Week 5 - Schizophrenia and the psychotic disorders Flashcards
The DSM-5 describes psychosis through:
A) A single, clear-cut definition
B) Various symptoms and criteria across different disorders
C) Only in relation to schizophrenia
D) A set of fixed, universally agreed-upon symptoms
B) Various symptoms and criteria across different disorders
(There is still no universally agreed-upon definition of psychosis)
In the DSM-5, psychotic disorders are conceptualized in terms of SEVERITY and the presence of which FIVE CORE SYMPTOMS?
A) Anxiety, mood swings, paranoia, aggression, and cognitive impairment
B) Delusions, hallucinations, disorganized thinking, grossly disorganized behavior, and negative symptoms
C) Depression, hallucinations, obsessive thoughts, memory loss, and confusion
D) Mania, apathy, disorganized speech, social withdrawal, and suicidal thoughts
B) Delusions, hallucinations, disorganized thinking, grossly disorganized behavior, and negative symptoms
In schizophrenia, what do positive symptoms entail?
A) The absence of normal behaviors
B) Cognitive impairments
C) The addition of disturbances such as hallucinations, delusions, and disorganization in thought and behavior
D) Emotional flatness and withdrawal
C) The addition of disturbances such as hallucinations, delusions, and disorganization in thought and behavior
In schizophrenia, which type of symptoms refer to deficits in psychological processes such as avolition, affective flattening, and alogia?
A) Positive symptoms
B) Cognitive symptoms
C) Negative symptoms
D) Mood symptoms
C) Negative symptoms
The state of highly disorganized thinking, formally known as ________ __________ or loosening of associations, is characteristic of individuals with schizophrenia.
A) Cognitive impairment
B) Thought disorder
C) Emotional detachment
D) Behavioral dysfunction
B) Thought disorder
The inability to initiate or persist with important activities is known as ________ and is a negative symptom of schizophrenia.
A) Alogia
B) Anhedonia
C) Avolition
D) Affective flattening
C) Avolition
Which scenario involving John best illustrates avolition in schizophrenia?
A) John struggles to understand abstract concepts
B) John feels persistent sadness and has lost interest in hobbies
C) John is unable to start or complete essential daily tasks such as going to work or maintaining hygiene
D) John experiences auditory hallucinations
C) John is unable to start or complete essential daily tasks such as going to work or maintaining hygiene
The term used to describe broad range of disturbances of bodily movement, such as excessive restlessness or slowed movement, is:
A) Avolition
B) Catatonia
C) Motor Disturbance
D) Disorganized thinking
C) Motor Disturbance
(Catatonia is a more specific condition with well-defined symptoms, whereas motor disturbances can be a symptom of many different underlying conditions)
Which scenario best illustrates a motor disturbance such as psychomotor agitation?
A) Michael remains in a fixed posture for long periods
B) Michael shows excessive restlessness, pacing around the room, and fidgeting
C) Michael experiences persistent sadness and loss of interest in hobbies
D) Michael has trouble understanding abstract concepts
B) Michael shows excessive restlessness, pacing around the room, and fidgeting
Distortions of reality where individuals believe they are seeing or hearing things that are not actually present.
Hallucinations
(reported by app 75% of patients with schizophrenia)
What is considered the most distressing psychotic symptom, such as hearing voices (reported by 65-70% of patients)?
A) Delusions
B) Auditory Hallucinations
C) Disorganized thinking
D) Negative symptoms
B) Auditory Hallucination
The severe reduction or complete absence of emotional responses to the environment, which is a negative symptom of schizophrenia, is known as:
A) Avolition
B) Alogia
C) Anhedonia
D) Affective flattening
D) Affective flattening
Which scenario best illustrates affective flattening in schizophrenia?
A) Emily has intense mood swings and frequently changes her emotional responses
B) Emily maintains a blank facial expression, speaks in a monotone voice, and shows no emotional reaction to significant news
C) Emily is highly reactive to emotionally charged events and shows vivid emotional expressions
D) Emily experiences auditory hallucinations that affect her emotional state
B) Emily maintains a blank facial expression, speaks in a monotone voice, and shows no emotional reaction to significant news
The deficiency in the quantity of speech, which is a negative symptom of schizophrenia, is known as:
A) Affective flattening
B) Avolition
C) Alogia
D) Anhedonia
C) Alogia
Which scenario best illustrates alogia in schizophrenia?
A) John provides very brief responses to questions, such as “Fine,” without elaboration
B) John frequently engages in elaborate and detailed conversations
C) John shows intense emotional reactions during conversations
D) John demonstrates excessive and repetitive speech patterns
A) John provides very brief responses to questions, such as “Fine,” without elaboration
“poverty of speach”
The psychotic symptom that entails perceptual experiences that are not real and can occur in any sensory modality (e.g., hearing voices or seeing things that are not present) is known as:
A) Delusion
B) Hallucination
C) Thought disorder
D) Affective flattening
B) Hallucination
Which aspect of psychotic disorders, often leading to increased need for treatment, including early intervention and prevention, involves difficulties with interaction and engagement in activities?
A) Cognitive decline
B) Social isolation and participation
C) Emotional instability
D) Motor disturbances
B) Social isolation and participation
Voices heard in psychotic disorders are typically critical and ______, but comforting voices are also reported.
A) Pleasant
B) Neutral
C) Hostile/Threatening
D) Encouraging
C) Hostile/Threatening
In addition to aural hallucinations, hallucinations can occur in other modalities such as:
A) Visual, olfactory, gustatory, tactile, somatic
B) Emotional, auditory, cognitive, behavioral, social
C) Cognitive, motor, affective, sensory, interpretive
D) Visual, auditory, affective, cognitive, social
A) Visual, olfactory, gustatory, tactile, somatic
Which scenario best illustrates a visual hallucination?
A) Sarah hears a voice speaking to her but sees no one present
B) Sarah feels a sensation of a hand on her shoulder that isn’t actually there
C) Sarah smells a rotting odor that others do not detect
D) Sarah sees a figure of a person in her room who is not actually there
D) Sarah sees a figure of a person in her room who is not actually there
Which scenario best illustrates an olfactory hallucination?
A) Sarah hears a voice speaking to her but sees no one present
B) Sarah feels a sensation of a hand on her shoulder that isn’t actually there
C) Sarah smells a rotting odor that others do not detect
D) Sarah sees a figure of a person in her room who is not actually there
C) Sarah smells a rotting odor that others do not detect
Which scenario best illustrates a gustatory hallucination?
A) Mark hears voices that no one else can hear
B) Mark sees objects that are not actually present
C) Mark constantly tastes a metallic flavor in his mouth despite having no cause for it
D) Mark feels as though a hand is touching his shoulder when no one is there
C) Mark constantly tastes a metallic flavor in his mouth despite having no cause for it
Which scenario best illustrates a tactile hallucination?
A) Lisa sees objects that are not actually there
B) Lisa hears voices speaking to her but no one else can hear them
C) Lisa feels as though bugs are crawling on her skin, although there are none
D) Lisa smells a rotting odor that others do not detect
C) Lisa feels as though bugs are crawling on her skin, although there are none
Which scenario best illustrates a somatic hallucination?
A) Tom hears a voice talking to him but sees no one
B) Tom tastes a metallic flavor in his mouth with no apparent cause
C) Tom feels as though his internal organs are being manipulated or something is moving inside his body
D) Tom sees objects that others cannot see
C) Tom feels as though his internal organs are being manipulated or something is moving inside his body
Which type of hallucinations involves specific instructions to the patient, such as directing them to harm themselves or others?
A) Visual
B) Auditory
C) Command
D) Somatic
C) Command
(reported by 33 and 74 per cent of voice hearers)
Which scenario best illustrates command hallucinations?
A) Jane sees a figure in her room that is not actually there
B) Jane hears a voice instructing her to harm herself, which causes her significant distress
C) Jane tastes a metallic flavor in her mouth with no apparent cause
D) Jane feels as though bugs are crawling on her skin, although there are none
B) Jane hears a voice instructing her to harm herself, which causes her significant distress
Which class of substances includes LSD and MDMA (ecstasy), known for producing perceptual illusions and distortions?
A) Stimulants
B) Depressants
C) Hallucinogens
D) Opioids
C) Hallucinogens
How beliefs and coping strategies regarding hallucinations (e.g. good vs. bad voices) can affect distress levels?
A) It has no impact on distress
B) It determines the frequency of the voices
C) It influences the level of distress, with bad voices causing more distress
D) It affects the duration of the hallucinations
C) It influences the level of distress, with bad voices causing more distress
Which statement is accurate about hallucinations?
A) They are always a reliable symptom of psychotic disorders
B) They can be experienced by the general population without requiring treatment
C) They only occur in psychotic disorders
D) They always indicate a need for hospitalization
B) They can be experienced by the general population without requiring treatment (e.g. due to sleep deprivation, severe fatigue, substance use)
(Hallucinations are not reliable symptom of psychotic disorders)
Which psychotic symptom involves a strongly held belief that is inconsistent with widely accepted beliefs and persists despite evidence to the contrary?
A) Hallucination
B) Delusion
C) Thought disorder
D) Affective flattening
B) Delusion
(The belief is not one ordinarily accepted
by other members of the person’s culture or subculture e.g. religion)
Which type of delusion involves a false belief that someone is seeking to harm the individual or their interests?
A) Grandiose delusion
B) Somatic delusion
C) Paranoid delusion
D) Religious delusion
C) Paranoid delusion
(e.g. believing that the Australian Security Intelligence Organisation [ASIO] is tracking the individual’s emails and phone calls)
Which scenario best illustrates a paranoid delusion?
A) John believes he has special abilities to influence world events
B) John thinks his coworkers are plotting against him and trying to harm his career, despite no evidence
C) John is convinced that he has a serious medical condition with no physical symptoms
D) John believes that he is being watched by aliens who are communicating with him
B) John thinks his coworkers are plotting against him and trying to harm his career, despite no evidence
Which type of delusion involves the belief that environmental stimuli have a special, personal significance?
A) Grandiose delusion
B) Paranoid delusion
C) Delusion of reference
D) Somatic delusion
C) Delusion of reference
(e.g. messages of a highly personal nature are being conveyed via neutral sources, commonly via electronic media (e.g., that advertisements on Facebook contain coded warnings to the individual)
Which scenario best illustrates a delusion of reference?
A) Maria believes that the news anchors are sending her personal messages through their broadcast
B) Maria thinks she has special powers to influence world events
C) Maria is convinced that someone is secretly plotting against her
D) Maria believes she has a serious medical condition with no symptoms
A) Maria believes that the news anchors are sending her personal messages through their broadcast
Which type of delusion involves a false belief about the appearance or functioning of one’s body?
A) Grandiose delusion
B) Paranoid delusion
C) Delusion of reference
D) Somatic delusion
D) Somatic delusion
(e.g. belief of having cancer and seeking extensive medical help).
Which scenario best illustrates a somatic delusion?
A) Tom believes that he has a special connection with the stars
B) Tom thinks that his internal organs are rotting, despite no medical evidence
C) Tom is convinced that everyone is plotting against him
D) Tom believes that he can control the weather with his mind
B) Tom thinks that his internal organs are rotting, despite no medical evidence
Which type of delusion involves a false belief about oneself, such as inflated worth, power, or relationships with famous people?
A) Paranoid delusion
B) Somatic delusion
C) Delusion of reference
D) Grandiose delusion
D) Grandiose delusion
(associated also with bipolar disorder)
(reported by 20–60% of patients)
Which scenario best illustrates a grandiose delusion?
A) Sarah believes she is a famous celebrity with the power to influence world events
B) Sarah thinks her coworkers are plotting against her
C) Sarah is convinced that her internal organs are malfunctioning
D) Sarah believes that the news anchors are sending her personal messages
A) Sarah believes she is a famous celebrity with the power to influence world events
Which scale measures the degree of preoccupation, distress, conviction, and life disruption caused by delusional beliefs?
A) Hamilton Rating Scale
B) Beck Depression Inventory
C) Psychotic Symptom Rating Scale (PSYRATS)
D) Positive and Negative Syndrome Scale (PANSS)
D) Positive and Negative Syndrome Scale (PANSS)
The PSYRATS is used to measure which aspects of delusional beliefs?
A) Only the degree of preoccupation and distress
B) Only the level of conviction
C) Only the disruption to the person’s life
D) All of the above
D) All of the above
In clinical practice, the severity of formal thought disorder is assessed through the person’s:
A) Emotions
B) Speech
C) Behavior
D) Memory
B) Speech
When assessing formal thought disorder, a clinician listens for disturbances in the coherence of:
A) Emotions
B) Behavior
C) Speech
D) Memory
C) Speech
Which term describes a marked decrease in reactivity to the environment, including unusual postures or repetitive movements?
A) Disorganized behavior
B) Catatonic behavior
C) Hyperactive behavior
D) Affective behavior
B) Catatonic behavior
Which scenario best illustrates catatonic behavior?
A) Jane repeatedly performs the same hand movements and remains motionless for hours
B) Jane speaks rapidly and changes topics frequently
C) Jane is overly energetic and cannot sit still
D) Jane exhibits extreme mood swings without any noticeable pattern
A) Jane repeatedly performs the same hand movements and remains motionless for hours
Disturbances in thought form are categorized into:
A) Cognitive and Affective
B) Positive and Negative
C) Internal and External
D) Verbal and Non-verbal
B) Positive and Negative
(the addition of disturbed thought processes and
deficits in thoughts processes)
Which of the following are examples of positive disturbances in thought form?
a) Delusions
b) Loose Associations
c) Flight of Ideas
d) Tangentiality/Derailment
e) All of the above
e) All of the above
What does “Loose Associations” refer to in the context of thought disturbances?
a) Disorganized thinking with loosely connected ideas
b) Fixed, false beliefs resistant to reasoning
c) Rapidly shifting from one topic to another with loosely connected ideas
d) Off-topic responses in speech
a) Disorganized thinking with loosely connected ideas
What does “Flight of Ideas” refer to in the context of thought disturbances?
a) Rapidly shifting topics with loose connections
b) Disorganized thinking with loosely connected ideas
c) Off-topic responses in speech
d) Fixed, false beliefs resistant to reasoning
a) Rapidly shifting topics with loose connections
What does “Tangentiality” refer to in the context of thought disturbances?
a) A pattern of speech where responses deviate significantly from the original question, often discussing unrelated topics
b) Rapidly shifting topics with only loose connections between ideas
c) Disorganized thinking where ideas are only loosely connected, leading to incoherent speech
d) Believing in fixed, false ideas that are resistant to contrary evidence
a) A pattern of speech where responses deviate significantly from the original question, often discussing unrelated topics
(deviates from the topic but still staying close to the topic, unlike derailment which is rapid shift between unrelated topics)
Which of the following best illustrates Tangentiality?
a) When asked about his daily routine, John talks about his favorite movies and travel experiences.
b) John describes his daily activities in detail when asked about his routine.
c) John provides a brief, direct answer about his daily routine.
d) John discusses a related topic but stays somewhat on track with his daily routine.
a) When asked about his daily routine, John talks about his favorite movies and travel experiences.
Which of the following best describes derailment in the context of schizophrenia?
a) A pattern of speech where responses are relevant but deviate significantly from the main topic.
b) A speech pattern characterized by rapid shifts between unrelated topics with minimal logical connection.
c) The use of newly invented words that are not understood by others.
d) A significant reduction in the quantity of speech or content.
b) A speech pattern characterized by RAPID shifts between unrelated topics with minimal logical connection.
Therapist: John what are your plans for the upcoming weekend?
John: “So, I was thinking of going to the park this weekend. I love spending time outdoors. Did you see the latest episode of that show with the talking animals? Oh, and did you know that the moon landing happened in 1969? It’s fascinating how they managed to… Oh, I need to buy some new shoes.”
This is an example of:
a) Alogia
b) Derailment
c) Tangentiality
d) Poverty of Though
b) Derailment
Which of the following are negative thought form disturbances?
a) Alogia
b) Poverty of Thought Content
c) Concrete Thinking
d) All of the above
d) All of the above
Alogia: Reduced speech or thought productivity.
Poverty of Thought Content: Limited or vague content in thoughts.
Concrete Thinking: Difficulty with abstract thinking and overly literal interpretation.
Which scenario best illustrates a positive disturbance in thought form?
A) Paul frequently shifts topics in conversation without logical connections
B) Paul struggles to initiate conversations and often has trouble following a train of thought
C) Paul’s speech is slow and sparse, with limited verbal output
D) Paul has trouble understanding the meanings of words and phrases
A) Paul frequently shifts topics in conversation without logical connections
Which of the following best describes clang associations?
a) Speech where topics are loosely connected but still relevant to the conversation
b) Speech where the connections between words are based on their sounds rather than their meaning
c) A pattern of speech with rapid topic shifts and minimal logical connection
d) Speech characterized by off-topic responses that are somewhat related to the original question
b) Speech where the connections between words are based on their sounds rather than their meaning
Allan responds to a question by saying, “More, door, core, and floor, I’m not sure but I adore a good score.”
Which of the following describes the example provided?
a) Loose Associations – Ideas are loosely connected but related to the topic.
b) Clang Associations – Words are connected based on their sound rather than their meaning.
c) Flight of Ideas – Rapidly shifting from one topic to another with minimal connection.
d) Tangentiality – Responses are off-topic but still somewhat relevant to the question.
b) Clang Associations – Words are connected based on their sound rather than their meaning.
What is passivity phenomena?
a) The experience of seeing or hearing things that are not present
b) The belief that one’s thoughts are being controlled or influenced by external sources
c) Speaking in a disorganized and fragmented manner
d) Having strong beliefs that are resistant to reason but not related to external control
b) The belief that one’s thoughts are being controlled or influenced by external sources
Which of the following best describes thought insertion and thought withdrawal?
a) The sensation of seeing or hearing things that are not present
b) The belief that thoughts are being placed into or taken out of one’s mind by external forces
c) The experience of having disorganized and fragmented speech
d) The belief in having unusual but self-originated ideas
b) The belief that thoughts are being placed into or taken out of one’s mind by external forces
According to the DSM-5, catatonia can be diagnosed as:
A) A feature of a mental disorder or as a catatonic disorder due to another medical condition
B) Only a feature of schizophrenia
C) Only due to a medical condition without a mental disorder
D) A temporary reaction to stress without a specific diagnosis
A) A feature of a mental disorder or as a catatonic disorder due to another medical condition
(either a feature of a mental disorder including brief psychotic disorder, schizophreniform disorder, schizophrenia or schizoaffective disorder or as a catatonic disorder in its own right due to another medical condition)
How many symptoms from the list are required for a diagnosis of catatonia?
A) 2
B) 3
C) 5
D) 7
B) 3
12 symptoms of catatonia:
1. stupor (no psychomotor activity; not actively relating to the environment)
2. catalepsy (maintaining a rigid body posture or rigidity of the limbs even when this would normally require some effort to do so)
3. waxy flexibility (a tendency to remain in a posture even when limbs are moved into place by another person)
4. mutism (little or no verbal response)
5. negativism (opposition or no response to instructions or external stimuli)
6. posturing (spontaneous and active maintenance of posture)
7. mannerism (odd, circumstantial caricature of normal actions)
8. stereotypy (repetitive, abnormally frequent, non-goal-directed movements such as repeatedly taking a step back and forth on the spot)
9. agitation (not influenced by external stimuli)
10. grimacing (odd facial movements such as baring of the teeth in the absence of provocation)
11. echolalia (mimicking another’s speech)
12. echopraxia (mimicking another’s movements).
How responsive is catatonia to treatment for schizophrenia, and what does this suggest?
A) Highly responsive, indicating it’s not separate from other psychotic symptoms
B) Less responsive, suggesting a potentially separate neurobiological basis
C) Fully resolved by antipsychotic treatment alone
D) Only responsive to psychotherapy
B) Less responsive, suggesting a potentially separate neurobiological basis
The decrease in prevalence of catatonic symptoms in schizophrenia over the past 50 years is likely due to:
A) Increased awareness and recognition of catatonia
B) Changes in diagnostic criteria
C) Certain medications and poor recognition in clinical practice
D) A decrease in overall schizophrenia cases
C) Certain medications and poor recognition in clinical practice
What term is used to describe symptoms that are necessary for a diagnosis?
A) Secondary features
B) Core features
C) Associated features
D) Peripheral features
B) Core features
Which disorder is characterized by symptoms lasting at least SIX MONTHS, including at least ONE MONTH of delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and/or negative symptoms?
A) Schizophreniform disorder
B) Brief psychotic disorder
C) Schizoaffective disorder
D) Schizophrenia
D) Schizophrenia
Which of the following scenarios best illustrates Schizophrenia?
a) Sarah has experienced delusions, hallucinations, and disorganized speech for over six months, with significant functional impairment, and no mood episodes.
b) Lisa has had symptoms of paranoia and hallucinations for four months, with no significant impairment in her daily life.
c) Tom shows symptoms of mood disturbances along with psychotic symptoms for six months, with no disorganized speech.
d) Emily experiences occasional delusions and hallucinations for two months, with good overall functioning.
a) Sarah has experienced delusions, hallucinations, and disorganized speech for over six months, with significant functional impairment, and NO MOOD EPISODES.
Explanation:
Schizophrenia is characterized by the presence of multiple symptoms including delusions, hallucinations, and disorganized speech that persist for more than six months and significantly impair daily functioning.
Which disorder is characterized by pervasive social and interpersonal deficits, cognitive or perceptual distortions, and eccentricities of behavior beginning before early adulthood?
A) Schizoid personality disorder
B) Paranoid personality disorder
C) Schizotypal personality disorder
D) Avoidant personality disorder
C) Schizotypal (personality) disorder
Which of the following is an example of a behavior someone with schizotypal personality disorder might exhibit?
a) Unusual beliefs such as magical thinking or telepathy
b) Severe discomfort in close relationships
c) Perceptual distortions such as sensing the presence of others when alone
d) Odd appearance or behavior
e) All of the above
e) All of the above
Which disorder is equivalent to schizophrenia but with a duration of ONE TO SIX MONTHS?
A) Schizoaffective disorder
B) Brief psychotic disorder
C) Schizophreniform disorder
D) Delusional disorder
C) Schizophreniform disorder
Which of the following scenarios best illustrates Schizophreniform Disorder?
a) John has experienced delusions, hallucinations, and disorganized speech for five months without significant mood disturbances.
b) Lisa has had persistent delusions and hallucinations for eight months, along with significant mood swings.
c) Tom exhibits symptoms of paranoia and disorganized speech for three weeks, with no other significant symptoms.
d) Emily experiences mood episodes and psychotic symptoms for seven months, including hallucinations and delusions.
a) John has experienced delusions, hallucinations, and disorganized speech for five months without significant mood disturbances.
Explanation:
Schizophreniform Disorder is characterized by the presence of psychotic symptoms (delusions, hallucinations, disorganized speech) for at least ONE MONTH BUT LESSS THAN SIX MONTHS, WITHOUT significant MOOD DISTURBANCES.
Which disorder involves the co-occurrence of SCHIZOPHRNIA SYMPTOMS and a MAJOR MOOD EPISODE, with at least a TWO WEEK PERIOD OF DELUSIONS OR HALUCINATIONS WITHOUT MOOD DISTURBANCE, and MOOD SYMPTOMS PRESENT FOR THE MAJORITY OF THE DISORDER’S DURATION?
A) Schizophreniform disorder
B) Brief psychotic disorder
C) Schizoaffective disorder
D) Major depressive disorder with psychotic features
C) Schizoaffective disorder
Which of the following scenarios best illustrates Schizoaffective Disorder?
a) Tom experiences frequent depressive episodes with feelings of sadness and worthlessness, and during these times, he also hears voices. His psychotic symptoms only occur during depressive episodes.
b) Sara has persistent psychotic symptoms, including delusions and hallucinations, but no mood episodes. Her psychotic symptoms have been present for several years.
c) Emily experiences alternating periods of depression and mania, and during these periods, she also has hallucinations and delusions. Her psychotic symptoms are also present for two weeks outside of her mood episodes.
d) Michael has episodes of elevated mood with increased energy, during which he experiences hallucinations. However, he does not have depressive episodes and his psychotic symptoms are always present during manic periods.
c) Emily experiences alternating periods of depression and mania, and during these periods, she also has hallucinations and delusions. Her psychotic symptoms are also present for two weeks outside of her mood episodes.
Explanation:
Schizoaffective Disorder involves MOOD EPISODES (depressive or manic) occurring SIMULTANOUSLY WITG PSYCHOTIC SYMPTOMS. Additionally, PSYCHOTIC SYMPTOMS should be present for at least TWO WEEKS OUTSIDE OF MOOD DISORDER> This scenario fits the criteria for Schizoaffective Disorder.
A 30-year-old individual presents with persistent auditory hallucinations and paranoid delusions. For at least a two-week period, they experienced these psychotic symptoms without significant mood disturbance. However, over the past year, they have also had several episodes of major depression, characterized by pervasive sadness and loss of interest in activities. Mood symptoms have been prominent and have impacted their daily functioning. What is the most likely diagnosis for this individual?
A) Schizophreniform disorder
B) Brief psychotic disorder
C) Schizoaffective disorder
D) Major depressive disorder with psychotic features
C) Schizoaffective disorder
The DELUSIONS have been present for AT LEAST ONE MONTH or longer is consistent with ________ disorder.
delusional
A 40-year-old individual has been experiencing persistent delusions for at least one month. The delusions involve a belief that they are being spied on by a secret organization, despite no evidence to support this belief. The individual does not exhibit other significant psychotic symptoms such as hallucinations or disorganized speech. What is the most likely diagnosis for this individual?
A) Schizophrenia
B) Schizophreniform disorder
C) Delusional disorder
D) Brief psychotic disorder
C) Delusional disorder
Which of the following best describes a scenario consistent with schizophreniform disorder?
A) A person with hallucinations and delusions for six months or more
B) A person with disorganized speech and behavior for less than one month
C) A person experiencing delusions and hallucinations for four months, impacting daily functioning
D) A person with mood swings and psychotic symptoms lasting more than one year
C) A person experiencing delusions and hallucinations for four months, impacting daily functioning
Which describes Brief Psychotic Disorder?
A) Lasts over a month but under six months, with return to baseline functioning.
B) Lasts less than a month with return to premorbid functioning.
C) Lasts over six months with delusions, hallucinations, and disorganized speech.
D) Includes mood symptoms and significant functional impairment.
B) Lasts less than a month with return to premorbid functioning.
Which scenario best illustrates Brief Psychotic Disorder?
A) Alex has delusions and hallucinations for three months but does not return to baseline functioning.
B) Mia experiences hallucinations for five days following a stressful event, with full recovery to her previous level of functioning.
C) Jordan has ongoing psychotic symptoms with mood disturbances for over six months.
D) Taylor has persistent delusions and disorganized speech for two months with significant functional impairment.
B) Mia experiences hallucinations for five days following a stressful event, with full recovery to her previous level of functioning.
Which of the following best describes a Psychotic Disorder Due to Another Medical Condition?
A) Psychotic symptoms that are a direct result of substance use or withdrawal.
B) Persistent hallucinations or delusions without any underlying medical condition.
C) Prominent hallucinations or delusions directly caused by another medical condition.
D) Psychotic symptoms occurring in response to severe stress or trauma.
C) Prominent hallucinations or delusions directly caused by another medical condition.
Which scenario best illustrates a Psychotic Disorder Due to Another Medical Condition?
A) Sarah experiences delusions due to long-term substance abuse.
B) Kevin has hallucinations following a traumatic life event but no medical issues.
C) Maria develops severe psychotic symptoms as a result of brain tumor, which improve after tumor was removed
D) Tom experiences persistent delusions without any identifiable physical or medical cause.
C) Maria develops severe psychotic symptoms as a result of brain tumor, which improve after tumor was removed
Which scenario best illustrates a Substance/Medication-Induced Psychotic Disorder?
A) Lisa has persistent hallucinations that started during a period of severe stress, with no substance use involved.
B) Mark develops psychotic symptoms due to a severe brain injury.
C) Emily has delusions related to a major depressive episode.
D) Daniel has hallucinations as a result of a high dose of cocaine, which resolve after the drug is metabolized.
D) Daniel has hallucinations as a result of a high dose of cocaine, which resolve after the drug is metabolized.
(Delusions and/or hallucinations that develop during or soon after substance intoxication or withdrawal or after exposure to medication)
Symptoms of psychosis that cause clinically significant distress or impaired functioning but do not meet full criteria for any other psychotic disorders are classified as __________.
A) Brief Psychotic Disorder
B) Delusional Disorder
C) Psychotic Disorder Not Otherwise Specified (NOS)
D) Schizophreniform Disorder
C) Psychotic Disorder Not Otherwise Specified (NOS)
(e.g., persistent auditory hallucinations in the absence of other psychotic features).
Which scenario best fits Psychotic Disorder Not Otherwise Specified (NOS), (clinician MUST SPECIFY why criteria for another disorder is not met)?
A) Jane has paranoia and hallucinations causing distress but does not meet full criteria for schizophrenia.
B) John has hallucinations due to alcohol withdrawal.
C) Lisa’s delusions are part of a depressive episode.
D) Mark has brief hallucinations after a traumatic event.
A) Jane has paranoia and hallucinations causing distress but does not meet full criteria for schizophrenia.
Symptoms of psychosis that cause clinically significant distress or impaired functioning but which do not meet full criteria for any other psychotic disorders (the clinician is NOT REQIRED TO SPECIFY the reasons why the criteria for this diagnosis are met)
Unspecified schizophrenia spectrum and other
psychotic disorder
According to the DSM-5, schizophrenia is diagnosed when there are TWO OR MORE of the following SYMPTOMS present for a significant proportion of time during a SIX month period:
- Delusions
- Hallucinations
- Disorganized speech
- Grossly disorganized or catatonic behavior
- Negative symptoms
(continuous signs of schizophrenia must have been consistently present for at least six months. This six-month period may have entailed a gradual deterioration in functioning, but must include at least one month of the psychotic symptoms)
Which of the following symptoms must be present for the diagnosis of schizophrenia, according to DSM-5?
A) Delusions
B) Hallucinations
C) Disorganized speech
D) At least one of the above
D) At least one of the above
DSM-IV-TR specified that only one symptom needed to be present if it took a specific form (e.g., auditory hallucinations that kept up a running commentary on the person’s behaviour or thoughts or if there were two or more voices conversing with each other).
The DSM-IV-TR also stipulated some subtypes of schizophrenia that have been dropped from the DSM-5.
Changes from DSM-IV compared to DSM-5
What is one reason why suicide rates are very high among people diagnosed with a psychotic disorder, such as schizophrenia?
A) Presence of psychotic symptoms
B) Depression
C) High levels of medication adherence
D) Low levels of stress
B) Depression
(5–10 per cent of people diagnosed with schizophrenia commit suicide)
The risk of suicide have _____ (increased/decreased)
significantly for individuals diagnosed with schizophrenia over the previous 100 years.
Increased
What are the possible reasons for the increased risk of suicide in individuals with psychotic disorders?
A) Brief hospitalisation
B) Unwanted side effects of antipsychotic medications
C) Effects of withdrawal from antipsychotic medications
D) All of the above
D) All of the above
What is true about the relationship between schizophrenia and social phobia and PTSD?
A) Social phobia and PTSD are uncommon in individuals with schizophrenia.
B) The risk of developing PTSD as a consequence of psychotic symptoms or treatment is lower in people with a history of childhood trauma.
C) Social phobia and PTSD are common in individuals with schizophrenia.
D) PTSD is unrelated to schizophrenia.
C) Social phobia and PTSD are common in individuals with schizophrenia.
(the risk of developing PTSD as a consequence of psychotic symptoms or treatment is higher in people who have PTSD from the experience of childhood trauma)
What percentage of patients with psychosis report substance abuse (cannabis), which is a predictor of increased risk of relapse if use persists?
A) 10%
B) 15%
C) 23%
D) 30%
C) 23%
(research shows that cannabis may induce psychosis)
Emil Kraepelin, a professor of psychiatry in Munich, Germany, in the late 1800s, identified the disorder ‘dementia praecox’ or ‘senility of the young’, which is the early term for:
A) Major Depressive Disorder
B) Bipolar Disorder
C) Schizophrenia
D) Post-Traumatic Stress Disorder
C) Schizophrenia
The term ‘schizophrenia,’ introduced by Eugen Bleuler, is derived from the Greek words ‘schizein,’ meaning ‘to split,’ and ‘phren,’ meaning:
A) Body
B) Emotion
C) Mind
D) Spirit
C) Mind
(Split mind)
In contrast to Kraepelin, Bleuler conceptualised manic depression and schizophrenia as occurring on a continuum rather than arguing for a categorical distinction between these two diagnoses. The legacy of both of these pioneers of empirical research in psychosis can be
seen in the modern diagnostic criteria for schizophrenia in the DSM-5, which include thought disorder (disorganised speech) and a deterioration in functioning.
Kurt Schneider, another German professor of psychiatry, argued that symptoms specific to schizophrenia—the so-called ‘first rank symptoms’—could be
identified, and these symptoms maintained a privileged place up until the DSM-IV-TR. They included
hearing voices arguing, hearing voices commenting on the individual’s actions and bizarre delusions including passivity phenomena.
The lifetime prevalence of schizophrenia is approximately -% and is more prevalent in _____ (men/women).
A) 0.5-1%, women
B) 1-2%, men
C) 2-3%, women
D) 1-2%, men
B) 1-2%, men
The peak period of onset for psychotic disorders is during:
a) Early childhood and middle age
b) Late adolescence and early adulthood
c) Late adulthood and middle age
d) Early adulthood and late childhood
b) Late adolescence and early adulthood
Which of the following phases involves the period before any signs of the disorder become apparent or where subtle early signs or vulnerabilities may be present?
a) Premorbid phase
b) Prodromal phase
c) Recovery phase
d) Acute phase
a) Premorbid phase
Which phase of psychotic disorders is characterized by more noticeable symptoms and deterioration in functioning?
a) Premorbid phase
b) Prodromal (acute) phase
c) Recovery phase
d) Residual phase
b) Prodromal (acute) phase
(duration varies between individuals and can go from absent to many years)
The risk of further episodes of psychosis remains high during the first ____ years after treatment is commenced, with relapse rates approximately ____%.
a) 1 to 3 years; 60-70%
b) 2 to 5 years; 80-90%
c) 3 to 7 years; 70-80%
d) 5 to 10 years; 50-60%
b) 2 to 5 years; 80-90%
During prodromal phase the symptoms are typical of psychotic disorders?
True/False
False
Symptoms are not specific for psychotic disorders but other mental conditions too (depressed mood, anxiety)
‘Prodromal schizophrenia’ has been excluded from current DSM-5 due to unspecificity of symptoms and uncertainty they precede acute phase.
True/False
True
Challenges including re-integrating into social, recreational and vocational pursuits and high unemployment rates are typical of _______ (early/late) recovery phase.
late
Early detection approach or ‘at-risk mental state’, has been pioneered at the EPPIC in Melbourne under the leadership of Patrick McGorry.
True/False
True
(e.g. regular screening for prodromal symptoms in adolescents)
What does the term Duration of Untreated Psychosis (DUP) refer to?
a) The length of time from the onset of symptoms to the start of treatment
b) The delay related to the time taken to respond to treatment once it commences
c) The duration of psychotic symptoms before diagnosis
d) The period between diagnosis and the initiation of therapy
b) The delay related to the time taken to respond to treatment once it commences
(the longer the DUP, the longer the patient’s symptoms take to improve with treatment)
Acute psychotic episodes/phase are characterised by:
a) The emergence of persistent positive and negative symptoms that clearly identify the condition as a psychotic disorder
b) A gradual onset of symptoms with minimal impact on functioning
c) Stable mood with occasional minor disturbances
d) The presence of only positive symptoms without negative symptoms
a) The emergence of persistent positive and negative symptoms that clearly identify the condition as a psychotic disorder
As the person begins to reflect on their diagnosis and its significance for their future, problems with depression and social anxiety may emerge for the first time during which phase?
a) Premorbid phase
b) Prodromal (acute) phase
c) Early recovery phase
d) Late recovery phase
c) Early recovery phase
The cognitive model of psychosis proposed by Morrison focuses on how cognitive processes contribute to the development and maintenance of psychotic symptoms. According to this model, psychotic symptoms, such as delusions and hallucinations, are understood as being influenced by:
a) Neurobiological abnormalities
b) Environmental stressors
c) Cognitive distortions and biases
d) Genetic predispositions
c) Cognitive distortions and biases
(e.g. if the person receives a mail delivery and notices that the envelope has a government return address, they might interpret this as evidence of a conspiracy against them, despite no actual evidence to support this belief. This cognitive distortion leads to the development and maintenance of the delusion, illustrating how cognitive biases can contribute to psychotic symptoms)
Which of the following is associated with the recurrence of psychosis?
A) Discontinuation of antipsychotic medication
B) Use of cannabis and amphetamines
C) Poorer premorbid adjustment
D) Conflictual interpersonal relationships (Expressed Emotion)
E) All of the above
E) All of the above
EE (emotional expression) is now a well-established predictor of psychotic relapse. True/False
True
(2-3 times higher relapse rate in high EE families)
Which of the following is typically measured using standardized methods of observing and rating patterns of family interactions, including high levels of criticism, hostility, and emotional over-involvement?
A) Cognitive Behavioral Therapy
B) Expressed Emotion
C) Medication Adherence
D) Social Support
B) Expressed Emotion
Reduced ______ to _______ (less than 35 hours per week) contact with family and being on mediation is found to reduce relapse rates.
face to face
(reduced EE)
More severe and persisting forms of psychosis are known to be associated with:
A) an earlier and more gradual onset of symptoms,
B) substance abuse,
C) longstanding personality traits which might compromise the individual’s capacity to cope with stress
D) All of the above
D) All of the above
The concordance rate
for schizophrenia between monozygotic
twins (share the same genes) and dizygotic twins (share 50 per cent of genes) is the same.
True/False
False
(higher for monozygotic twins)
Which gene-environmental factors contribute to the development of psychosis?
A) Maternal infection during fetal development
B) Exposure to trauma in early childhood
C) Exposure to illicit substances in adolescence
D) Living in an urban environment/stress reactivity
E) All of the above
E) All of the above
Which neurotransmitter has been the most widely investigated in schizophrenia research, although multiple neurotransmitters are likely involved?
A) Serotonin
B) Norepinephrine
C) Dopamine
D) Glutamate
C) dopamine
What does the revised dopamine hypothesis suggest about schizophrenia?
A) Schizophrenia is linked to higher dopamine levels.
B) Schizophrenia is linked to excessive numbers of or oversensitive dopamine receptors.
C) Schizophrenia is caused by a deficiency in dopamine levels.
D) Schizophrenia is related to irregular dopamine production.
B) Schizophrenia is linked to excessive numbers of or oversensitive dopamine receptors
(rather than higher dopamine levels)
Negative symptoms (e.g., a lack of speech, affect, and behavior) are associated with loss of grey and white matter and tissue in the __________ cortex.
A) Pre-frontal
B) Occipital
C) Temporal
D) Parietal
A) Pre-frontal
Fluid-filled spaces in the brain that are larger than normal and suggest a deterioration in brain tissue are known as:
A) Ventricular enlargement
B) Cystic degeneration
C) Hydrocephalus
D) Subdural hematomas
A) Ventricular enlargement
Individuals with no family history of psychotic disorders were found to have significantly smaller volumes of the left:
A) Amygdala
B) Prefrontal cortex
C) Hippocampus
D) Thalamus
C) Hippocampus
(structural changes
in the hippocampus appear to predate the onset of psychosis (at least among those without a family history of psychosis) and may worsen over the course of the illness)
Biological abnormality relevant to psychosis is the:
A) Dopamine-serotonin system
B) Serotonin-norepinephrine pathway
C) Hypothalamic-pituitary-adrenal (HPA) axis
D) Endocannabinoid system
C) Hypothalamic-pituitary-adrenal (HPA) axis
(important biological system in the physiological response to stress)
Which hypotheses explain changes in HPA axis function?
A) Environmental factors and genetic factors.
B) Only environmental factors.
C) Only genetic factors.
D) Neither environmental factors nor genetic factors.
A) Environmental factors and genetic factors.
(1) that environmental factors (such as exposure to cannabis or high levels of conflict in relationships) affect the HPA axis; or
(2) that the genes associated with the risk
for schizophrenia
Urban environment, migration, being
socially excluded and experiences of childhood abuse are examples of ________ factors which increase vulnerability to psychotic disorders.
social
Psychotic disorders are relatively rare and more prevalent in men than women.
True/False
True
Which major endocrine gland produces the largest number of different hormones and controls other endocrine glands?
A) Thyroid gland
B) Adrenal gland
C) Pituitary gland
D) Pancreas
C) Pituitary gland
Within the DSM-5,
psychosis is best conceptualised:
as a neurological disorder
along a continuum of severity
as a categorical disorder
as a disorder of adolescence
along a continuum of severity
(The DSM-5 recognizes that psychosis can vary in severity and can be part of a broader spectrum of mental health conditions. This perspective acknowledges that psychotic experiences can range from mild to severe and can occur across different disorders, rather than being categorized strictly as a single, discrete disorder. The continuum model helps in understanding the variability in symptoms and their impact on functioning)
Significantly larger volumes of the __________ (indicating higher levels of stress hormones) were found in high-risk individuals who developed psychosis compared with high-risk patients who did not go on to develop psychosis.
A) Hippocampus
B) Pituitary
C) Prefrontal cortex
D) HPA axis
B) Pituitary
Once a comprehensive assessment has been completed and psychosis is accurately diagnosed, acute phase treatments focus on:
A) Immediate reduction of symptoms and associated distress.
B) Long-term rehabilitation and support.
C) Preventing relapse and managing chronic symptoms.
D) Only psychological therapy.
A) Immediate reduction of symptoms and associated distress.
Consumers of psychiatric services have developed their own empowering recovery model of psychosis, with a strong emphasis upon:
A) Recovery, the strengths of the individual, and the reduction of stigma.
B) Medication management and hospitalizations.
C) Strict adherence to clinical guidelines and protocols.
D) Avoidance of personal responsibility and self-management.
A) Recovery, the strengths of the individual, and the reduction of stigma.
Approximately ______ of people diagnosed with schizophrenia report experiencing hallucinations.
50%
20%
75%
100%
75%
The key difference in the nature of hallucinations experienced by the general population and those experienced by people with schizophrenia is:
the need for intervention
the age of onset
persistence over time
the type of hallucination
persistence over time
(In the general population, hallucinations, such as those experienced in sleep deprivation or extreme stress, are typically transient and do not persist long-term. In contrast, hallucinations in individuals with schizophrenia are more persistent, frequent, and disruptive, often becoming a chronic aspect of the disorder that significantly impacts their daily life and functioning).
Erica burns all of her rubbish, will pay for groceries only in cash, and uses false names on facebook to ensure that the malevolent forces of the Third Wheel don’t locate her. Erica is likely suffering from:
nihilistic delusions
delusions of reference
paranoid delusions
delusions of grandeur
paranoid delusions
(Paranoid delusions involve beliefs that one is being persecuted or targeted by malevolent forces. Erica’s behaviors, such as burning her rubbish, paying only in cash, and using false names to avoid detection, suggest she believes that she is being watched or threatened by the “Third Wheel,” which aligns with paranoid delusions).
_________ (primary/secondary) delusions are those that occur in the absesnce of a psychological or other identifiable trigger.
Primary
(They are typically spontaneous and not secondary to other psychological conditions or external events, meaning they arise without an obvious external cause and are a direct manifestation of the individual’s psychotic disorder)
Emily believes she is being persecuted by a secret organization that is monitoring her every move. No external events or triggers have been identified. What type of delusion does this describe?
a) Secondary Delusion
b) Primary Delusion
c) Bizarre Delusion
d) Mood Congruent Delusion
b) Primary Delusion
John believes he is being watched by a secret organization. As a result, he starts to think that everyone in his neighborhood is part of this organization. John’s belief that his neighbors are involved in the conspiracy is an example of:
a) Primary Delusion
b) Mood Congruent Delusion
c) Secondary Delusion
d) Bizarre Delusion
c) Secondary Delusion
Which of the following is not a symptom of psychosis as defined by the DSM-5?
delusions
grossly disorganised thinking
hallucinations
grossly organised behaviour
grossly organised behaviour
(this term is not typically used to describe symptoms of psychosis. Instead, the DSM-5 uses terms like “grossly disorganized or catatonic behavior” to describe disorganized and impaired behavior associated with psychotic disorders)
The primary difference between tangentiality and derailment of speech is:
the degree of relevance of speech content
how long it takes the speaker to reach his/her point
how many nonsense words are used in a sentence
how much the words used sound like each other
the degree of relevance of speech content
(tangentiality involves answers that are still somewhat related to the topic, derailment involves a significant loss of coherence and relevance in the speech)
When upset or confused, Ali often hears the calming, supportive voice of his recently deceased partner. Ali would likely be diagnosed with:
nothing
psychosis
command hallucinations
auditory hallucinations
nothing
(Reason: This would be considered culturally appropriate, and so no diagnosis is warranted)
Thought insertion and thought withdrawal are examples of:
hallucinations
delusions
passivity phenomena
grossly disorganised thinking
passivity phenomena
(Passivity phenomena involve the experience of one’s thoughts, feelings, or actions being controlled or influenced by external forces.
Thought insertion refers to the belief that thoughts have been placed into one’s mind by an external source.
Thought withdrawal involves the belief that thoughts have been taken out of one’s mind by an external force).
Hallucinations can occur in the context of:
Multiple select question.
migraine
REM sleep
carbon monoxide poisoning
complex partial seizures
migraine
complex partial seizures
___________ is associated with earlier onset of psychotic illness and poorer overall functioning in the longer term.
Catatonia
Rebecca has been hearing a repetitive, unidentifiable voice that has been keeping up a running commentary on her every move. She has interpreted this voice as evidence that she is being monitored by ASIO. This interpretation is an example of a(n):
auditory hallucination
command hallucination
primary delusion
secondary delusion
secondary delusion
(Secondary delusions are false beliefs that arise as a result of an underlying experience, such as hallucinations. In this case, the auditory hallucination (the running commentary) leads Rebecca to form a delusional belief (being monitored by ASIO). The hallucination itself is primary, but the interpretation or belief about the voice (that she is being monitored) is a secondary delusion).
Allan is experiencing an episode of psychosis. He shows evidence of disorganised thinking through his speech. For example, when asked how he was feeling, he replied ‘for sure, more, door, good to the core’. This is an example of:
echolalia
clang associations
derailment
tangentiality
clang associations
(involve speech in which the connections between words are based on their sounds rather than their meaning. In this case, Allan’s response appears to be driven by the rhyming or phonetic similarity of the words (“more,” “door,” “core”) rather than coherent content or relevance to the question asked)
Hallucinations are perceptual experiences that occur in the absence of _________ input.
sensory
Negative symptoms of psychosis can be difficult to distinguish from:
Multiple select question.
depression
medication side effects
normal lack of motivation
bipolar disorder
depression
medication side effects
(Bipolar disorder is less commonly confused with negative symptoms of psychosis, as it generally involves mood episodes (mania or depression) along with psychotic features, which are distinct from the negative symptoms seen in schizophrenia or other psychotic disorders)
Primary delusions are theoretically _________ (easier/harder) to treat using psychological methods.
harder
(Primary delusions are deeply ingrained beliefs that are not based on any external evidence or influence. They often arise from a direct distortion in thinking and can be resistant to change because they are not based on external reality but rather on internal cognitive distortions. This makes them more challenging to address with psychological methods compared to secondary delusions)
Within the DSM-5,
____________ is classified as the most severe psychotic disorder.
schitzophrenia
Errol was recently diagnosed as having experienced a brief psychotic disorder. Which of the following symptoms is Errol most likely to have experienced?
hallucinations for an afternoon
paranoia about leaving the oven on
delusions for a fortnight
intoxication
delusions for a fortnight
(lasting for at least one day but less than one month)
Which of the following factors would NOT be considered a core feature of a psychotic disorder?
significant impact of symptoms for at least one month
limited insight into the disturbance in the midst of a psychotic episode
a decline in personal functioning and achievement
having experienced multiple psychotic episodes
having experienced multiple psychotic episodes
(A single episode of psychosis can be sufficient for diagnosis, dependent upon other symptoms)
Which of the following is NOT a symptom of disorganised behaviour?
posturing
derailment
agitation
catalepsy
derailment
( symptom of disorganised thinking)
Which of the following is NOT a negative symptom of psychosis?
aggression
alogia
affective flattening
avolition
aggression
(positive symptom)
Individuals diagnosed with a psychotic disorder often experience reduced quality of life due to declines in:
Multiple select question.
occupational functioning
relationship functioning
intellectual functioning
emotional functioning
occupational functioning
relationship functioning
emotional functioning
Reasons for an increased risk of suicide for people diagnosed with a psychotic disorder include:
Multiple select question.
medication side effects
social isolation
comorbid depression
increased lethality of methods
medication side effects
social isolation
comorbid depression
The key feature of
________ disorder is the presence of delusions for at least one month.
delusional
Eugen Bleuler coined the term ______________ to describe the symptom of loosening associations between thought structures.
schizophrenia
Less well-recognised health risks associated with psychotic disorders include:
Multiple select question.
emphysema
diabetes
asthma
obesity
diabetes
obesity
Due to the high degree of overlap between the symptoms of various psychotic disorders of varying severity, researchers are arguing for a _______ versus categorical approach to diagnosis.
dimentional
Which of the following disorders was not categorised along with psychotic disorders until the DSM-5?
delusional disorder
bipolar disorder
schizophrenia
schizotypal disorder
schizotypal disorder
(In earlier editions of the DSM, schizotypal personality disorder was categorized under personality disorders rather than psychotic disorders. The DSM-5, however, includes schizotypal personality disorder within the broader category of psychotic disorders due to its features that are closely related to psychotic symptoms, such as eccentric behavior and thoughts, and significant cognitive or perceptual distortions)
Unemployment is estimated to affect approximately _____ of individuals with a psychotic disorder.
90–100%
10–20%
70–80%
40–50%
40–50%
The peak period of onset for psychotic disorders is late
____________and
early ___________.
adolescence
adulthood
The prodromal phase of a psychotic disorder is typified by:
the presence of marked positive and negative symptoms that impact functioning
the presence of risk factors for psychotic episodes
a gradual decline in functioning across multiple domains
depression, anxiety and delusions
a gradual decline in functioning across multiple domains
(the presence of marked positive and negative symptoms that impact functioning is more typical of the acute phase)
Due to the __________
and associated emotional harm often associated with a diagnosis of schizophrenia, some researchers advocate a change of label or diagnostic process.
stigma
Which of the following researchers is credited with first formally identifying schizophrenia?
Eugen Bleuler
Richard Bentall
Kurt Schneider
Emil Kraepelin
Emil Kraepelin
Gerard was born in a metropolitan area to migrant parents. Ailish was born in a small country town, to sixth-generation Australian parents. According to researchers, and all other factors being equal, who is at greater risk of developing schizophrenia?
They share an equal risk
It cannot be determined
Gerard
Ailish
Gerard
The course of psychosis during which there are active, intense symptoms is called the
_______ phase.
acute
The risk of relapse following the first episode of psychosis is highest during the first:
2–5 years
1–2 years
5–6 years
6–9 years
2–5 years
Which of the following factors are associated with enduring psychosis?
Multiple select question.
being female
early onset
genetic vulnerability
comorbid substance use
early onset
comorbid substance use
The most consistent brain abnormality found in individuals with schizophrenia is
global loss of white matter
enlarged hippocampus
impaired executive function
enlarged ventricles
enlarged ventricles
(hippocampus is smaller not larger)
Jarli recently experienced auditory hallucinations, delusions of reference and alogia. His doctor thinks he may have schizophrenia, and sends him for an MRI to assist with diagnosis. If Jarli has schizophrenia, what is his doctor likely to notice on the MRI?
Multiple select question.
reduced hippocampal volume
increased white matter in the pre-frontal cortex
enlarged ventricles
increased dopaminergic activity
reduced hippocampal volume
enlarged ventricles
Indigenous populations in Australia and New Zealand experience higher rates of psychosis. Researchers suggest this is due to
gene–environment interactions
reduced access to medical care
social factors
genetic factors
social factors
(many Indigenous populations experience more adverse social conditions than non-Indigenous populations and this can increase the risk of psychosis due to increased stress, and associated risk factors)
High levels of
_______ ________, or EE, is associated with increased risk of relapse.
expressed
emotion
Researchers have identified that excessive dopamine is associated with:
positive symptoms of psychosis
causing schizophrenia
protecting against the development of schizophrenia
negative symptoms of psychosis
positive symptoms of psychosis
(Dopamine dysregulation, particularly excessive dopamine activity in certain brain areas, is closely linked to the positive symptoms of psychosis, such as hallucinations, delusions, and disorganized thinking. This is a key element in the dopamine hypothesis of schizophrenia, which suggests that increased dopaminergic activity contributes to these symptoms)
Individuals with enduring psychosis are more likely to experience:
Multiple select question.
financial stability
homelessness
physical health conditions
unemployment
homelessness
physical health conditions
unemployment
_______ has been identified as a key psychosocial risk factor for triggering psychosis.
Stress
Cognitive models of psychosis emphasise the ______________ of culturally inappropriate thoughts as the basis of the disorder.
misinterpretation
When investigating differences between the brains of those with and without psychotic disorders, researchers rely heavily on:
positron emission topography
transmagnetic stimulation
magnetic resonance imaging
computed tomography
magnetic resonance imaging
The theory of hallucinations that has received the most empirical support is that which suggests people who experience psychosis:
experience confusion between internally and externally generated behaviours
experience a dysfunction in verbal self-monitoring
are able to imagine particularly vivid sounds
experience deficits in the vividness of sound
experience a dysfunction in verbal self-monitoring
(This theory posits that individuals with psychosis may have difficulty distinguishing between internally generated speech (thoughts) and external speech (real sounds). This dysfunction in self-monitoring can lead to the experience of auditory hallucinations, where the individual might perceive their own internal thoughts as external voices. This model helps explain why the content of these hallucinations can be distressing or confusing, as they are experienced as coming from an external source rather than being recognized as self-generated)
Researchers have found that delusions are more likely to be experienced by those who
externalise success
externalise failure
have inflated self-esteem
have low self-esteem
externalise failure
(Externalizing failure refers to attributing personal failures or negative events to external factors rather than internal ones. This cognitive style can be associated with delusions, particularly those involving paranoia or beliefs that one is being targeted or persecuted. People who externalize failure might be more prone to developing delusions as they attribute negative outcomes to external sources rather than their own actions or shortcomings)
Although often misperceived as a causal factor, __________ ________ can be a trigger for a psychotic episode.
illicit
substances
Children of parents with schizophrenia may be at greater risk of _________ when their parents are experiencing active psychosis.
neglect
Researchers propose that thought disorder is due to problems with information ________.
storage
The theory of auditory hallucinations that has received most research support states that hallucinations result from:
noticing clear intentions to speak
deficits in the vividness of auditory imagery
extreme vividness of auditory imagery
confusing internally and externally generated speech
confusing internally and externally generated speech
Researchers have found that individuals with delusions are more likely to make _________
errors in tasks of general reasoning.
cognitive
The majority of acute interventions will include the use of ________,
medication
The ______- ______ model of psychosis is the overarching model that informs the treatment of psychotic disorders.
diathesis - stress
Researchers have found which of the following to be the most effective treatment during the prodromal phase of psychosis?
cognitive behaviour therapy + medication
social support
medication
cognitive behaviour therapy
cognitive behaviour therapy
Within the context of schizophrenia, thought disorders are generally more prominent when discussing:
high-frequency words
the effectiveness of medication
highly emotional content
the disorder itself
highly emotional content
(Emotional content can exacerbate disorganized thinking, leading to more noticeable disruptions in speech and thought processes. For instance, individuals may struggle with coherent expression or logical organization of thoughts when discussing topics that evoke strong emotions, which can further highlight the disorganized nature of their thinking)
The most extensively researched treatment for psychosis focuses on which phase of intervention?
relapse prevention
premorbid
acute
prodromal
acute
A key focus of interventions for schizophrenia is to:
encourage resumption of everyday activities
involve family members
improve tardive dyskinesia
reduce reliance on medication
encourage resumption of everyday activities
As a method of relapse prevention, CBT approaches for the management of schizophrenia have been found to
________ social function.
improve
_________ is an alternative antipsychotic often prescribed to those with enduring psychosis.
Clozapine
The consumer recovery model emphasises the role of ___________
between the consumer and clinician in shaping treatment.
collaboration
Even with ongoing medication use, up to ______ of individuals with schizophrenia will experience relapse
60%
30%
40%
50%
40%
A primary limitation of current treatment options for individuals with psychosis is the:
lack of insight into their personal treatment needs
limited access to effective treatments
lack of effective treatments
high cost of treatment
limited access to effective treatments
Which aspect of treatment for psychosis is recommended at every stage of the process?
medication + cognitive behaviour therapy
family therapy
cognitive behaviour therapy
medication
cognitive behaviour therapy
Many individuals who have experienced psychosis prefer to be referred to as:
consumers
clients
schizophrenic
patients
consumers
In the absence of medication, it is estimated that ______ of individuals with psychosis will relapse within one year of hospitalisation.
73%
65%
41%
57%
65%
Eugen Bleuler invented the term ‘schizophrenia’, referring to:
a.
the loosening of connections between thought structures.
b.
split personality, which he believed was common in this illness.
c.
the social stigma that is commonly experienced.
d.
All of the given options are correct.
e.
None of the given options is correct.
a.
the loosening of connections between thought structures.
The consumer recovery model of psychosis and serious mental illness focuses on the:
a.
need for consumers to ‘shop around’ until they have the right doctor.
b.
need for more information about antipsychotic medication.
c.
need for 24-hour access to mobile crisis teams.
d.
importance of doctors’ decision making in the treatment process.
e.
rights, choices and individuality of people with mental illnesses.
e.
rights, choices and individuality of people with mental illnesses.
Which of the following best describes the prodromal phase of a psychotic disorder?
a.
the period of normality before any mental problems occur
b.
the gradual period of deterioration in mental status, before the onset of acute symptoms of psychosis
c.
the period during which acute symptoms of psychosis occur
d.
the early recovery period
e.
the relapse period
b.
the gradual period of deterioration in mental status, before the onset of acute symptoms of psychosis
A serious side effect of neuroleptic medication is:
a.
anhedonia.
b.
worsening of positive symptoms.
c.
worsening of negative symptoms.
d.
tardive dyskinesia
e.
All of the given options are correct.
d.
tardive dyskinesia
The dimensional approach to psychosis argues that:
a.
psychotic diagnoses represent arbitrarily defined categories.
b.
psychotic experiences are normally distributed across the population.
c.
there is no clear cut-off point between those diagnosed with schizophrenia and those who are not.
d.
All of the given options are correct.
e.
None of the given options is correct.
d.
All of the given options are correct.
During the early recovery phase of psychosis:
a.
problems with depression and social anxiety may emerge.
b.
patients may express that they were traumatised by their experience of psychosis.
c.
patients may either respond defensively to the past experience of psychosis or try to make sense of their experiences.
d.
family members may remain distressed and worried.
e.
All of the given options are correct.
e.
All of the given options are correct.
Formal thought disorder includes the following except:
a.
lack of coherence of thought.
b.
circumstantiality.
c.
catalepsy.
d.
derailment.
e.
echolalia.
c.
catalepsy.
Large-scale surveys suggest that psychotic experiences are:
a.
very rare in the general population.
b.
normally distributed across the general population.
c.
very common in the general population.
d.
common among those of higher socioeconomic status.
e.
None of the given options is correct.
b.
normally distributed across the general population.
Psychotic delusions are usually categorised in terms of their:
a.
sensory modality.
b.
content and bizarreness.
c.
persistence.
d.
response to treatment.
e.
frequency.
b.
content and bizarreness.
What are the criteria for identifying individuals in the prodromal phase of psychosis?
a.
less severe features, such as suspicious thinking
b.
transient psychotic features
c.
deterioration in general psychological health
d.
family history of psychosis
e.
All of the given options are correct.
e.
All of the given options are correct.
Which of the following is true of individuals who return home to a family with high expressed emotion after a psychotic episode?
a.
They are more likely than others to relapse.
b.
They receive high levels of emotional support from their families.
c.
They are more likely than others to relapse and they receive high levels of emotional support from their families.
d.
They are neither more likely than others to relapse nor to receive high levels of emotional support from their families.
e.
They are less likely than others to relapse.
a.
They are more likely than others to relapse.
Which of these is not a first-rank symptom of schizophrenia, according to Schneider’s classification system?
a.
bizarre delusions including passivity phenomena
b.
elevated mood
c.
hearing voices arguing
d.
hearing voices commenting on the individual’s actions
e.
disorganised speech
b.
elevated mood
For people with long-term psychosis and persistent positive symptoms, provision of cognitive behaviour therapy (CBT) as well as medication is likely to:
a.
reduce psychotic symptoms during CBT treatment.
b.
have long-term benefits after CBT treatment ceases.
c.
reduce psychotic symptoms during CBT treatment and have long-term benefits after CBT treatment ceases.
d.
neither reduce psychotic symptoms during CBT treatment nor have long-term benefits after CBT treatment ceases.
e.
reduce psychotic symptoms but have no long-term benefits after CBT treatment ceases.
c.
reduce psychotic symptoms during CBT treatment and have long-term benefits after CBT treatment ceases.
The strongest research support for the existence of familial genetic factors for schizophrenia comes from:
a.
twin studies.
b.
family studies.
c.
research into the role of neurotransmitters.
d.
research into structural brain abnormalities.
e.
adoption studies.
e.
adoption studies.
An individual with schizophrenia who believes that the television newsreader is sending coded messages to him/her is demonstrating what type of delusion?
a.
grandiose delusion
b.
narcissistic delusion
c.
delusion of reference
d.
paranoid delusion
e.
nihilistic delusion
c.
delusion of reference
