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Psychology 385 > Chapter 9 - Schizophrenia > Flashcards

Chapter 9 - Schizophrenia Flashcards

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1
Q

What does it mean to say that schizophrenia is a heterogenous condition?

A
  • Means it presents in many different ways
  • Often comorbid with many other disorders
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2
Q

T/F: Social drift is common in those with schizophrenia.

A
  • TRUE
  • Can lose their jobs very quickly, end up without shelter
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3
Q

What are the common positive symptoms (i.e., exaggerated, distorted behaviour)?

A
  • Hallucinations - usually auditory (voices), associated with other symptoms (delusions)
  • Delusional belief - irrational and rigidly held beliefs by the patient against all evidence
  • Disorganized symptoms - speech, loose associations, tangentiality
  • Bizarre behaviour - catatonia, unpredictable movements, incongruity of affect and behaviour
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4
Q

What’s catatonia?

A
  • The ability to remain in odd positions for a long time
  • Very rigid positions
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5
Q

What are the negative symptoms (losses/deficits in normal functioning) found in those with schizophrenia?

A

(5 A’s)
- Avolition/apathy - lack of motivation and interest
- Anhedonia - diminished capacity to anticipate and experience pleasurable emotions
- Asociality - lack of interest in social interactions
- Alogia - poverty of speech, blocking (may want to talk, but nothing comes out)
- Affective flattening - lack of emotional expressivity, diminished facial expression

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6
Q

What are the diagnostic criteria for schizophrenia?

A
  • Must have 2 out of the five major symptom groups which include delusions, hallucinations, disorganized speech, grossly disorganized behaviour (ex. catatonia) and negative symptoms. One of them must be one of the first three listed
  • A decline in social or occupational behaviour for at least 3 months
  • Continuous signs of disturbance persist for at least 6 months
  • Mood disorders have been ruled out
  • Not due to drugs or medications, or medical condition
  • If there is autism, or another pervasive developmental disorder, then prominent hallucinations or delusions, in addition to the other symptoms of schizophrenia, must be present for at least a month
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7
Q

What are some common facts regarding the epidemiology of schizophrenia?

A
  • Lifetime prevalence is between 0.5% and 1%
  • Incidence is 1 per 10 000 per year
  • Mean age of onset is between 20 and 45 years old (don’t know why people shift)
  • 71% of patients experience their first symptoms by age 25. Treatment often starts at that time
  • Schizophrenia is associated with a 12-15 years decrease in life expectancy
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8
Q

What are the common phases associated with the course of schizophrenia?

A
  • Premorbid phase - can start in childhood/adolescence. Mild impairments in cognitive/social functioning
  • Prodromal phase - early adolescence, sub-threshold positive symptoms, comorbid mood and anxiety symptoms, functional problems
  • Psychotic phase - first-episode psychosis, meets criteria for diagnosis, late adolescence/early adult years
  • Stable phase - May start to decline slowly, others can remain stable with symptoms that persist for years
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9
Q

What % of individuals develop a severe, unremitting form of schizophrenia?

A
  • 10-15% of those diagnosed
  • Treatment resistance may develop in 1/3 of the patients
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10
Q

T/F: The course of schizophrenia over the first two years following diagnosis often predicts long-term outcomes. Some patients go into remission in the first 5 years post-diagnosis

A
  • TRUE
  • Professionals don’t know why
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11
Q

What’s the difference between functional recovery and personal recovery?

A
  • Personal recovery - Individual has a reduction in symptoms such as hallucinations and delusions
  • Functional recovery - individual returns to work and is able to socialize (much less common)
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12
Q

What are some differences between men and women concerning the epidemiology of schizophrenia?

A
  • Men and women experience the disorder equally
  • Men experience symptoms 4-5 years earlier than women, are more likely to exhibit negative symptoms and to have a chronic, deteriorating course
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13
Q

What are some of the better predictors of having a better prognosis for schizophrenia?

A
  • Being female
  • Rapid (vs. slow over time) onset
  • Predominance of positive symptoms (fewer negative)
  • Good pre-disorder functioning
  • Personal characterisics and resources (resilience)
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14
Q

T/F: There is strong support for a genetic influence in schizophrenia.

A
  • TRUE
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15
Q

What were some important genetic findings discovered by the Schizophrenia working group of the psychiatric genomics consortium?

A
  • Many of the genes involved govern the functioning of neurotransmitters such as dopamine and glutamate
  • The strongest findings concern chromosome 6, which is heavily involved in immune functioning
  • Many alleles that indicate high risk for schizophrenia also indicate high risk for bipolar disorder
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16
Q

How can schizophrenia be viewed as a neurodevelopmental disorder?

A
  • Research has shown that allele mutations, deletions, and duplications might play a role in schizophrenia, similar to autism, ADHD, and intellectual disabilities
17
Q

What has brain imaging revealed about the neuropathology concerning schizophrenia?

A
  • Abnormally reduced in overall gray matter, including reduced frontal brain volumes and frontal brain blood flow
  • Abnormalities in the left temporal lobe, which is strongly connected to the frontal lobes, the amygdalae, and the hippocampus
  • Enlargement of the ventricles, indicating a general loss of surrounding neural tissue.
    *These are not signs of the disorder
18
Q

T/F: Neuropsychological testing indicates that most people with schizophrenia are cognitively impaired, and many have low IQ.

A
  • TRUE
  • IQ may decline over time
19
Q

What’s the dopamine hypothesis?

A
  • Many drugs that stimulate dopamine (ex. LSD, cocaine) cause hallucinations
  • Recent research has emphasized dopamine dysregulation as a contributor to schizophrenic symptoms
  • Particularly, increased sub-cortical dopamine may result in the development of aberrant salience (i.e., attach importance to things that have no significance)
20
Q

How may glutamate levels be affected in those with schizophrenia?

A
  • May have lower levels of glutamate in the prefrontal cortex and the hippocampus
  • May help explain more of the negative symptoms
21
Q

T/F: Most people who are diagnosed with schizophrenia appear typical during childhood.

A
  • FALSE
  • Most show problems in childhood
22
Q

What developmental factors may contribute to schizophrenia?

A
  • Pregnancy and birth complications such as exposure to viruses, prolonged labor, preterm delivery, low birth weight, and fetal distress
  • Early signs of motor impairment, cognitive limitations, social withdrawal, and aggression
  • ACEs
23
Q

What are the cognitive problems associated with schizophrenia?

A
  • Impaired problem solving
  • Memory deficits
  • Impaired learning and word recall
24
Q

What are the different subtypes of schizophrenia?

A
  • Impaired problem solving
  • Memory deficits-memory impaired
  • Cognitively impaired
  • Cognitively normal (will have better rehabilitation)
25
Q

What psychosocial factors may contribute to schizophrenia?

A
  • Lower socio-economic strata/poverty may be a stressor
  • Urban living (surge in diagnoses coincided with the industrial revolution, may be due to abject poverty)
  • Urbanization potentially cause people are exposed to more distress
26
Q

How can family interactions contribute to the etiology of schizophrenia?

A
  • Relapse in diagnosed patients is associated with high levels of expressed emotions (i.e., negative/intrusive attitudes and behaviours directed at the patients)
27
Q

What’s potentially the best current explanation for schizophrenia?

A
  • Integrated theories between genetics and psychosocial factors
28
Q

What are different markers of vulnerability that may be observed in those with schizophrenia?

A
  • Continuous performance test (sit in front of a computer with different tasks)
  • Eye tracking dysfunction (more staccato in those with schizophrenia)
  • Wisconsin card sorting test (tests ability to make decisions/abstract thinking)
29
Q

What are endophenotypes?

A
  • Characteristic deficiencies that underly an observable symptom and have a genetic component
  • Ex. psychotic behaviour is a phenotype, but the underlying endophenotype would be lack of sensory gating and a poor working memory
30
Q

What’s the main benefit of using antipsychotic medication for schizophrenia?

A
  • They reduce the severity mostly of positive symptoms
  • Considered unethical to not administer medications to those with schizophrenia
31
Q

What’s dyskinesia?

A
  • Involuntary erratic, writhing movements of the body and face
32
Q

What’s the relapse rate for those on medication versus those who are not?

A
  • 90% relapse rate if not on antipsychotics, 40% if taking them
33
Q

What system do atypical antipsychotics target?

A
  • Mostly the serotonin system
  • Ex. Risperdal, Clorazil, Zyprexa
34
Q

What are the different types of psychosocial treatments for those with schizophrenia?

A
  • Family-oriented aftercare
  • Social skills training
  • Cognitive remediation (ex. memory skills)
  • Community-based treatment
  • CBT (especially effective in the prodromal phase
  • Institutional programs
35
Q

T/F: Many people with a genetic vulnerability to schizophrenia never actually develop the disorder

A
  • TRUE
36
Q

What are the different types of delusions?

A
  • Persecutory delusions - one is being conspired against, spied upon, or persecuted
  • Grandiose delusions - one possesses special powers, abilities, or knowledge
  • Religious delusions
  • Somatic delusions - believe that one’s body is changing
  • Referential delusions - believe that common events, objects, or other individuals hold a personally and relevant significant meaning to the person
37
Q

Hypnogogic hallucinations vs. hypnopompic hallucinations?

A
  • Hypnogogic hallucinations - occur as someone is falling asleep
  • Hypnopompic - occur as someone is waking up
38
Q

What’s source monitoring?

A
  • The ability of the brain to determine and remember whether the source of stimulation is internal or external
  • People with schizophrenia are bad at this
39
Q

What used to be a very common treatment for those with schizophrenia?

A
  • Frontal lobotomies
  • Not done anymore

Psychology 385 (9 decks)

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