Psychosis Flashcards
what is psychosis
a state of being out of touch with reality.
What are the different diagnoses under psychosis
Schizophrenia Schizoaffective disorder Delusional disorder Schizophreniform disorder breif psychotic disorder
what are positive symptoms and examples
Excess of normal functioning
- Hallucinations
- Delusions
- Disorganised thought (speech)
what are negative symptoms and examples
Absence of normal functioning
- emotionless flat affect
- withdrawal
emotions and feelings in schizophrenia
Schizoaffective disorder
low motivation, low energy, anhedonia (cant recognise own emotions- flat affect), depression, anxiety, irritability, elation
thoughts and percetions
: hallucinations, unusual beliefs (delusions), disorganised thinking, poor concentration.
behaviours
withdrawal from others, isolation, reduced speech (poverty of content), irritability, aggression, impulsivity.
What are hallucinations
Hearing voices (auditor) are the most common form of hallucinations Present in about 70% of individuals with schizophrenia.
The perception of something present which isn’t actually, alien to themselves (very often inside their head- theories to account for this)
Related to:
- Reality monitoring difficulty distinguishing self from others
- Disconnection between speech generating and speech perception brain regions.
Visual hallucinations: coincide with auditory- seeing the face of someone in a ghosty way.
Voices unpleasant- highly critical, orders, more than one- commenting.
Brain regions which are activated in auditory hallucinations include Brocas and Wernickes area- speech centres of the brain, inner speech is misattributed to an external source.
Disorganised thinkinging (speech)
- Actually a communication disorder
- Word salad- don’t really make sense.
- Derailment (knights move thinking) – make associations between topics.
- Tangentiality- going off on a tangent
- Clanging- rhyming or alliteration
- Neologisms
Incoherent to the listener. Emotionally important topics brings it out.
delusions
beliefs.
- Paranoid delusions
- delusions of grandeu
Bipolar disorder
Spectrum of bipolar disorders (Akiskal et al., 2000)
Major depressive episode.
Manic episode.
Hypomanic episode
Mixed episode
Euthymic phase- normal.
Mania : Elation, irritability/ anger, decreased sleep, increased goal directed activity, risk taking behaviour, impulsivity, pressure of speech, energy and drive, flight of ideas, distractibility, grandiosity, psychotic symptoms (hallucinations, paranoid delusions).
Bipolar is not two ends of a spectrum. Mixed episodes are common and positive and negative mood fluctuate independently over time (Johnson et al 2011).
Prevalence
• 1% lifetime risk for a diagnosis or bipolar. 3% for any psychotic disorder.
Risk factors
disadvantaged urban areas.
age of onset
late teens early 20s
men seem to have earlier onset (<25)
Problems with diagnosis
Poor reliability and validity • Disagreement between clinicians • Don’t always cluster together • Doesn’t predict course or prognosis • Does not predict response to particular treatments
Tells us nothing about the cause
Alternative to diagnosis
Symptom based approach- try to develop explanatory models and treatment for specific symptoms.
Psychological models
Continuum model
Psychosis might actually be on a continuum more common than think
- Hallucinatios 10-15% (Tein, 1991)
- Delusions 12% (van Os et al 2000)
- Paranoai 12.6% (poulton et al 2000)
Bipolar spectrum 6.4% (Judd and Akiskal, 2000)
Stress vulnerability model
Zobin Stuart and Condray (1992)
Underlying vulnerability may be biological or psychological
environmental stress combines with vulnerability to produce problems
Cognitive processes
A and D
problems with attention and distractability associated with negative symptoms of thought disorder (Green, 1992)
Cogntiive processes (TOM)
Frith, 1994) theory of mind deficits associated with paranoid delusions
cognitive processes (bias)
jumping to conclusion bias especially associated with delusions (Dud;ey et al., 1997)
Cognitive processes (monitor)
Source monitoring deficits, especially associated with hallucinations (bentall and Slade, 1985)
Trauma
Vanesse et al (2012) Wide range of stressors and trauma associated with psychosis: sexual abuse, assault, bullying,
PTSD
(morrison, Frame, and Larkin, 2003) PTSD is highly assicated 20% of individuals also have PTSD- highlighting association with trauma.
