Schizophrenia Spectrum and other Psychotic Disorders Flashcards
Schizophrenia Spectrum includes:
- Schizophrenia
- other psychotic disorders
- Schizotypal (personality) disorder
Schizophrenia, other psychotic disorders, and Schizotypal (personality) disorder are all defined by…
Abnormalities in one or more of the 5 domains
5 Domains of Abnormalities
- Delusions
- Hallucinations
- Disorganized thinking (speech)
- Grossly disorganized or abnormal motor behavior (including catatonia)
- Negative symptoms
Negative Symptom
Demunition or loss of functioning
Most common Negative Symptoms seen in Schizophrenia Spectrum Disorders
- Diminished emotional expression
- Avolition
- Alogia
- Anhedonia
- Asociality
Diminished emotional expression
A Negative Symptom:
- Reductions in expression in face, eye contact, and movements of hand, head, face that give emotion to speech
Avolition
A Negative Symptom:
- Decrease in motivated self-initiated purposeful activities
- May stir for long periods of time and show little interest in activities
Alogia
A Negative Symptom:
- Diminished speech output
Anhedonia
A Negative Symptom:
- Decreased ability to experience pleasure from positive stimuli or a degradation in the recollection of pleasure previously experienced
Asociality
A Negative Symptom:
- Apparent lack of interest in social interactions
Positive Symptoms
Excess or distortion of normal functions
Delusions
“False” beliefs
Ex. There are ants under my skin
Types of Delusions
- Persecutory
- Referential
- Grandiose
- Nihilistic
- Somatic
Persecutory
Delusional belief that one is going to be harmed
Referential
Delusional belief that gestures, comments, environmental cues are directed at them
Grandiose
Delusional belief of having exceptional abilities
Nihilistic
Delusional belief that a catastrophe will occur
Somatic
Delusional preoccupations with health and organ functions
Delusions are Bizarre if…
- They are clearly implausible
- They are not understandable to same-culture peer
- They do not derive from ordinary life experiences
Examples of Bizarre Delusions
- Thought withdrawal - believes thoughts have been removed from an outside force
- Thought insertion - believes thoughts have been put into their mind
- Delusions of control - believes body or actions are manipulated by outside force
Hallucinations
- Sensory distortions
- Perception-like experiences that occur without an external stimulus
Ex. I can feel red ants under my skin (scratching)
What is the most common type of hallucination in schizophrenia spectrum disorders?
Auditory Hallucinations
Disorganized Thinking
- Typically inferred from speech
- Must be severe enough to impair communication
Derailment
Type of disorganized thinking:
- Switching from one topic to another
- Loose associations
Tangential
Type of disorganized thinking:
- Answers to questions may be barely related or completely unrelated
Incoherence (or “word salad”)
Type of disorganized thinking:
- Speech may be so disorganized it is incomprehensible
- Rare
Disturbances in Behavior
- Explosiveness
- Pacing
- Inappropriate social behavior
Disorganized or Abnormal Motor Behavior
- Ranges from childlike “silliness” to unpredictable agitation
- Leading to difficulties in performing activities of daily living
Catatonic Behavior
- Marked decrease in reactivity to the environment
Catatonic Features include
- Resistance to instructions (negativism)
- Maintaining rigid, inappropriate or bizarre posture
- Lack of verbal responses (mutism)
- Lack of motor responses (stupor)
- Catatonic excitement - purposeless and excessive motor activity without cause
Disturbances in sense of self and others
- Loss of identity: Experiencing self as parts or not human
- Withdrawal from social connections
- Unclear boundaries
