Schizophrenia and Psychotic Disorders Flashcards
Aetiology of Schizophrenia: the diathesis-stress model
individuals are exposed to stressful events in the course of their life and these events may precipitate the symptoms in some people who have predisposition to mental health
Aetiology of Schizophrenia: Biochemical theories
chemicals known as neurotransmitters responsible for the transmission of nerve impulses across synapse have also been thought to be responsible for the development of schizophrenia
Delusion
fixed false belief that are inconsistent with one’s social, cultural and religious beliefs and not amenable to change despite conflicting evidence or argumentation
Disorganised thinking
The symptoms must be severe enough to substantially impair effective communication. this is evident if:
- the person switches topids erratically (derailment or loose association)
- their response to questions are unrelated (tangentially)
- their speech is incoherent or disorganised
the ideas fail to follow one another with a logical flow and sequence; this results in shifting from one subject to another resulting in loss of significant meaning.
perceptual disturbance
vivid involuntary perceptions that are experienced as “normal” and occur without external stimuli
Affect: emotional blunting
being “flat” or inappropriate; voice is a monotone and face is imobile
Bizarre Behaviour: catatonia
a marked decrease in reactivity to the environment, behaviour induced resistance to instructions, ridgid posture
Bizarre Behaviour: Abnormal motor behaviour
can rage from agitation to childlike silliness, which leads to difficulties in performing activities of daily living
Bizarre Behaviour: Clothing and Appearence
reflects mental state: can be dishevelled, poorly groomed, quiet and immobile or screaming and agitated; may be; inappropriately dressed for the occasion, environment and temperature
Bizarre Behaviour: social or sexual behaviour
loss of ego boundaries can cause confusion in relationship with others,
positive symptoms of psychotic disorders and schizophrenia
- hallucinations, delusions, disordered speech, bizarre behaviour
negative symptoms of psychotic disorders and schizophrenia
diminished emotional expression (reduced facial expression, eyecontact, head/hand movement), avolition, alogia. anhedonia, asoslity, poverty of ideas and anergia
Schizophrenia- introduction
- prevalence, approx 1% population
- predominantly young people (18-24)
- high presence in the socially disadvantaged and homeless
- research yet to determine cause of schizophrenia
- increasingly viewed as a neurological illness rather than a disorder of the mind
- most debilitating and misunderstood disorder
Biological theories Theories
Neuroanatomical abnormalities - Genetic predisposition - Biochemical theories -
The Diathesis-stress model
- brings much of what is known into one model of understanding
- exposure to stress
- environmental and family
- expressed emotion
Schizophrenic disorder- considerations
Not just schizophrenia; psychosis is the main set of symptoms associated with schizophrenia diagnosis dependent on - specific symptoms - length of time experienced individual experience is unique needs to be contextual consider cultural identity
Psychosis
set of symptoms associated with the following disorders
- schizophrenia
- acute mania
- depression
- drug intoxication
- organic brain injury
- head injury
- delirium
presentation can and does change over time
linked to events, experiences and relationships
DSM 5 criteria for Schizophrenia
two or more of the following, each present for a significant proportion of time during a 1 month period
- delusions
- hallucinations
- disorganised speech
- grossly disorganised or catatonic behaviour
- negative symptoms
Hallucinations
when someone hears, sees, feels, or smells something that is not there. Hearing voices that others cannot hear or when there is no one else in the room is very typical for psychosis. sometimes these voices will talk about or to the affected individual
the voices sometimes command them to do things. For some, these voices can be inside their head; occasionally they may be seen to come from within their body, or from the radio or television
Thought disturbances
How an individual processes thought or have the ability to concentrate and maintain a train of thought may be affected. For example the person may feel like their thoughts are racing and friends may notice they are constantly changing the topic of conversation or that the person is easily distracted or may laugh at irrational times
speech may become quiet disorganised, and the individual may use made up words that they only understand
Mood symptoms
loss of motivation- interest or pleasure in things. everyday tasks such as washing up become difficult
mood changes- the person will tell friends there feeling great or never better. however, their behaviour will be recognised as excessive by friends or family . they may also be quite unresponsive and be unable to express joy or sadness
social withdrawal- people may notice that an individual may become very careless in dress and self-care. or have periods of seemings to do little and periods of being extremely active . other symptoms include subtle difficulties with tasks like problem solving or they may show signs of depression- commonly experienced by people with schizophrenia
Positive symptoms
- delusions (context of thought)
- hallucinations (perceptual disturbances)
- adutiotory (voices)
- visual (visions)
- olfactory (odours)
- gustory (tastes)
- tactile (feelings)
- thought disorder (severe thought process disturbance)
Negative symptoms
- Anhedonia (the inability to take pleasure in activities one would normally find enjoyable)
- Avolition ( lack of initiative or goals)
- Affective flattening (absence in mood, a decrease or a low level in individuals emotion)
- Thought disorder alogia (speaking very little or a lack of spontaneous content in conversation, called poverty of speech)
Cultural consideration
- hearing voices is not always considered a bad thing
- beliefs around tapu or makatu
- spiritual interpretation possession and demons
- spiritual enlightenment
