Schizophrenia Exam II

Question 1

Diagnostic Criteria

Answer 1

• Two or more of the following for 1+ month (must have one of bolded items)

1. Delusions
2. Hallucinations
3. Disorganized speech (e.g., frequent derailment/incoherence)
4. Disorganized or catatonic behavior
5. Negative symptoms (diminished emotional expression or avolition)
6. Functioning is markedly lower than prior to onset
7. Disturbance for 6+ months

Question 2

Assessments

Answer 2

• SCID-5
• Mental Status Exam
• MMPI-2 (scales 6 & 8) (Minnesota Multiphasic Personality Inventory)

Question 3

Theory

Answer 3

• Genetic Disorder (disorder of neurology)
o Hypofunctionality in the Prefrontal Cortex (PFC)
o Hyperfunctionality in the temporal lobes (hallucinations)
• Onset during 20s
• Family contributions
o High expressed emotion
• Comorbid
o MDD, suicidality
• Top emotion is fear (fear or going crazy or losing mind)

Question 4

CBT

Answer 4

 Safety (most important)
 Psychoeducation
 Normalize symptoms
 Simple and objective treatment Goals
 Reality testing
 With Delusions:
 Start with least emotionally charged/distressing
 Determine themes of delusions
 Teach patient about searching for alternative possibilities
 With Hallucinations:
 Try to move to background and dampen voices (not eliminate)
 Evidence for and against voices/images
 Recognition that hallucination cannot actually harm them or others
 Helping patient learn signs of psychotic episode
 Can intervene at family level
 Developing & maintaining routines
 For negative symptoms:
 Use successive approximations of activity, small steps
 Can help to build in positive activities
 Mindfulness
 HW:
 Must be simple, short, clearly explained
 Want high probability of success but also clinically useful