult
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23
Q

Social Withdrawal

A

Withdraw from their social environment to attend to their own ideas and fantasies because their ideas are illogical and confused which withdrawal participates in helping distance them further from reality

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24
Q

Catatonic Stupor

A

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

25
Q

Catatonic Rigidity

A

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

26
Q

Catatonic Posturing

A

Assuming awkward, bizarre positions for long periods of time
- ex: holding their arm at 90 degrees for hours

27
Q

What percent of people recover completely from schizophrenia

A

25%

28
Q

When does schizophrenia appear?

A

Between late teens and early thirties

29
Q

Prodromal Phase

A

Symptoms are not yet obvious, but the person is beginning to deteriorate
- may withdrawal from society, have strange ideas, express little to no emotion, speak in vague or odd ways

30
Q

Active Phase

A

Symptoms become apparent

- usually triggered by a life stress or trauma

31
Q

Residual phase

A

The return to a prodromal-like level of functioning

  • may retain some negative symptoms such as blunted emotions but have a lessening of the striking symptoms of active phase
  • most people with schizophrenia get to this stage
32
Q

Type 1 Schizophrenia

A
  • 80 to 80 percent of cases
  • dominated by positive symptoms such as delusions, hallucinations and certain formal thought disorders
  • Usually well pre-adjusted to life and have a let onset of schizophrenia.
  • Improve with medicine
33
Q

Type 2 Schizophrenia

A
  • 15 to 20 percent of cases

- dominated by negative symptoms such as restricted affect, poverty of speech and loss of volition

34
Q

Schizophrenia spectrum disorder

A
  • many different disorders that are similar to schizophrenia
  • doctors believe most of these disorders can be treated the same way as schizophrenia
  • Schizophrenia is the most prevelent of these disorders
    ex: schizophreniform disorder
35
Q

Diathesis-stress relationship

A

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

36
Q

Genetic Factors of Schizophrenia

A

More likely to have schizophrenia if:

  • relatives have abnormal brains or schizophrenia of first degree (10%), second degree (3%)
  • Identical twins (48%) the other will have it
  • Fraternal twins (17%) the other will have it
  • biological parents are more likely to have a child with schizophrenia than the adoptive parents
37
Q

How many specific gene sites are linked to schizophrenia

A

281 to date

38
Q

How might genetic factors lead to the development of schizophrenia? (2 kinds of biological abnormalities)

A
  • Biochemical abnormalities

- dysfunctional brain chemistry

39
Q

Dopamine Hypothesis

A

Certain neurons that use the neurotransmitter dopamine fire too often and transmit too may messages, thus producing the symptoms of schizophrenia

40
Q

Anitpsychotic drugs

A

Medications that help remove the symptoms of schizophrenia

41
Q

Phenothiazines

A
  • First generation antipsychotic drug
  • discovered in the 1950’s to try to help with antihistamines
  • found it worked well with schizophrenic patients by reducing their symptoms
  • bind strongly to D-2 receptors
42
Q

Second-generation antipsychotic drugs

A
  • “atypical antipsychotic drugs”
  • More effective than first generation drugs
  • Binds to D-1. D-2, GABA, glutamate and serotonin
43
Q

What is the schizophrenia-related circuit

A
  • believed to be the circuit for schizophrenics
  • Cannot say if it is hyperactive or underactive
  • Clearly different in patients with and without schizophrenia
  • Interconnectivity between particular structures in the circuit is typically excessive or diminished in schizophrenic patients
  • may be 2 distinct subcircuits whose various structures sometimes overlap
44
Q

What does the dysfunction of the substantia nigra and striatum “subcircuit” do for schizophrenic patients

A

Responsible for positive symptoms such as hallucinations or delusions
- has prominent dopamine activity

45
Q

What does the dysfunction of the hippocampus and amygdala “subcircuit” do for schizophrenia patients

A

Responsible for negative symptoms such as flat affect and poverty of speech

46
Q

What hand do viral problems play in schizophrenia

A
  • 5 to 8 percent of children born in late winter are more prone to be exposed to viruses causing shizophrenia
  • Influenza in moms have shown children to have this disorder
47
Q

Psychological Views of Schizophrenia

A

Believe that the psychological parts of the body are huge factors

48
Q

Schizophrenogenic Mothers

A
  • “schizophrenic causing”
  • Used child to meet their own needs
  • are often cold, domineering and uninterested in their child’s needs
  • Created by Fromm-Reichmann based off Freud
  • most of society has rejected this theory because no support of research
49
Q

What are the two explanations of why cognitive-behavioralists believe people have schizophrenia

A
  • Operant conditioning

- Misinterpretations

50
Q

Operant Conditioning (cognitive-behavioral)

A
  • Process by which people learn to perform behaviors for which they have been rewarded frequently (operant conditioning definition)
  • people arent reinforced to their attention to social cues
  • at best a partial explanation for schizophrenia
51
Q

Misinterpreting Unusual Sensations (cognitive-behavioral)

A
  • in short take a “rational path to madness”
  • process of drawing incorrect and bizarre conclusions
  • people with schizophrenia have a tendency to jump to conclusions
    • ex: People will first turn to friends and family about the voices they hear, but they deny them and these people believe they are then hiding the truth. They then begin to reject all feedback and develop delusions
52
Q

What to Socioculturalists believe?

A

That multicultural factors, social labeling and family dysfunction all contribute to schizophrenia

53
Q

What race is more likely to get schizophrenia

A
  • African americans (2.1%)
  • Non-Hispanics (1.4%)
  • not clear why black people are more prone to get it than white people besides the fact that clinicians from majority groups are unintentionally biased or misread cultural differences and economic status
54
Q

Do schizophrenics in developed countries have better recovery rates than those in developing countries?

A

No, developing countries, like Nigeria, are more tolerant of hearing voices than Western developed countries

55
Q

Social Labeling

A

Society assigns the label of “schizophrenic” to people who fail to conform to certain norms of behavior. Once the label is assigned it becomes a self-fulfilling prophecy that promotes the development of many schizophrenic symptoms

56
Q

Family Dysfunction (parents influence)

A

Parents of schizophrenics often:

  • display more conflict
  • have more difficulty communicating with one another
  • are more critical of and over involved with their children than other parents
57
Q

Expressed emotion

A

members frequently express criticism, disapproval, hostility toward each other and intrude on one another’s privacy
- People trying to recover from schizophrenia are 4 times more likely to replace with this type of environment

58
Q

Developmental Psychopathology view

A

The theorists contend that the road to schizophrenia begins with a genetically inherited predisposition to the disorder which is expressed by a dysfunctional brain circuit
- similar to diathesis-stress relationship

59
Q

Dysfunctional Immune system

A
  • characterized by heightened inflammation throughout the brain
  • Caused by overreactive HPA stress pathway and chronic stress reactions