CP: Chapter 9 Schizophrenia Flashcards
positive symptoms =
any change in behaviour or thoughts, such as hallucinations or delusions
negative symptoms =
when people appear to withdraw from the world around then, take no interest in everyday social interactions, and often appear emotionless and flat.
acute episodes are usually characterized by … symptoms
positive
delusions=
beliefs contrary to reality and firmly held in spite of disconfirming evidence
thought insertion =
person may believe that their thoughts are not their own, but put in by an external source.
thought broadcasting =
person may believe that his or her thoughts are broadcast or transmitted, so that others know what they are thinking
grandiose delusions=
exaggerated sense of their importance/power/knowledge/identity.
ideas of reference =
incorporating unimportant events within a delusional framework and reading personal significance into trivial activities of others.
somatic =
delusional body experiences, bv denken dat er iets mis is met je lichaam
erotomanic =
false belief that someone is in love with them
nihilistic =
rejecting all religious and moral principles in the belief that life is meaningless.
hallucinations -
sensory experiences in the absence of any relevant stimulation from the environment -> can occur in all modalities but most common in auditory
negative symptoms
behavioural deficits –> detract from reality, you dont experience things the same way as before.
hoe lang blijven negatieve symptomen
these tend to endure beyond an acute episode
avolition =
lack of motivation and a seeming absence of interest in or inability to persist in routine activities (work/school/hobbies)
asociality =
severe impairments in social relationships
anhedonia =
loss of interest in experience of pleasure
2 soorten pleasure (anhedonia)
consummatory pleasure and anticipatory pleasure
consummatory pleasure =
amount of pleasure experienced in the moment
anticipatory pleasure =
amount of expected or anticipated pleasure for future events
in welke soort pleasure hebben mensen met schiz een deficit in
in anticipatory pleasure, maar niet in consummatory pleasure
blunted affect =
lack of outward expression of emotion (stare, motionless muscles, lifeless eyes, flat and toneless voice)
alogia
significant reduction in the amount of speech production
2 domains in which the 5 negative symptoms can be divided
motivation and pleasure domain (motivation, emotional experience, sociality)
expression domain (outward expression of emotion and vocalization)
welke symptomen horen bij motivation and pleasure
avolition
asociality
anhedonia
expression domain
blunted affect
alogia
disorganized speech =
ook wel formal thought disorder
= problems in organizing ideas and in speaking so that a listener can understand (problems in executive functioning)
loose associations/derailment =
onderdeel van disorganized symptoms
= person can be more successful in communicating with a listener but has a difficulty sticking to one topic
Associative looseness often results in vague and confusing speech, in which the individual will frequently jump from one idea to an unrelated one.
disorganized behaviour =
they seem to lose the ability to organize their behaviour and make it conform to communicty standards (unusual clothes, act childlike, silly, hoard food, collect garbage)
3 soorten disorganized behaviour
catatonia
catatonic immobility
waxy flexibility
catatonia =
Catatonia is a complex neuropsychiatric behavioral syndrome that is characterized by abnormal movements, immobility, abnormal behaviors, and withdrawal.
catatonic immobility =
heel stijf, unusual position
waxy flexibility =
another person can move limbs into positions and then maintain for long periods of time
dus soorten delusions =
thought insertion
thought broadcasting
grandiose delusions
ideas of reference
somatic delusions
erotomanic
nihilistic
dus soorten negative symptoms=
avolition/apathy
asociality
anhedonia
blunted affect
alogia
dus disorganized symptoms soorten =
disorganized speech (loose associationsderailment)
disorganized behaviour (catatonia/catatonic immobility/waxy flexibility)
schizophreniform disorder =
schizophrenia but only lasts 1-6 months
(want schiz. is langer dan 6 maanden)
brief psychotic disorder =
same as schizophrenia but last from 1 day to 1 month, often due to extreme stress
schizoaffective disorder =
mixture symptoms of schizophrenia and mood disorders
delusional disorder =
troubled by persistent delusions of persecution or by delusional jealousy
what do family studies of schiz show
that it is genetic, hoe closer the relationship hoe meer risico
risk for mz twins =
44,3%
risk for dd twins =
12%
dus twins laten zien….
dat als alleen genetic transmission accounted for schizophrenia, both twins would always have schizophrenia
adoption studies laten zien
dat er een strong relation is tussen having a parent with schizophrenia and developing the disorder
wat doen association studies
try to notice specific genes related to schizophrenia etc.
genome association studies =
identify rare mutations, bv copy number variations
dopamine theory globaal
positive symptoms: may be due to increased sensitivity of dopamine receptors
negative symptoms: may be due to dopamine underactivity in the prefrontal cortex.
waar is dopamine in involved, wat voor psychologische systemen
reward and motivation in the strium (in schiz: minder motivation)
welke andere neurotransmitters zijn involved in schizophrenia
serotonin, glutamate, GABA, NMDA
3 issues in brain structure bij schiz
- enlarged ventricles
- prefrontal cortex veranderingen
- problems in temporal cortex
enlarged ventricles laten zien…
dat er loss of brain cells is
prefrontal cortex veranderingen
minder gray matter, no loss of neurons but loss of dendritic spines. hierdoor zijn conections impaired.
lower glucose metabolism
waar leidt less activity in prefrontal cortex naar
naar meer severe negative symptoms
problems in temporal cortex and surrounding regions
reduced volume of hippocampu , amygdala, anterior cingulate
wat zou kunnen leiden tot volume reductions bij hippocampus
door stress reactivity and disrupted HPA
3 soorten connectivity en wat is het
structural connectivity - how structures are connected, via white matter
functional connectivity - how regions are connected based on BOLD signal (blood oxygen level dependent)
effective connectivity - combines structural and functional -> BOLD ++ direction and timing of activations
het kan zijn dat excessive pruning, stress and hpa axis in early adolescence leiden tot dat schiz emerges during late asolescence
oke
relatie met cannabis
cannabis use leads to a higher risk for those who are genetically vulnerable to developing schiz. but neither is alone responsible
2 hypotheses about the relationship between schiz and socioeconomic status
sociogenic hypothesis
social selection hypothesis
(social selection hypothesis meer support)
sociogenic hypothesis
stress that comes with poverty (low edu, stigma, less opport) -> leads to schiz
dus poverty -> schizophrenia
selection hypothesis
during the course of illness, ppl with schiz drift into poor neighborhoods because they cannot live anywhere else
urbanicity and schiz
ppl born in urban areas have a greater risk of developing schiz in adulthood
early theories blamed…
the mothers
wat is belangrijk binnen een familie
communication, slechte communicatie kan leiden tot meer schiz
wat kan relapse predicten in schiz
expressed emotion -> families with high ee were more prone to relapse, due to bidirectional relation between hpa activation and dopamine activity
maar cultural differences in ee!
wat lieten retrospective studies zien
dat adults with schiz had lower iqs and were withdrawn and delinquent as children, sometimes also poor motor skills and negative emotion
prosprective study
confirmed that low iq is a predicter of the later onset of schizophrenia
soorten medicatie voor schizophrenia
first-generation antipsychotic drugs
second-generation antipsychotic drugs
psychological treatments soorten
social skills training
family therapy
cognitive behavioural therapy
cognitive remediation therapy
psychoeducation
case management
residential treatment
cognitive behavioural therapy focused op..
thinking and elusions
cognitive remediation therapy focuses op…
improving cognitive skills
psychoeducation
educate about symptoms, expected time course, biological and psychological triggers and treatment strategies
case management
holding together + coordinating the range of medical and psychological services they need
residential treatment
protected living units
