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Abnormal Psych > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

acute onset

A

sudden psychotic symptoms with good premorbid adjustment

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2
Q

chronic onset

A

slow process of steady deterioration without periods of remisson

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3
Q

Which onset has better prognosis (predicting the development)

A

acute onset

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4
Q

Gender with Schizophrenia

A
  • more younger males FIRST diagnosed then younger females
  • more OLDER women FIRST diagnosed than older men
  • majority of both males and females are diagnosed when younger
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5
Q

hallucinations

A

-involuntary sensory experiences WITHOUT stimulation

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6
Q

Types of hallucinations

A
  • mostly auditory
  • visual
  • olfactory (smell)
  • tactile (touch/sensations)
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7
Q

What o the voices do?

A
  • the voices seem very realistic and seem to come from outside the head
  • they comment, are critical, commanding, and they whisper
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8
Q

Delusions

A

false belief that is fixed and not open to change

-thinking everything refers to them

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9
Q

What are the types of delusions

A
  • persecution (associated with paranoia)
  • grandeur (thinking youre better)
  • reference (belief that random events are directed at them
  • thought broadcasting (belief that others can hear/read their thoughts)
  • mind reading (belief they can read someone elses mind)
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10
Q

Disordered thinking is manifested by…

formal thought disorder

A
  • loosely connected thoughts
  • speech that doesn’t seem to make sense
  • impaired logic
  • conreteness
  • neologisms
  • problems with selective attention
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11
Q

concreteness

A
  • inability to understand figurative speech

- being very literal

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12
Q

neologisms

A

making up new words that don’t exist

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13
Q

selective attention

A

unable to distinguish important from unimportant

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14
Q

What are the typical emotions of someone who is schizophrenic?

A
  • agitated “manic”
  • inappropriate in some situations
  • flat, blunted affect
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15
Q

What is motivation like?

A
  • loss of interest
  • anhedonia
  • avolition
  • loss of drive
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16
Q

avolition

A

loss of goals

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17
Q

What is social life like?

A
  • social withdrawal

- loss of social skills

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18
Q

what do loss of social skills include?

A
  • missing subtle cues
  • loss of social graces
  • etc
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19
Q

What is motor behavior like?

A
  • purposeless motor acts
  • agitation and pacing
  • catatonia
  • loss of coordination (i.e. left/right confusion)
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20
Q

catatonia

A

motionless, frozen state, strange postures

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21
Q

positive vs negative symptoms

A

positive symptoms ADD something while negative symptoms take away

  • does mean good or bad
  • positive symptoms are easier to treat with meds and suggest a better prognosis
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22
Q

what are positive symptoms in schiz?

A

hallucinations, delusions, agitation

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23
Q

What are negatve symptoms of schiz?

A
  • loss of logical thinking
  • loss of coherent speech
  • anhedonia
  • avolition
  • alogia
  • social withdrawal
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24
Q

alogia

A

having nothing to say in conversations

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25
Q

DSM-5

A

At least 2/5 symptoms must be present and one of the symptoms needs to be hallucinations, delusion, or disorganized thinking

  1. delusions
  2. hallucinations
  3. disorganized thinking (speech)
  4. disorganized/abnormal motor behavior
  5. negative symptoms
    - significant deterioration of functioning in work, interpersonal relations, self-care)
    - signs for at least 6 months
    - symptoms NOT caused by substance or medical condition
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26
Q

Schizophrenia paranoid type

A
  • mostly positive symptoms
  • delusions of persecution
  • almost always auditory hallucinations
  • paranoia-related fear, anger, or hostility
  • cog skills still intact (no thought disorder)
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27
Q

Who responds well to antipsychotic meds

A

Schizophrenia paranoid type because they mostly have positive symptoms
- but they are the ones that typically refuse treatment

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28
Q

Disorganized Schizophrenia type

A
  • mostly negative symptoms
  • formal thought disorder
  • social withdrawal
  • flat/inappropriate affect (giggling to self)
  • anhedonia, avolition, alogia
  • bizarre mannerisms
  • childlike immature behavior
  • inappropriate behavior (masturbating in public)
  • may experience hallucinations
  • early onset/poor prognosis
  • chronic course (with likely brain damage)
29
Q

Prodromal Phase

A
  • beginning phase
  • symptoms are not yet obvious but the person is beginning to deteriorate
  • may have social withdrawal, speak in odd ways, develop strange ideas, or express little emotion
30
Q

Active phase

A
  • symptoms become more apparent

- sometimes this phase is triggered by stress

31
Q

Residual phase

A
  • they return to the prodromal phase

- might retain some negative symptoms

32
Q

What percent of patients recover?

A

25% but the rest have some residual problems for the rest of their lives

33
Q

brief psychotic disorder

A

symptoms last less than a month

34
Q

Schizoaffective disorder

A

-both a mood disorder and schizophrenia

35
Q

delusion disorder

A
  • delusions are only psychotic symptoms

- nothing else

36
Q

What do structural abnormalities cause and where are they often seen?

A

They cause more NEGATIVE symptoms and they are most often seen with chronic schizophrenia and disorganized schizophrenia type

37
Q

Biochemical abnormalities

A

map more onto the positive symptoms of schizophrenia

38
Q

What is the most popular reason for how schizophrenia occurs?

A

Someone has a predisposition and a stressful events makes it clear (diathesis-stress relationship)

39
Q

Biochemical abnormalities

A
  • schiz might be from excess dopamine and antipsychosis meds can help reduce dopamine
  • focus more on positive symptoms
40
Q

Finding in the brain of schizophrenia?

A
  • progessive loss of white and grey matter
  • dilation of ventricles
  • decrease of hippocampus
  • thalamus irregularities
  • shrinking/underactive frontal lobes
  • temporal lobe abnormalities
  • thinner corpus callosum
  • EEG abnormalities
  • eye movement abnormalities
  • developmental abnormalities (handedness, fingerprints)
41
Q

In the video studies where they compared a children who would LATER develop schizophrenia to their siblings, the predisposed children showed…

A

-motor abnormalities, less coordinated
-facial tics like blinking
-more negative emotional expressions
lower social competence
problems with attention

42
Q

Neuronal triming/pruning abnormalities

A

takes place in late teens/20’s and involves the frontal lobes

43
Q

progressive loss of grey matter

A

starts in parietal cortex then goes to temporal the frontal

44
Q

progressive loss of white matter

A

demyelinization

-white matter loss in temporal region correlated with poor social functioning

45
Q

Dopamine System

A
  • over-reactivity of dopamine receptors in schizophrenic brain
  • **amphetamines and cocaine are dopamine agonists and thats why they create “positive symptoms”
  • dopamine inhibits glutamate
46
Q

Seratonin system

A

LSD mimics seratonin molecules and blocks seratonin receptors
- LSD can cause psychotic symptoms because of this

47
Q

Glutamate system

A
  • involved in memory, mood, frontal activity
  • schizophrenia is associated with diminished glutaminergic activity, especially in the hippocampus and the ACC
  • PCP is a glutamate antagonist so it produces both positive and negative symptoms
48
Q

Maternal factors

A
  • critical time is 3-4 months
  • if high stress happens during this time there is a .67% increase of schiz in the child
  • bad nutrition as a fetus can be a cause
  • birth complications (low birth weight, oxygen loss, etc)
49
Q

Exposure to virus in pregnancy

A

The virus itself does not cross the placenta so it doesn’t directly hurt the fetus but the virus mobilizes the moms immune system which produces antibodies and those antibodies cross the placenta which is bad

50
Q

Is schiz a genetic disorder?

A

NO, there is a predisposition to developing it but it is not genetic that is only a partial contributor

51
Q

are multiple genes involved?

A

yes!

-these multiple pathways and the gene overlap may account for the different forms of schiz

52
Q

Amount of people with schiz that have family history?

A

1/3 (typically first or second degree relatives)

53
Q

Genetic mutations

A

3-4 times more (nonspecific) genetic glitches were found in schiz patients

54
Q

genetic glitches and what do they influence

A

DNA duplications or omissions in the genetic code

  • they influence how neuronal circuits get sculptured
  • this can lead to signals not getting filtered out and could create hallucinations, thought problems and general “overload”
55
Q

Probability of general population

A

1%

56
Q

probability of spouse

A

2%

57
Q

probability of first cousin

A

2%

58
Q

probability of nephew/niece

A

4%

59
Q

probability of sibling

A

9%

60
Q

probability of fraternal twin

A

17%

61
Q

probability of identical twin

A

48%

62
Q

probability of offspring of 1 schiz parent

A

13%

63
Q

probability of offspring of 2 schiz parents

A

46%

64
Q

Finnish Adoption Study with children of one (biological) parent

A
  • adoption into HIGH stress NON-schiz fam: 37%
  • adopted into LOW stress NON-schiz fam: 6%
  • raised by schizophrenic parent: 17%
65
Q

Masturbation theory

A

-thought through the 19th century

“brain rot”

66
Q

Schizophrenic mother theory

A
  • US 1940’s-60’s

- cold, distant mothers cause schiz in their kids

67
Q

Double blind theory

A

contradictory communication in families cause schiz in kids

68
Q

Thomas Szasz theory

A

“fake disease”

“Myth of mental illness”

69
Q

R.D. Laing

A

an antipsychiatrist said that schiz is an SANE response to an INSANE world

Abnormal Psych (7 decks)

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