Schizophrenia Spectrum and Other Psychotic Disorders - Ch. 15 Flashcards
4 phases of schizophrenia behavior
Phase 1 - Premorbid phase
Phase 2 - Prodromal phase
Phase 3 - Schizophrenia
Phase 4 - Residual phase
Phase 1 - Premorbid phase
- Social maladjustment
- Antagonistic thoughts and behavior
- Shy and withdrawn
- Poor peer relationships
- Doing poorly in school
- Antisocial behavior
Phase 2 - Prodromal phase
- Lasts from a few weeks to a few years
- Deterioration in role functioning and social withdrawal
- Substantial functional impairment
- Sleep disturbance, anxiety, irritability
- Depressed mood, poor concentration, fatigue
- Perceptual abnormalities, ideas of reference, and
suspiciousness herald onset of psychosis
Phase 3 - Schizophrenia
- In the active phase of the disorder, psychotic symptoms are prevalent
- Delusions
- Hallucinations
- Impairment in work, social relations, and self-care
Phase 4 - Residual phase
Symptoms similar to prodromal phase.
Flat affect and impairment in role functioning are prominent.
Prognosis of schizophrenia
A return to full premorbid functioning is not common.
Factors associated with a positive prognosis include:
Good premorbid functioning
Later age at onset
Female gender
Abrupt onset precipitated by a stressful event
Associated mood disturbance
Brief duration of active-phase symptoms
Minimal residual symptoms
Absence of structural brain abnormalities
Normal neurological functioning
Family history of mood disorder
No family history of schizophrenia
Predisposing factors of schizophrenia: Biological Influences
Biological influences:
- Genetics: genetics plays an important role in the development of schizophrenia.
- Biochemical influences: One theory suggests that schizophrenia may be caused by an excess of dopamine activity in the brain. Abnormalities in other neurotransmitters have also been suggested.
- Physiological influences: Viral infection, Anatomical abnormalities, Electrophysiology, Epilepsy, Huntington’s Disease, Birth trauma, Head injury in adulthood, Alcohol abuse, Cerebral tumor, Cerebrovascular accident, Systemic lupus erythematosus
Predisposing factors of schizophrenia: Psychological Influences
NONE MOTHERFUCKER - These theories no longer hold credibility. Researchers now focus their studies of schizophrenia as a BRAIN DISORDER.
Psychosocial theories probably developed early on out of
a lack of information related to a biological connection.
Predisposing factors of schizophrenia: Enviromental Influences
Sociocultural factors: Poverty has been linked with the
development of schizophrenia.
Downward drift hypothesis: Poor social conditions seen as consequence of, rather than a cause of schizophrenia.
Stressful life events may be associated with
exacerbation of schizophrenic symptoms and increased
rates of relapse.
Studies of genetic vulnerability for schizophrenia have
linked certain genes to increased risk for psychosis and
particularly for adolescents who use cannabinoids.
Predisposing factors of schizophrenia: Theoretical integration
Schizophrenia is most likely a biologically based disease, the onset of which is influenced by factors in the internal or external environment.
Delusion disorder: definition and types
The existence of prominent, nonbizarre delusions.
Erotomanic type
Grandiose type
Jealous type
Persecutory type
Somatic type
Mixed type
Brief psychotic disorder: definition
Sudden onset of symptoms
May or may not be preceded by a severe
psychosocial stressor
Lasts less than 1 month.
Return to full premorbid level of functioning.
Substance-induced psychotic disorder: definition
The presence of prominent hallucinations and
delusions that are judged to be directly attributable to
substance intoxication or withdrawal
Psychotic disorder associated with another medical condition: definition
Prominent hallucinations and delusions are directly attributable to a general medical condition.
The catatonic features specifier
Catatonic features may be associated with other psychotic disorders, such as brief psychotic disorder, schizophreniform disorder, schizophrenia, schizoaffective disorder, and substance-induced psychotic disorder.
Symptoms of catatonic disorder
Stupor and muscle rigidity or excessive, purposeless motor activity, Waxy flexibility, negativism, echolalia, echopraxia
Catatonic disorder associated with
another medical condition: define
This diagnosis is made when the catatonic symptoms
are directly attributable to the physiological
consequences of a general medical condition.
Schizophreniform disorder: define
Same symptoms as schizophrenia with the exception
that the duration of the disorder has been at least 1 month but less than 6 months
Schizoaffective disorder: define
Schizophrenic symptoms accompanied by a strong
element of symptomatology associated with the mood disorders either mania or depression
Positive vs. negative symptoms in psychotic disorders
Positive sx: something added – hallucinations, delusions, cognitive distortions.
Negative sx: something taken away – flat affect (affect taken away), anhedonia (energy taken away), etc.
Negative sx will be the baseline for someone with schizophrenia that they will have to learn to live with once theyre are in the postdromal stage
Content of though symptoms - delusions, religiosity, paranoia, and magical thinking (positive symptoms)
Delusions: False personal beliefs
Religiosity: Excessive demonstration of obsession with religious ideas and behavior
Paranoia: Extreme suspiciousness of others
Magical thinking: Ideas that one’s thoughts or behaviors have control over specific situations
Form of thought symptoms - Associative looseness, neologisms, concrete thinking, clang associations (positive symptoms)
Associative looseness (also called loose association): Shift
of ideas from one unrelated topic to another
Neologisms: Made-up words that have meaning only to the
person who invents them
Concrete thinking: Literal interpretations of
the environment
Clang associations: Choice of words is governed by sound
(often rhyming)
Form of thought symptoms - Word salad, circumstantiality, tangentiality, mutism, and perseveration (positive symptoms)
Word salad: Group of words put together in a
random fashion
Circumstantiality: Delay in reaching the point of a communication because of unnecessary and tedious details
Tangentiality: Inability to get to the point of communication due to introduction of many new topics
Mutism: Inability or refusal to speak
Perseveration: Persistent repetition of the same word or idea in response to different questions
Hallucinations: define & types (positive symptom)
Hallucinations: False sensory perceptions NOT associated with real external stimuli (something that is NOT there)
− Auditory
− Visual
− Tactile
− Gustatory
− Olfactory
Illusions/Delusions: define (positive symptoms)
Illusions/Delusions: Misperceptions of real external stimuli
Sense of self symptoms - echolalia, echopraxia, identification and imitation, and depersonalization (positive symptoms)
Echolalia: Repeating words that are heard.
Echopraxia: Repeating movements that are observed.
Identification and imitation: Taking on the form of behavior one observes in another.
Depersonalization: Feelings of unreality.
Affect symptoms - inappropriate affect, bland, flat, apathy (negative symptoms)
Inappropriate affect: Emotions are incongruent with the circumstances.
Bland: Weak emotional tone
Flat: Appears to be void of emotional tone.
Apathy: Disinterest in the environment
Avolition definition
Avolition: Impairment in the ability to initiate goal-directed activity.
Avolition symptoms - emotional ambivalence and deterioration in appearance (negative symptoms)
Emotional ambivalence: Coexistence of opposite emotions toward same object, person, or situation.
Deterioration in appearance: Impaired personal grooming and self-care activities.
Interpersonal symptoms - impaired social interaction and social isolation (negative symptoms)
Impaired social interaction: Clinging and intruding on
the personal space of others, exhibiting behaviors that.
are not culturally and socially acceptable.
Social isolation: A focus inward on the self to the
exclusion of the external environment.
Lack of insight symptoms: anosognosia, anergia, anhedonia (negative symptoms)
Anosognosia: Lack of awareness of any illness or disorder.
Anergia: deficiency of energy.
Anhedonia: Inability to experience pleasure.
Other negative symptoms - waxy flexibility, posturing, pacing and rocking, regression, and eye movement abnormalities.
Waxy flexibility: Passive yielding of all movable parts
of the body to any effort made at placing them in certain positions
Posturing: voluntary assumption of inappropriate or bizarre postures
Pacing and rocking: Pacing back and forth and rocking
the body
Regression: Retreat to an earlier level of development
Eye movement abnormalities
Recovery after an initial schizophrenia episode (RAISE)
A program of case management that takes a team
approach in providing comprehensive, community-based psychiatric treatment, rehabilitation, and support to persons with serious and persistent mental illness
Typical (first gen) antipsychotic action
Typicals: Dopaminergic blockers with
various affinity for cholinergic, α-adrenergic, and histaminic receptors.
Atypical (second gen) antipsychotic action
Atypicals: Weak dopamine antagonists; potent 5HT2A antagonists; also exhibit antagonism for cholinergic, histaminic, and adrenergic receptors.
