PSYC 3607- Exam Flashcards
schizophrenia
- disorders in: thinking, communication, and emotion
- heterogenous in presentation
- symptoms may be positive (too much of a behaviour) or negative (absence of a behaviour)
positive schizophrenia symptoms**
- too much of a behaviour
- disorganized speech and behaviour (tangentiality and derailment), delusions, hallucinations
tangentiality
tendency to talk about a topic unrelated to the main topic of discussion
derailment (loose associations)
lack of connection between ideas
delusions
- implausible beliefs, typically based on misinterpretations of experiences of perceptions
- beliefs persist despite evidence they are faulty
- may reflect: persecutory, referential, somatic, religious, or grandiose themes (persecutory is the most common)
persecutory delusions
- most common
- delusions of paranoia
referential delusions
- belief that ordinary events and human behaviour have hidden meanings that relate to the individual
- individual believes they’re receiving special messages (e.g. song lyrics, newspapers)
somatic delusions
individual believes that something is wrong with all or part of their body
religious delusions
religious stories provide insight into how to destroy or save the world
grandiose delusions
unfounded or inaccurate beliefs that one has special powers, wealth, mission, or identity
hallucinations
- misinterpretations of sensory perceptions while awake
- see, smell, hear, or feel things that aren’t really present (auditory is the most common)
- affects 70% of patients
- involves brocas area (speech production)
disorganized behaviour
complex movements, manic limb flailing, catatonia, waxy flexibility
negative schizophrenia symptoms
- absence of a behaviour that should be evident in most people
- behavioural deficits
behavioural deficits (5)
- avolition- lack of energy
- alogia- poverty of speech
- anhedonia- lack of interest in recreation activities, relationships, etc.
- flat affect- important for early detection
- asociality- few friends, poor social skills
subtypes of schizophrenia
- paranoid- delusions and/or hallucinations with absence of cognitive or affective impairment
- disorganized- disorganized speech or behaviour and flat or inappropriate affect
- catatonic- psychomotor disturbance, extreme negativism and rigidity
- undifferentiated- when criteria A is met but cannot be effectively classified
schizophrenia and violence/self harm
- schizophrenics are not more violent than the general population
- schizophrenics are more likely to self harm and commit suicide
schizophrenia age of onset and course
- 20-24 for M, 25-29 for F
- 22%
- stress, recreational drug use, etc. have been tied to the initial experience of the disorder (like a trigger)
excessive pruning hypothesis
excessive pruning of the prefrontal cortex
schizophrenia and SES
- no difference in occurrence between SES groups, but individuals diagnosed with schizophrenia tend to drift towards low SES groups
- once afflicted, less likely to finish education or maintain employment
- social drift vs social causation
dopamine theory
- schizophrenia is thought to be related to increased activity of dopamine receptors
- drugs effective in treating schizophrenia decrease dopamine activity and produce similar side effects to Parkinson’s which is caused by too little dopamine
- amphetamines increase dopamine and can result in schizophrenia- like symptoms
substantia nigra
- critical brain region for the production of dopamine, which affects the CNS (movement, executive functioning, limbic activity)
- neuronal death in the substantia nigra leads to Parkinson’s symptoms
brain structure and function and schizophrenia
effects ventricles (enlarged- implies loss of subcortical brain cells), hippocampus, and prefrontal cortex (responsible for speech, decision making- reduced grey matter and neural connections)
schizophrenia treatment
- shock and psychosurgery (prefrontal lobotomy)
- drug therapy (neuroleptics and antipsychotics)
phenothiazines
- produces antipsychotic effects
- blocks post-synaptic receptor sites for dopamine (D2)
neurocognitive disorders
- significantly reduced mental abilities relative to one’s prior level of functioning
- changes in cognitive functioning are the primary set of features and are often associated with increased anxiety and depression as secondary features
- must be: compared to a person’s prior functioning and distingue from normal age related changes
three types of neurocognitive disorders
- delirium, amnestic disorder, dementia
- all three mainly affect older adults
two sets of abilities of intelligence
crystallized and fluid
crystallized intelligence
- ability to apply prior knowledge
- improves with age
fluid intelligence (executive functioning)
- ability to reason quickly and indepently of past experiences
- assessed with visual motor skills, problem solving, and perceptual speed
- declines after the age of 55
amnestic disorder
- difficulty storing new information and recalling stored information, more severe than expected for normal aging
- other mental processes (consciousness, attention, etc.) remain intact
- may be transient (lasting a few days to a month, may result from seizures) or chronic (longer than a month)
- tend to confabulate
confabulate
- creating stories to fill in gaps in memory
- family members are usually the best source of information as the patient may be a poor historian
neurological factors of amnestic disorder
- substance use
- general medical conditions (e.g. damaging brain areas involved in memory- hippocampus, mammilary bodies, fornix)
treating amnestic disorder
- no cure; partial or full memory function can return over time
- goal of treatment is rehabilitation
- help the patient learn to function as well as possible
- techniques and strategies to compensate for memory problems (e.g. mnemonics, writing info down, etc.)
- organizing the environment to aid memory
delirium
- impaired cognition (trouble concentrating, focussing, and maintaining a coherent and directed stream of thought) and marked change in awareness (illusion, hallucinations, perceptual disturbances)
- swings in activity (erratic to lethargic) and mood (depression, euphoria, anger, irritability)
- may have lucid intervals and become alert and coherent
what causes delirium?
drug intoxication and withdrawals, metabolic and nutritional imbalances, infections, fevers, neurological disorders, changing a person’s surroundings, severe or chronic illness
unique symptoms of delirium
- rapid onset
- symptoms fluctuate within a 24hr period
- hallucinations are frequent and tend to be visual
- symptoms often gradually improve
- person is not alert or focused
unique symptoms fo dementia
- gradual onset
- symptoms do not fluctuate
- no hallucinations
- symptoms rarely improve
- person is consistently alert
medical factors that affect cognition
- head injures (blunt force trauma to the head, stroke)
- prescribed and illicit substances (older adults are more sensitive to medications)
- other medical conditions (encephalitis, brain tumours, arthritis, chronic pain)
- hearing loss or vision problems may mimic deficits in cognitive functioning
stroke
- interruption of normal blood flow to or within the brain resulting in neuronal death
- cognitive, emotional, and behavioural consequences depend on which specific group of neurons was affected
aphasia**
problems in producing or comprehending language
broca’s aphasia**
- problems in producing speech
- damage to the left frontal lobe