Psychosis literature

Question 1

waar staan we nu met dopamine hypothesis

Answer 1

• antipsychotic medication increase dopamine turnover, especially at dopamine D2 receptors
• the involvement of dopamine in psychosis itself is not fully proven
• post mortem studies: wel abnormalities in dopaminergic indexes in schizophrenia
• providing dopamine kan induce psychosis

the dopaminergic abnormality in schizophrenia may not be exclusive or primary, and it is likely a state abnormality rather than a fundamental abnormality. “the wind of the psychotic fire”

Question 2

anhedonia hypothesis =

Answer 2

posits that dopamine medidates pleasure associated with rewarding experiences and neutral stimuli.

however, observations that dopamine is involved in both rewarding and aversive events, and that dopamine precedes pleasure consummation, challenges this view

Question 3

incentive/motivational salience hypothesis=

Answer 3

dopamine converts neutral stimuli into attractive or aversive entities, theraby influencing goal directed behaviour

emphasizes the role of the mesolimbic dopamine system in attributing salience to events and thoughts, driving action and influencing decision making

Question 4

psychosis is therefore a disorder of…

Answer 4

aberrant salience

Question 5

patients typically undergo a gradual evolution of heightened awareness and emotional intensity before the onset of a full psychosis

Answer 5

oke

Question 6

amphetamine can exacerbate symptoms in those with a history of psychosis

Answer 6

oke

Question 7

verschil tussen delusions and hallucinations

Answer 7

delusions are often illogical but not impossible beliefs, arise as explanations for experiences of abberant salience, whilst hallucinations stem from the abnormal salience of internal perceptions and memories.

Question 8

hoe is symptom improvement van antipsychotics

Answer 8

gradual and cumulative, with patients often reporting reduced distress rather than complete resolution of delusional beliefs

they reduce salience in the environment

Question 9

hoe denkt aberrant salience over dopamine

Answer 9

dopamine dysregulation drives the neurochemical aspect, the individuals cognitive/psychodynamic and cultural context shapes the experience

Question 10

hoe zou schizophrenia in relatie staan tot drug abuse

Answer 10

antipsychotics are associated with dysphoria, porentially stemming from their dampening effect on salience. this dampening may affect not only aberrant saliences but also normal motivations and pleasures => high incidence of drug abuse

Question 11

this framework acknowledges brain-level and mind-level, without presuming etiological factors but instead pathophysiological.

Answer 11

oke

Question 12

3 potential barriers for mutual understanding with individuals of psychosis:

Answer 12

1. different narratives about the mental health system
2. varying levels of insight and therapist theoretical perspectives
3. stigmatizing beliefs held by both client and therapist

Question 13

intersubjectivity=

Answer 13

the sharing and appreciation of subjective experiences between two individuals, forms the basis of relatedness and self-reflection in psychotherapy

Question 14

what is the intersubjective proces in the context of psychotherapy

Answer 14

agreeing on treatment goals

Question 15

1. different narratives about the mental health system

Answer 15

the client may think of it as oppressing whilst the therapist may view it as benevolent -> leading to misunderstandings

Question 16

2. varying levels of insight and therapist theoretical perspectives

Answer 16

the client may have poor insight, deny their illness, whilst the therapist may hold theoretical perspectives on psychosis.

-> complicated shared meaning-making

Question 17

3. stigmatizing beliefs held by both client and therapist

Answer 17

therapist may adopt paternalistic attitudes, whilst the client may internalize stigma, leading to passivity and withdrawal from the therapeutic process

Question 18

how can these barrieres be addressed

Answer 18

• metacognition
• empathy

Question 19

metacognition=

Answer 19

awareness and integration of mental experiences, ranging from discrete perceptions to complex representations of the self and others.

Question 20

empathy =

Answer 20

involves cognitive and emotional elements, allowing individuals to perceive and share others’ affective states

Question 21

in therapy, empathy can lead to …

Answer 21

greater awareness and integration of experiences, fostering shared emotional states and facilitating the creation of integrated representations

Question 22

therapeutic alliance is….

Answer 22

an intersubjective space where a unique shared narrative emerges and where coherence is prioritized over accuracy!!!

Question 23

waar focused psychodynamic therapy op

Answer 23

childhood experiences and the function of psychotic symptoms

Question 24

waar focused CBT op

Answer 24

the interpretation of these psychotic symptoms

Question 25

why are talk therapies like CBT limited for people with psychosis

Answer 25

• limited resources
• therapist reluctance due to challenging nature of treating these clients