Schizophrenia Flashcards
What does schizophrenia equal/mean?
psychotic disorder
What were the other disorders we studied
when compared to schizophrenia
others were neuroses
What could be a symptom of neuroses?
May have had tried out of touch with reality symptoms
When does schizophrenia mainfest?
late adolescence
Schizophrenia is based in…
biology
What is schizophrenia related too?
brain functioning
What is the prevalence of schizophrenia?
-Prevalence: constant across the globe and this suggestion of biological basis
-1% of US population
-0.7% across the globe
-24 million worldwide
What are the characteristic symptoms of schizophrenia?
-Characteristic symptoms: very individualized
-Mild to severe spectrum
What is the timeline of a diagnosis and what does treatment do for a person?
it is a chronic psychotic disorder and treatment may help person become more functional
What is schizophrenia characterized by?
Characterized by range of cognitive, behavioral, perceptual, and emotional dysfunction
What are positive symptoms?
Positive symptoms: something added which are the psychotic symptoms
What is the definition of delusions?
-Delusions: false beliefs
-Fixed beliefs that are not amenable to change in light of conflicting evidence
-delusions represent disturbed thought content
-Not always distressing
What are the types of delusions?
-Persecutory
-Referential
-Grandiose
-Erotomanic
-Nihilistic
-Somatic
What is a persecutory delusion?
belief that one is going to be harmed, harassed, or a target
What is a referential delusion and give an example?
belief that certain gestures, comments, environmental cues are specifically directed to person
EX: someone watching the news and believes anchor is making gesture to them
What is a grandiose delusion?
belief that individual has exceptional abilities, wealth, fame or that they are somebody famous
What is an erotomania delusion?
belief that person is in love with them
What is a nihilistic delusion?
belief that major catastrophe will occur
What is a somatic delusion?
belief that they have somatic symptom and they are usually bizarre (clearly implausible)
What is thought broadcasting?
belief that one’s thoughts are transmitted to external world so others can hear them
What is thought insertion
belief that thoughts have been implanted in their mind by an external source
What is thought withdrawal?
belief that one’s thoughts have been removed from one’s mind
What are hallucinations?
sensory perception-like experiences that occur without an external stimulus, very vivid and lifelike
What are the types of hallucinations?
-Auditory
-Visual
-Olfactory
-Gustatory
-Tactile
-Command
-Somatic
What is an auditory hallucination?
Hearing voices distinct from one’s thoughts and it is the most common
What is a visual hallucination?
seeing
What is an olfactory hallucination?
smelling
What is a gustatory hallucination?
taste
What is a command hallucination?
perceives that they are being commanded by someone else to do something
What is a somatic hallucination?
bodily sensation
How does schizophrenia impact thinking and speech?
leads to disorganized thinking or speech
What is thought disorder?
disturbance in thinking characterized by the breakdown of logical association between thoughts
What are the different types of thought disorders?
Derailment or loose associations, tangentiality, and incoherence
What is derailment?
Person switches from one topic to another
What is loose association?
person make associations between things that don’t exist
What is tangentiality?
answers don’t seem to go with the questions that are asked
What is incoherence?
“word salad”
the individual speaks in incoherent way which doesn’t make sense
What does schizophrenia do to behavior?
causes grossly disorganized or catatonic behavior
What are the presentations of schizophrenia?
Various presentations: child-like silliness to aggressive outbursts
What is catatonia?
-Catatonia: marked decrease in reactivity to the environment
-Difficulty with too much stimuli and filtering out irrelevant stimuli
-Ranges from resistant to instructions or requests to maintaining very rigid posture or bizarre/inappropriate posture with no movement
What are stereotypical movements of schizophrenia?
-Stereotyped movements: repetitive, purposeless behaviors
-Also seen in autism spectrum disorder
-May manifest in staring behavior, echoing speech
-May be excessive motor movement
What are negative symptoms?
something absent
What are some examples of negative symptoms?
-Diminished emotional expression
-Lack of volition: avolition
-Diminished speech output, anhedonia, asociality
What is diminished emotional expression?
“Flat affect”, poor eye contact, lack of gesturing and intonation
What is lack of volition/avolition?
Decrease in motivated and self-initiated purposeful actions
What is diminished speech output, anhedonia, asociality?
Anhedonia: person does not experience pleasure in typically pleasurable activities
Asociality: disinterest in sociality
How do you diagnose schizophrenia?
At Least 6 months of symptoms with 2 or more of:
-Delusions
-Hallucinations
-Disorganized speech
-Grossly disorganized or catatonic behavior
-Negative symptoms
At least 1 month of symptoms that are particularly prominent
Individuals with schizophrenia are….
clearly different, evident by the inappropriate affect, such as laughing when sad
Is there impairment with schizophrenia?
Impairment in important areas of life
What do you need rule out for schizophrenia?
Rule out substance use or medical condition as causal
What are the phases of schizophrenia?
-Onset: late adolescence/early adulthood
-Prodromal phase: Individual begins to develop disorder
-Acute phase: Delusions, hallucinations, illogical thinking (psychosis)
-Residual: similar to prodromal
What is the onset phase of schizophrenia?
Onset: late adolescence/early adulthood
this aligns with theory of abnormal brain functioning (brains are not fully myelinated until late adolescence, so it is believed that brain development must be fairly complete before brain dysfunction is apparent)
Men: early to mid 20’s
Women: closer to late 20’s
What is the prodromal phase in schizophrenia?
Prodromal phase: Individual begins to develop disorder
Signs or symptoms appear in milder forms
Gradual deterioration (very subtle)
No hallucinations or delusions
Typically person is unable to take care of themselves in the same way
What is the acute phase in schizophrenia?
Acute phase: Delusions, hallucinations, illogical thinking (psychosis)
Very flagrant symptoms
What is the residual phase in schizophrenia?
Residual: similar to prodromal
Odd thoughts and behaviors but not obvious psychosis
What is the psychodynamic theoretical perspective of schizophrenia?
the ego is overwhelmed by primitive, sexual, aggressive drives of the ID (unconscious) leading to intense conflict
Leads to regression to oral stage of development (earliest)
Incomplete
What is the psychodynamic treatment of schizophrenia?
Treatment: Individuals experiencing symptoms of schizophrenia, not really amenable to psychoanalytic treatment (self-exploration)
What is the learning theoretical (behaviorism) perspective of schizophrenia?
individual learns how to exhibit bizarre behavior through modeling
What is the family theoretical perspective of schizophrenia?
-schizophrenogenic mother - cold and aloof, overprotective mothers stripped child of self-esteem which stifled their independence
-Increased risk of developing if fathers were passive or absent
-Discredited
Family theory: Level of stress in the family, family communication skills, awareness of increased stress and ability to reduce stress: implicated in schizophrenia
What is the biological theoretical perspective of schizophrenia?
concordance rates
MZ twins: 48% risk of developing schizophrenia if the other person has it
Closer the genetic relationship: higher risk of developing
What is the biochemistry theoretical perspective of schizophrenia?
dopamine hypothesis
Individuals appear to have overabundance of dopamine or overreactivity to neurotransmitter
Medications that reduce the amount of dopamine, reduce psychotic symptoms
What is the viral infections theoretical perspective of schizophrenia?
in mother during pregnancy may increase the risk of developing schizophrenia
Researcher noticed larger number of people diagnoses were born at particular time of year
Particularly if mother contracts the flu in the 1st trimester (typically winter)
What is the brain abnormalities theoretical perspective of schizophrenia?
-Structure: size of the ventricles which are holes in the brain where cerebrospinal fluid is drained in the brain
~Many individuals with schizophrenia have significantly enlarged ventricles meaning less brain matter to do the work of the brain
~Suggested that prefrontal cortex is smaller: initiate activities, persevere with activities
-Brain circuitry: networks that connect the prefrontal cortex to the __ impaired
-Brain damage or improperly developing brain may be cause of structural or circuitry issues
What does the diathesis-stress model theoretical perspective of schizophrenia?
Explains why some monozygotic develop disorder and others don’t
Also includes protective factors: can reduce the likelihood that mental health diagnosis would develop or reduce the severity
Level of intelligence, personality factors, resources: financial stability, enriched environment
What are some treatment approaches with schizophrenia?
-Antipsychotic medication
-a variety of learning based
-psychosocial rehabilitation
-family intervention
What is involved with the antipsychotic treatment of schizophrenia?
-Antipsychotic medication: block dopamine receptors
~Side effect: tardive dyskinesia
~~Invariably results from long term use of antipsychotics
~~Involuntary chewing movement, eye movement, lip smacking, facial grimacing, involuntary trunk or limb movements frequent eye blinking
~More contemporary have fewer side effect or delay effects of side effects
~Weigh the benefit and risk
What are some examples of learning based treatment in schizophrenia?
Selective reinforcement: selectively reinforcing behaviors that would be repeated
Token economy: if using reinforcement, small rewards or reinforcements are given for desired behavior so person can save small rewards to trade in for something larger
Social skills training: providing direct and concrete training in appropriate social behavior
What is psychosocial rehabilitation treatment in schizophrenia?
-Difficulties in social and occupational roles addressed
~Enhancing cognitive skills
~~EX: cueing self to pay attention
What is family intervention treatment in schizophrenia?
-Contemporary viewpoints: role of family as support
-Designed to help family members understand schizophrenia, the needs of the person with schizophrenia, reduction of stress in the household and the role that stress can play in the functionality of the individual
What is brief psychotic disorder?
individual experiences psychotic symptoms 1 day to 1 month usually following a major stressor
What is schizophreniform disorder?
individual experiences schizophrenia like symptoms for less than 6 months
What is delusional disorder?
individual experiences schizophrenia like symptoms for less than 6 months
What is schizoaffective disorder?
chronic psychiatric disorder involving features of schizophrenia as well as severe mood disorder
What is erotomania?
primary feature is delusion that someone is loved by someone they are not
