Lecture 9

Question 1

general consensus of schizophrenia

Answer 1

a debilitating psychiatric condition which is characterised by the individual demonstrating a loss of contact with reality

Question 2

statistics

Answer 2

affects approximately 1% of the population - 1 in 100
typical onset during the 20 - 30s
affects men in teens to 20s
affects women equally 20s to 30s

Question 3

early accounts of schizophrenia

Answer 3

Haslam 1810 produced detailed patient notes of James Matthew’s
the patient believed he was being controlled by a mind machine which he named the “air loom”
he continued these beliefs no matter what people showed him - they couldn’t be disputed

Question 4

Mordel

Answer 4

cases study of a 13 year old boy who underwent rapid intellectual decay, displaying homicidal thoughts towards his father
the disorder was termed “dementia praecox” following the believe that the brain had degenerated, the brief was it was heredity

Question 5

Kraeplin

Answer 5

“dementia praecox” was a form of mental deterioration in early life
considered the condition hereditary
physical abnormalities were a sign of markers for the condition such as deformities of finger and toes

Question 6

Bleuler

Answer 6

disagreed with the term “dementia praecox”
argued it can occur before and after adolescence and that deterioration isn’t the only outcome
instead he focused on the psychological aspects of the condition and provided us with the term schizophrenia meaning split mind

Question 7

Bleuler’s psychological aspects of sz

Answer 7

4 fundamental features of SZ:
blunted affect
loosening of associations
ambivalence
loss of awareness of external events

Question 8

blunted effect

Answer 8

reduced emotional response to stimuli
for example, is there is a loud bang they won’t react

Question 9

loosing of associations

Answer 9

disordered or contradictory responses
they find it difficult to learn environmental cues

Question 10

ambivalence

Answer 10

unable to make decisions

Question 11

loss of awareness of external events

Answer 11

preoccupied on the internal world
this may be unrelated ti the external world

Question 12

postive symptoms

Answer 12

an excess of experiences which are not normal

Question 13

negative symptoms

Answer 13

the absence of normal behaviour or experiences

Question 14

cognitive symptoms

Answer 14

deficits in cognitive abilities

Question 15

examples of positive symptoms

Answer 15

delusions - a fixed belief that have no basis
hallucinations - perceptions without external stimulus
disorganised thinking/speech or behaviour

Question 16

delusions

Answer 16

an erroneous belief held with conviction despite contradictory evidence
different types of delusions include:
persecutions - people plotting against the individual
grandiose - persons has great fame, wealth or power
very common, around 90% experience these

Question 17

hallucinations

Answer 17

a sensory experiment without an external stimulus to provoke it
auditory hallucinations are most common - this must be consistent not just a one off

Question 18

disordered thought/speech and behaviour

Answer 18

disorganised thoughts - difficulty in concentrating, had to complete tasks
disordered speech - difficulty in making sense, may jump around in conversations, or appear to present logical sentences but have made up words
disordered behaviour - may dress oddly to others, demonstrate odd reactions

Question 19

examples of negative symptoms

Answer 19

5As
blunted affect - reduced emotional response to stimuli
alogia - diminished speech output, difficult to communicate with others
anhedonia - inability to feel pleasure during enjoyable activities
asociality - reduction in social initiative
avolitation - inability to complete goal directed tasks due to lack of motivation

Question 20

examples of cognitive symptoms

Answer 20

these tend to be stable throughout
difficulty sustaining attention
impaired working memory
poor abstract thinking
poor problem solving
low psychomotor speed

Question 21

difference between + and -

Answer 21

+ symptoms are often the defining factor and are easy to treat
- symptoms are most problematic, and are often made worse by medication
cognitive symptoms are also hard to treat, with medication often making them worse

Question 22

Sz phases

Answer 22

prodromal phase - negative symptoms occur, marked by social withdrawal and loss of interest in normal activities
active phase - positive symptoms e.g. a psychosis which marks the disturbance as sz
residual phase - postive symptoms decrease, negative symptoms remain

Question 23

DSM-5 criteria A

Answer 23

two or more of the following present for significant portions of time during one month period at least of these mist be present
1. delusions
2. hallucinations
3. disorganised speech

4. disorganised or catatonic behaviour
5. negative symptoms

Question 24

DSM-5 criteria B and C

Answer 24

B) social or occupational dysfunction: quality of work/interpersonal relationships or self-care if significantly below level before disturbance

C) duration: continuous signs of disturbance persist for at least 6 months. must include at least in month of symptoms from A

Question 25

DSM-5 criteria D, E and F

Answer 25

D) schizoaffective disorder and depressive or bipolar disorder ruled our

E) substance/general medical condition excluded

F) relationship to developmental disorders

Question 26

subtypes of SZ

Answer 26

prior to the DSM-5

paranoid - postive symptoms, persecutory delusions
disorganised - though, speech, behaviour
catatonic - decrease/increase in movement
undifferentiated - neither of the first 3
residual - minimum positive symptoms, but still negative symptoms