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Intro to Abnormal Psychology > Psychotic Disorders > Flashcards

Psychotic Disorders Flashcards

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1
Q

Psychosis

A

Inability to differentiate between what is real and what is unreal

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2
Q

Negative symptoms

A

Loss of normal function. Can include symptoms such as lack of pleasure (anhedonia), lack of emotion, lack of motivations, etc.

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3
Q

Positive symptoms

A

Excesses or distortions, such as delusions, hallucinations and disorganized speech.

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4
Q

Schizophrenia

A

Chronic and severe psychotic disorder

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5
Q

Active phase of schizophrenia

A

Basically psychosis. Involves disturbance of thoughts, behaviours and emotions.

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6
Q

Why is schizophrenia known as a heterogeneous disorder?

A

There are a number of symptoms that aren’t shared among all the individuals with the disorder; so not very easy to point to one thing that characterizes it (e.g. depression -> sadness, panic disorder -> panic attacks) - so two individuals with the disorder may not look anything alike

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7
Q

DSM-5 criteria for schizophrenia

A

2 or more active phase* symptoms for > 1 month
- *Delusions
- *Hallucinations
- *Disorganized Speech
- Disorganized or catatonic behavior
- Negative Symptoms
Continuous signs > 6 months (basically chronic)

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8
Q

Symptom presentation of schizophrenia

A
  • Acute
  • Prodromal
  • Residual
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9
Q

Acute symptoms

A

Significant symptoms are present and cause marked

impairment in functioning

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10
Q

Prodromal symptoms

A

Milder symptoms present for at least 1-2 years before first acute episode

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11
Q

Residual symptoms

A

Milder symptoms between acute episodes

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12
Q

Types of hallucination

A
  • Auditory: Hearing voices; most common (e.g. might speak in 3rd person, might command individual to do things, might be running commentaries)
  • Visual: e.g Seeing a figure
  • Olfactory: e.g. Smelling burning
  • Tactile: e.g. Bugs crawling on skin
  • Somatic: e.g. Stomach rotting
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13
Q

Wernicke and Broca’s areas during hallucinations

A

Broca’s area (language production), but not Wernicke’s (language comprehension), was activated during hallucinations, which suggests that auditory hallucinations have more to do with generating words than listening to them - brain can’t recognize difference between thoughts and speech.

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14
Q

Types of delusions related to thought

A
  • Broadcasting
  • Insertion
  • Withdrawal
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15
Q

Thought broadcasting

A

Delusion that others can hear or are aware of an individual’s thoughts

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16
Q

Thought insertion

A

Thoughts are put into mind by external source (e.g. evil thoughts transmitted into head through modem/router)

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17
Q

Thought withdrawal

A

Thoughts are being removed (e.g. your roommate is stealing your thoughts while you sleep)

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18
Q

Delusions of….

A
  • Grandeur
  • Persecution
  • Reference
  • Being controlled
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19
Q

Delusions of grandeur

A

A false impression of one’s own importance (e.g. setting out to save the world)

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20
Q

Delusions of persecution

A

Most common; belief that one is being plotted against/threatened

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21
Q

Delusions of reference

A

A neutral event is believed to have a special and personal meaning (e.g. people on TV are making fun of you, broadcasting coded info about you)

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22
Q

Delusions of being controlled

A

Actions, thoughts, etc. are controlled by someone/something else (e.g. demons)

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23
Q

Capgras syndrome

A

People who experience this syndrome will have an irrational belief that someone they know or recognize has been replaced by an imposter.

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24
Q

Types of disorganized speech

A
  • Loosening of association
  • Word salad
  • Neologisms
  • Clanging
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25
Q

Loosening of association

A

Derailment, speech is very tangential, topic to topic

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26
Q

Word salad

A

More extreme, speech is illogical and makes no sense

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27
Q

Neologisms

A

Makes up words that have no meaning to the person being spoken to

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28
Q

Clanging

A

Stringing together words that rhyme

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29
Q

Types of disorganized symptoms

A
  • Disorganized speech (formal thought disorder)
  • Disorganized affect: Inappropriate emotional behaviour (inappropriate to situation)
  • Disorganized behaviour (Unusual behaviours) and catatonia
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30
Q

Types of catatonia

A
  • Catatonic immobility
  • Catatonic excitement
  • Catatonic posturing
  • Waxy flexibility
31
Q

Catatonic immobility

A

Lack of behavior

32
Q

Catatonic excitement

A

Uncontrolled excitation

33
Q

Catatonic posturing

A

Person assumes a bizarre or inappropriate posture and maintains it over a long period of time

34
Q

Waxy flexibility

A

The limb or other body part of a catatonic person can be moved into another position that is then maintained

35
Q

Types of negative symptoms (5 A’s)

A
  • Affective flattening
  • Alogia
  • Avolition (apathy)
  • Anhedonia: Lack of pleasure; indifference
  • Asociality: Severe relationship impairment
36
Q

Affective flattening

A

Little expressed emotion (nothing to do with feeling emotions)

37
Q

Alogia

A

Reduction in speech amount/content (e.g. delayed comment, brief comments - thought disorder, not inadequate communication skills)

38
Q

Avolition (apathy)

A

Lack of initiation/persistence - don’t do even the most basic things (e.g. basic hygiene)

39
Q

Cognitive deficits in schizophrenia

A
  • NOT criteria for diagnosis; simply correlated with schizophrenia
  • Deficits in attention (focusing and maintaining attention) and working memory (hold and manipulate info actively in mind)
  • May be present before development of full blown disorder - might be an early marker for the disorder
40
Q

Consequences of cognitive deficits

A
  • Information and stimulation flood awareness and individual can’t figure out the source or differentiate between what’s real/not real
  • Delusions/hallucinations might develop as a way to make sense of the information bombarding them
41
Q

Genain quadruplets

A
  • Identical quadruplets
  • All of them developed schizophrenia by age 24
    VERY VERY rare
  • Symptom presentation + course of disorder = very different for each sister
42
Q

Development of schizophrenia in the Genain quadruplets

A
  • Genetic risk from grandmother
  • Concordance is only about 40-50% though
  • Toxic family environment
  • Birth complications -> lack of oxygen (even for short period of time) + family history -> increased risk
  • Myra was the least impaired since she didn’t experience birth complications nor abuse; Hester was the most impaired because she experienced both
43
Q

Excess dopamine affects the _____ and leads to ____

A

mesolimbic pathway, positive symptoms

44
Q

Dopamine deficit affects the _____ and leads to _____

A

prefrontal cortex, negative symptoms

45
Q

Brain abnormalities in schizophrenia

A
  • Enlarged ventricles (due to atrophy or improper development of surrounding regions that gave them room to enlarge)
  • Smaller PFC (language, emotional expression, planning); less activation
  • Smaller hippocampus, abnormal activation
  • Only affected twins show these differences (implication that they’re environmental)
46
Q

Damage to developing brain

A
  • Birth complications (30% with perinatal hypoxia - inadequate oxygen)
  • Maternal viral infections
  • Maternal nutritional deficiencies
  • Maternal herpes simplex viral infection
  • Most vulnerable during 2nd trimester (when extreme development occurs), and simply increases the risk (but not by a lot)
47
Q

Schizophrenia and low SES

A
  • Low SES might be a risk factor (low SEs -> schizophrenia)

- Social drift - those with disorder are more likely to “drift” down into lower SES (schizophrenia -> low SES)

48
Q

Influence of urban settings on schizophrenia

A

Higher likelihood of viral infections (i.e. could lead to brain damage in developing fetuses)

49
Q

Effects of stress

A
  • Increases risk for relapse

- May precede first onset of acute symptoms

50
Q

Types of stress

A
  • Family environment
  • Stressful life events
  • Immigration
51
Q

Role of culture

A
  • Symptom expression: Content of delusions and hallucinations can differ
  • Prognosis: Better prognosis in developing countries
  • Risks: Sensitivity to family functioning
52
Q

Expressed emotion

A

The critical, hostile, and emotionally over-involved attitude that relatives have toward a family member with a disorder. Can lead to more symptoms, and more symptoms can lead to more expressed emotion. Culture can influence whether it’s well meaning or an act of control.

53
Q

Study by Rosenbarb

A
  • Participants: Patients with schizophrenia
  • Independent variables: Relative’s criticism/intrusiveness, patient’s odd thinking and race
  • Dependent variable: Amount of time before patient NEEDED to take medication (e.g. showed signs of relapse, couldn’t cope with family therapy alone)
  • Method: Recorded families problem solving, coded intrusiveness and criticism
  • Results: High in expressed emotion + high odd thinking -> medication more needed
54
Q

Treatment options

A
  • Neuroleptics (first discovered)

- Atypical antipsychotics (newer)

55
Q

Neuroleptics

A
  • Block receptors for dopamine
  • Treat positive symptoms not negative symptoms
  • 25% don’t respond
  • 98% of patients have relapse within 2 years if they go off
  • Serious side effects
56
Q

Atypical antipsychotics

A
  • Affect dopamine in various ways
  • Treat positive well and negative to some degree
  • Better side effect profile but still not great
57
Q

Individual therapy

A
  • Cognitive: focus on changing attitudes about
    treatment and seeking help
  • Behavioral: reinforcing appropriate social interaction
  • Social support: increase contact with others and
    learn problem solving skills
58
Q

Family therapy

A
  • Educate families about disorder
  • Improve communication skills
  • Improve problem solving
  • Healthier family relationship and reduces stress on patient; reduces criticism towards patient
59
Q

Assertive community teamwork

A
  • Team of social workers, medical professionals, and psychologists
  • 24-hour assistance
  • Services provided in home and community
60
Q

Outcomes of assertive community teamwork

A
  • Reduces hospitalizations
  • Increases likelihood of employment
  • Reduced symptoms
  • BUT gains decline if treatment stopped
61
Q

Acceptance and commitment therapy

A
  • Views avoidance/control as the problem

- Focus on accepting, not avoiding, inner experiences

62
Q

Outcomes of acceptance and commitment therapy

A
  • Reduces hospitalizations
  • Reduces believability of hallucinations
  • Increases reported delusions/hallucinations
63
Q

Poor prognosis of schizophrenia

A
  • 40-60% don’t receive treatment in a given year
  • Re-hospitalization 50-80%
  • 10-15% suicide
  • BUT most stabilize after 5-10 years
64
Q

Poor prognostic indicators of schizophrenia

A
  • Males earlier onset/more severe
  • Worse functioning in younger patients
  • Less social support
  • More criticism
65
Q

Schizoaffective disorder

A

Mix of schizophrenia and a mood disorder

66
Q

Schizophreniform disorder

A

Symptoms of schizophrenia present for less than 6 months

67
Q

Brief psychotic disorder

A

Sudden onset of delusions, hallucinations, disorganized

speech, and/or disorganized behavior lasting for up to a month

68
Q

Delusional disorder

A

Delusions lasting at least 1 month regarding situations

that occur in real life

69
Q

Schizotypal personality disorder

A

Lifelong pattern of significant oddities with respect to
self-concept, ways of relating to others, thinking and
behavior

70
Q

Criteria for involuntary commitment

A
  • Incapacity: Incapacitation to the point of an inability to care for basic needs
  • Dangerousness to self: Imminently suicidal
  • Dangerousness to others: Must be imminent
71
Q

Process of involuntary commitment

A
  • Review process - doctor determines if patient should be kept within facility
  • Anyone detained involuntarily have the right to a hearing
  • Two opinions are needed to maintain admission - have to be in agreement
  • Being homeless with a mental illness isn’t sufficient
72
Q

Right to treatment

A
  • Provided humane psychological and physical environment
  • Given by qualified staff
  • Individualized treatment plan
  • Minimum restrictions of freedoms
73
Q

Right to refuse treatment

A
  • Must have informed consent to treatment (patient understands and agrees to treatment)
  • In some jurisdictions this can be overruled

Intro to Abnormal Psychology (7 decks)

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