Psychotic Disorders--General + Stahls Minibook + Trials Flashcards
what defines the family of disorders known as the “schizophrenia spectrum and other psychotic disorders” (i.e what abnormalities must be present)
defined by abnormalities in ONE or MORE of the following FIVE domains:
delusions
hallucinations
disorganized thinking (speech)
grossly disorganized or abnormal motor behaviour (including catatonia)
negative symptoms
what are delusions
FIXED beliefs that are not amenable to change in light of conflicting evidence
“fixed false belief”
what types of themes might characterize delusions?
which are most common?
persecutory
referential
somatic
religious
grandiose
erotomanic
nihilistic
somatic
PERSECUTORY is most common (referential also common)
define persecutory delusion
belief that one is going to be harmed, harassed, and so forth by an individual, organization, or other group
define referential delusions
belief that certain gesture, comments, environmental cues and so forth are directed at oneself
–also common
define grandiose delusions
when individual believes has exceptional abilities, wealth or fame
define erotomanic delusions
when individual believes falsely that another person is in love with him or her
define nihilistic delusions
involve conviction that a major catastrophe will occur
define somatic delusions
preoccupations regarding health and organ function
under what conditions are delusions deemed “bizarre”
if they are clearly implausible and not understandable to same-culture peers and do not derive from ordinary life experiences –> delusions that express a loss of control over mind or body are generally thought to be bizarre
i.e belief that an outside force has removed his or her internal organs and replaced with someone elses organs without leaving any wounds or scars
NONbizarre would be –> belief one is under surveillance by the police despite lack of convincing evidence
give some examples of delusions that involve loss of control over mind/body that are generally thought to be bizarre in nature
thought withdrawal (thoughts removed by outside force)
thought insertion (alien thoughts inserted into ones own mind)
delusions of control (ones body or actions beying acted upon or manipulated by some outside force
how do you distinguish between a delusion and a strongly held belief
sometimes are to make this distinction
depends in part on the degree of conviction with which the belief is held despite clear or reasonable contradictory evidence regarding its veracity
define hallucination
perception like experiences that occur without an external stimulus
they are VIVID and CLEAR with the FULL FORCE AND IMPACT of normal perceptions and NOT under voluntary control
may occur in any sensory modality –> AH most common in SCZ
**must occur in context of a CLEAR SENSORIUM*
may be normal part of some religious/cultural contexts
how are auditory hallucination usually experienced
as voices–> can be familiar or unfamiliar
perceived as distinct from one’s own thoughts
define hypnagogic hallucination
hallucination that occurs in the process of falling asleep
define hypnapompic hallucination
hallucination that occurs in the process of waking up
are hypnagogic and hypnapompic hallucinations true hallucinations?
no–> considered within the range of normal experience
how is thought form disorder usually inferred clinically
from persons speech
define derailment/loose associations
individual switches from one topic to another
define tangentiality
answers to questions may be obliquely related or completely unrelated
define incoherence/”word salad”
speech that is so severely disorganized is it nearly incomprehensible and resembles receptive aphasia in its linguistic disorganization
how severe must disorganized speech be to make you consider psychosis
severe enough to impair effective communication (mildly disorganized speech is common and nonspecific)
how might grossly disorganized or abnormal motor behaviour manifest
in a variety of ways
i.e childlike “silliness” to unpredictable agitation
define catatonic behaviour
marked DECREASE in REACTIVITY to the environment
ranges from resistance to instructions (negativism)–> maintaining rigid, inappropriate or bizarre posture–> complete lack of motor response (mutism/stupor)
can also include purposeless and excessive motor activity without obvious cause (catatonic excitement)
other features–> repeated stereotyped movements, staring, grimacing, mutism, echoing of speech
are catatonic symptoms always/only seen in schizophrenia?
NO
often associated with this but catatonia is NONSPECIFIC and may occur in other mental disorders (i.e bipolar, depressive disorders) and in medical conditions
what types of symptoms account for a substantial portion of the morbidity associated with schizophrenia
negative symptoms
do you often see negative symptoms with other psychotic disorders
no not as much
which two negative symptoms are particularly prominent in SCZ
diminished emotional expression
+
avolition
define “diminished emotional expression” as a negative symptom
includes reductions in the expression of emotions in the face, eye contact, intonantion of speech (prosody), and movements of hands, head, face that normally give emotional emphasis to speech
define avolition
decrease in motivated self-initiated purposeful activities
may sit for long periods of time and show little interest in participating in work or social activities
list all the negative symptoms
diminished emotional expression
avolition
alogia
anhedonia
asociality
