Week 7: Chapter 8: Psychosis - Stolar & Wolfe

Question 1

Psychosis

Answer 1

consist of delusions (false beliefs) and hallucinations (seeing or hearing things)

Question 2

What is the difference between positive symptoms (ADDITION) and negative symptoms (REMOVAL)?

Answer 2

Positive symptoms = any change in behaviour or thoughts, such as hallucinations or delusion
● Includes: formal thought disorder (FTD) and bizarre behaviour: ADDITION
Negative symptoms = where people appear to withdraw from the world around them
take no interest in everyday social interactions, and often appear emotionless and flat
● Includes: lack of: motivation [avolition], interest [apathy], socialisation [asociality], a ect [blunted a ect], speech [alogia], and pleasure [anhedonia]: REMOVAL

Question 3

What are three treatmens in the history of psychosis?

Answer 3

1. Blood-Letting
2. Trephination
3. Exorcisms

Question 4

What is Blood-Letting?

Answer 4

believed to rid the body of impure fluids to cure a host of conditions. Originally, bloodletting involved cutting a vein or artery, at the elbow or knee, to remove the a ected blood

Question 5

What is Trephination?

Answer 5

Drilling holes in the skull to release demons.

Question 6

What are Exorcisms?

Answer 6

ejecting a possessing entity from a person, object, or location

Question 7

What dangerous treatmens were utilised in the 1900s?

Answer 7

Hydrotherapy, insulin coma therapy and lobotomies

Question 8

What was insulin coma therapy?

Answer 8

According to the medical staff at the Bronx Veteran’s Administration Hospital, writing about their treatment regime in 1960, insulin coma therapy was thought to relieve symptoms including “anxiety, tension, fear, irritability, hostility, elation, paranoid projections, obsessive and compulsive thinking, delusions, and

Question 9

What us Thorazine?

Answer 9

Thorazine was a medical treatment that began in 1952: (= used to treat certain mental/mood disorders: helps to think more clearly, feel less nervous, and take part in everyday life)

Question 10

What is Cognitive Behavioural Therapy for Psychosis (CBTp)?

Answer 10

an evidence-based treatment approach shown to improve symptoms and functioning in patients with psychotic disorders

Question 11

What is the aim of
Cognitive Behavioural Therapy for Psychosis (CBTp)?

Answer 11

it aims to enhance function despite di cult symptoms and experiences such hallucinations, negative symptoms, thought disturbances, and delusions

Question 12

What are limitations of CBTp?

Answer 12

some have symptoms too severe to allow meaningful utilisation of CBTp (or any psychotherapy, for that matter) → if comprehension, attention, memory, language, and/or motivation are severely impaired (due to cognitive deficits, FTD, negative symptoms, and/or distraction by hallucinations), the interchange necessary for therapy to proceed does not occur

Question 13

What is the General Cognitive Model from Beck?

Answer 13

an event activates an automatic thought (AT) or belief (AB) which is influenced by a core belief about oneself, others (the world), and the future
→ this belief leads to an emotional reaction (including a physiological response) that can have behavioural consequences as well: individual symptoms of psychosis and schizophrenia can be viewed in terms of this general model

Question 14

What are bizarre behaviours?

Answer 14

behavioural responses that are approached by determining what led to the behaviours: beliefs, voices, or disorganisation, → also includes catatonic behaviour.

Just odd behaviour basically

Question 15

What is catatonic behaviour?

Answer 15

neurological symptoms which include: lack of movement and communication, and also can include agitation (nervous excitement), confusion, and restlessness

Question 16

What is Formal Thought Disorder (FTD)?

Answer 16

Formal thought disorder refers to an impaired capacity to sustain coherent discourse (written or spoken communication), and occurs in the patient’s written or spoken language. Whereas delusions reflect abnormal thought content, formal thought disorder indicates a disturbance of the organization and expression of thought

can be considered a physiological response, similar to stuttering → results from beliefs about situations, leading to anxiety and hence a stress response

Question 17

Name the 6 types of delusions.

Answer 17

1. Persecutory → to believe that someone or something is “out to get them”
2. Erotomanic → to believe (falsely) that another person, or many people, are in love with them
3. Grandiose → to believe that they are superior to other people
4. Jealous → to believe that their partner is unfaithful and look for evidence that that is true
5. Somatic → to believe, falsely, that something is wrong with their body
6. Mixed/Unspecified → to have multiple types of delusions and/or do not fit into a category

Question 18

What are three types of hallucinations?

Answer 18

1. Visual → seeing things like lights, objects, people who are not there
2. Auditory → hearing sounds or voices no one else hears
3. Tactile → feeling something touch or move on your skin, like a hand

Question 19

Treatment of psychosis are divided into 10 stages. Which ones?

Answer 19

1. Establishing rapport
2. Assessment (making a judgement about something)
3. Goal setting
4. Coping skills.
5. Normalisation
6. Cognitive/behavioural approach
7. Case conceptualization
   8.Treatment completion
8. Relapse management
9. Termination (beëindiging)

Question 20

The efficacy of CBTp. Where does is show?

Answer 20

• Clinical high risks
• Prodromal phases, first episodes of psychosis and stable chronic symtpoms, but also it has recently been found to lower ratings of positive and negative symptoms scores in those that are unmedicated → has been recommended as extra treatment to include medication management