Schizophrenia Spectrum and Psychotic Disorders Flashcards
What are acute episodes of schizophrenia characterized by? (5)
Delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behaviour.
During episodes of schizophrenia, how do sufferers act?
They may still be unable to think clearly and lack proper emotional responses.
What did Emil Kraeplin call schizophrenia?
Dementia praecox; to be out (dementis) of one’s mind (praecox).
What was Kraeplin’s idea of dementia praecox?
There was something wrong with the body; it presented in childhood; it spiralled downwards.
Who brought the term “schizophrenia”?
Eugen Bleuler
What were Bleuler’s 4 A’s for schizophrenia symptoms?
Associations, affect, ambivalence, and autism.
What were the problems with Bleuler’s association?
Relationships among thoughts become disturbed, disrupted, and tangential.
What were the problems with Bleuler’s affect?
Emotional responses become flattened or inappropriate.
What were the problems with Bleuler’s ambivalence?
Holding conflicting feelings towards others.
What were the problems with Bleuler’s autism?
Withdrawal into a private fantasy world that is not bound by logic.
What did Kurt Schneider believe about schizophrenia?
That there were first-rank and second-rank symptoms.
What are first-rank symptoms?
They must be experienced in order to diagnose schizophrenia, mainly included delusions and hallucinations.
What are second-rank-symptoms?
Symptoms associated with schizophrenia that also occur in other psychological conditions. E.g., disturbances of mood and confused thinking.
What is the main issue with first and second rank symptoms?
The potential for misdiagnosis occurs.
What percentage of the adult Canadian population does schizophrenia affect?
1%
Which gender is more often affected by schizophrenia?
Both are affected equally, but men develop the disorder earlier.
What is an indicator of the likely severity of schizophrenia?
How early it develops.
Where does schizophrenia place on the list of causes of disability worldwide?
5th.
What percentage of schizophrenics attempt suicide?
40-60%
What percentage of schizophrenics die because of suicide?
10%
How much more likely are schizophrenics to die from suicide compared to the rest of the population?
15-25 times more likely.
What are the 3 phases of schizophrenia?
Prodromal, acute, and residual.
What is the prodromal phase characterized by?
Waning interest in social activities and increasing difficulty meeting the responsibilities of everyday living. The person deteriorates, but is not actively delusional.
What is the acute phase characterized by?
Active delusions and/or hallucinations. Presence of positive symptoms.
What is the residual phase characterized by?
Behaviour returns to the level similar in function prior to the first acute phase.
What are the 6 categories of major features of schizophrenia?
Disturbances of thought and speech, disturbances in form of thought, attentional deficiencies, perceptual disturbances, emotional disturbances, and other.
Disturbances of thought and speech are characterized by what?
Delusions.
What are the types of delusions experienced by schizophrenics?
Delusions of persecution, reference, being controlled, grandeur, thought broadcasting, thought insertion, and thought withdrawal.
What are delusions of persecution?
Thinking that people are out to get them.
What are delusions of reference?
Thinking that people are talking about them.
What are delusions of being controlled?
Believing one’s thoughts, feelings, or actions are being controlled by external forces (agents or devils).
What are delusions of grandeur?
Believing oneself to be more important than they really are. E.g., believing oneself to be Jesus on a special mission, or having a grand but illogical plan to save the world.
What is thought broadcasting?
A delusion that one’s thoughts about being transmitted to the external world so that people can hear them.
What is thought insertion?
A delusion that one’s thoughts have been planted into one’s mind by an external source.
What is thought withdrawal?
A delusion that one’s thoughts have been removed from one’s mind.
What are 6 disturbances in the form of thought?
Thought disorder, neologisms, perservation, clanging, blocking, and poverty of speech.
What is thought disorder?
The breakdown in the organization, syntax, processing, and control of thoughts.
What are neologisms?
Words made up by the speaker that have little or no meaning to others.
What is perservation?
Inappropriate but persistent repetition of the same words or train of thought.
What is clanging?
Stringing together words or sounds on the basis of rhyming.
What is blocking?
Involuntary, abrupt interruption of speech or thought.
What is poverty of speech?
Not speaking much, and what is spoken makes no sense.
What is an example of an attentional deficiency?
Hyper-vigilance: acute sensitivity to extraneous senses, especially during the early stages of the disorder.
What are common perceptual disturbances?
Auditory hallucinations, self talk, tactile hallucinations, olfactory hallucinations, and command hallucinations.
What percentage of cases present with auditory hallucinations?
60%
What are command hallucinations? What percentage of cases present with them?
Beliefs that you must do something, often hurting someone. 80% have them.
What is the theory of the causes of hallucinations?
Especially sensitive dopamine receptors.
What is an example of an emotional disturbance?
Flat affect: low levels of arousal.
What are some other types of impairment?
Stupor: a state of relative or complete unconsciousness in which the person is not generally aware of the environment.
What is the categorical model of schizophrenia?
There are two types of schizophrenia: type I and type II.
What is type I schizophrenia?
The presence of positive symptoms; abnormal behaviour such as hallucinations, delusions, thought disorder, disorganized speech, inappropriate affect, etc.
What is type II schizophrenia?
The presence of negative symptoms; absence of normal behaviour. Social skills deficit, social withdrawal, flat affect, poverty of speech or thought, psychomotor retardation, failure to experience pleasure.
Are the two types of schizophrenia mutually exclusive?
No, the may both present in a diagnosis.
What is the psychodynamic perspective on schizophrenia?
The person is regressing to an early period in the oral stage due to stressors.
What is Harry Stack Sullivan’s psychodynamic theory of schizophrenia?
Anxious and hostile interactions between parent and child lead the child to take refuge in a private fantasy world.
What is the learning perspective (Ulmann and Krasner) on schizophrenia?
If children grow up in a non-reinforcing environment, they never learn to respond appropriately to social stimuli.
Why do learning theorists believe people present with sever schizophrenic symptoms?
They model after the more severe schizophrenics because they are getting the most attention.
What is the biological perspective on schizophrenia?
Viral infections, brain abnormalities, genetic, and biochemical factors contribute.
What is the dopamine theory of schizophrenia?
They do not produce more dopamine, but rather have a greater than normal amount of receptors that are more sensitive.
What drugs are used to treat schizophrenia based on the dopamine theory?
Neuroleptic drugs that block dopamine receptors.
What is the viral infection theory of schizophrenia?
The theory that schizophrenia is a slow-acting virus that attacks the developing brain of a fetus or newborn child.
What areas of the brain are indicated to affect schizophrenia?
The hippocampus and the amygdala.
What is the family theory of schizophrenia?
That schizophrenogenic mothers, contradictory or mixed messages, communication deviance, expressed negative emotions, or stress from the family contribute to schizophrenic behaviour.
What are schizophrenogenic mothers?
Cold, aloof, but also overprotective and domineering mothers.
What is the biological approach to treatment?
The use of antipsychotics.
What is an example of an antipsychotic drug used to treat schizophrenia?
Phenothiazines such as Haloperidol.
What is tardive dyskinesia?
A movement disorder characterized by involuntary movements of the face, mouth, neck, trunk, or extremities.
What is the psychoanalytic approach to treatment? How effective is it?
Personal therapy is used, it is not well suited to treatment.
What percentage of schizophrenics will go off their drugs? What percentage will relapse?
90% go off drugs; 40% relapse.
What is the learning-based approach to treatment?
Selective reinforcement, token economies, and social skills training.
What is psychosocial rehabilitation?
Self-help groups and community programs run by nonprofessionals.
What are family intervention programs?
Programs that educate family members on the practical aspects of daily living with someone schizophrenic.
What do early intervention programs yield? (7)
Reduced disruption of activities, disruption of relationships, likelihood of hospitalization, disability and relapses, risk of suicide, improved capacity to maintain self-identity, and faster and more complete recoveries.
What is anosognosia?
Not knowing that you are sick; believing yourself to be normal and everyone else to be abnormal.
