Chapter 14 - Schizophrenia and Related Disorders Flashcards
What is Schizophrenia? greek word “split mind”
A psychotic disorder in which personal, social and occupational functioning deteriorate as a result of unusual perceptions, odd thoughts, disturbed emotions, and Moto abnormalities
What is psychosis?
A state in which a person loses contact with reality in key ways. Their ability to perceive and respond to the environment becomes disturbed
What are hallucinations ?
False sensory perceptions, the experiencing of sights, sounds, or other perceptions in the absence of external stimuli
What are delusions?
A strange false belief firmly held despite evidence to the contrary
What is a MICA?
Mentally ill chemical abuser (dual diagnosis patient)
They display both a severe mental disorder, as well as a substance use disorder
What is the downward drift theory?
Theory that schizophrenia causes suffered to fall from a higher to lower socioeconomic level or to remain poor because they are unable to function effectively
What is a common belief, clinicians have about schizophrenia today?
Most believe that schizophrenia is actually a group of distinct disorders that happen to have some features in common
What are the positive symptoms of schizophrenia?
Symptoms of schizophrenia that seem to be excesses of or bizarre additions to normal thoughts, emotions or behaviours (excesses of thought, emotion and behaviour)
What are the negative symptoms of schizophrenia?
Symptoms of schizophrenia that seem to be deficits in normal thought, emotions, or behaviours
What other symptoms of schizophrenia are there?
Significant difficulties with memory and other kinds of cognitive functioning
What are the positive symptoms associated schizophrenia?
These “pathological excesses” to a persons behaviour include delusions, disorganized thinking and speech, heightened perceptions and hallucinations, and inappropriate affect
Which form of delusion is most common?
Delusions of persecution, in which they are being targeted
What are delusions of reference?
Attach special and personal meaning to the actions of others or to various objects or events
What are delusions of grandeur?
Believe themselves to be great inventors, religious saviours, or other specially empowered persons
What are delusions of control?
Believe their feelings, thoughts, and actions are being controlled by other people
What is formal thought disorder?
A disturbance in the production and organization of thought
What are the positive symptoms associated with formal thought disorder?
Loose associations, neologisms, perseveration and clang
What is loose associations (derailment)?
Most common formal thought disorder, rapidly shift from one topic to another, believing that their incoherent statements make sense
What are neologisms?
Made-up words that typically have meaning only to the person using them
What is perseveration?
They repeat their words and statements over and over again
What is clang?
A rhyme to think or express themselves
ex: “well, hell, its well to tell”
What are heightened perceptions?
The perceptions and attention of people with schizophrenia seem to intensify, they feel their senses are being flooded by all the sights and sounds that surround them
What are the tracking skills of a person with schizophrenia?
They have deficiencies in smooth pursuit eye movement, possibly because of their difficulties in attention
What is the most common form of hallucinations?
auditory hallucinations, in which they hear sounds and voices that seem to come from outside of their heads. The voice can either talk directly to them or be overheard by them
What does research suggest about people with auditory hallucinations?
They actually produce the nerve signals of sound in their brains, “hear” them, and then believe that external sources are responsible
Link between Broca’s area and auditory hallucinations?
More blood flow in Broca’s area (the region of the brain that helps people produce speech)
Link between the auditory cortex and auditory hallucinations?
PET scans show that there is heightened activity during a hallucination
Link between the front of the brain and auditory hallucinations?
The front of the brain, responsible for determining the source of sounds is quiet during hallucinations, the brain cannot recognize that the sounds are actually coming from within
What are tactile hallucinations?
May take the form of tingling, burning, or electric-shock sensations
What are somatic hallucinations?
Feel as if something is happening inside the body
What are visual hallucinations?
May produce vague perceptions of colours or clouds or distinct visions of people or objects
What are gustatory hallucinations?
Regularly find that their food or drink tastes strange
What are olfactory hallucinations?
Smell odours that no one else does
What is inappropriate affect?
Displays of emotions that are unsuited to the situation, may undergo inappropriate shifts in mood, may be a result that they are being responding to other stimuli flooding their senses
What are the negative symptoms associated schizophrenia?
“Pathological deficits”, are characteristics that are lacking in a person. Including: poverty of speech, blunted and flat affect, loss of volition, and social withdrawal
What is poverty of speech/ Alogia
Alogia is absence of or a decrease in speech (negative kind of formal thought disorder)
What is blunted affect (restricted affect)?
They display less anger, sadness, joy and other feelings than most people
What is flat affect (restricted affect)?
A marked lack of apparent emotions, showing no emotions at all
What is believed about restricted affect?
May actually reflect an inability to express emotions as others do, they may feel just as much but cannot express it
What is loss of volition (Avolition /apathy)
A symptom of schizophrenia marked by apathy and an inability to start or complete a course of action, they feel drained of energy and of interest in normal goals
What is ambivalence?
People with schizophrenia often have conflicted feelings
What is catatonia?
A pattern of extreme psychomotor symptoms, which may include catatonic stupid, rigidity, catatonic posturing and catatonic excitement
What is catatonic stupor?
Stop responding to their environment, remaining motionless and silent for long stretches of time
What is catatonic rigidity?
maintain a rigid, upright posture for hours and resist efforts to be moved
What is catatonic posturing?
Assuming awkward, bizarre positions for long periods of time
What is catatonic excitement?
A different form of catatonia, move excitedly, sometimes wildly waving their arms and legs
What is lycanthropy?
The delusion of being an animal
What are the common three phases of developing schizophrenia?
Prodromal, active and residual, may last for days or years
What is the prodromal phase?
Symptoms are not yet obvious, but the person is beginning to deteriorate, may withdraw socially, speak in vague or odd ways, develop strange ideas, or express little emotion
What is the active phase?
Symptoms become apparent. Sometimes this phase is triggered by stress or trauma
What is the residual phase?
Return to a prodromal-like level of functioning
Who is more likely to have a fuller recovery from schizophrenia?
People who functioned quite well before the disorder (good premorbid functioning)
Diagnosis of schizophrenia criteria
DSM-5 states symptoms must persist for at least 6 months or more, in at least one of those months the person must be in an active phase, marked by significant hallucinations, delusions, or disorganized speech, must be a deterioration in the person’s work, social relations, and ability to care for themselves
What is Type 1 schizophrenia?
Individual displays mostly positive symptoms, such as delusions, hallucinations, formal thought disorders
What is Type 2 schizophrenia
Individual displays mostly negative symptoms, such as restricted affect, poverty of speech, loss of volition
Which type is more likely to show improvement?
Type 1 are more likely to show improvement, especially tally when treated with medications, they also seem to have been better adjusted prior to their disorder and have later onset of symptoms.
Which other disorders are most similar to schizophrenia in severity and duration?
Schizoaffective disorder and schizophreniform disorder
What is a diathesis-stress relationship (proposed theory)?
People with a biological predisposition will develop schizophrenia only if certain kinds of events or stressors are also present
What is the biological explanation of schizophrenia?
Argue there are key roles of inheritance and brain activity in the development of schizophrenia
What do genetic studies suggest?
Studies of genetic linkage and molecular biologic have indicated possible gene defects on several chromosomes (including chromosome X) that may predispose a person to develop schizophrenia
What is a polygenic disorder?
Suggest that schizophrenia is caused by a combination of gene defects
What are the two suggest biological abnormalities (inherited genetic factors)?
Biochemical abnormalities and dysfunctional brain circuitry
What is the dopamine hypothesis? (biological abnormalities)
The theory that schizophrenia results from excessive activity of the neurotransmitter dopamine. Certain neurons that use the neurotransmitter dopamine fire too often and transmit too many messages, producing the symptoms of schizophrenia
What is L-Dopa?
Used to treat Parkinson’s disease, L-Dopa raises the dopamine activity, too much of it has shown to produce psychosis
What do second-generation antipsychotic drugs suggest?
Schizophrenia may be related to abnormal activity or interactions of both dopamine and other neurotransmitters, not just abnormal dopamine activity alone
What is said about the schizophrenia-related brain circuit?
It is not defined as being either hyperactive or hypoactive, rather it operates abnormally and the interconnectivity (flow of communication) between particular structures is excessive or diminished
What other theory is suggested to explain brain abnormalities?
Brain abnormalities may result form exposure to viruses before birth
Link between viruses and schizophrenia?
A viral infection triggers an immune system response in the mother, is passed on to the developing fetus, enters their brains and interrupts proper brain development
What is microglia?
Microglia are brain immune cells that provide a first line of defence against brain infections and inflammation. Microglia is especially active in the brains of people with schizophrenia
What is the psychodynamic explanation of schizophrenia?
In support of Sigmund Freud, Freida Fromm-Reichmann contended that cold or un-nurturing parents may set schizophrenia in motion
What is a schizophrenogenic mother?
schizophrenia-causing mothers
A type of mother, supposedly cold, domineering and uninterested in the needs of her children, who was once thought to cause schizophrenia in her child
What do self theorists (psychodynamic theorists)
Suggest that biological deficiencies cause people with schizophrenia to develop a fragmented, rather than integrated self
What is folie à deux? or shared psychosis?
When two or more persons share a delusion or hallucination
What is the cognitive-behavioural explanation of schizophrenia?
Offered two explanations, the first focusing on the behaviours of people and the second focusing on the unusual thoughts
What is the first explanation?
focusing on the behaviours of people, applies the principles of operation conditioning
What is the second explanation?
Focusing on the unusual thoughts, stresses the possible role of misinterpretations
Link between operant conditioning and schizophrenia?
The bizarre responses are rewarded with attention or other types of reinforcement, they are likely to be repeated again and again
What are erotomanic delusions?
False beliefs that they are loved by and in a relationship with the object of their attention
What is the misinterpretation explanation of schizophrenia? “A rational path to madness”
Accepts the biological position that the brains of people with schizophrenia are actually producing strange and unreal sensations -sensations triggered by biological factors- when they have hallucinations. When the individuals attempt to understand their unusual experiences, more feature of their disorder emerge. They draw incorrect and bizarre conclusions (delusions)
What is the sociocultural explanation?
Believe that multicultural factors, social labeling, and family dysfunction all contribute to schizophrenia
What are the multicultural factors?
Suggest that some racial groups are more prone to develop schizophrenia, or that clinicians are unintentionally biased in their diagnoses or misread cultural differences as symptoms of schizophrenia. Economic differences is another factor
True or false schizophrenia differs from country to country?
True in terms of the course and outcome of the disorder, but not in prevalence
Who has better recovery rates?
Schizophrenic patients in developing countries have better recovery rates than patients in western and other developed countries
What is social labeling?
Influenced by the diagnosis itself. Society assigns the lable “schizophrenic” to people who fail to conform to certain norms of behaviour. It becomes a self-fulfilling prophecy, developing the symptoms
Link between family dysfunction and schizophrenia?
Linked to family stress. Parents of people with schizophrenia display more conflict, have more difficulty communicating, are more critical of and over involved with their children
What is expressed emotion?
The general level of criticism, disapproval, and hostility toward each other and intrusion on each others privacy in a family.
What is the developmental psychopathology explanation?
Begins with a genetically inherited predisposition, the predisposition may lead to schizophrenia if, over the course of development, they experience significant life stressors, difficult family interactions, and/or other negative environmental factors
First contribution of the developmental psychopathology explanation?
Contends that schizophrenia typically begins to unfold long before the actual onset of the disorder in young adulthood. Research suggest symptoms are found in their early development
Second contribution of the developmental psychopathology explanation?
Consider the circuits impact on the operation of the hypothalamic-pituitary-adrenal stress pathway, dysfunction by the schizophrenia-related brain circuit leads to repeated over reactions by the HPA pathway in the face of stress, leave individuals highly sensitive to and unsettled by stressors throughout their development
Third contribution of the developmental psychopathology explanation?
Overreactive HPA stress pathway and chronic stress reactions lead to the development of a dysfunctional immune system, heightened inflammation throughout the brain
Fourth contribution of the developmental psychopathology explanation?
Emphasizes the advantages of prevention in dealing with schizophrenia
