Lecture 3 Flashcards
Schizophrenia & Related Disorders
Prior to the _______ mental disabilities were often described in one category which included intellectual delay, mental illness, and organic brain disorders.
1800’s
Early _____ - Start of division of mental illness into cognitive – affective – behavioural domains
1800
1897 - Emil Kraepelin coined the term _______
dementia praecox
1911 - Eugen Bleuler coined the term __________, and positive and negative symptoms
schizophrenia
1959 - Kurt Schneider developed his concept schneiderian symptoms of schizophrenia
Become the foundation of the ______
DSM II
Audible thoughts
Experience of influences controlling the body
Thought broadcasting
Thought withdrawal
Thought insertion
Delusional perception
Scheiderian symptoms
appears to be the strong predictor in development of schizophrenia
Genetics (family history)
is not solely responsible in ½ of the cases of identical twins only one twin will experience schizophrenia
Genetics
Prenatal exposure to influenza
Prenatal exposure to lead
Prenatal exposure to toxoplasma gondii
Obstetrical complications
Prenatal and Perinatal factors
Predispositions and vulnerabilities for schizophrenia (diatheses)
People’s vulnerabilities must interact with life stresses to trigger the onset of the illness
Vulnerability + Stress
Diathesis-stress models
_______ can include:
Trauma
Virus
Prenatal and perinatal complications
Substance use
Diathesis-stress models: Stressors
Good evidence to show that ______ can trigger schizophrenia, cause relapse, and worsen symptoms.
stress
3 neurotransmitters schizophrenia
Dopamine hypothesis
Glutamate hypothesis
Serotonin hypothesis
Reduced grey matter
Low activation of frontal cortex
Ventricle enlargement
Hippocampal atrophy
Neurological changes: Schizophrenia
Schizophrenia
Schizophreniform Disorder
Schizoaffective Disorder
Schizotypal Personality Disorder
DSM 5 – Schizophrenia Spectrum
Delusions
Hallucinations
Positive Symptoms
Distortions or exaggerations in language and communication
Disorganized speech
Disorganized behavior
Cognitive Symptoms
Affective flattening
Avolition
Alogia
Anhedonia
Asociality
Anosognosia
Apathy
Catatonia
Negative Symptoms
significant or severe lack of motivation or a pronounced inability to complete purposeful tasks
Avolition
symptom that causes you to speak less, say fewer words or only speak in response to others
Alogia
lack of interest, enjoyment or pleasure from life’s experiences
Anhedonia
lack of motivation to engage in social interaction, or a preference for solitary activities
Asociality
a neurological condition in which the patient is unaware of their neurological deficit or psychiatric condition
Anosognosia
lack of interest, enthusiasm, or concern
Apathy
a lack of movement and communication, and also can include agitation, confusion
Catatonia
Being spied on by someone who means harm or who is part of a conspiracy. Being followed or tracked. Being lied to or given misinformation.
Delusion: Persecutory/paranoid
refers to the mistaken belief that ordinary events and normal human behavior have hidden meanings that somehow relate to the individual experiencing the delusions
Delusion: Referential
are unfounded or inaccurate beliefs that one has special powers, wealth, mission, or identity
Delusion: Grandiose
an individual believes that another person, usually of higher status, is in love with them
Delusion: Erotomanic
belief of being dead, decomposed or annihilated, having lost one’s own internal organs or even not existing entirely as a human being
Delusion: Nihilistic
the individual believes something is wrong with part or all of their body
Delusion: Somatic
“I am god”
Delusion: Religious
something that could never happen in real life, such as being cloned by aliens or having your thoughts broadcast on TV
Delusion: Bizarre
individual has a delusional belief that their spouse (or sexual partner) is being unfaithful w/ no evidence
Delusion: Jealous
he belief that a person can control others with their thoughts, or that they have godlike powers
Delusion: Magical thinking
Thought insertion
Thought broadcasting
Thought withdrawal
Delusions of control
involves somehow experiencing one’s own thoughts as someone else’s
Thought insertion
Delusion that one’s thought is projected and perceived by others
Thought broadcasting
the delusional belief that thoughts have been ‘taken out’ of the patient’s mind, and the patient has no power over this
Thought withdrawal
lack of logical relationship between thoughts and ideas – conversation shifts from one topic to another in unrelated manner
Loose associations
takes a long time to make a point – excessive detail
Circumstantiality
speaker does not return to central point
Tangentiality
pause or interruption in train of thought (paucity of thought)
Thought blocking
creation of new words
Neologisms
rapid verbalization, jumping from one topic to another
Flight of ideas
incoherent mixture of words
Word salad
focused on a specific topic, returns to the topic even after topic has changed
Perseveration
use of words or phrases that have similar sounds (hell, bell, sell, well, swell) – not associated in meaning
Clang association
echoing the words and statements used by others
Echolalia
Psychomotor agitation
Psychomotor retardation
May not be goal directed and leads to difficulty preforming activities of daily living
Cognitive Symptoms: Disorganized Behaviours
______ and ________ can both refer to either motor symptoms or psychic symptoms.
Agitation; retardation
internally agitated
Psychic agitation
pacing etc
Motoric agitation
internal feeling of being slowed down
Psychic retardation
slowed movements
Motoric retardation
Combination of cognitive, affective and motor symptoms
Catatonic symptoms
Stupor
Catalepsy
Waxy flexibility
Mutism
Negativism
Posturing
Mannerism
Stereotypy
Agitation
Grimacing
Echolalia
Echopraxia
Negative Symptoms: Catatonia
a state of near-unconsciousness or insensibility.
Stupor
a medical condition characterized by a trance or seizure with a loss of sensation and consciousness accompanied by rigidity of the body
Catalepsy
patient’s body showing resistance to being moved
Waxy flexibility
an inability or unwillingness to speak, resulting in the absence or marked paucity of verbal output
Mutism
little or no response to instructions or external stimuli
Negativism
actively holding a posture against gravity
Posturing
carrying out odd, exaggerated actions
Mannerism
repetitive movements without an apparent reason
Stereotypy
holding the same facial expression, usually with stiff or tense facial muscles
Grimacing
involuntary repetition or imitation of another person’s actions
Echopraxia
Criterion A: Presence of one or more delusions for one month or more
Criterion B: Has never met Criterion for schizophrenia
Criterion C: Functioning not markedly impaired & behaviour not obviously odd, mental status & social functioning intact (outside of direct impact of delusion).
Criterion D: Any mood disorders are brief compared with total duration of delusional period
Criterion E: Not better accounted for by substances or general medical condition
Types of delusional disorders
May appear fairly sudden to others but symptoms often begin to slowly develop over six months to a year
Prodromal Stage
- Changes in personality
- Withdrawal
- Dropping out of normal activities
Onset of Schizophrenia
