Schizophrenia Spectrum & Personality Disorders Flashcards
Schizophrenia
- a psychological disorder characterized by disturbances in thought processes, perception and affect invariably resulting in a severe deterioration of social and occupational functioning
Stages of schizophrenia: premorbid phase
Those that occur before there is clear evidence of illness
Stages of schizophrenia: prodromal phase
More clearly manifest as signs of the developing illness of schizophrenia
Stages of schizophrenia: schizophrenia
Active phase, psychotic symptoms are present
Stages of schizophrenia: residual phase
Symptoms absent
Schizophrenia - manifestations
2 or more of the following symptoms for a significant portion of a 1 month period of time:
- delusions
- hallucinations
- disorganized speech
- grossly disorganized or catatonic behavior
- negative symptoms
- level of functioning in one or more major areas has decreased
- disturbance persists for > 6 mos.
- other disorders must be ruled out
- disturbances cannot be attributed to substance abuse or med. cond.
Delusional disorder
The presence of delusions for at least 1 month
Delusional disorder: erotomanic type
Individual believes that someone, usually of a higher status, is in love with them
Delusional disorder: grandiose type
Individuals have irrational ideas regarding their own worth, talent, knowledge or power
Delusional disorder: jealous type
The individual believes their partner is unfaithful
Delusional disorder: persecutory type
Individuals believe they are being persecuted or malevolently treated in some way
Delusional disorder: somatic type
Individuals believe they have some kind of medical condition
Delusional disorder: mixed type
Delusions are prominent, but no single theme is predominant
Delusional disorder - manifestations
- delusions for at least one month
- no hallucinations
- no overly-bizarre behavior
Brief psychotic disorder
- identified by the sudden onset of psychotic symptoms that may or may not be preceded by a severe psychological stressor
- symptoms last at least 1 day, but less than 1 month
- eventual return to premorbid function
Brief psychotic disorder - manifestations
- sudden onset of psychotic symptoms
- individual experiences emotional turmoil or overwhelming perplexity or confusion
- catatonic features may occur
Substance- or medication-induced psychotic disorder
- prominent hallucinations and delusions directly attributable to substance intoxication or withdrawal
- dx made when symptoms are more excessive than usual intoxication or w/d symptoms
Substance- or medication-induced psychotic disorder - manifestations
- prominent hallucinations and delusions
- medical hx, physical exam or lab findings suggesting that s/s occurred in association with a substance intoxication or w/d or exposure to a med or toxin
Catatonic disorder d/t another medical condition
- when the symptomology is evidenced from health hx, physical assessment, or lab data
Psychotic disorder d/t another medical condition
Prominent hallucinations and delusions that can be attributed to another medical condition
Schizophreniform disorder
Like schizophrenia, except the duration is > 1 month or < 6 mos.
Schizphreniform disorder - manifestations
- s/s same as schizophrenia
- catatonic features may be noted
Schizoaffective disorder
- characterized by abnormal thought processes and deregulated emotions
- the diagnosis is made when the person has features of both schizophrenia and a mood disorder—either bipolar disorder or depression—but does not strictly meet diagnostic criteria for either alone
- decisive factor = presence of hallucinations and/or delusions for at least two weeks without a major mood episode
Schizoaffective disorder - manifestations
- manifested by s/s of schizophrenia
- also a strong element of symptomology associated with mood disorders, depression or mania
- client may appear depressed w/ psychomotor retardation and suicidal ideation
- euphoria
- grandiosity
- hyperactivity
Paranoid personality disorder
- pattern of pervasive mistrust/suspicion of others
- misinterpretation of others’ moments as malevolent
Paranoid personality disorder - manifestations
- being constantly on guard/hypervigilant
- being ready for any real or imagined threat
- appear tense and irritable
- have a hard exterior
- avoid interactions with others
- over sensitive
- “test” the honesty of others
- do not accept responsibility for own behaviors/actions
Schizoid personality disorder
- characterized by a profound defect in the ability to form personal relationships with others
- individuals with this disorder are often seen as isolated or lonely
Schizoid personality disorder - manifestations
- appear cold, aloof and indifferent
- typically have a long hx of engaging in primarily solitary activities
- engage more with animals than people
- prefer isolation
- appear shy, anxious or uneasy to others
Schizotypal personality disorder
- once described as “latent schizophrenia”
- behavior is odd and eccentric, but does not decompensate to level of schizophrenia
Schizotypal personality disorder - manifestations
- aloof and isolated
- magic thinking, ideas of reference illusions and depersonalization part of their everyday world
- speech pattern is sometimes bizarre
- under stress, may decompensate and show psychotic symptoms
Antisocial personality disorder
A pattern of socially irresponsible, exploitative and guiltless behavior that reflects a general disregard for the rights of others
Antisocial personality disorder - manifestations
- individuals exploit and manipulate others for personal gain
- are unconcerned for obeying the law
- have difficulty sustaining enjoyment and developing stable relationships
- often associated with substance abuse
Borderline personality disorder
Characterized by a pattern of intense and chaotic relationships with affective instability and fluctuating attitudes toward others
Borderline personality disorder - manifestations
Individuals are impulsive, directly and indirectly self-destructive and lack a clear sense of identity
Histrionic personality disorder
- colorful, dramatic and extroverted behavior in excitable, emotional people
- they require constant affirmation of approval and acceptance from others
Histrionic personality disorder - manifestations
- individuals tend to be self-dramatizing, attention seeking, overly gregarious and seductive
- they use manipulative and exhibitionistic behaviors in their demands to be the center of attention
- have an all-consuming need for approval and strive to be conspicuous and evoke affection or attract attention at all costs
- somatic complaints not uncommon
- fleeting episodes of psychosis may appear during stress
Narcissistic personality disorder
- people have an exaggerated sense of self-worth
- they lack empathy and are hypersensitive to the evaluation of others
Narcissistic personality disorder- manifestations
- individuals appear to lack humility
- are overly self-centered and exploit others to fulfill their own desires
- are “superior beings”, entitled to special rights and privileges
- usually optimistic, relaxed, carefree
- mood can easily change when challenged d/t fragile self esteem
Avoidant personality disorder
- individual is very sensitive to rejection and consequently may lead a very socially resolved life
- may strongly desire a relationship, but extreme shyness and fear of rejection creates need for unusually strong assurances of unconditional acceptance
Avoidant personality disorder - manifestations
- awkward and uncomfortable in social situations
- may be perceived as timid, withdrawn or cold and strange
- those close to them learn of their sensitivities, touchiness, evasiveness and mistrustful qualities
Dependent personality disorder
Characterized by lack of self-confidence and extreme reliance on others to take responsibility for them
Dependent personality disorder - manifestations
- individuals have a notable lack of self-confidence that is often apparent in their posture, voice and mannerisms
- assume passive and submissive roles in all relationships
- avoid positions of responsibility and are easily hurt by criticism
Obsessive-compulsive personality disorder
- individual has an intense fear of making mistakes
- manifests in inflexible and perfectionist behavior
- no evidence of obsessive-compulsive rituals
Obsessive-compulsive personality disorder: manifestations
- individuals inflexible and lack spontaneity
- social behavior tends to be polite and formal
- are very “rank conscious”
- appear calm and controlled
- underneath lies a great deal of ambivalence, conflict and hostility
Interventions for schizophrenia
- individual psychotherapy
- group therapy
- behavior therapy
- social skills training
- family therapy
- assertive community treatment
- the recovery model
- RAISE
- psychopharmacology (typical and atypical antipsychotics)
Interventions for personality disorders
- individual psychotherapy
- milieu or group therapy
- cognitive behavior therapy
- dialectical behavior therapy
- psychopharmacology
Schizophrenia and personality disorders - client and family education: nature of the illness
- what to expect as the illness progresses
- symptoms associated with the illness
- ways for family to respond to behaviors associated with the illness
Schizophrenia and personality disorders - client and family education: management of the illness
- connection of exacerbation of symptoms to times of stress
- appropriate med management
- side effects of meds
- importance of not stooping meds
- when to call HCP
- relaxation techniques
- social skills training
- daily living skills training
Schizophrenia and personality disorders - client and family education: support services
- financial assistance
- legal assistance
- caregiver support groups
- respite care
- home health care
