Schizophrenia Flashcards
What are acute episodes characterized by?
Delusions, hallucinations, illogical thinking, incoherent speech and bizarre behaviour
What do people experience between episodes?
May still be unable to think clearly and may lack appropriate emotional responses to people and events in their lives
Schizophrenia affects…
thoughts, speech and behaviour
Touches every facet of a person’s life
Emil Kraeplin originally called schizophrenia by this name…
Dementia Praecox- out of one’s mind, general deterioration of your abilities, attributed to some physical or mental cause
Eugen Bleuler changed the name to schizophrenia and referred to the 4 A’s
Associations: relationships among thoughts become disturbed
Affect: emotional responses become flattened or inappropriate
Ambivalence: hold conflicting feelings toward others
Autism: withdrawal into a private fantasy world that is not bound by principles of logic
Kurt Schneider came up with the concept of First-rank symptoms and second-rank symptoms. What are they?
First rank: central to the diagnosis, have to have these to be diagnosed (hallucinations and delusions)
Second rank: symptoms associated with schizophrenia that also occur in other psychological conditions (disturbances in mood and confused thinking)
What is the problem with first and second rank symptoms?
Other people can experience hallucinations and delusions in other disorders as well
The earlier you are diagnosed, the more….
severe the disorder will be
What is the Prodromal phase?
Deterioration phase- waning interest in social activities and increasing difficulty in meeting the responsibilities of daily living
What is Residual phase?
Behaviour returns to the level that was characteristic in functioning prior to the first acute phase
Is full return to normal behaviour common?
No, but it may occur
What are the 4 disturbances in the CONTENT of thought?
- Delusions of persecution: “police are out to get me”
- Delusions of reference: “the people on the bus are talking about me”
- Delusions of being controlled: believing thoughts and feelings are being controlled by external forces such as agents or devils
- Delusions of Grandeur: believing oneself to be Jesus or be on a special mission
What are some common forms of delusions?
1) Thought Broadcasting- believing that one’s thoughts are somehow transmitted to the external world so that others can overhear them
2) Thought Insertion- believing that one’s thoughts have been planted in one’s mind by an external source
3) Thought Withdrawal- Believing that thoughts have been removed from one’s mind
Disturbances in FORM of thought
- Thought disorder: breakdown in organization and control of thoughts
- Neologisms: words made up by speaker, have no meaning to others
- Perseveration: inappropriate but persistent repetition of the same words or train of thought
- Clanging: stringing together of words or sounds that rhyme
- Blocking: involuntary abrupt interruption of speech or thought
What is hyper-vigilance?
An attentional deficit characterized by acute sensitivity to extraneous sounds, especially during the early stages of the disorder
What perceptual disturbances are experienced?
Auditory hallucinations in 60% of cases
Command hallucinations- belief that there are commands you have to obey
What are the causes of hallucinations?
Increased dopamine because receptors are overactive
What type of emotional disturbances are experienced?
Flat affect: minimal emotions, neutral, low energy
What is Stupor?
State of relative or complete unconsciousness in which a person is not generally aware of or responsive to the environment
What is Type 1 Schizophrenia?
Type 1 involves Positive symptoms: the presence of abnormal behaviour
- such as hallucinations, delusions, thought disorder, disorganized speech and inappropriate affect
What is Type II Schizophrenia?
Type II involves Negative symptoms: absence of normal behaviour
- such as social skills deficits, social withdrawal, flattened affect, psychomotor retardation, failure to experience pleasure
Which type is more likely to respond to medication?
Type 1
type 2 is more difficult to treat
What is the first line of treatment for schizophrenia?
Medications
Is Premorbid functioning better in Type 1 or 2?
Better in Type 1
Psychodynamic Perspective
Primary narcissism: person regresses to early period in the oral stage because we are too overwhelmed
Harry Stack Sullivan: mother-child relationships that were anxious and hostile so the child takes refuge in fantasy world
Learning Perspective
Ulmann and Krasner: Reinforcement, children may grow up in non-reinforcing environments and never learn to respond appropriately to social stimuli
Biological Perspective
Used the cross fostering studies the examine differences in prevalence among adoptives
10x more likely to get schizophrenia if you have a biological relative with it. Closer the relative, higher the risk
Biochemical factors
Dopamine: do not produce more dopamine, just have a greater than normal number of receptors that are overly sensitive to dopamine
Neuroleptic drugs: block dopamine receptors –> side effect makes you crave sugar
Theories that schizophrenia is a viral infections
A slow acting virus that attacks the developing brain of a fetus or newborn
Brain Abnormalities as a cause of schizophrenia
Hippocampus: impairs memory
Amygdala: impairs emotions
What is the Schizophrenogenic Mother?
Family theory: a cold, aloof, but also overprotective and domineering mother. Father is more passive
What is Double-bind communications theory?
Family theory: The transmission of contradictory or mixed messages
What is Communication Deviance?
Family theory: Unclear, vague, disruptive, or fragmented parental communication
What is Expressed Emotion-negative?
Family Theory: hostile, critical, and unsupportive of the schizophrenic family member which is more harmful for the treatment and outcome
Families can be seen as either causes or sources of stress
Increase risk is disturbed communication and emotional interaction
Biological treatments
Antipsychotic drugs: Phenothiazines (Haldol) help with hallucination and delusions
What is a bad side effect of phenothiazine antipsychotics?
Tardive Dyskinesia: movement disorder characterized by involuntary movements of the face, mouth, neck, extremities.
-most common is eye blinking
25% develop this
If you stop the drugs once you get TD, 40% will relapse
Psychoanalytic approach to treatment
Personal therapy: not well suited for schizophrenia..
Learning based approaches to treatment
- Selective reinforcement of desired behaviours
- Token Economy
- Social skills training
Psychosocial rehabilitiation
Self-help groups: usually run by non professionals, people with schizophrenia
Community programs: housing, jobs, education
Family Intervention programs
Practical aspects of daily living, educating family members, improving communication
Early Intervention Programs
Reduced disruption of activities, reduced likelihood of hospitalization, reduced disability, improved self-identity and self-esteem
Schizophrenia Video:
- Why did they first seek help?
- What was the treatment used to help manage it?
- What were some of the barriers to treatment?
- What is the prognosis of individuals with schizophrenia?
1) Seek help when they have first psychotic break, hallucinations, usually when they committed a crime
2) Medications and therapy were used (respiratol), support groups, social skills training
3) Barriers = stigmas and medication compliance
4) Living dysfunctional lives
