psychotic disorders Flashcards
characteristics of psychosis
- disorganization
- can’t put thoughts or actions together - decreased social functioning
- inability to interact - loss of contact with reality
predisposing factors
- *no single cause, but a combo
1. biological (genetics, neurotransmitters, diseases)
2. psychological (family, stress)
3. environmental/sociocultural (lower socioeconomic status)
transaction model
- precipitating event that leads to symptoms
- predisposing factors
- cognitive appraisal
- quality of response (adaptive or maladaptive)
positive symptoms
- exaggeration of normal function
- more successful at treating
- content of thought
- form of thought
- perception
- sense of self
negative symptoms
- loss of normal function
- more detrimental
- affect
- volition
- impaired social function
- psychomotor
- associated features
phases of psychotic disorder
- premorbid
- prodomal
- schizophrenia/psychosis
- residual
content of thought (+ symptoms)
- delusions
- religiosity
- paranoia
- magical thinking
- idea of reference
delusion of persecution
some out to get you
delusion of grandeur
somebody super important
delusion of reference
everything in the environment pertains to me; someone is trying to send me a message
delusion of control & influence
someone is controlling me
somatic delusion
related to body; you say you are pregnant, but you really aren’t
nihilistic delusion
self or a body part is non existent
idea of reference
if 2 people are talking or laughing, they are talking about me
form of thought (+ symptoms)
- associative looseness
- neologisms
- concrete thinking
- clang associations
- word salad
- circumstantiality
- tangentiality
- mutism
- perservation
associative looseness
- speech shifts from one thought to an unrelated thought
- sort of connected but doesn’t really make sense
neologisms
make up own word
concrete thinking
thinking literally
clang associations
using words that rhyme
word salad
words with no connection put together in a sentence
circumstantiality
give so many details that you never get to the point
tangentiality
jumping from one subject to another
perservation
person gives the same answer/idea to every question
perception (+ symptoms)
- hallucinations (nothing there)
- illusion (something there, interpreting differently)
sense of self (+ symptoms)
- uniqueness and individuality a person feels
- echolalia (words)
- echopraxia (actions)
- identification
- imitation
- depersonalization
identification
unconscious, imitating actions
imitation
conscious, imitating actions
depersonalization
outside looking in; an observer watching self
affect (- symptoms)
- inappropriate (incongruent with circumstances)
- bland/blunted (weak)
- apathy (don’t care what’s happening around)
- flat
volition (- symptoms)
- inability to initiate a goal directed activity
- emotional ambivalence (conflict between need & fear)
interpersonal function (- symptoms)
- autism
- no care for appearance
psychomotor (- symptoms)
- anergia
- waxy flexibility
- posturing
- pacing & rocking (lack of purpose)
anergia
no energy to do anything
waxy flexibility
put into a position, stay in that position
-able to move if moved by another person
posturing
voluntary positioning
-resistance if moved by another person
associated features
- anhedonia
- regression
anhedonia
no pleasure in anything
-high correlation with suicide
regression
-returning to a previous level of development and using coping mechanisms of that level of development
phase 1 of psychosis
- premorbid
- functional
- shyness, difficulty making friends
- do poor in school
phase 2 of psychosis
- prodomal
- symptoms begin to manifest
- decline in function, can’t work or go to school
- nonspecific symptoms (anxiety, sleep disturbance, fatigue)
phase 3 of psychosis
- schizophrenia/psychosis
- active + and - symptoms
- full blown
phase 4 of psychosis
- residual
- pt gets a little bit better, less + symptoms
- negative symptoms still there
- impairment in role functioning
disorganized schizophrenia
- most debilitating
- early onset (25 yrs old or before)
- most severe form
catatonic schizophrenia
- stupor: extreme psychomotor retardation
- excitement: extreme psychomotor agitation; can be life threatening
paranoid schizophrenia
- delusions of persecution/grandeur
- a. halluc
undifferentiated schizophrenia
- NOS
- looks like schizo, but have different types of schizo in one
residual schizophrenia
- pt has the chronic form of dx and is in the stage that follows an acute episode
- no strong symptoms
schizoaffective disorder
psychosis + mood disorder
brief psychotic disorder
- sudden onset
- short term (<1 mo)
- precipitating event
- full recovery
schizophreniform disorder
-pt has all the features of schizo, but it hasn’t been 6 mo yet
delusional disorder
-presence of one or more non bizarre delusions
shared psychotic disorder
- two people share psychosis
- stronger personality convinces the weaker personality
- usually a dependent & close relationship
psychotic disorder d/t medical condition
- head injury
- brain tumor
- this dx is not made during dementia
substance induced psychotic disorder
from crystal meth
dual dx psychotic disorder
substance abuse + psychosis
phases of tx
- active phase
- develop a trusting relationship
- safety
- alleviate symptoms - maintenance phase
- help improve daily function
- 3. rehab phase
- restore back to highest capacity
