WEEK 3 - Clinical disorders 3 & 4 Flashcards
What is schizophrenia?
- Umbrella term for a number of disorders
- Includes some loos of contact with reality
- Involves delusions and hallucinations
- Disruptions in perception, thoughts, feelings and behaviour
What is the lifetime prevalence of schizophrenia?
4 per 1000 (Saha et. al, 2005)
Not everyone who experiences _______ and/or ________ has schizophrenia.
- Delusions
2. Hallucinations
What is included in the hallucination symptoms of schizophrenia?
Perceptions in the absence of sensory stimulation
What are the different types of hallucinations that can be experienced with schizophrenia?
- Auditory
- Commenting
- Conversing
- Somatic/tactile
- Olfactory
- Visual
What is included in the delusional symptoms of schizophrenia?
Strange beliefs that are maintained despite evidence to the contrary
What are the types of delusions that someone with schizophrenia may have?
- Persecutory delusion
- Grandiose delusions
- Religious delusions
- Somatic delusions
- Delusions of reference
- Delusions of being controlled
- Delusions of mind reading
- Thought broadcasting
- Thought insertion
- Thought withdrawal
What may classify a thought disorder?
Tendency of thought to move along associative lines, rather than being controlled, logical or purposeful
What are some symptoms of a thought disorder?
Derailment: Ideas slip off track onto obliquely related areas
Circumstantiality: speech stays on track but very delayed in reaching goal
Distractible speech: Speech changed mid-sentence in response to a stimulus
Clang associations - sounds rather than meaning govern word choice
What are negative symptoms?
Symptoms that reflect a reduction or disappearance of abilities, emotions or drives that are usually present
What are some examples of negative symptoms in relation to schizophrenia?
Blunting: unchanging expression
Alogia: poverty of speech, increased latency of response
Avolition: poor hygiene, low motivation
Anhedonia: loss of enjoyment/interest
How does schizophrenia effect people throughout the course of their lives?
- Typically begins in early adulthood
- males = 18
- females - 25
- The lifetime course of schizophrenia varies greatly - some have a few episodes and recovers, for others it occurs their entire adult life.
What is the dopamine hypothesis in relation to the development of schizophrenia?
- A drug that reduces dopamine (Chlopromazine) was found to reduce some symptoms.
- When chloprozamine was used, only positive symptoms were reduced. Negative symptoms were worse
What is the diathesis-stress model of schizophrenia development?
- People who are biologically vulnerable may develop schizophrenia either directly or as a result of experiencing additional stressors
What are personality disorders?
Normal vs disordered variations in personality
What needs to be considered when diagnosing personality disorders?
- Culturally determined expectations of normal
- Introversion v extraversion
- Consider context of behaviour eg. is it consistent or only in some contexts?
- Observe longitudinally, not cross-sectionally
- Issues with self-report
eg. social desirability bias/lack of insight
Difficulty defining disordered personality traits means low reliability in diagnosis
When should personality disorders be diagnosed?
- Personality traits first appear by adolescence
- Traits are inflexible, stable and expressed in a wide variety of situations
- Traits lead to distress or impairment for themselves/others
- Rarely diagnosed before age 18
How many personality disorders are listed in the DSM-5
10, grouped into 3 ‘clusters’ based on broad symptom types
What is cluster A of personality disorders?
‘Odd, eccentric cluster’
Most common disorder is paranoid personality disorder
What classifies cluster B of personality disorders?
‘Dramatic, emotional, erratic’
Most common disorder is borderline personality disorder
What classifies cluster C of personality disorders?
‘Anxious, fearful cluster’
Most common disorder is dependent personality disorder
What are some current issues involved with personality disorders?
- High levels of comorbidity: debate regarding the distinction between some disorders - often high level of 2 or more PDs.
- Frequency of unspecified diagnosis: Often several criteria are met for a number of PDs, but the person doesn’t meet sufficient number of criteria for one PD
How many symptoms need to be met to be diagnosed with cluster A personality disorders?
4
Maggie has an unfounded suspicion of others and assumes everyone intends to deceive, harm or exploit her. She constantly bears grudges, has unjustified suspicions that her partner is unfaithful, and she is unwilling to confide in others. What cluster of personality disorders may she be diagnosed with?
Cluster A.
Debbie is preoccupied with doubts about loyalty or trustworthiness of friends/family. She constantly interprets positive or neutral remarks as being offensive or threatening, she perceives personal attacks where others do not and is excessively defensive and aggressive in response. What cluster of personality disorders may she be diagnosed with?
Cluster A -Paranoid personality disorder
What is the prevalence of cluster A personality disorders?
0.5-2.5% of general population; 10-30% of inpatients; 2-10% outpatients
- increase prevalence if have relative with schizophrenia or delusional disorders
- No sex differences
What are some behaviours involved in Cluster A personality disorders (Paranoid personality disorder)?
- Expect to be ignored in times of need
- Jokes do not go down well
- Pathologically jealous
- Reluctant to confide/refuse to provide personal information
How many symptoms need to be identified in order for someone to be diagnosed with cluster B personality disorders?
5
Jenny goes to frantic efforts to avoid abandonment, she constantly has unstable and intense relationships that swing from idolising someone, to devaluing them. She is impulsive in at leat 2 areas and constantly self harms/participates in suicidal behaviour. What cluster of personality disorders may she be diagnosed with?
Cluster B- Borderline personality disorder
What is borderline personality disorder?
Cluster B - Long term instability of relationships, self image and mood
What is paranoid personality disorder?
Cluster A - Pervasive distrust and suspiciousness of others. Assume others’ intentions are malevolent.
Mark has an unstable sense of self, he is emotionally volatile with extreme mood swings and he cannot regulate emotions. He has chronic feelings of emptiness and anger problems. He also had short term paranoid thoughts and/or severe dissociative symptoms. What would you diagnose him with?
Cluster B - Borderline personality disorder
What are some characteristics of Cluster B - borderline personality disorder?
- Mostly diagnosed in females
- High comorbidity with mood disorders and substance disorders
- Thought to be associated with childhood trauma
- Tendency to improve midlife
What is the prevalence of borderline personality disorder in the general population?
2%
What is antisocial personality disorder?
Long-term disregard and violation of the rights of others.
How many symptoms need to be identified for cluster B - anti social personality disorder?
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