Lecture 12: Schizophrenia Flashcards
1
Q
psychosis
A
losing contact with reality; not knowing what is real and what is not
2
Q
2 categories of psychosis
A
- functional psychosis: psychosis in which there is no apparent pathology of CNS
- non-functional psychosis: psychosis in which there is pathology of CNS
3
Q
symptoms of psychosis
A
- positive symptoms: exaggeration or disturbance of normal functions (delusions, hallucinations, formal thought disorders)
- negative symptoms: diminishing of normal functions (social withdrawal, lack of drive)
- cognitive symptoms
- disorganization, affective symptoms
4
Q
schizophrenia
A
psychotic disorder, marked by unusual perceptions, disturbed emotions, strange thoughts, and motor dysfunction. more common in low SES groups
5
Q
downward drift theory
A
that people who experience schizophrenia descend on the economic ladder
6
Q
checklist for schizophrenia
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- for 1 month, the individual displays two or more of the following symptoms: delusions, hallucinations, disorganized speech, and abnormal motor activity, including catatonia, and negative symptoms
- at least one symptom must be delusions, hallucinations, or disorganized speech
- lower functioning compared to before symptoms emerged
- some degree of impaired functioning for at leat 5 additional months
7
Q
types of schizophrenia
A
- type I schizophrenia: having more positive symptoms (more common type)
- type II schizophrenia: having more negative symptoms
8
Q
brief psychotic disorder
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1 or more: delusions, hallucinations, chaotic speech, chaotic or catatonic behavior with a duration of less than 1 month with a full return to functioning
9
Q
schizophreniform disorder
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schizophrenia but duration more than 1 and less than 6 months
10
Q
schizoaffective disorder
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6 months or more wherein criteria of mood disorder and schizophrenia are met, and period with only delusions/hallucinations
11
Q
delusional disorder
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delusion more than a month, functioning not impaired and behavior not obviously bizarre
12
Q
3 types of delusional disorder
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- erotomatic type: belief that another person of higher status is in love with them
- persecutory type: belief that they are being mistreated, or someone is spying on them or planning to harm them
- somatic type: false belief that a person’s internal or external bodily functions are abnormal
13
Q
psychotic disorder due to another medical condition
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hallucinations, delusions or disorganized speech caused by a medical illness or brain damage
14
Q
substance/medication-induced psychotic disorder
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hallucinations, delusions, or disorganized speech caused directly by a substance
15
Q
other psychotic disorders in DSM-5
A
- persistent auditory hallucinations syndrome
- delusions with significant overlapping mood episodes
- attenuated psychosis syndrome
- delusional symptoms in the partner of an individual with delusional disorder
16
Q
positive symptoms
A
excesses of thoughts, emotions, and behaviors; the healthy person does not have them
17
Q
delusions
A
strange false beliefs firmly held despite evidence of the contrary
18
Q
delusions of persecutions
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believe they are being plotted against
19
Q
delusions of reference
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attach special meaning to actions of others or to various objects or events
20
Q
delusions of grandeur
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believe to be specially empowered persons
21
Q
delusions of control
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believe feelings, thoughts and actions are controlled by others
22
Q
formal thoughts disorders
A
disturbance in production and organization of thought
23
Q
lose associations/derailment
A
quicky shifts from one topic to another
24
Q
neologisms
A
made-up words
25
perservation
repeating words and statements again and again
26
clang
rhyme to think or express themselves
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heightened perceptions and hallucinations
perceptions in absence of actual external stimuli
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tactile hallucinations
take the form of tingling, burning sensations or sensations of electric shock
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visual hallucinations
producing vague perceptions of colors or clouds
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taste hallucinations
induce the idea that food and drinks taste strange
31
somatic hallucinations
feelings as if something is going on in the body, for example, a snake crawling through the abdomen
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olfactory hallucinations
for example, the smell of poison that is not there
33
inappropriate affect
displays of emotions that are unsuited to the situation
34
negative symptoms
missing things that are not present in thoughts, emotions, and behaviors; healthy people do have them
35
poverty of speech/alogia
decrease in speech or speech content
36
blunted and flat affect
displaying fewer emotions than most people (blunted) or displaying no emotions at all (flat). internally they do experience emotions
37
avolition/apathy
having no interest or energy to indulge in activities or take action
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social withdrawal
people turn their backs on their social environment and confine themselves to their own world
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psychomotor symptoms
unusual movements or gestures
- moving slowly or making odd or awkward movements
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catatonia
extreme psychomotor symptoms
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catatonic stupor
stop responding to environment, motionless and silent
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catatonic rigidity
rigid, upright posture and resisting efforts to be moved
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catatonic posturing
awkward and bizarre positions
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catatonic excitement
move excitedly
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3 phases of schizophrenia
schizophrenia usually appears between one's late teens and mid 30's
- prodromal phase: starting to deteriorate but symptoms not yet obvious
- active phase: symptoms are clearly present
- residual phase: lessening of symptoms, returning to prodromal-like level
46
genetic/diathesis-stress (biological view of causes of schizophrenia)
people who inherit biological predispositions (diathesis) will develop schizophrenia only if certain kinds of events or stressors are also present
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dopamine hypothesis (biological view of causes of schizophrenia)
schizophrenia results from excessive activity of dopamine, which mainly contributes to positive symptoms
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first generation antipsychotic drugs
drugs that help correct grossly confused or distorted thinking by decreasing dopamine
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phenothiazines
first group of effective antipsychotic medications
50
second generation antipsychotic drugs
are more effective than first generation drugs and target several neurotransmitters
51
dysfunctional brain structure and circuitry (biological view to causes of schizophrenia)
enlarged ventricles, smaller temporal and frontal lobes, less gray and white matter, and abnormal interconnectivity. abnormal dopamine activity is part of a broader circuit dysfunction
52
schizophrenogenic (schizophrenia-causing) mothers (psychodynamic view of causes of schizophrenia)
children with mothers who do not care for their needs may develop schizophrenia. little research support
53
operant conditioning (cognitive-behavioural view of causes of schizophrenia)
people who are not reinforced to pay attention to social cues may start paying attention to other stimuli-> develop more bizarre responses which are reinforced through attention from others -> schizophrenia
54
misinterpreting unusual sensations (cognitive-behavioural view of causes of schizophrenia)
- strange sensations caused by schizophrenia are due to brain abnormalities
- when people pay attention to sensations, more symptoms emerge -> develop cognitions based on conclusions from sensations -> schizophrenia
55
multicultural factors (sociocultural view of causes of schizophrenia)
schizophrenia rates differ between racial groups and the course and outcome of the disorder vary from country to country
56
social labelling (sociocultural view of causes of schizophrenia)
certain symptoms of schizophrenia may emerge because of the diagnosis itself (self-fulfilling prophecy)
57
family dysfunction (sociocultural view of causes of schizophrenia)
- family stress is linked to schizophrenia. parents of people with schizophrenia display more conflicts, struggle to communicate with one another, and are more critical of and over involved with their children
- expressed emotion = family members openly showing criticism and hostility towards each other, a risk factor for relapse
58
institutionalization (treatment of schizophrenia)
put away in public mental hospitals where patients were generally neglected
- overcrowding resulted in shortcomings in resources and staff, which resulted in bad treatment, which worsened mental states
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milieu therapy
social climate for patients to improve, they must be able to be productive, develop self-respect and adopt individual responsibility
60
token economy programs
rewarding patients who behave in an acceptable manner and do not reward them when they do not
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drug therapy (treatment of schizophrenia)
most effective form of treatment
- first generation antipsychotics (neuroleptic drugs)
- second generation antipsychotics
62
extrapyramidal effects
first generation antipsychotic drugs sometimes lead to movement problems
- parkinsonian symptoms (muscle tremors and rigidity) appear within days or weeks
- tardive dyskinesia: extrapyramidal effects involving involuntary movements that patients have after they have taken antipsychotic drugs for more than 6 months.
63
agranulocytosis
second-generation antipsychotic drugs can cause decrease in white blood cells, which can be fatal
64
cognitive-behavioral therapies (treatment of schizophrenia)
- cognitive remediation: focuses on cognitive impairments
- hallucination reinterpretation and acceptance: the aim is to help clients feel more control over their hallucinations and to reduce their delusional ideas
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family therapy (treatment of schizophrenia)
- provide training and guidance for the family to deal with the patient so that a constructive base can be developed, in which the client can recover
- clients with a positive view towards family usually do better
66
social therapy (treatment of schizophrenia)
teach social skills and help clients function in the social world
67
community mental health centers (community approach to treatment of schizophrenia)
facilities that provide medication, psychotherapy, and emergency care and coordinate treatment in the community
68
short-term hospitalization (community approach to treatment of schizophrenia)
when outpatient therapy is not sufficient, people can be hospitalised for a short period of time
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day centers/hospitals (community approach to treatment of schizophrenia)
patients spend their time in the hospital during the day
70
halfway houses (community approach to treatment of schizophrenia)
facilities where people can live, who do not need hospitalisation, but are not able to live at home by themselves
71
sheltered workshop (community approach to treatment of schizophrenia)
workplace where employees with mental disorders who are not ready for a real job can work so that they can adapt to having a job
72
problem with community approach to treatment of schizophrenia
- failing to communicate between facilities + staff and patients are not well informed about alternative mental health agencies
- solution: case managers = people who guide clients through the community system
- shortage of services and failure to provide good service to people with severe mental disorders
