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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
Q

Risk factors of schizophrenia

A

father is over 50 at the time someone is conceived; parents are in dry-cleaning business; males experience greater severity

26
Q

Factors affecting the course of schizophrenia

A

gender, family environment in dealing with stress, age of onset, premorbid functioning, cognitive ability, access to treatment (especially in first 3-5 years)

27
Q

Factors creating a worse prognosis for schizophrenia

A

delay in treatment, males, birth complications, severe hallucinations and delusions

28
Q

Biological factors of schizophrenia

A

genes explain 80% of risk of inheriting a tendency; environment affects expression of symptoms

29
Q

Behavioral markers of schizophrenia

A

tracking deficits in smooth-pursuit eye movement

30
Q

Brain abnormalities due to schizophrenia

A

attentional and working memory deficits, impaired social cognition, loss of brain volume, white matter, disorganized cytoarchitecture, disrupted brain development in adolescence

31
Q

Brain structure abnormalities due to schizophrenia

A

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
Q

Brain function abnormalities due to schizophrenia

A

hypofrontality; reduced neural connectivity; negative symptoms; PFC inhibits DA in limbic system; impaired working memory causing disorganized behavior, speech, and thought

33
Q

Hypofrontality

A

frontal lobe of the brain is less active

34
Q

Which part of the brain is active during auditory hallucinations?

A

Broca’s area (responsible for speech production)

35
Q

DA hypothesis

A

schizophrenia is associated with a DA excess

36
Q

How do DA drugs affect schizophrenic people?

A

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
Q

2 dopaminergic pathways

A

mesolimbic pathway (positive symptoms) to the nucleus accumbens and ventral tegmental area; mesocortical pathway (negative symptoms) to the frontal cortex

38
Q

Glutamate hypothesis

A

DA receptors inhibit glutamate activity so too much DA activity leads to too little glutamate activity

39
Q

Glutamate

A

plays a role in learning, memory, and neural processing; explains problems with attention, working memory, and executive function

40
Q

Neurodevelopmental hypothesis

A

SCZ results from a “silent lesion,” wherein abnormalities lie dormant until normal developmental processes expose problems

41
Q

How is SCZ neurodevelopmental?

A

presence of neuromotor, cognitive, and behavioral abnormalities; congenital minor physical and craniofacial anomalies (e.g. velocardial facial syndrome); gestational and perinatal exposures

42
Q

Examples of neuromotor abnormalities in SCZ

A

smaller head circumference at birth, slower to reach typical developmental milestones, higher rates of left-handedness

43
Q

Examples of gestational and perinatal exposures in SCZ

A

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
Q

Relationship between SCZ and cannabis

A

people with SCZ are 2x as likely as the general population to smoke cannabis (an environmental stressor)

45
Q

Diathesis-stress model of SCZ

A

genetic factors, prenatal and perinatal events > brain vulnerability > psychosis with the experience of stress and developmental maturation processes

46
Q

Multiple-hit model of SCZ

A

brain development > anatomical and functional disruption in neuronal connectivity > cognitive dysmetria > impairments in higher-order cognitive processes > SCZ symptoms

47
Q

Cognitive dysmetria

A

dysregulation of information processing in the brain

48
Q

Psychosocial factors of SCZ

A

stress, migration, urbanization, low SES, expressed criticism, hostility, and emotional over-involvement lead to increased relapse rate

49
Q

Past biological treatments for SCZ

A

prefrontal lobotomy, institutionalization, insulin coma, ECT

50
Q

Current biological treatments for SCZ

A

antipsychotic medication that blocks DA receptors and reduces positive symptoms

51
Q

2 types of antipsychotics for SCZ

A

1st generation or conventional and 2nd generation or atypical

52
Q

How do people respond to 1 or more psychotic episodes?

A

relatively rapid return to normal functioning and good prospects for recovery

53
Q

How do people respond to years of psychotic relapses?

A

periods of remission that tend to involve varying degrees of residual impairment

54
Q

Psychosocial treatments for SCZ

A

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
Q

Goals of CBT for SCZ

A

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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