Module 4: Psychotic and Personality Disorders Flashcards
Psychosis
Severe mental condition characterized by a loss of contact with reality
Hallucinations
false sensory perceptions
Delusions
false beliefs
Understand the different situations where we might see psychosis and how that does not mean there is a psychotic disorder present
we might see them with other psychological disorders like bipolar, or depressive disorder
Schizophrenia
a severe psychological disorder characterized by disorganization in thought, perception, and behavior. They do not think logically, perceive the world accurately or behave in a way that permits everyday life and work.
4 types of delusions with schizophrenia
SIPS
Influence: Beliefs that behavior or thoughts are controlled by others. Or mind reading by another person.
Self-significance: Thoughts or grandeur, reference, religion, guilt, or sin.
Persecution or paranoid: Thoughts that others are out to harm the person.
Somatic: Belief that one’s body is rotting away or has been taken over by an outside source.
Dissociative identity disorder (DID)
Dissociative identity disorder. Considered to have two or more distinct personalities each with their own thoughts, feelings, and behaviors.
Key criteria for schizophrenia
Two or more of the following, each present for a significant portion of time during a 1 month period. At least one of these must be the first three.
- Delusions
- Hallucinations
- Disorganized speech.
- Grossly disorganized or catatonic behavior
- Negative symptoms
(b)For a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas, such as work, interpersonal relations, or self-care, is markedly below the level achieved prior to the onset (or when the onset is in childhood or adolescence, there is failure to achieve expected level of interpersonal, academic, or occupational functioning).
(c ) Continuous signs of the disturbance persist for at least 6 months. This 6-month period must include at least 1 month of symptoms (or less if successfully treated) that meet Criterion A (i.e., active-phase symptoms) and may include periods of prodromal or residual symptoms. During these prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or by two or more symptoms listed in Criterion A present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
(d) Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out because either 1) no major depressive or manic episodes have occurred concurrently with the active-phase symptoms, or 2) if mood episodes have occurred during active-phase symptoms, they have been present for a minority of the total duration of the active and residual periods of the illness.
(e ) The disturbance is not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
(f) If there is a history of autism spectrum disorder or a communication disorder of childhood onset, the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations, in addition to the other required symptoms
five types of hallucinations present in schizophrenia
Good Animals Oink Very Soon
Auditory: Noises or voices, perhaps speaking to or about the person.
Visual: Visions of religious figures or dead people
Olfactory: Smells
Gustatory: Tastes
Somatic: Feelings of pain or deterioration of parts of one’s body or feeling that things are crawling on or in the skin or the body.
What is the most common kind of hallucination
auditory, then visual
Loose associations
thoughts that have little or no logical connection to the next thought.
Example of a loose association
(I once worked at an army base. The middle east- I like to travel, my favorite place is arizona)
Thought blocking
Exemplified by unusually long pauses in the patient’s speech that occur during a conversation.
Clang associations
in which speech is governed by words that sound alike rather than words that have meaning.
example of clang association
I have bills, summer hills, bummer, drum solo.)
catatonia
a condition in which a person is awake but is nonresponsive to external stimulation.
Diminished emotional expression
describes reduced or immobile facial expressions and a flat, monotone voice that does not change even when the topic of conversation becomes emotionally laden.
anhedonia
lack of capacity for pleasure. They feel no joy or happiness.
(late 19th century: from French anhédonie, from Greek an- ‘without’ + hēdonē ‘pleasure’.)
avolition
or apathy, is an inability to initiate or follow through with plans.
away from
alogia
decreases quality and/or quantity of speech
(comes from the Greek words meaning “without speech”)
cognitive impairments
impairments in visual/verbal learning, attention problems, decreased processing speed, impaired abstract thinking, and deficits in executive functioning.
Why do schizophrenia presentations look different?
since the diagnosis only requires the presence of two of five of the symptoms people can appear very differently.
For example, one person may have paranoia and hallucinations and another may have catatonia and mutism.
Relationship between substance use and schizophrenia
“90% of people with schizophrenia smoke cigarettes, and smoking is associated with poorer physical health outcomes in this group as well as poorer treatment outcomes, higher depression rated, and lower quality of life.”
Brief psychotic disorder
the sudden onset of any psychotic symptom, such as delusions, hallucinations, disorganized speech, or grossly disorganized or catatonic behavior. This disorder may resolve after 1 day and does not last for more than one month.
schizophreniform disorder
Identical to those of schizophrenia with two exceptions. First, the duration of the illness is shorter, ranging from at least 1 month to less than 6 months. In a few instances, the symptoms seem to disappear In other instances, a person is treated successfully and never has another episode.
schizoaffective disorder
might be considered to have both schizophrenia and an affective disorder. That is, in addition to having the symptoms of psychosis, the patient also experiences major depressive, manic, or mixed episode disorder at some point during the illness.
delusional disorder
consists of the presence of a nonbizzare delusions (defined as an event that might happen) They do not have other psychotic symptoms except perhaps hallucinations that are directly related to the delusion
shared psychotic disorder (folie à deux)
Begins when one person develops a psychotic disorder with delusional content. The inducer is the dominant person in the relationship and over time imposes the delusional system on the second person, who then adopts the belief system and acts accordingly.
