Schizophrenia Flashcards by Liam Brant

Emil Kraepelin (1898) described a patient with ‘_______ _______’, which included impairments in ____________, _________, and goal directed behaviour.

dementia praecox
impairments in attention, memory and goal directed behaviour

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True or false, the dementia praecox symptoms were progressive and persistent.

True

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Who defined dementia praecox symptoms as schizophrenia ?

Eugen Bleuler

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Bleuler was the first doctor to define Schizophrenia as having
A fragmented thinking
B positive symptoms
C negative symptoms
D all of the above

D All of the above

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According to DSM, schizophrenia has what 3 sets of symptoms ?

Positive
Negative
Cognitive deficits

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Positive (type 1) symptoms include __________, __________ and ________ behaviour

hallucinations
delusions
disorganised behaviour

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Give 4 examples of delusional thoughts?

thoughts insertions
thought withdrawal
thought broadcasting
inability to control own actions

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Negative (type 2) schizophrenic symptoms contain what 2 subdivisions?

Diminished emotional response
A-volition

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Diminished emotional experiences can be involve a lack of _______ and lack of _________

lack of emotion
lack of speech

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A-volition involves _______, ________ and social________

apathy
anhedonia
social withdrawal

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What percentage of schizo patients have cognitive deficits?

75-80%

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What are the 5 most common cognitive deficits?

executive control
memory
attention
social cognition
processing speed

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Cognitive impairments can first be detected in
A Infancy
B Childhood
C Adolescence
D Both B and C

D both B and C

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One issue with cognitive impairments is that ______________________________ do not correlate with ______________________.

clinical assessments of cognitive impairments do not correlate with subjective perceived impairments

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Which type of schizophrenic symptoms typically appear first?
A Negative symptoms
B Positive symptoms
C Cognitive deficits
D They all appear at the same time

C cognitive deficits in childhood/ adolescence

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Schizophrenia occurs in _% of the population. Children with parents/siblings of schizophrenia are __ times more likely to develop schizophrenia. Whilst genetics explain a small amount of variance, schizophrenia is thought to be ____________.

occurs in 1% of pop
people with schizo parents 10x more likely
polygenetic disorder

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What are the 4 main environmental risk factors?

prenatal factors - poor nutrition
potential hippocampus injury
certain viruses in early childhood
urban environmental issues (pollution)

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In terms of environmental risk factors, they are mainly concerned with pre-natal, childhood and adolescent __________

development

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What are the 4 main neurotransmitters altered/involved in schizophrenia?

Dopamine
Ach
GABA
Glutamate/NMDA

The dopamine hypothesis of schizophrenic drug treatment suggests that dopamine agonists such as cocaine and amphetamines induce ________ __________ and disturbance in DA system leads to _______ _________.

DA agonists induce psychotic symptoms
altering DA systems leads to impaired cognitive impairment

Anti psychotic medication ______
A Are DA agonists
B Are NMDA agonists
C Reduce positive symptoms
D Both A and C

D both a and c

The improved DA hypothesis suggests that the cortex is in a _____________ state, whereas the striate is in a ___________________ state

Cortex = hypodopaminergic state
Striate = hyperdopaminergic state

Disruption of the DA system is a secondary effect of a disruption to what other neurotransmitter system?

Glutamate

Moghaddam & Javitt (2012) proposed what 2 phases of glutamate disruption?

loss of inhibitory control = increased glutamate levels
excitotoxicity leading to loss of glutamate connection = decreased glutamate levels

In a metanalysis of Magnetic Resonance spectroscopy of glutamate levels it was found that SZ patients have a __________ glutamate function compared to healthy people.

decreased glutamate function

What are the 6 main neuroanatomical differences in SZ brains compared to healthy brains?

weigh less than average enlarged ventricles reduced neurons in PFC thinner parahippocampal gyri abnormal cellular structure in PFC and hippocampus reduced grey matter in a number of areas

Which area is not found to have reduced grey matter in SZ individuals? A Left thalamus B Left caudate C Amygdala D Cerebellum

D cerebellum

Which type of Schizophrenic symptom has more impact on quality of life and day-to-day living A Positive symptoms B Cognitive symptoms C Negative symptoms D They all effect quality of daily life the same

B Cognitive

Despite ________ symptoms being treated using antipsychotics, _________ symptoms and _______ symptoms are harder to treat.

Cognitive easier to treat than positive and negative

Cognitive symptoms of SZ are highly ______ and _________,, making it difficult to understand _________ _________ and develop ____________.

highly variable and widespread, hard to understand the underyling mechanisms and develop interventions.

Cognitive deficits of SZ are described as deficits in proactive control, which is an impairment in what?

Having a representation of goal information in WM and guiding goal directed behaviour.

Which frontal cortex area is associated with proactive control?

Dorso-lateral Pre frontal cortex

What is a goal? Give an example

intended outcome of an action such as the point of info u want to convey in a convo

A meta-analysis of FMRI studies showed reduced activity in the _______ when in tasks requiring proactive _______.

reduced DLPFC in proactive control tasks

Reduced activity in DLPFC leading to deficits in goal representation in SZ patients is associated with what part of Baddeley's Working Memory Model? A Central Executive B Episodic Buffer C Phonological loop D This deficit is involved in all 3 aspects of the WMM

A central executive

As well as proactive control deficits, a meta-analysis found impairments in ___________ speed in SZ patients.

processing speed deficits

What are the 2 possible causes of slow processing speed in SZ patients?

lack of integrity in white matter tracts Working memory deficits due to task demands

Episodic memory is also impacted in SZ patients, with _________ memory more impaired than _____ memory. When it comes to remembering, __________is more impaired than _________.

Relational memory more impaired than item memory Recollection more impaired than familiarity

What is the difference between recollection and familiarity in remembering?

Recollection = remembering exactly where/how we know/heard Familiarity = feeling of knowing, without knowledge of how

What are the main 3 cognitive impairments for SZ patients?

proactive control episodic memory working memory

In what 3 ways is the DLPFC impacted in SZ patients?

overall dysfunction connectivity Neurotransmitter inputs to DLPFC

SZ patients also have motivational impairments affecting ______ and ________ functioning. There are currently no effective_________ and the __________ mechanisms are unclear.

motivational impairments affecting social and occupational functioning no effective treatments and underlying mechanisms unclear

In terms of effort SZ individuals have _______ ____--_____ ________ ______, meaning they will put in less effort for ________ _________

atypical effort based decision making meaning less effort for monetary reward

What 3 main structures are involved in effort based decision making in healthy people, which are also low in activity in SZ patients during effort based decision making?

Anterior cingulate cortex/medial frontal cortex ventral striatum dopamine systems

In healthy people, activity in the _______ and ________ increased with reward value, but decreased with more _______ required.

activity in ACC and striatum inc with reward value and decreased with more effort required

What are the 5 main factors involved in Effort based decision making?

Reward responsivity anticipatory pleasure cognitive control defeatist performance beliefs dopaminergic medication

Despite antipsychotic medication treating positive symptoms, they can dampen ________ systems, which may impact ____-_____ ______ _______.

they can dampen Dopamine systems influencing effort based decision making