Schizophrenia Flashcards
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
True or false, the dementia praecox symptoms were progressive and persistent.
True
Who defined dementia praecox symptoms as schizophrenia ?
Eugen Bleuler
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
According to DSM, schizophrenia has what 3 sets of symptoms ?
Positive
Negative
Cognitive deficits
Positive (type 1) symptoms include __________, __________ and ________ behaviour
hallucinations
delusions
disorganised behaviour
Give 4 examples of delusional thoughts?
thoughts insertions
thought withdrawal
thought broadcasting
inability to control own actions
Negative (type 2) schizophrenic symptoms contain what 2 subdivisions?
Diminished emotional response
A-volition
Diminished emotional experiences can be involve a lack of _______ and lack of _________
lack of emotion
lack of speech
A-volition involves _______, ________ and social________
apathy
anhedonia
social withdrawal
What percentage of schizo patients have cognitive deficits?
75-80%
What are the 5 most common cognitive deficits?
executive control
memory
attention
social cognition
processing speed
Cognitive impairments can first be detected in
A Infancy
B Childhood
C Adolescence
D Both B and C
D both B and C
One issue with cognitive impairments is that ______________________________ do not correlate with ______________________.
clinical assessments of cognitive impairments do not correlate with subjective perceived impairments
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
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
What are the 4 main environmental risk factors?
prenatal factors - poor nutrition
potential hippocampus injury
certain viruses in early childhood
urban environmental issues (pollution)
In terms of environmental risk factors, they are mainly concerned with pre-natal, childhood and adolescent __________
development
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
