unit 7b Flashcards
Thought Disorders
schizophrenia
disorder characterized by POSITIVE symptoms:
- hallucinations, delusions, disorg. speech & thought
NEGATIVE symptoms:
- absence of normal cognition or affect, flat affect, poverty of speech, lack of motivation & cognitive symptoms (problems w/ working memory + attention)
Prevalence of symptoms is similar across cultures (1-2%)
- incidence = same for men & women
hallucination (+)
perception in absence of stimulus
- stricter sense: defined as perceptions in a conscious & awake state in the absence of external stimuli ~ which have qualities of real perception, in that they are vivid, substantial, & located in external objective space (think sensory disorder)
Command hallucinations can occur + involve voices giving orders
Delusion (+)
an idiosyncratic, irrational belief or impression that is firmly maintained despite being contradicted by what is generally accepted as reality or rational argument
- typically a symptom of mental disorder (think thought disorder)
Disorganized speech/thought (+)
Over-Inclusion
- jumping f/ idea to idea w/o benefit of logical association
Paralogic thought
-on the surface, thinking may appear logical, but is actually seriously flawed
- - ‘Para’= ‘almost’ or ‘next to’ so this terms means “almost logical”
Flat affect (-)
affect is a medical term for mood
A patient has very little reaction to events around them
- display little-to-no emotion physically, & may not feel emotions very much either
Inappropriate affect (-)
Mood (affect). patient displays does not match the circumstances
ex: laughing at serious things
Catatonic behavior (catatonia) (-)
unresponsiveness to environment, usually marked by immobility for extended periods & echolalia
~Echolalia- parrot-like repetition of speech
~Wavy flexibility- a psychomotor symptom which leads to decreased response to stimuli & tendency to remain in an immobile posture
Subtypes of schizophrenia
-Paranoid
-Disorganized
-Residual
-Catatonic
-Undifferentiated
Paranoid type
well formed hallucinations & delusions (eg of persecution, grandeur)
Mostly positive symptoms /fewer symptoms
Most common & best prognosis
Disorganized type
disorganized speech, silly behavior, & flat affect / disturbed emotional expression
Delusions & hallucinations are less pronounced than in the paranoid type + have little meaning or logic
Patients tend to be incoherent/unintelligible have issues w/ daily self-care
- AKA hebephrenic (‘childish behavior’)
Residual type
primarily displays negative (-) symptoms like flat affect, reduced speech, lack of motivation
Catatonic type
unresponsive to surroundings w/ echolalia, waxy flexibility; rare
Undifferentiated type
Combination of hallucinations, specific delusions, & general disorganization
- no single symptoms type is most prominent
As w/ undifferentiated versions of other nuerorpsych disorders, these patients **dont fit well **into other categories
Possible causes of schizophrenia
-congenital risks
-brain structure changes
→ hypofrontality hypothesis
-neurochemical changes
→ dopamine & glutamate
Congenital risks (schizo.)
difficult birth (eg oxygen deprivation), prenatal viral infection
brain structure changes (schizo.)
Enlarged ventricles, decr. hippocampus & amygdala, loss of temporal + frontal cortex
Hypofrontality changes (schizo.)
theory that **problems in frontal lobe are assoc. w/ schizo. **
Ex; In identical twins, the 1 w/ schizo has decr. ↓ blood flow to frontal lobes
Schizophrenics have problems w/ exec. func. tasks like Wisconsin card sorting task.
- evidence suggests genetic & environ. changes to frontal lobes may cause schizo.
neurochemical changes (schizo.)
Dopamine
- affects mood, energy, sexual desire & motor coordination
- may play role in schizo., esp. w/ hallucinations
-antipsychotic meds decr. ↓ dopamine
Glutamate
- key excitatory neurotransmitter
-key evidence suggests that glutamate decr. ↓ may be correlated w/ schizo.
-meds that incr. ^ glutamate DO NOT help symptoms (instead incr. ^ risk of seizures)
Treatments for Schizophrenia
-Anti-psychotic medications
→ tardive dyskinesia
-Electroconvulsive Shock Therapy (ECT)
→ used mainly in CATATONIC schizo.
-Occupational therapy
→ self-care, work options
antipsychotic medications
typical antipsychotic (older, more side effects) decr. ↓ dopamine BRAIN WIDE
- primary effect on POSITIVE (+) symptoms
Atypical antipsychotics (fewer side effects) affect dopamine pathways in more complex form & may also interact w/ serotonin pathways
- primary effect on POS. (+) symptoms, also some negative (-) ones
Tardive dyskinesia
Possible permanent disorder of involuntary, repetitive, purposeless mvmts as side effect of long-term or high dose use of dopamine ANTAGONISTS, like antipsychotics
Compare to L-Dopa for Parkinson’s, (which cause psychosis [abnormal cognition like delusions + hallucinations] in patients w/ PD by incr. ^ dopamine too much )
- Here antipsychotics decr. ↓ dopamine so much that patients may develop mvmt disorders - tar dive dyskinesia specifically
Schizophrenic Spectrum Disorders
-Schizophreniform disorder
-Schizoaffective disorder
-Schizotypal personality disorder
→ magical thinking
-Schizoid personality disorder
-Schizophreniform disorder
disorder characterized by symptoms of schizo.
- FOR LESS THAN 6 MONTHS
- less social dysfunction than schizophrenia
-more likely recovery
May simply be early diagnosis of schizo.
Schizoaffective disorder
disorder characterized by mood changes & psychosis
(think SCHIZO. + BIPOLAR disorder)
Schizotypal personality disorder
personality disorder characterized by symptoms of:
- social anxiety, paranoia, inapp. & reduced affect, lack of close relationships, MAGICAL THINKING, & vague metaphorical speech
These symptoms resemble positive (+) symptoms of schizo., which is why its included in spectrum
Magical Thinking
thought pattern commonly seen in schizotypal personality disorder
- patient experiences fear of performing certain acts & or having certain thought b/c of an assumed correlation b/t doing so & threatening calamities
may lead ppl to believe that their thoughts by themselves can bring abt effect in world or that thinking something corresponds w/ doing it
Schizoid personality disorder
disorder characterized by:
- lack of interest in social relationships
- tendency towards solitary lifestyle
-secretiveness
- emotional coldness
These symptoms resembles negative (-) symptoms of schizo.
Such patients often act like HERMITS, happily withdrawing f/ society
