Chapter 9: Schizophrenia Flashcards
Schizophrenia (term translate as )
schizo: split
phrenia: mind
Schizophrenia
Influences the way a person thinks, feels, and behaves
Disordered thinking
Ideas not logically related
Faulty perception and attention
Lack of emotional expressiveness
A blunted affect
Mood incongruent affect – the way a person feels is not the way they feel
Disturbances in movement or behavior
Widespread disruptions in life:
Maintaining jobs, living independently, having close relationships
Onset typically in late adolescence/early adulthood
Men diagnosed at a slightly earlier age
Often experience several acute episodes with less severe symptoms between episodes
Three major clusters of symptoms:
Positive : hallucinations and delusions, an addition to what normally experience in life
Negative :taking away things normally experience in life. Subtracting it
Disorganized : seen a lot in verbal communication, person appears to be very confident in what they are talking about, jumping from one sentence to the next
Delusions
-types of delusions
-a Positive Symptom
Beliefs contrary to reality
Firmly held despite disconfirming evidence
Types of delusions: Thought insertion Thought broadcasting Feelings or behaviors are controlled by external force Grandiose delusions Ideas of reference
Hallucinations
-a Positive Symptoms
Sensory experiences in the absence of sensory stimulation
Most often auditory and visual
Hearing thoughts spoken by another voice
Voices arguing or commenting on behavior
People who have auditory hallucinations may misattribute their own voice as someone else’s voice
Negative Symptoms
behavioral deficits in motivation, pleasure, social closeness, and emotion expression
Endure beyond an acute episode
Have profound effects on the lives of people with Schizophrenia
Strong predictor of a poor quality of life
Representing two domains:
Motivation and pleasure: Motivation, emotional experience, sociality
Expression domain: Outward expression of emotion, vocalization
5 Types of Negative Symptoms ***
Avolition: Lack of motivation; apathy
Asociality: Little interest in being around others and close relationships
Anhendonia: Inability to experience pleasure
Appears to be in anticipating pleasure, not experiencing pleasure in the presence of pleasurable things
Blunted affect: Lack of outward expression of emotion
Alogia: Significant reduction in speech
Avolition def
Avolition: Lack of motivation; apathy
a type of negative symptom
Anhendonia:
Anhendonia: Inability to experience pleasure
Appears to be in anticipating pleasure, not experiencing pleasure in the presence of pleasurable things
-a negative symptom
Disorganized speech (formal thought disorder)
Disorganized speech (formal thought disorder)
- Problems in organizing ideas and in speaking coherently
- Loose associations (derailment)
- Difficulty sticking to one topic
Neologism
-falls under the loose associations of disorganized speech.
a word that does not exist – makes it up
(it sounds like a made up word haha)
disorganized symptoms
disorganized speech and disorganized behavior
Disorganized behavior
Difficulty organizing behaviors and conforming to community standards
- Catatonia
- Peculiar, increased, repeated gestures or immobility
- Seldom seen today due to effective medications
DSM-5 Criteria: Schizophrenia
Two or more of the following symptoms for at least 1 month; one symptom should be either 1, 2, or 3:
(1) delusions
(2) hallucinations
(3) disorganized speech
(4) disorganized (catatonic) behavior
(5) negative symptoms (diminished motivation or emotional expression)
Functioning in work, relationships, or self-care has declined since onset
Signs of disorder for at least 6 months; or, if during a prodromal or residual phase, negative symptoms or two or more of symptoms 1-4 in less severe form
Do you need negative symptoms present to give a dx of schizophrenia?
YES
Medications: First-Generation Antipsychotics
Reduce positive and disorganization symptoms
Little or no effect on the negative symptoms
- 30% of people don’t respond
- Many stop quit due to side effects
Maintenance dosages help to prevent relapse
*Side Effects
Sedation, dizziness, restlessness, sexual dysfunction
Extrapyramidal side effects (e.g., tremors, shuffling gait)
Tardive dyskinesia
Medications: Second-Generation Antipsychotics
Equally as effective as first-generation at reducing positive symptoms and disorganization
Modestly more effective at reducing negative symptoms
More effective at improving cognitive functioning
Also produce unpleasant side effects: Weight gain
Associated with other serious health concerns (e.g., Type 2 diabetes)
Many people also stop taking these medications
African Americans often do not receive these medications
Medications: Evaluation of Drug Treatments
A Review of over 60 years of clinical trials:
Just over half of people with schizophrenia had a minimal response compared to placebo
-Only 23% had a good response
*Even though these drugs work better than placebo, they do not work well for many people
More work is needed to develop better medications for schizophrenia
Psychological Treatments of schizophrenia
Patient Outcomes Research Team (PORT) treatment recommendation:
Social Skills Training
Family Therapy
Psychological Treatments: Social Skills Training
Teach skills for managing interpersonal situations
- Completing a job application
- Reading bus schedules
- Make appointments
Involves role-playing and other practice exercises, both in group and in vivo
Associated with fewer relapses, better social functioning, and a higher quality of life