schizophrenia (wk 9) Flashcards
describe the prevalence of schizophrenia in the general population / between men and women.
at what age is it most frequently diagnosed? describe the gender difference for the age of onset
-~1% of population worldwide
-men/women seem to be at equal risk
-most freq diagnosed between age 15-45
-small gender diff for age of onset: men display symptoms earlier (early-mid 20s); women display later (late 20s-early 30s)
describe the course of schizophrenia (prodromal phase, onset of symptoms indicator, predicting course + outcome, what causes poorer outcomes)
-prodromal phase: variety of clinically significant symptoms may emerge slowly over time
-social isolation + withdrawal, poor hygiene, impairment in school/work fnxing, lack of interest, suspiciousness etc
-typically, development of positive symptoms mark onset of first episode of schizophrenia
-course + outcome n indiv patients is v difficult to predict
-poorer outcomes assoc w male gender, younger age of onset, delayed treatment
what are complications of schizophrenia?
-lower educational attainment
-higher unemployment rates (finding + maintaining)
-more likely to dev depression + substance use disorders
-schizophrenia tends to be a chronic + relapsing cond that will req support throughout the lifetime
compare positive and negative symptoms
-positive symptoms: more “obvious” symptoms of psychosis; addition of abnormal behaviors
-Delusions
-Hallucinations
-disorganized speech and/or Thought Disorder
-grossly disorganized / catatonic behaviors
-negative symptoms: absence / loss of typical behaviors
-diminished emotional expression (“flat affect”)
-alogia (poverty of speech)
-avolition (total lack of motivation)
explain/describe hallucinations. what are the most common type?
misinterpretations of sensory perception that occur while a person is awake + conscious
-can be in the presence or absence of corresponding stimuli
-people hear, see, smell, and/or feel things that are either not really present, OR not as how other people experience them
-auditory hallucinations are the most common type of hallucination
what are delusions? what are 4 common types of delusions (and which of these are the most common)? give examples for each
-implausible, strongly held beliefs that persist despite evidence contradicting them ; usu clearly false + represent abnormality in person’s thinking
- persecutory (most common): paranoid belief of being pursued, targeted, ridiculed, someone trying to harm them
→ eg: strangers on the street are CIA tailing them; nurses/drs in the hospital - referential: belief that common, meaningless occurrences have significant + personal meaning
→ eg: song on the radio is about them - religious: involve biblical / religious stories
→ eg God/Satan is speaking to me / controlling my actions / monitoring them
-religiousness vs delusion: depends on intensity / scope of which it appears in other areas of life - religiousness doesn’t impair fnxing + doesn’t impact other areas of lives - delusions of grandeur: belief they possess special abilities / knowledge
→ eg ability to influence world events / the future
describe the 5 ‘Stages of Alternate Reality’ that can be used to explain how immersed someone is in positive symptoms
- Cell phone
- Tablet
→ occasionally, get distracted by unusual / suspicious thought (eg is that person laughing at me?); however able to move on + detach - Computer
- TV
→ unusual ideas more prevalent in daily life, eg that family is out to harm you – might spend a few hours a day engaging in that belief + feeling more fearful
-harder to disengage from fears ATP - IMAX
→ fully immersed in unusual belief/psychotic experience; like being in a “surround sound. 3D movie”
describe loosening of associations
-one feature of disorganized speech - lack of logical connections between ideas in speech
-ideas not related in an organized / coherent way
-No single coherent train of thought
-freq derailment [from idea to idea]
-Abnormal spread / unusual linking of words / wd meanings / ideas
what are some motor symptoms?
-can range from agitated movements (eg tics, repetitive movements) to immobility
-catatonic behavior: holding rigid, unusual postures + resisting efforts by others to change these postures
-waxy flexibility: will allow others to move their bodies into new positions + maintains these positions
what are the 2 ‘core’ negative symptoms?
-diminished emotional expression (“flat affect”): failure to convey emotion in face, tone of voice, body language etc
-avolition: decreased motivation + more limited ability to initiate / persist in self-directed activities
-can result in difficulties w grooming + basic hygiene
describe anhedonia and alogia (negative symptoms)
-anhedonia: ↓ ability to experience + recall pleasure / experiences assoc w reward
-alogia: lessening of speech, 2 forms:
-poverty of speech: amount of speech is greatly ↓
-poverty of content of speech: amount is adequate but speech communicates little information (vague + repetitive)
is cognitive impairment a diagnostic requirement? give examples of cognitive deficits commonly found in those with schizophrenia
-not part of the DSM5 criteria, but is often clinically relevant (+debate to add it to next DSM)
-wide-spread cognitive deficits (IQ, language, executive functioning, attention/processing speed, memory)
what are the diagnostic criteria of schizophrenia?
A. 2+ of the following, for a significant period of time during a 1mo period; AL one of these should incl 1-3 (positive symptoms)
1. delusions*
2. hallucinations*
3. Disorganized speech*
4. Grossly disorganized/catatonic behavior
5. Negative symptoms (ie diminished emotional expression, avolition)
B. for a significant period of time since onset, lvl of fnxing (eg work, self care, social relationships) is markedly below what was achieved before the onset
C. continuous signs of the disturbance persist for AL 6 months (must incl AL 1 month of symptoms from criteria A)
explain the Hearing Voices Movement and its contribution to CBT for Pyschosis
-peer support groups
-aim is for people to dev personal meaning abt their unusual experiences, normalize the experience of psychosis, share coping strategies
-many concepts from CBT for psychosis derived from early Hearing Voices groups in England
give an example of how social + cultural factors may impact individuals’ interpretations of their experiences with schizophrenia
-US patients experienced voices as violent/hateful + viewed them as a brain disease
-patients from Africa + India reported more positive experiences w voices, tended to view them as spirit guides, were not highly distress
