Task 8 Flashcards
What is the defintion of psychosis ?
- not able to tell the difference between what’s real and what isn’t
What is the definition of schizophrenia ?
- alterations between inactive and active psychosis phases
What two types of symptoms do we have regarding schizophrenia ?
- Postive and negative symptoms
What is the definition of the posotive symptoms regarding schizophrenia ? (als name the four types)
- overt expressions of unusual perceptions, thoughts, and behaviours
1. Delusions
2. Hallucinations
3. Disorganised Thought/Speech
4. Disorganised/ Catatonic Behaviour
What is meant by delusion ?
- ideas exist but are highly unlikely or even impossible to become true
- resistant against compelling arguments
- be aware of high cultural differences
What is meant by Persecutory delusions ?
- believe they are being watched
What is meant by Delusions of reference ?
- believe random events/comments by others are directed at them
What is meant by Grandiose delusions ?
- believe they are a special being or possess special powers
What is meant by Delusions of thought insertion ?
believe that thoughts are being controlled by outside forces
What is meant by delusion of thought withdrawl ?
- belief that thoughts are being removed by someone
What is meant by the delusion of guilt or sin ?
- False belief that one has commited a terrible act
What is meant by the delusion of thought broadcasting ?
- belief that ones thaught are being broadcast (other can hear your thought)
What is the defintion Hallucinations ?
- Unreal perceptual experiences
- frequent presistent complex and bizzare
- Auditory, visual, tactile (outside), somatic (inside) -> all senses can provoke a hallicunation
- important to keep cultural differences in mind
What is the definition of Disorganised Thought/Speech ? (and which gender is more prevalence for the symptoms)
- they have a formal thought disorder = disorganized thinking
- Loose association: slip from one topic to another (unrelated topic)
- men = Less bialetrally language control
What are the 3 stages of loose association ?
- Word salad: totally incoherent (gegensetzlich)
- Neologism: make up words
- Clangs: make associations btw words based on their sounds rather than content
What is the definition of Disorganised/ Catatonic Behaviour ? (2 types)
- Unpredictable & apparently untriggered movement -> daily routines can not be followed
- Catatonia: unresponsiveness to environment
Name the 3 types and there function of cantonia:
- Negativism: lack of response to instructions
- Mutism: complete lack of verbal/motor responses
- Catatonic excitement: purposeless and excessive motor activity for no apparent reason
What is the defintion of negative symptoms regarding schizophrenia ? (name the 2 types)
- loss of certain qualities of the person
1. Retsricted affect
2. Avolition/ Asociality
What is meant by the retsricted affect ?
- Severe reduction/ absence of emotional expression
- or intense emotions (overload)
- Having anhedonia
What is meant by anhedonia ?
- loss of the ability to experience pleasure
What is meant by Avolition/ Asociality ?
- Avolition: inability to initiate/ persist at common goal-directed activities
- Asociality -> no interest in socialisation
What are the cognitive deficits regarding schizophrenia patients ?
- Deficits in: attention, memory (especially working memory), and processing speed
- Can’t distinguish relevant from irrelevant can’t ignore the irrelevant
- Cognitive deficits have been found to be present before the definite onset
According to the auditory verbal hallucinations article, are external explanations an indicator of schizophrenia ?
- Having an external explanation was not an indicator for psychotic disorders
According to the auditory verbal hallucinations article, what are the differences between a disorder and “normal person”?
- Disorder patient had more:
1. Negative emotional valence of content
2. higher frequency of hali
3. less control
4. later onset 21
According to the auditory verbal hallucinations article, what are the similarities between a disorder and “normal person”?
- Both experinced: location (inside vs. outside), number of voices, loudness, personification
What are the DSM 5 charactersitics of schizophrenia ?
- 2 or more of the positive and negative symptom have to be present
- at least a month
- one of them (delusion hallucinationa and disorganies speach must be present)
- functioning in major areas is impaired (school)
- has to have a 6 months ratio which can be split up in prodromal/ residual symptoms and major month disorder
- not a depressive or bipolar disorder (do not met full criteria
- not due to substance
- if autism is present hallucination or delusion must also be present
What is meant by prodromal symptoms ?
- symptoms occurring (more or less 6 months) before the acute phase
- more characterized by negtaive symptoms
What is meant by residual symptoms ?
- symptoms occurring after the acute phase (+/- 6 months)
- more characterized by negtaive symptoms
What are the prevalenzes of schizophrenia ?
- 1-2%
- Onset: late adolescence/ early adulthood (for men a bit earlier, teenager)
- chronic
- improve with age
- life expectancy 10 years shorter
- high suicide: 10-15%
- worse symptoms in man
- 50% in man and 50% in woman
What are the causes of relapse ?
- stressful life events, or not taking given medication
Why is it for man more common then for woman to develope schizophrenia ?
- higher risk for abnormal brain development (because onset is in teenage time)
- Estrogen in woman has a protective function
What is meant by Schizoaffective Disorder ?
- Mix of schizophrenia and mood disorder
2. At least 2 weeks of hallucinations or delusions without mood symptoms (other then that mood must be persistent)
What is meant by Schizophreniform Disorder ?
- show symptoms that last only 1-6 months
- functional impairment is not neccesary
What is meant by brief psychotic Disorder ?
- Only lasts one day to one month, afterword’s the symptoms are completely gone
What is meant by delusional Disorder ?
- Only show delusions
- at least a month
- late onset and more in females
What is meant by Schizotypal personality Disorder ?
- Think & behave in odd ways, but remain control on reality
- completly similar besides no impaiment with reality
What is meant by Paranoid schizophrenia Disorder ?
- characterized by delusions and hallucinations that involve themes of persecution and grandiosity
- most common type
How do gentic theories explain schizophrenia ?
- Different genes responsible for different symptoms
- Risk decreases as genetic similarity decreases
- Genes more than environment
- Connected to genes which regulate the dopamine system
Do only genetic factors play a role regarding schizophrenia ?
- expression is depending on environment
- so it is an interaction between both
- genes are cuases
How do brain abnormalities explain schizophrenia ?
- Grey matter reduction
- PFC: abnormal activity
- Hippocampus: abnormal activation, shape & volume
- White matter reduction in WM areas
- Ventricles are larger -> leads to decrease of other brain tissue
How does brain damage explain schizophrenia ?
- birth complications -> such as Perinatal hypoxia or prenatal viral exposure
What is meant by Perinatal hypoxia ?
- oxygen deprivation before or after birth
What is meant by prenatal viral exposure ?
- viral infections while pregnant -> immune system of mother is more active
- When immune system is more active -> it negatively impacts the devlopment of brain cells and dopamine sytem of child
How does a deficit in neurotransmitter explain schizophrenia ?
- Via the orginal dopamine theory
- Via the revised dopamine theory
Explain the orignal dopamine theory:
- To much Dopamine accounts for everything
- > Stated as wrong because drugs which reduce lvl of dopamine only weakned positive symptoms
Explain the revised dopamine theory:
- It is about different lvl of dopamine in different areas
- To much in mesombolic pathway -> account for postive symptoms
- to low lvl of dopamine in PFC -> accounts for negative symptoms
- > Also states that serotonin modulates dopamine and also a lower lvl of glutamate and gaba impact the disorder
How do psychological theories explain schizophrenia ?
- via the Social drift theory and the urban birth theory
- Also it states that high stress lvls are determined as causes and Families with high expression/fluctuation of emotions
Define the social drift theory:
- symptoms interfere with functioning thus people drift down in social class
Define the urban birth theory:
- Large city = more stress + overcrowding leads to viral infections of pregnant people
How do cognitive theories explain schizophrenia ?
- people use certain cognitive biases or thinking styles to preserve (erhalten) their limited cognitive resources
- delusion and hallucinations help to understand the overwhelming information streaming ( portection for intact brain parts)
- have an hypersensitvity to input
What is meant by the jumping to conclusion bias ?
- gather only little info and jump straight to the conclusion
What is meant by the metamemory bias ?
- having a reduced memory vividness & overconfidence in errors
What is meant by the theory of mind deficit bias ?
- Influences all other biases
- not able to follow/dentify others intention /emotions and feeling
- they belive that others are hiding there intention and are hostile (gegner)
What are the biological treatment options ?
- Phenothiazines or Neuroleptics
- Atypical Antipsychotics
How do phenothiazines or neuroleptics work and what do they treat ?
- block dopamine receptors -> less dopamine
- only control positive symptoms
What were the major side affects of phenothiazines or neuroleptics ?
- Akinesia
- Tardive dyskinesia
What does akinesia stand for ?
- slowed motor activity
What does Tardive dyskinesia stand for ?
- involuntary movements of the face, mouth
How do Atypical Antipsychotics work and what do they treat ?
- affect dopamine availability -> more dopamine for meso limbic system
- treats negative and positive symptoms
- via Clozapine and Risperidone
How does psychological and social treatment treat schizophrenia ?
- Increase social skills, reduce isolation, stress and conflict
- also making the patient understand the disorder
- remain the medication
- teaching them coping effect with side mechanism
- Via cognitive behavioural, famliy and social intervention treatment, Reattribution
How does cognitive treatment try to treat schizophrenia ?
- try to teach them how to participate in social life
- change attitude regarding the illness
How does behavioural try to treat schizophrenia ?
- social learning theory+operant conditioning
- try to be a role model to teach them how to inniate or maintain conversation
How does social intervention try to treat schizophrenia ?
- self-support groups for increasing contact and support
How does family treatment try to treat schizophrenia ?
- combine basic education with coping and behavioural techniques to encourage appropriate behaviour within the family
How does the reattribution theory treat people with schizophrenia ?
- Ecourage patient to consider normal causes for hallucination
What is meant by the attributional style bias ?
- blame negative events on other people and institutions rather than spreading blame over multiple sources
What is meant by the bais against disconformity evidence ?
- clients do not listen to counterarguments
How does the metacognitive training work ?
- raise patients’ awareness of biases & make them critically reflect on and change current way of thinking
- hybrid model using psychoeducation, cognitive remediation and cognitive-behaviour therapy
- it works with 8 modules
- Greater decline in Positive and Negative Syndrom
How does the frontal lobe model explain schizophrenia ?
- Hypo-frontality: psychos have reduced frontal to posterior blood flow
- DLPFC blood flow
- > leads to less activity or hyperactvity
- not 100% true dependent on the behavioural state
- WM deficit was given as true cause.
How does the temporal lobe model explain shizophrenia ?
- dysfunction is characterized by a left
hemispheric overactivation during task - Also LTM problems because of hippocampal and frontal lobe abnormalities
How does the disrupted connectivity explain schizophrenia ?
- deficit in
the connectivity between frontal and temporal lobe - disruption in brain network rather than a disorder in a single brain region
- might be due to Abnormal correlations between left STG and left DLPFC,
- increased temporal-VLPFC connectivity to compensate
