Lecture 12: Psychotic Disorder Part 2

Question 1

Cognitive impairment in Schizophrenia (4)

Answer 1

1. Attention
2. Working memory
3. Learning
4. Executive functioning

Question 2

There seems to be cognitive deficits in ______ of people with schizophrenia which suggests genetic influence

Answer 2

Relatives

Question 3

Biological mediators of Schizophrenia (7)

HINT for first 3: There are volume deficits in 3 areas

Answer 3

1. Volume deficits in amygdala
2. Volume deficits in hippocampus
3. Volume deficits in frontal lobe
4. Enlargement of ventricles
5. Decreased 5HT2A receptors
6. Neurons in cortex and hippocampus are smaller in size
7. Increased D2 Receptors

Question 4

What type of neurotransmitter receptor is a 5HT2A receptor?

Answer 4

A type of serotonin receptor

Question 5

What type of neurotransmitter receptor is a D2 receptor?

Answer 5

A type of dopamine receptor

Question 6

Some studies suggest that brain volume progressively ______ across the lifespan for people with schizophrenia

Answer 6

Decreases

Question 7

The dopamine hypothesis (2) for schizophrenia! This talks about the activations of certain areas in the brain

Answer 7

1. OVERACTIVATION of Mesolimbic dopamine pathway (MDP) causing POSITIVE symptoms
2. UNDERACTIVATION of Mesocortical dopamine pathway causes NEGATIVE and COGNITIVE symptoms

Question 8

The dopamine hypothesis originated from the use of _______ ________

Answer 8

Antipsychotic medication

Question 9

The mechanism of action for most antipsychotic medication is to act as a ___ ____ _____

Answer 9

Dopamine receptor antagonist

Question 10

Receptor antagonist

Answer 10

1. A molecule that BINDS to a receptor
2. which BLOCKS neurotransmitters or neuromodulators
3. from binding to the receptor
4. which INTERRUPTS neurotransmission

Question 11

Antipsychotic medication _____ dopamine receptors and _______ the overactive MDP in people with schizophrenia

Answer 11

BLOCKS

DOWNREGULATES

Question 12

Additional support for the dopamine hypothesis is that stimulants like methamphetamine which act as dopamine receptor agonists can cause _______

Answer 12

psychosis

Question 13

Receptor agonist

Answer 13

1. A molecule that BINDS to a receptor
2. STIMULATING it
3. And INCREASING neurotransmission

Question 14

Additional support for the dopamine hypothesis is that ______ _____ show higher levels of dopamine and higher density of D2 receptors in the _____

Answer 14

Postmortem studies

Striatum

Question 15

One problem with using dopamine antagonists to treat schizophrenia is that while it helps ______ positive symptoms, it can make negative symptoms worse by ________ the mesocoritcal dopamine pathway

Answer 15

REDUCE

DOWNREGULATING

Question 16

Stress activates the ____ ____ which releases ______ in the bloodstream

Answer 16

HPA axis

Cortisol

Question 17

Cortisol has been shown to increase activity of __________ ______ which maybe trigger the onset of schizophrenia in _____ _____ _______

Answer 17

Dopaminergic circuits

Genetically vulnerable people

Question 18

People with schizophrenia seem to have lower rates of reproduction so how did it persist? Why wasn’t it selected out?

What’s the deflationary answer

Answer 18

Deflationary answer: People with schizophrenia have lower rates of reproduction in modern societies but more in ancestral societies

Question 19

People with schizophrenia seem to have lower rates of reproduction so how did it persist? Why wasn’t it selected out?

What are the 2 adaptionist answers?

Answer 19

1. People with schizophrenia contributed to group survival by adopting the role of shamans/other religious leaders that contributed to group cohesion and fitness
2. People with schizophrenia usually have relatives with schizotypal traits (atypical cognition andd behaviors) like creativity which can be beneficial

Question 20

People with schizophrenia seem to have lower rates of reproduction so how did it persist? Why wasn’t it selected out?

What is the non-adaptionist answer?

Answer 20

Women with schizophrenia tend to have a psychotic episode later in adulthood, giving them a period of average reproductive success

Question 21

Rates of schizophrenia have found to be higher among what demographic?

Answer 21

African American people

Question 22

Researchers have debated how to interpret the schizophrenia findings (2)

Answer 22

1. Results reflect a real phenomenon
2. Results are spurious

Question 23

If the assumption of SZ rates among AA are real then it might be due to: (3)

Answer 23

1. Genetic causes eg. Gene linkages that are risk factors for psychosis appear more in genomes of AA
2. Environmental causes eg. Prenatal malnutrition that might disproportionately affect AA communities
3. Sociocultural factors eg. Discrimination and racisms that disproportionately affect AA and causes traumatic stress which is a risk factors for SZ

Question 24

If the assumption of SZ rates among AA are spurious then it might be due to: (3)

Answer 24

1. Cognitive biases/stereotype of clinicians conducting assessments
2. Differences in psychotic system-presentation across racial/ethinic groups
3. Diagnostic procedures at low-income community mental health clinics that disproportionally serve AA compared to procedures at higher income hospital that disproportionately server other racial/ethnic groups

Question 25

Currently is there enough evidence to say wither higher reported rates of SZ among AA are attributable to factors that make it a real discrepancy?

Answer 25

NO!

Question 26

Some cognitive scientists have argues that the mind is largely _____ in its organization

Answer 26

Modular

Question 27

Mental module: part of the mind that is: (3)

Answer 27

1. Domain specific 2. Informationally encapsulated 3. Other properties that we don’t need to worry about

Question 28

Domain specificity

Answer 28

Each module processes one type of information

Question 29

Informational encapsulation

Answer 29

Information processing of one module is unavailable to other modules with the exception of a narrow range of inputs and outputs between modules

Question 30

Example of informational encapsulation

Answer 30

The müller-layer illusion ~ short and long lines with arrows inwards and one outwards

Question 31

Some cognitive scientists believe that visual perception and belief formation are ____ _____ _____ that don;t have access to eachothers information processing

Answer 31

Separate mental modules

Question 32

Some scientists also believe that while ____ ____ processing occurs, little ____ _____ processing occurs in normal human perception and cognition

Answer 32

Bottom-up Top-down

Question 33

“Bottom-up” processing

Answer 33

Information that flows from perception to cognition

Question 34

Example of bottom up processing

Answer 34

Alone, outside at night, you see a dark figure and then believe you’re in danger

Question 35

“Top-down” information processing

Answer 35

Information processing that flows from cognition to perception

Question 36

Example of top down processing

Answer 36

Alone, outside at night, you believe you’re in danger and so perceive a shadow as a person

Question 37

Powers et al (2016) argue that hallucinations are an example of ____ _____ __________

Answer 37

Top down processing

Question 38

Evidence for the hallucinations = top down processing include? (4)

Answer 38

1. People who hallucinate are more susceptible to sensory conditioning 2. Content of hallucinations tends to be mood-congruent (perception affected by emotion) 3. Illusory pattern perception is common in non-clinical population (perception affected by prior belief) 4. Hallucinations aren’t limited to people with psychotic disorders but also loved ones after bereavement. (perception affected by emotion and belief)

Question 39

Sensory conditioning

Answer 39

False perception of a stimulus that has been previously associated (through conditioning) with another stimulus

Question 40

In sensory conditioning preception is affected by ______/______ which is a _____ state

Answer 40

Expectation/association Cognitive

Question 41

Mood-congruent

Answer 41

Related to mood

Question 42

When hallucinations are mood-congruent, perception is affected by ______ which is a _____ state

Answer 42

Emotion Cognitive

Question 43

When hallucinations are based on illusory pattern perception (eg. People’s belief about the stock market trending downwards) perception is affected by ____ ____, which is a _____ state

Answer 43

Prior belief Cognitive

Question 44

When hallucinations are after bereavement, perception is affected by _____ (eg. ______) and _______ (e.g. the lost person survives in an afterlife)

Answer 44

Emotion eg. Sadness Belief

Question 45

What’s Bayes theorem

Answer 45

P(A|B) = P(B|A) x P (A) / P (B)

Question 46

Explain/Read: P(A|B) = P(B|A) x P (A) / P (B)

Answer 46

The probability of A, given that B is trueis equal to the product of the probability of B given that A is true multiplied by the probability of A divided by the probability of B

Question 47

Use the Bayes Theorum to explain the probability you have COVID given that you have a cough

Answer 47

The probability you have COVID given that you have a cough is equal to The probability that you would have a cough if you have COVID Multiplied by the probability that you have COVID (local rates of covid) Divided by the probability that you just have a cough in general (for any reason)

Question 48

In psychotic disorders people tend to have impaired _______ reasoning

Answer 48

Bayesian

Question 49

A client with a psychotic disorders believed that his roommate was tampering with his computer because he was having recurrent Zoom connection difficulty. He thought this was highlight probable because (3)

Answer 49

1. He overestimated the probability that tampering would result in connection difficulty 2. He overestimated the probability of how much computer tampering by roommates exists in the world 3. He underestimated the probability of Zoom connection difficulty

Question 50

The primary treatment of Schizophrenia and schizoaffective disorders people tend is with ______ ________. Typically these are ______ _________.

Answer 50

Antipsychotic medication Dopamine antagonists

Question 51

Examples of dopamine antagonists used to treat schizophrenia

Answer 51

1. Clorazil 2. Abilify

Question 52

Primary treatment of bipolar disorder is done with ______ ________ for example. _____ or _______

Answer 52

Mood stabilizers like Lithium or Depakote

Question 53

Secondary treatment of schizophrenia and other psychotic disorders is with _______ and ____ ________

Answer 53

Psychotherapy and case management

Question 54

Psychotherapy and case management typically includes (3)

Answer 54

1. Psychoeducation about psychosis 2. open conversations about delusions and hallucinations 3. Methods to help reduce and manage delusions and hallucinations

Question 55

What are some methods to help reduce and manage delusions and hallucinations (8)

Answer 55

1. Follow a daily schedule that provides consistent structure 2. Reduce unexpected events 3. Reduce stress caused by work/relatinoship conflict 4. increase social support and social services 5. Help process stigma and loss of previous life goals 6. Help develop new life goals 7. Practice social skills 8. Individual and/or group psychotherapy

Question 56

People with schizophrenia and other psychotic disorders often have _______ and _______

Answer 56

Comorbid anxiety and depression

Question 57

More specifically people with schiziphrenia and other psychotic disorders often have Comorbid anxiety and depression i.e., (2)

Answer 57

1. A hyperactive threat/avoidance system and/or 2. A hypoactive reward/approach system

Question 58

Because people with schizophrenia and other psychotic disorders often have Comorbid anxiety and depression, they benefit from interventions that (2)

Answer 58

1. Decrease activity of the threat/avoidance system 2. Increase activity of the reward/approach system