Schizophrenia Spectrum

Question 1

schizophrenia

Answer 1

a psychological disorder characterized by delusions, hallucinations, disorganized speech, and/or diminished or inappropriate emotional expression

Question 2

schizoaffective disorder

Answer 2

a psychological disorder characterized by the combination of mood and psychotic symptoms; in this disorder, both the symptoms of schizophrenia and a major depressive, manic, or mixed episode are experienced for at least one month

Question 3

psychoses

Answer 3

disorders in which hallucinations or delusions indicate some loss of contact with reality

Question 4

hallucinations

Answer 4

false sensory experiences, such as seeing something in the absence of an external visual stimulus

No external stimulus; can be a symptom of an underlying condition.

cat sitting on a chair that isn’t actually there

Question 5

illusions

Answer 5

*Misperception of a real sensory experience

Misinterpretation of a real external stimulus; common and can happen to anyone.

Optical illusions are a common type

Question 6

derealization

Answer 6

*False perception that the environment has changed

Question 7

depersonalization

Answer 7

*Nonspecific feeling of lost identity

a dissociative experience where you feel disconnected from your own thoughts, body, or identity.

Question 8

catatonia

Answer 8

behavioral syndrome marked by an inability to move normally, which can manifest in various ways including stupor, negativism, rigidity, excitement, and posturing

A patient with catatonia might exhibit echolalia and echopraxia

Question 9

bizarre behaviors

Answer 9

may take form of a stilted, rigid demeanor and eccentric dress, grooming and rituals

(stilted, rigid demeanor): A person might speak in a monotone voice, avoid eye contact, and exhibit very limited facial expressions, making it difficult for others to read their emotions or intentions.

Question 10

delusions

Answer 10

false fixed beliefs that cannot be corrected by reasoning

Question 11

All of the symptoms of schizophrenia have the ability to render the person unable to…

Answer 11

function normally
-impairment in occupational and social functioning
-impairment in the ability for self-care
-impairment in maintaining social relationships

Question 12

positive symptoms of schizophrenia

Answer 12

symptoms that have been added - hallucinations and delusions
cognitive and speech disturbances, catatonia/bizarre behaviors

Question 13

negative symptoms of schizophrenia

Answer 13

the absence of appropriate behaviors
ex: Poverty of speech, blocking
Avolition
Anergia
Anhedonia
Anosognosia (a condition in which a person is unaware of or denies the existence of their disability or impairment)

Question 14

apathy

Answer 14

a lack of feeling, emotion, or interest

Question 15

avolition

Answer 15

lack of motivation; inability to initiate tasks such as social contacts or ADLs

Question 16

anhedonia

Answer 16

inability to experience pleasure

Question 17

anergia

Answer 17

lack of energy

Question 18

affective blunting

Answer 18

A reduction in the expression, range, and intensity of affect (In flat affect, no facial expression is present.)

Question 19

poverty of speech

Answer 19

restriction in the amount of speech used; replies may be monosyllabic (one-word answers

Question 20

cognitive symptoms of schizophrenia

Answer 20

problems with working memory, attention, verbal and visual learning and memory, reasoning and problem-solving, processing, and speech

Question 21

Delusions: Ideas of reference

Answer 21

the person believes a neutral event has a special and personal meeting
ex: someone believes a message on a billboard is a personal message

Question 22

delusions: thought broadcasting

Answer 22

belief that others can hear one’s thoughts

Question 23

delusions: thought insertion

Answer 23

beliefs that one’s thoughts are being controlled by outside forces/inserted into one’s mind

Question 24

delusions: thought withdrawal

Answer 24

belief that one’s thoughts have been removed by some outside force

Question 25

associative looseness

Answer 25

thinking becomes haphazard, illogical, and confused

“I was walking my dog yesterday, and the leash was red. Red reminds me of apples. Apples fall from trees. Trees are in forests. Forests are where you can get lost. I don’t want to lose my keys. Keys open doors.”

Question 26

tangential thinking

Answer 26

the train of thought of a speaker wanders off in another direction, NEVER returning to the initial topic

Question 27

neologisms

Answer 27

Made-up words that typically have only meaning to the individual who uses them.
Example: “I was late because I had to wait for the stoplizzle.”

Question 28

word salad

Answer 28

Incoherent mixture of words, phrases, and sentences

Example: “Apple carpet drive sunshine book to the yesterday evening.”

Question 29

echolalia

Answer 29

pathological repeating of another’s words by imitation

Question 30

echopraxia

Answer 30

Mimicry or imitation of the movements of another person.

Question 31

Brain imaging techniques used for schizophrenic diagnostics (occasionally used)

Answer 31

*Computed tomography (CT)
*Magnetic resonance imaging (MRI)
*Functional magnetic resonance imaging (fMRI)
*Positron-emission tomography (PET)

Question 32

there is reduced brain activity in what lobe of the brain of a patient with schizophrenia

Answer 32

frontal lobe

Question 33

Course of Schizophrenia

Answer 33

*Prodromal
*Acute - Phase I
*Stabilization - Phase II
*Maintenance - Phase III

Question 34

Prodromal Phase

Answer 34

before the client develops floridly psychotic symptoms of schizophrenia (similar to schizotypal)

Question 35

Acute Phase I

Answer 35

*Inpatient stabilization with medications & nursing interventions

Question 36

goals of acute phase I

Answer 36

*Crisis management (safety & communication in a milieu setting), Establish support system for stabilization & maintenance

Question 37

Phase II Stabilization

Answer 37

*Transition client to the home /community setting

Question 38

goal of phase II stabilization

Answer 38

*Outpatient continuity of care, med compliance/ adherence, support of family or case managers
*May require group residential setting if no family support is available

Question 39

Phase III: Maintenance goal

Answer 39

*keep client stable & out of the hospital

Question 40

acute phase I interventions

Answer 40

-Psychopharmacologic treatment
-Supportive/directive communications
-Limit setting (milieu management and counseling)
-Psychiatric, medical, neurologic evaluation

Question 41

Phases II & III (Stabilization & Maintenance) interventions

Answer 41

-Family psychoeducation/community support

-Health teaching (Disease, medication management, Cognitive and social skills enhancement, Stress and anxiety controls)

-Health promotion and maintenance (Improve functional deficits, Encourage nonthreatening activities, Encourage family and social interaction)

Question 42

interventions for auditory hallucinations

Answer 42

*Always ask if the client is hearing voices and what they are saying, then document and report.
*Ask if hearing command voices and if so, must institute precautions for safety.
*Provide a reality check for voices by saying, “I know you are hearing voices but I do not hear anyone else talking right now.”
*Stay calm, refer to voices as “the voices” or “your voices”
*Assess for increased anxiety, agitation, or fear.

Question 43

interventions for delusional thinking

Answer 43

*Always help the client get in touch with emotions they are expressing/feeling
*Never argue about the delusions, but you can voice doubt
*Help decrease anxiety, give space and do not touch, possibly stand side-by-side to decrease direct eye contact
*Offer sealed food/drink that is visibly not tampered with

Question 44

Assertive Community Treatment (ACT)

Answer 44

community-based programs that provide many of the services that are necessary for successful community living; including case management, problem-solving, social skills training, support, and teaching on a 24/7 basis
-Provide interventions for clients in crisis
-Reduces the rate of rehospitalization during relapses

Question 45

Family’s role in treatment

Answer 45

-Psychologic strategies aimed at reducing psychotic symptoms
-Teaching client and family about illness
-Recognizing the effect of stress
-Psychosocial activities
-Identifying support sources
-Medication groups for patients and family

Question 46

Clanging

Answer 46

Choosing words based on their sound rather than their meaning, often resulting in rhyming or alliteration.

Example: “The pike likes to hike and Mike fed the bike near the tike.”

Question 47

Circumstantial

Answer 47

Providing excessive and unnecessary detail that is usually relevant to the question but far too elaborate.

Example: When asked where they live, responding with a long story about the day they moved in, rather than simply stating their address.

Question 48

Concrete Thinking

Answer 48

Difficulty understanding abstract concepts, taking things very literally.

Example: Interpreting the phrase “it’s raining cats and dogs” as actual cats and dogs falling from the sky.

Question 49

Flight of Ideas

Answer 49

Rapidly shifting from topic to topic, with superficial connections between them.

Example: “I need to make a doctor’s appointment. My friend is a doctor. She has a lot of doctor friends. Friends are important.”

Question 50

Blocking (Thought Blocking)

Answer 50

Abruptly stopping in the middle of a thought or sentence.

Example: “I was on my way to the store to buy some… (silence).”