Psychotic Disorders Flashcards
positive symptoms
characterized by the presence of an excess of abnormal features
negative symptoms
characterized by the absence or reduction of normal mental functioning
four positive symptoms
hallucinations, delusions, disorganized speech, disorganized behavior
five negative symptoms
flat affect, avolition, alogia, anhedonia, asociality
command hallucination
a voice telling you to do something
persecutory delusions
the belief that someone or something is after you
controlling delusions
thought insertion beliefs
grandiose delusions
the belief that you are significantly more powerful, knowledgeable, or capable than reality; can also include believing that you are a different (powerful or famous) person
referential delusions
the belief that external events have a special meaning for you alone
mild disorganized speech
loose associations & topic derailment
moderate disorganized speech
tangential speech & unrelated thoughts
severe disorganized speech
rhyming, word salad, neologisms
neologisms
made-up words with no real meaning
catatonia
a state of being fully unresponsive to the environment
avolition
lack of motivation
alogia
lack of speech
anhedonia
diminished ability to experience pleasure
asociality
impairments in social relationships
diagnosis requirements for schizophrenia
at least 2 psychotic symptoms (one must be positive) for at least one month
marked impairment
continuous signs of the disorder for at least six months
cognitive defects related to schizophrenia
attention, working memory, executive functioning
brief psychotic disorder
one positive psychotic symptoms for less than one month followed by a full recovery
schizophreniform disorder
at least 2 psychotic symptoms (one must be positive) for 1-6 months
2/3 of patients later develop schizophrenia or schizoaffective disorder
schizoaffective disorder
at least 2 psychotic symptoms (one must be positive) AND major depressive disorder or a manic episode occurring at the same time
high level of functioning and high risk of suicide
delusional disorder
no symptoms other than delusions
symptoms last for at least one month
erotomanic delusions
the belief that someone is in love with you
somatic delusions
the belief that something is wrong with your body
mixed delusions
experiencing more than one type of delusion
unspecified delusions
experiencing a different type of delusion
folie a deux
a shared delusion among two or more people, stemming from a primary patient with a psychotic disorder
schizotypal personality disorder
not technically a psychotic disorder
eccentric behavior and difficulties with social relationship
no psychotic symptoms
worldwide prevalence of schizophrenia
1%
the course of schizophrenia
premorbid phase
prodromal phase
active phase
residual phase
premorbid phase
before symptoms develop
some people may display personality characteristics or cognitive deficits that later evolve into negative symptoms
prodromal phase
between the onset of symptoms and the time when the minimum criteria for a disorder are met
active phase
the person exhibits symptoms that meed the criteria for a disorder
residual phase
after positive symptoms have subsided and the full criteria for diagnosis are no longer met
rule of thirds
1/3 of patients improve significantly
1/3 stay the same, having relapses and permanent deficits
1/3 become chronically and severely disabled
biological etiology
enlarged ventricles, high levels/sensitivity of dopamine, low level of estrogen, heredity
enlarged ventricles as a vulnerability
when the ventricles are filled with fluid and enlarged, there are less brain cells and reductions in brain matter in the frontal and temporal lobes
possible causes of brain abnormalities
maternal malnourishment during 1st trimester
maternal viral sickness during 6th month of pregnancy
oxygen deprivation to a fetus or newborn
biological marker
a neurological, bodily, or behavioral characteristic that distinguishes people with a psychological disorder
smooth pursuit eye movements
biological marker for schizophrenia
difficulty maintaining smooth, continuous eye movements when tracking a light as it moves
sensory gaiting
biological marker for schizophrenia
having the same response to two clicks in succession, as opposed to a lessened response to a second one
the dopamine hypothesis
proposes that an overproduction of dopamine or an increase in the number or sensitivity of receptors is responsible for schizophrenia
the estrogen production hypothesis
proposes that they hormone estrogen protects against symptoms of schizophrenia via its effects on serotonin and dopamine
psychological etiology
cognitive deficits
beliefs and attributions
emotional expression
social etiology
family and community interactions
high expressed emotion family interaction style
basic social stressors, especially during critical periods
theory of mind
a person’s ability to predict how others will react to a given situation
lacking in people with schizophrenia
the social selection hypothesis
proposes that people who are mentally ill drift to a lower socioeconomic level because of impairments
social causation hypothesis
proposes that the daily stressors of urban life, especially as experienced by people in low socioeconomic classes, trigger mental illness in those who are vulnerable
four step treatment process
treat positive symptoms
treat negative symptoms
address cognitive deficits
increase ability to function in normal life
traditional antipsychotics
work on the original neurotransmitter system implicated in psychotic disorders (dopamine)
only treat positive symptoms
atypical antipsychotics
work on both dopamine and serotonin systems
aimed to have less side effects
more successful
treat both positive and negative symptoms
side effects of atypical antipsychotics
metabolic side effects - significant weight gain causing obesity-related problems
low white blood cell count
extrapyramidal side effects
effects on a specific nerve tract in the brain by the decrease in dopamine, causing motor side effects
tardive dyskinesia
side effect that produces involuntary lip smacking and odd facial contortions as well as other movement-related symptoms
community care
programs that allow mental health care providers to visit patients in their homes at any time of day or night
supported employment programs
place people in regular work settings and provide an onsite job coach to help them adjust
sheltered employment programs
involves working in settings that are specifically designed for people with emotional or intellectual problems who cannot maintain a regular job
