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PSYC 300A > Psychosis & schizophrenia > Flashcards

Psychosis & schizophrenia Flashcards

1
Q

Psychosis

A

significant loss of contact with reality; a hallmark of schizophrenia

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2
Q

Schizophrenia

A

major disturbances in thought, emotion, and behavior

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3
Q

Disturbances experienced in schizophrenia

A

disordered thinking (e.g. ideas not logically related, faulty perception and attention); flat or inappropriate affect; highly unusual motor activity

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4
Q

3 hallmark symptoms of schizophrenia

A

delusions, hallucination, disorganized speech and/or behavior

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5
Q

Positive symptoms

A

excess and/or distortion in typical range of behavior and/or perception (e.g. delusions, hallucinations)

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6
Q

Negative symptoms

A

deficit of typically present behaviors

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7
Q

Delusions

A

erroneous beliefs, highly unusual thought content that are firmly held despite evidence

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8
Q

Hallucinations

A

sensory experiences or any sensory modality that seems real despite no external stimulus

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9
Q

Examples of delusions

A

thought insertion, broadcast thoughts, thought withdrawal

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10
Q

Examples of hallucinations

A

voices talking negatively about the person or speaking their thoughts aloud, arguing, or commenting on person’s actions

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11
Q

Thought insertion

A

believing that someone else put thoughts into your head

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12
Q

Broadcast thoughts

A

believing that others can read what you’re thinking

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13
Q

Thought withdrawal

A

believing that someone is taking away your thoughts

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14
Q

Examples of negative symptoms

A

behavioral deficits like reduced expressive behavior (e.g. alogia or minimal speech, flat affect) and reduced motivation/pleasure (e.g. avolition or minimal goal-directed activity, anhedonia, asociality), disorganization in speech content, form, or behavior

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15
Q

Anhedonia

A

not caring about things one used to care about, social withdrawal and isolation

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16
Q

Which kind of symptom has poorer prognosis?

A

negative symptoms worsen faster over time and respond poorly to treatment

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17
Q

Loose associations

A

grammatically correct form but content makes no sense

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18
Q

Clang associations or word salads

A

string of unrelated words with grammatically incorrect form

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19
Q

Catatonia

A

unusual complex movements and wavy flexibility or immobile posture

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20
Q

3 phases in schizophrenia

A

prodromal, active, residual

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21
Q

Prodromal phase

A

obvious deterioration in role functioning and change in personality

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22
Q

Active phase

A

experience of psychosis

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23
Q

Residual phase

A

improvement in positive symptoms but continued negative symptoms

24
Q

Lifetime risk of schizophrenia

A

1% or in 1 in 100 people

25
Risk factors of schizophrenia
father is over 50 at the time someone is conceived; parents are in dry-cleaning business; males experience greater severity
26
Factors affecting the course of schizophrenia
gender, family environment in dealing with stress, age of onset, premorbid functioning, cognitive ability, access to treatment (especially in first 3-5 years)
27
Factors creating a worse prognosis for schizophrenia
delay in treatment, males, birth complications, severe hallucinations and delusions
28
Biological factors of schizophrenia
genes explain 80% of risk of inheriting a tendency; environment affects expression of symptoms
29
Behavioral markers of schizophrenia
tracking deficits in smooth-pursuit eye movement
30
Brain abnormalities due to schizophrenia
attentional and working memory deficits, impaired social cognition, loss of brain volume, white matter, disorganized cytoarchitecture, disrupted brain development in adolescence
31
Brain structure abnormalities due to schizophrenia
decreased brain volume due to enlarged ventricles, reduced thalamus volume causing disorganized perception and thoughts, abnormalities in temporal lobe areas (e.g. reduced hippocampus and amygdala volume)
32
Brain function abnormalities due to schizophrenia
hypofrontality; reduced neural connectivity; negative symptoms; PFC inhibits DA in limbic system; impaired working memory causing disorganized behavior, speech, and thought
33
Hypofrontality
frontal lobe of the brain is less active
34
Which part of the brain is active during auditory hallucinations?
Broca's area (responsible for speech production)
35
DA hypothesis
schizophrenia is associated with a DA excess
36
How do DA drugs affect schizophrenic people?
drugs that increase DA lead to schizophrenia-like behavior (e.g. amphetamine, L-dopa) and drugs that decrease DA reduce schizophrenia-like behavior but not negative symptoms (e.g. neuroleptics)
37
2 dopaminergic pathways
mesolimbic pathway (positive symptoms) to the nucleus accumbens and ventral tegmental area; mesocortical pathway (negative symptoms) to the frontal cortex
38
Glutamate hypothesis
DA receptors inhibit glutamate activity so too much DA activity leads to too little glutamate activity
39
Glutamate
plays a role in learning, memory, and neural processing; explains problems with attention, working memory, and executive function
40
Neurodevelopmental hypothesis
SCZ results from a "silent lesion," wherein abnormalities lie dormant until normal developmental processes expose problems
41
How is SCZ neurodevelopmental?
presence of neuromotor, cognitive, and behavioral abnormalities; congenital minor physical and craniofacial anomalies (e.g. velocardial facial syndrome); gestational and perinatal exposures
42
Examples of neuromotor abnormalities in SCZ
smaller head circumference at birth, slower to reach typical developmental milestones, higher rates of left-handedness
43
Examples of gestational and perinatal exposures in SCZ
pregnancy and bir th complications like maternal starvation in 1st trimester, obstetric complications (e.g. premature birth, hypoxia), viral infections, early nutritional deficiencies and maternal stress
44
Relationship between SCZ and cannabis
people with SCZ are 2x as likely as the general population to smoke cannabis (an environmental stressor)
45
Diathesis-stress model of SCZ
genetic factors, prenatal and perinatal events > brain vulnerability > psychosis with the experience of stress and developmental maturation processes
46
Multiple-hit model of SCZ
brain development > anatomical and functional disruption in neuronal connectivity > cognitive dysmetria > impairments in higher-order cognitive processes > SCZ symptoms
47
Cognitive dysmetria
dysregulation of information processing in the brain
48
Psychosocial factors of SCZ
stress, migration, urbanization, low SES, expressed criticism, hostility, and emotional over-involvement lead to increased relapse rate
49
Past biological treatments for SCZ
prefrontal lobotomy, institutionalization, insulin coma, ECT
50
Current biological treatments for SCZ
antipsychotic medication that blocks DA receptors and reduces positive symptoms
51
2 types of antipsychotics for SCZ
1st generation or conventional and 2nd generation or atypical
52
How do people respond to 1 or more psychotic episodes?
relatively rapid return to normal functioning and good prospects for recovery
53
How do people respond to years of psychotic relapses?
periods of remission that tend to involve varying degrees of residual impairment
54
Psychosocial treatments for SCZ
CBT, cognitive remediation (to improve cognitive functioning), family therapy (to improve communication skills and decrease expressed emotion), case management, social and living skills training, vocational rehabilitation
55
Goals of CBT for SCZ
to reframe positive symptoms, identify triggers for symptoms, improve social skills, reduce relapse (but not helpful for negative symptoms)

PSYC 300A (11 decks)

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