Psychosis

Question 1

What is psychosis?

Answer 1

A state defined by a loss of contact with reality. The perceive and respond to the environment is significantly disturbed - functioning is impaired.

Question 2

What are the symptoms of psychosis?

Answer 2

Hallucinations and or delusions. They can be substance induced or caused by brain injury but most psychosis appears in the form of schizophrena.

Question 3

What socioeconomic group is more likely to have sz? Why could this be the case?

Answer 3

More frequent in lower classes. Stress of poverty is theorised to cause sz. There is also the downward drift theory that posits that SZ causes victims to fall from higher social levels and remain at lower levels

Question 4

What are the statistics of marital status and sz?

Answer 4

3% of divorced or separated people
2% of single people
1% of married people
Unclear whether marital problems are a cause of a result

Question 5

Do men and women’s diagnosis differ?

Answer 5

Equal number of men and women are diagnosed , in men symptoms begin earlier and are more severe

Question 6

What is the link between schizophrenia and ethnicity ?

Answer 6

About 2% of african americans are diagnosed , compared with 1.4% of caucasians . African americans are more likely to be poor and experience marital separation.
When controlling for these factors, rates of schizophrenia are equal for the two racial groups.

Question 7

What does sz affect?

Answer 7

Brain and behaviour disorder affecting how one thinks, feels and acts. Can have trouble distinguishing reality from fantasy , expressing and managing normal emotions and making decisions. Can have trouble distinguishing reality from fantasy , expressing and managing normal emotions and making decisions.

Question 8

What are the three types of symptoms?

Answer 8

• negative
• positive
• psychomotor

Question 9

Briefly list positive symptoms of SZ

Answer 9

Delusions, disordered thinking and speech, heightened perceptions , hallucinations

Question 10

Briefly list negative symptoms of SZ

Answer 10

poverty of speech , long lapses before responding to questions, slow speech, blunted and flat affect, expressionless face, apathetic, monotonous voice, loss of volition (motivation) , social withdrawal.

Question 11

Briefly list psychomotor symptoms of SZ

Answer 11

Awkward movements, repeated grimaces, odd gestures , movements seem to have a magical quality, catatonia, stupor, rigidity, excitement

Question 12

What are the five subtypes of SZ in the DSM-5?

Answer 12

Disorganised, catatonic , paranoid, undifferentiated, residual

Question 13

What is disorganised SZ?

Answer 13

confusion, incoherence, flate or inappropriate affect

Question 14

What is catatonic sz?

Answer 14

psychomotor disturbance of some sort

Question 15

What is paranoid sz?

Answer 15

Orgabnised system of delusions and auditory hallucinations

Question 16

What is undifferentiated sz?

Answer 16

characterised by symptoms which fit no subtype, vauge category

Question 17

What is residual sz?

Answer 17

Symptoms which have lessened in strength and number, the person may contibue to display blunted or inappropriate emotions

Question 18

What are the features of type I schizophrenia?

Answer 18

Dominated by positive symptoms .
- Better adjustment prior to onset of symptoms
- More positive outcome
- Tied to biochemical abnormalities

Question 19

What are the features of type II schizophrenia?

Answer 19

Dominated by negative symptoms
- Poorer adjustment prior to onset of symptoms
- Earlier onset of symptoms
- Less positive outcomes
- Symptoms tied to structural abnormalities

Question 20

What is the biological understanding of schizophrenia? Biochemical abnormalities

Answer 20

Biochemical abnormalities
- DOPAMINE may be overactive due to larger than usual number of dopamine receptors
- Autopsy findings have found an unusually large number of dopamine receptors

Question 21

What is the biological understanding of schizophrenia? abnormal brain structure

Answer 21

Brain scans = large ventricles - more likely to display symptoms of Type II
–> May be a sign of poor development in related brain regions
–> People with SZ have been found to have smaller temporal and frontal lobes and abnormal blood flow to certain brain area

Question 22

What is the psychological view of schizophrenia? psychodynamic

Answer 22

Freud, sz developed from two processes
= regression to pre-ego stage
= efforts to reestablish ego control
- People regress tp the earliest points in their development in which they only recognise their needs
- Leads to self-centred symptoms such as lddelusions of grandeur

Question 23

What is the psychological view of schizophrenia? cognitive view

Answer 23

Cognitive theroists agree that biology plays a role
- Due to faulty development due to faulty interpretation and a misunderstanding of symptoms
- Not much research on this

Question 24

What is the sociocultural view of schizophrenia?

Answer 24

Multicultural factors - african america patients are more likely than white amercians to be assessed as having symptoms and admitted to state hospitals. Could be that african americans are more prone to the development of the disorder . Unintenonally biassed clinicians due to diagnoses of african americans or misreading cultural differences as symptoms
Afican americans more likely to be poor.

Question 25

What is the family dysfunction explanation of schizophrenia?

Answer 25

Double bind communications - communicating pairs of mutually contradictory messages that place children in double bind situations - nothing they do is right

Family stress - ‘over expressive’ emptionaly, displaying more conflict, having greater difficulty communicating with one another - more overinvolved than other parents

Question 26

What was the issue with institutional care in the past?

Answer 26

Many patients failed to improve but developed additional symptoms due to institutionalisation itself .

• Social breakdown syndrome - extreme withdrawal, anger and physical aggressiveness. Los of interest in personal appearances and functioning

Question 27

What is milieu treatment?

Answer 27

Based on humanistic principles . Creates a social climate that prmotes productive activity, self-respect and individual responsibility .

Question 28

What do token economy programs involve?

Answer 28

Operant conditioning principles, used in institutions
- Rewarded for for socially acceptable behaviour
- Immediate rewards suvch as cigarettes , food or privileges
No longer as popular as once was but sometimes used longside medication
Helps self image and personal care of patients

Question 29

what type of symptoms does antipsychotic drugs reduce

Answer 29

Positive symptoms are reduced quicker than negative

Question 30

What are the unwanted effects of antipsychotic drugs as a treatment for sz?

Answer 30

Tardive dyskinesia - tic like movements of the mouth, lips, tongue and body. Affects more than 10% of these taking the drugs , can be difficult, sometimes impossible to eliminate

Question 31

What are the positive effects of newer drugs?

Answer 31

Atypical drugs are more effective especially for negative symptoms.
- fewer extrapyramidal side. effects and less likely to cause tar dive dyskinesia. But can cause life threatening drop in white blood cells. Weight gain, dizziness and elevations in blood sugar.

Question 32

How does psychotherapy help treat schizophrenia?

Answer 32

CBT seeks to change reactions to hallucinations. This is done through education, learning about the comings and goings of their hallucinations and delusions. Challenges inaccurate ideas and teaches coping skills. The new wave of psychotherapy helps clients to accept their streams of problematic thoughts and helps them gain a sense of greater control.

Question 33

What is family therapy?

Answer 33

Sz can create family stress, family therapy reduces relapse by addressing issues and creating more realistic expectations and provides psychoeducation about the disorder . family support groups

Question 34

what is social therapy?

Answer 34

problem solving, decision making, social skills training, medication management, employment counselling financial assistance and housing.

Question 35

what is the community approach to treating schizophrenia?

Answer 35

Receiving care within the community rather than taken to institutions far from home

Led to the massive deinstitionalisation of patients however it is inadequate for tge care of patients, ‘revolving door’ syndrome. In the 1963, US congress passed the community mental health act.

Question 36

how has community treatment failed?

Answer 36

• lack of funding
• shortage off services
• and poor coordination (burnt out staff)

Question 37

What do sociocultural theorists believe people with mental disorders are victims of socially?

Answer 37

Victims of multicultural factors, social labelling and family dysfunction . These are important in the development of SZ however their precise relationship has not yet been clarified by research

Question 38

What is milieu therapy ?

Answer 38

Patients make clinical progress by creating a social climate that promotes productive activity, self respect and individual responsibility . Patients with SZ who are part of milieu-style programs often leave the hospital at higher rates than patients receiving custodial care.

Question 39

What does tardive dyskinesia involve?

Answer 39

Involves writhing or tic-like involuntary movements , usually of the mouth, lips, tongue, legs , to body. Difficult to eliminate, almost impossible.

Question 40

What is assertive community treatment ?

Answer 40

a combination of services , another key feature is coordinated services and short term hospitalisation , partial hospitalisation and supervised residences