LESSON 4 Flashcards by Adel Camante

❏ ___ (England) wrote a description of the symptoms of schizophrenia

John Haslam

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___ (France) described cases of schizophrenia.

❏ Philippe Pinel

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❏___ used the term ___ (loss of mind) ___ (early) to describe schizophrenia

Benedict Morel
démence
précose

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____ provided the most enduring description of schizophrenia and
coined it as ___
➔ ___ – alternating immobility and agitation
➔ ___ – silly and immature emotionality
➔ – delusions of grandeur or persecution

emil kraeplin
dementia praecox.
Catatonia
Hebephrenia
Paranoia

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___ proposed that the reason for having schizophrenia is due to ___ (destruction of forces that connect functionalities of the personality to the other

Bleuler
Associative splitting

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__coined the modern term schizophrenia (came from Greek words skhizein for “split” and phren for “mind”

Eugen blueler

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Generally refer to symptoms that distort reality and are NOTICEABLE for people with psychotic disorders to have these symptoms compared to
normally functioning individuals

Positive symptoms

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FIXED and IRRATIONAL belief that is seen by most people as misrepresentation of reality; called as “THE BASIC CHARACTERISTIC OF MADNESS” (Jaspers, 1963).

Delusions

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NO BIZARRE DELUSIONS
belief that one is going
to be harmed by others; most common delusion

Ex: believing that your neighbor is spying on you and plotting to harm

Persecutory delusions

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NON BIZARRE
belief that every event
(comments and gestures) are directed at
oneself

overthinker

EX: you think that the strangers laughing in a public place are secretly laughing at you

Referential delusions

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NON BIZARRE
– belief that one has
exceptional abilities, wealth, fame, etc.

si Quiboloy

A person claiming they have the ability to control global events like weather or economies

Grandiose delusions

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NON BIZARRE
belief that another
person is falsely in love with the individual

feelingera

EX; stranger smiling at you and you think its the confirmation that he loves you

Erotomanic delusions

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NON BIZARRE DELUSIONS
belief that major catastrophes will occur

o.a

The world is ending or tomorrow will have the greater earthquake

Nihilistic delusions

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NON BIZARRE
belief about something is
wrong about their health and organ functioning

Ex; worms crawling inside the body or a body part is deformed or changed in some way

Somatic delusion

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NON BIZARRE
belief that the partner is
unfaithful

Jealous delusions

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BIZARRE DELUSIONS

belief that some outside
force “removed” one‘s thoughts

Ex; a person think that someone like the government is stealing his thoughts or erasing them from their mind

Thought withdrawal

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BIZARRE
belief that thoughts are
being inserted by an outside force

“someone put this thought into my mind against my will”

ex; aliens or gov. placing speicific ideas or beliefs into their head

Thought insertion

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BIZARRE

belief that one‘s body or
action is being manipulated by an outside force

Delusion of control

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BIZARRE

belief that believes someone
he or she knows has been replaced by a double

impostor / doubleganger (michael jackson)

a person might think that their spouse is not truly their spouse but a impostor that looks like them

Capgras syndrome

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BIZARRE
belief that one is already
dead

delusion of negation

a person insist that they have no brain or heart and their body is decaying, or they are dead and ghost

Cotards syndrome

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these fixed and irrational beliefs are attempts to deal with and relief oneself from stress and anxiety; delusions serve as distraction from stress and to make sense out of uncontrollable anxiety.

Motivational view of delusions

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these beliefs are caused by
BRAIN DYSFUNCTION that creates distortion of reality.

Deficit view of delusions

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experience of sensory events
without any input from the surrounding environment.

created within the mind, yet often feel very real

the brain perceives sense, sights, sounds, smell, taste and touch without input.

Hallucinations

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❏ The hallucinations must occur in the context of a ____; those that occur while falling asleep ___ or waking up ___
are considered to be within the range of normal
experience.
❏ Hallucinations may be a normal part of religious
experience in certain cultural contexts

Clear sensorium
(hypnagogic)
(hypnopompic)

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❏ ___ – one has heard something that did not really exist; most common hallucination ❏ ___ – sense of sight ❏ ___ – sense of taste ❏ ___ sense of smell ❏ ___ – sense of touch

Auditory Hallucination Visual Hallucination Gustatory Hallucination Olfactory Hallucination Tactile Hallucination

❏ ___ is the most active part during an auditory hallucination. ❏ ___ theory that people who are hallucinating are not hearing the voices of others but are listening to their own thoughts or their own voices and cannot recognize the difference -- it is suggested that auditory hallucinations are caused by poor emotional prosody comprehension

Broca’s area Metacognition

❏ Two negative symptoms are particularly prominent in schizophrenia: ___ and ____.

diminished emotional expression avolition

❏ Absence or insufficiency of normal behavior

Negative symptoms

reduction of expressed emotion and other nonverbal gestures ## Footnote Ex; speak in monotone voice and maintain neutral facial expression when the discussion is fun or sad

Deminished emotional expression

decrease in motivated self initiated purposeful activities; inability to initiate and persist in activities (also known as apathy) | Ex: not bathing or grooming despite having resources ## Footnote avoiding work, school or household tasks because of an inability to initiate action even if they know its importance

Avolition

reduced or lacked speech | nonchalant ## Footnote Ex; responding with very brief or one word answer or taking long pause during conversation

Alogia

decreased ability to experience pleasure | EX; feeling emotionaly detached to spending time with your loved ones ## Footnote no longer feel joy with hobby that you like

Anhendonia

lack of expression | neutral facial expression ## Footnote speaking without changes in tone, even discussing emotional topics

Affective flattening

lack of interest in social interaction

Asociality

Unusual behaviors that affect speech, motor behavior and emotional reactions

Disorganized symptoms

person switches from one topic to another

Derailment/loose association

answer to questions are obliquely related or not related at all ## Footnote ex; when ask about fav food, answer i use to like pizza when i lived near the school, but then the road construction made it difficult to travel

Tangentiality

speech is nearly incomprehensible

Incoherence (word salad)

variety of movements or speech that are very unusual compared to others | inappropriate for the given context

Grossly disorganized or abnormal motor behaving

marked decrease in reactivity to the environment

Catatonic behavior

no psychomotor activity; not actively relating to environment ## Footnote ex; a person might sit emotionless in a chair, staring blankly into space, showing no reaction even if someone speaks to them

Stupor

passive induction of a posture held against gravity. ## Footnote a person might hold their arm raised for extended outward for hours without any apparent reason

Catalepsy

slight, even resistance to positioning by examiner.

Waxy flexibility

no, or very little, verbal response

Mutism

opposition or no response to instructions or external stimuli | Uncooperative attitude ## Footnote when ask to sit, they will stand

Negativism

spontaneous and active maintenance of a posture against gravity | intentionally ## Footnote ex; a person might intentionally place themselves in a rigid, awkward position and maintain for long time

Posturing

odd, circumstantial caricature of normal actions

Mannerism

repetitive, abnormally frequent, non-goal-directed movements ## Footnote head banging, rocking back and forth, tapping fingers

Stereotypy

(not influenced by external stimuli) ## Footnote pace bakc and forth in a room or repeatedly tap fingers on a surface even though their sorroundings are calm and free of any triggers

Agitation

distortion of face that is usually used to express pain, disgust or disapproval; maintained for an abnormal long period of time

Grimacing

mimicking another’s speech mimicking another’s movements

Echolalia Echopraxia

❏ If at least __ of the mentioned abnormalities in motor/verbal activity is present in line with an existing mental disorder, the additional diagnosis would be “with catatonia”

Catatonic behavior 3

❏ Presence of at least one (1) of the following wherein one symptom must be (1), (2), or (3): 1. Delusion 2. Hallucination 3. Disorganized Speech 4. Grossly Disorganized or Catatonic Behavior

Brief psychotic disorder

❏ Symptom(s) for at least __ day to less than __ month ❏ After the episode, the individual goes back to its premorbid level of functioning ❏ The disturbance is not better explained by a depressive or bipolar disorder with psychotic features, by schizoaffective disorder, or by schizophrenia and is not attributable to the physiological effects of a substance or another medical condition ❏ average age at onset is in ___

Brief psychotic disorder 1 - 1 mid 30s

❏ Presence of at least 2 of the following wherein one symptom must be (1), (2), or (3): 1. Delusion 2. Hallucination 3. Disorganized Speech 4. Grossly Disorganized or Catatonic Behavior 5. Negative Symptoms

Schizophreniform Disorder

❏ Presence of symptoms for at least __ month to less than __ months ❏ The person may or may not have severe impairment in functioning

Schizophreniform Disorder 1 - 6

Schizophrenia

❏ Presence of disturbance for at least __ months, wherein at least __ month of active phase, and remaining time is at prodromal and residual phase. ❏ Decreased level of functioning compared to their functioning prior to the onset of the disorder.

Schizophrenia 6 1

mild presence of symptoms that marks the beginning of a psychotic episode; negative symptoms are most noticeable

Prodromal phase

presence of full-intensity psychotic symptoms

Active phase

psychotic symptoms with similar intensity in prodromal phase, wherein it marks the end of a psychotic episode; negative symptoms are also most noticeable

Residual phase

❏ People diagnosed with schizophrenia tend to have suicide risk, sometimes due to the commands of their hallucinations ❏ Some may have ____ (lack of awareness of their disorder) ❏ Some individuals with schizophrenia show social cognition deficits (i,e.,

Anosognia

inability to infer the intentions of other people; and may interpret irrelevant events or stimuli as meaningful (delusions) | difficulty undertanding simple mental states ## Footnote difficulty interpreting other emotins, impairment in understanding others thoughts and belifes

Theory of mind

❏ No found difference in prevalence between the male and female. ❏ Age onset occurs in the early to mid-___ for men and in the late-___ for women. ❏ Onset prior to late adolescence is rare. ❏ Childhood-onset cases tend to resemble poor-outcome adult cases. ❏ Late-onset cases (i.e., onset after age 40 years) are more common in women

20 20

Schizoaffective disorder

❏ An uninterrupted period of illness during which there is a major mood episode (major depressive or manic) concurrent with psychotic symptoms ❏ When the person is at a time that it is not suffering from a major mood episode (major depressive or manic), it experiences delusions or hallucinations for 2 or more weeks ❏ Symptoms that meet criteria for a major mood episode are present for the majority of the total duration of the active and residual portions of the illness.

Schizoaffective disorder

This subtype applies if a manic episode is part of the presentation. Major depressive episodes may also occur. ## Footnote schizophrenia with episodes of mania (extreme highs) and depression

Bipolar type

This subtype applies if only major depressive episodes are part of the presentation. ## Footnote major depressive episodes but no mania

Depressive type

Period of abnormally energetic or irritable mood for at least __ week. ❏ Mood is associated with at least 3 of the following (or 4, if mood is irritable) 1. Grandiosity 2. Decreased need for sleep 3. More talkative 4. Flight of ideas or racing of thoughts 5. Distractibility 6. Increased activity 7. Excessive involvement to risky activities

Manic episode 1

❏ Period of ___symptoms for at least ___ weeks, associated with at least 5 of the following in which at least one of the symptoms is (1) 1. Depressed mood 2. Anhedonia 3. Significant weight loss/gain, or loss of appetite 4. Insomnia/hypersomnia 5. Restlessness/slowness of movements 6. Fatigue 7. Feelings of worthlessness, or excessive guilt 8. Diminished ability to think or concentrate 9. Suicidal ideation/attempt *** major depressive episode for schizoaffective must include depressed mood

Depressive symptoms 2

❏ Person may or may not be severely impaired in functioning ❏ Suicide is possible (presence of depressive symptoms is correlated with a higher risk for suicide) ❏ Typical age onset is ____ ❏ ___ bipolar type, may be more common in young adults; schizoaffective disorder, depressive type, may be more common in older adults.

Schizoaffective disorder Early adulthood

❏ Presence of one or more delusions for at least ___month or longer ❏ Criterion A for schizophrenia has never been met (If hallucinations are present, it should be relative to the delusions) ❏ Impairments in psychosocial functioning may be less severe than those seen in other psychotic disorders (schizophrenia), and behavior is not obviously bizarre or odd ❏ If mood episodes occur concurrently with the delusions, the total duration of these mood episodes is brief relative to the total duration of the delusional periods ❏ The delusions are not attributable to the physiological effects of a substance or another medical condition and are not better explained by another mental disorder.

Delusionals disorder 1

Delusions tend to be non bizzare in ____ compared to schizophrenia

Delusional disorder

probably more common in men than in women; no major sex or gender differences in the overall frequency of delusional disorder

Delusional disorder

-1 month or longer -delusions only (If hallucination present, it should be related with delusion)

Delusional disorder

- 1 day to less than 1 month - No negative symptoms

Brief psyhotic disorder

1 month to less than 6 months Significant impairment is not a requirement

Schizophreniform disorder

At least 1 month for major mood episode concurrent with psychotic symptoms; 2 or more weeks of delusions or hallucinations with mood episode/s

Schizoaffective disorder

6 months or longer significant impairment

Schizohrenia

delusions, hallucinations or both, caused by a particular substance or medication

Substance/medication-induced psychotic disorder

delusions, hallucinations or both, caused by a particular substance or medication

Psychotic disorder due to another medical condition

condition where the intensity of psychotic symptoms is mild and insight is relatively maintained (similar to prodromal and residual phase) ## Footnote Imagine a young adult who occasionally hears voices that others do not hear. These voices are not constant and the individual is aware that they are not real. This person might also experience brief periods of paranoia or unusual thoughts but can still function relatively well in daily life. They might seek help due to the distress these experiences cause, but their symptoms do not meet the full criteria for a psychotic disorder like schizophrenia.

Attenuated psychosis syndrome

condition where the individual develops delusions simply by being in a close relationship with another who already has delusions

Delusional symptoms in the context of relationship with an individual with prominent delusions

Psychotic disorders are heritable, and symptoms of another generation of family affected are not always the same with the past generation; The more severe, the more it is highly heritable ❏ Older paternal age ❏ Genes responsible for eye-tracking deficit might be related

Biological factors

suggests that an increase in dopamine is involved in psychotic symptoms and reduction of this excess dopamine will remove the symptoms ● Current studies disprove this simplification; suggesting that dopamine activities during psychotic episodes are more complex

Dopamine hypothesis

Increased activity in ___= positive symptoms

Mesolimbic pathway

Decreased activity in ___= negative symptoms

mesocortical pathway

Normal functioning in___ but is affected during medication = parkinsonian symptoms

mesostriatal pathway

Enlargement of ventricles ❏ Hypo- or hyperfrontality in dorsolateral prefrontal cortex ❏ Prenatal problems (e.g., exposure to virus-like diseases like fluenza, stress, infection, malnutrition, maternal diabetes) or birth complications ❏ Fetal exposure to viral infections ❏ Chronic and early use of cannabis is potential influence

Bioligical factors

❏ It was once thought that___ (cold, dominant and rejecting) causes psychotic disorders ❏ It was once theorized that the cause is ____ (communicating with conflicting messages) ❏ These 2 theories were found to be invalid

Psychosocial factors schizophrenogenic mother double bind communication

❏ Tragic life events ❏ Homelessness ❏ Urban living ❏ Refugees (for some migrant groups, and for socially oppressed groups facing discrimination) ❏ Severity of positive and negative symptoms appears to be associated with the severity of adverse childhood experiences, such as trauma and neglect.

Psychosial factors

❏ Current studies focus on effect of families on relapse (i.e., acquiring the disorder again) rather than etiology ❏ Expressed Emotion seemed to have impact on relapse of schizophrenia (e.g., criticism, hostility, intrusiveness) ➢ Low Expressed Emotion = Lower Relapse Rate ➢ High Expressed Emotion = Higher Relapse Rate ❏ Shorter duration of being with family entails lower relapse rate ❏ Families with high EE tend to see symptoms as controllable and hostility arises when they think patients don‘t just want to help themselves

Psychosocial factors

➢ Electroconvulsive therapy ➢ Antipsychotic medications (neuroleptics) ➢ Transcranial Magnetic Stimulation for hallucinations

Biological treatment/ interventions

➢ Social skills training ➢ Family therapy ➢ Supportive employment

Psychosocial interventions/ treatment