Chapter 9 - Schizophrenia Flashcards

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1
Q

Heterogeneity

A

Tendency for people with disorder to differ from each other in symptoms, family, personal background, response to treatment and ability to live outside the hospital

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2
Q

What is the first formal onset of first episode of schizophrenia?

A

development of psychotic/positive symptoms

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3
Q

What is the age onset?

A

15-45 years of age

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4
Q

How do the symptoms show up?

A

can be gradual or abrupt

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5
Q

what is the gender differences in developing the disorder

A

equal rates in both men and women

if disorder develops after 45 years of age, more common in women

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6
Q

is schizophrenia a relapsing disorder?

A

yes, and tends to be chronic

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7
Q

What groups is schizophrenia most common in?

A

lower socio-economic groups - developing countries

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8
Q

ratio of recovery

A

1/7 patients

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9
Q

positive symptoms

A

exaggerated, distorted adaptions of normal behaviour

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10
Q

what are examples of psychotic/positive symptoms

A

hallucinations, delusions, thought and speech disorder, catatonic behaviour, grossly disorganized

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11
Q

negative symptoms

A

absence or loss of typical behaviours and experiences

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12
Q

what are examples of negative symptoms

A

avolition, alogia, anhedonia, associality

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13
Q

avolition

A

loss of motivation

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14
Q

alogia

A

speaking loss

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15
Q

anhedonia

A

inability to feel pleasure/lack of emotional responsiveness

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16
Q

hallucination

A

Perception like experiences that occur without external stimuli - auditory is most common

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17
Q

delusions

A

Fixed beliefs that don’t change even in light of conflicting evidence

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18
Q

persecutory delusions

A

paranoid delusions - individuals believe that they are being pursued or targeted for sabotage, ridicule, or deception (ex. strangers on street are undercover agents)

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19
Q

referential delusions

A

a belief that events, objects, or other individuals have personality relevant meaning (ex. songs that a DJ is playing have special meaning in life)

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20
Q

somatic delusions

A

perception of a change or disturbance in personal appearance or bodily function (ex. aliens in body causing headaches)

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21
Q

religious delusions

A

unusual religious experiences or beliefs (ex. Satan is leaving messages for me via TV)

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22
Q

grandiose delusions

A

possession of special or divine powers, abilities, or knowledge (ex. “I have the power to change the course of history”)

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23
Q

affective flattening

A

negative symptom - a lack of emotional expressiveness, failing to convey any feeling in their face, tone of voice, or body language

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24
Q

what symptoms are involved with schizophrenia?

A

1) delusions
2) hallucinations
3) disorganized speech
4) grossly disorganized or catatonic behaviour
5) negative symptoms - ex. alogia, anhedonia, avolition etc.

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25
Q

how long must these symptoms be present?

A

1 month active period - 1 out the 3 symptoms (delusions, hallucinations, disorganized speech) and the other can be anything - total of two, and a total of 6 month period with disturbance inclusive of 1 month active period

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26
Q

disease markers

A

biological or behavioural traits or features of an individual that reliably reflect the presence of a medical or psychiatric disease or a predisposition to develop such a disease

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27
Q

endophenotypes

A

Stable and enduring trait of the disorder that occurs before the onset of symptoms ex. Eye tracking and deficits on performance tests in schizophrenics

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28
Q

Schizophrenogenic

A

the unsupported theory that cold and rejecting behaviour causes schizophrenia

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29
Q

collective unconscious

A

the concept that symbols and myths are shared among people in a culture but remain beneath awareness - ex. swinging penis

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30
Q

social drift

A

the tendency for people vulnerable to schizophrenia to “drift” down to lower social and economic levels

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31
Q

hypokrisia

A

biological diathesis that occurs throughout the brain making nerve cells abnormally reactive to incoming stimulation

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32
Q

cognitive slippage

A

information is disorganized, incoherent, and “scrambled”

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33
Q

aversive drift

A

in Meehl’s theory, the tendency for people with a genetic predisposition for schizophrenia to be perceived negatively and subjected to personal rejection, leading progressively to social withdrawal and alienation

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34
Q

schizotype

A

suffer from “primary” cognitive slippage, difficulty feeling pleasure, social alienation, and other consequences of aversive drift

35
Q

vulnerability

A

diathesis - hereditary

36
Q

disorder-promoting events

A

stress - environmental

37
Q

neuropsychological tests

A

activate and depend on frontal region of brain - impairment on this test supports hypothesis that frontal brain is defective in the disorder

38
Q

FAS technique

A

20-25 words that began with F,A,S in 3 one minute trials - results showed that schizophrenic patients produced fewer words than healthier people

39
Q

Wisconsin Card Sorting Test

A

shown 4 key cards and patient is asked to match each card out of a deck of cards to a key card - results showed is easier for healthy people and schizophrenic patients make more mistakes and frequent mistakes

40
Q

brain structure in schizophrenics (CT/MRI)

A

larger ventricles, reduced grey matter volumes

41
Q

blood flow in schizophrenics (PET/fMRI)

A

less reduced blood flow or metabolism in the frontal region when engaged in a mental “activation” task

42
Q

Paul Meehl

A

hypokrisia , cognitive slippage, aversive drift - brain is overstimulated (too much info) causing info to be unorganized and then it interferes with how important/rewarding you find relationships

43
Q

Daniel Weinberger

A

biological vulnerability and surging stress hormones - person could inherit genetic defect that creates vulnerability for the disorder, also believed it was possible that subtle brain injuries during fetal development or birth could become a diathesis

44
Q

diathesis - stress model

A

genetic vulnerability/predisposition (diathesis) interacts with the environment/life events (stressors) to trigger behaviours or psychological disorders

45
Q

Elaine Walker

A

people with biological vulnerability for schizophrenia cannot cope with the effects of surging stress hormones on brain chemistry and begin to develop symptoms and clinical illness

46
Q

dopamine receptors hypothesis

A

dopamine is central to schizophrenia - antipsychotic drugs reduce symptoms by blocking dopamine receptors since dopamine increases activity

47
Q

insulin-coma

A

a seizure and loss of consciousness induced by administration of insulin

48
Q

psychosurgery

A

use of brain surgery to alter behaviour especially in relation to psychiatric disorders

49
Q

frontal lobotomies

A

the surgical cutting of connecting fibres within the frontal brain

50
Q

how does biological treatment help?

A

control/manage symptoms, less time in hospitals, few relapses, better life functioning

51
Q

where does biological treatment fall short?

A

discontinuation of medication, side effects, not helpful in providing occupational/daily living skills or social support

52
Q

what four elements did CBT focus on

A

1) emotional disturbances
2) psychotic symptoms
3) social disabilities
4) risk of relapse

53
Q

CBT theory

A

emotional and behavioural disturbances are influenced by subjective interpretation of life and illness experiences

54
Q

what is done in CBT therapy

A

patients are taught how to interpret correctly relevant environmental events and how to respond appropriately to social cues while interacting and communicating with other people

55
Q

results of CBT

A

gains in their psychosocial functioning, motivation and experienced reduced positive symptoms

56
Q

social skills training

A

learning-based intervention model for the development of practical social skills in schizophrenics - effective with younger patients

57
Q

CBBST

A

individual or group based treatments

58
Q

family therapy

A

conceptualizes the patient as a member of a family system and tailors treatment to the family as a whole

59
Q

prodrome

A

period before the appearance of psychotic symptoms when vulnerable adolescents often become withdrawn and suspicious

60
Q

Schizoaffective disorders

A

co-occurence of a major mood episode with schizophrenic symptoms (2 or more)

61
Q

how long must the delusions/hallucinations be present for in schizoaffective disorder?

A

2 weeks without the mood symptoms, mood symptoms are present for the majority of the total time meeting criteria for schizophrenia

62
Q

how long should the symptoms be present in schizoaffective disorders?

A

1 month period

63
Q

what is one symptom that must be present in schizoaffective disorders?

A

pervasive low mood

64
Q

what gender is schizoaffective disorders more common in?

A

females

65
Q

cannabis and psychosis

A

use is associated with twice the higher risk of psychosis

66
Q

what are the four psychotic disorders?

A

delusional disorder, brief psychotic disorder, schizophrenia, schizoaffective disorder

67
Q

how long must delusional disorder symptoms be present

A

1 month without any other psychotic symptoms

68
Q

what are some other categories that need to be met for delusional disorder

A
  • behaviour is not bizarre
  • has never had schizophrenia
  • if mood symptoms are present, they are brief compared to duration of delusions
69
Q

what are the delusional disorder types

A

erotomanic, grandiose, jealous, persecutory, somatic, mixed, unspecified, with bizarre content

70
Q

gender differences for delusional disorder

A

equally common in men and women, more prevalent in older adults

71
Q

which type of delusional disorder type is the most common

A

persecutory

72
Q

what is the most common delusional disorder type in males

A

jealous

73
Q

brief psychotic disorder symptoms

A

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior

74
Q

how long must the symptoms for brief psychotic disorder be present

A

from 1 day to a month - can occur after a severe stressor or during/after pregnancy

75
Q

gender differences for brief psychotic disorder

A

twice as common in women

76
Q

average age onset for brief psychotic disorder

A

mid-thirties, more common in developing ocuntries

77
Q

Bizzare delusion

A

Clearly implausible, not understandable, not related to real world content

78
Q

Disorganized or catatonic behaviour

A

Ranges from child like silliness to unpredictable agitation

Catatonic behaviour - negativism

79
Q

Outcomes of brief psychotic disorder

A

High risk of relapse and usually excellent outcome

80
Q

What happens if schizophrenics don’t have an insight on their disorder?

A

Non-adherence to medication, relapse, involuntary treatment, aggression, poor course of illness

81
Q

What is more associated with increased risk of aggression for schizophrenia?

A

Young makes, past history of violence, non-adherence to treatment, substance abuse, impulsivity

82
Q

Schizophrenia and age expectancy

A

10-25 years shorter lifespan for schizophrenics and 2-3x higher mortality rate than general population

83
Q

Causes of excess mortality in schizophrenia

A

1) physical illness is common but are detected later and treated poorly
2) antipsychotic medications have negative side effects
3) unhealthy lifestyle ex. Smoking
4) lifetime suicide risk

84
Q

Cognition remediation training

A

Targets cognitive skills (ex. Memory, attention), medium range effect that are maintained over time