LECTURE 18

Question 1

Delusions

Answer 1

False beliefs that are often fixed, hard to change even when the person is presented with conflicting information, and are often culturally influenced in their
content. The most common delusions are of persecution-involve the belief that individuals or groups are trying to hurt, harm or plot against the person. . Other types of delusions include grandiose delusions,
where the person believes that they have some special power or ability. referential delusions, where the person believes that events or objects in the environment have special meaning for them

Question 2

Hallucinations

Answer 2

These are perceptual experiences that occur even when
there is no stimulus in the outside world generating the experiences. They can be auditory, visual, olfactory (smell), gustatory (taste), or somatic (touch). The most common hallucinations in psychosis (at least in adults) are auditory, and can involve one or more voices talking about the person, commenting on the person’s behavior, or giving them orders. The content of the
hallucinations is frequently negative

Question 3

Disorganized Speech

Answer 3

Talking to someone with schizophrenia is sometimes difficult, as their speech may be difficult to follow, either because their answers do not clearly flow from your
questions, or because one sentence does not logically follow from another.

Question 4

Disorganized behavior

Answer 4

Behavior or dress that is outside the norm for almost all subcultures, can include odd dress, odd makeup or unusual rituals (e.g., repetitive hand gestures). Abnormal motor behavior can include catatonia, which refers to a variety of behaviors that seem to reflect a reduction in responsiveness to the external environment.

Question 5

“Negative symptoms” of Schizophrenia

Answer 5

Absence of certain things we typically expect most people to have. For example, anhedonia or a motivation reflect a lack of apparent interest in or drive to engage in social or recreational activities. These symptoms
can manifest as a great amount of time spent in physical immobility. Flat affect and reduced speech (alogia) reflect a lack of showing emotions through facial expressions, gestures, and speech intonation, as well as a reduced amount of speech and increased pause frequency and duration.

Question 6

Schizophrenia Symptoms

Answer 6

Must be either display catatonic behavior, delusions, gross behavior, disorganized speech, hallucinations, negative symptoms for a month minimum. Must be affected in areas of function like: social, self-care, occupation etc since the onset of illness. Continuous signs of symptoms for six months.

Question 7

Schizophreniform Disorder

Answer 7

Similar symptoms as schizophrenia, symptoms should be present for a month at least but not more than six.

Question 8

Schizoaffective Disorder

Answer 8

Qualify for manic or depression episode along with schizophrenia.Person experiences delusions or hallucinations for atleast 2 weeks when not experiencing these episodes. Symptoms fitting criteria of depression or manic episodes are present for over half the illness duration.

Question 9

Delusional Disorder

Answer 9

Must be experiencing delusion atleast once a month. Doesn’t fit the criteria of schizophrenia. Person’s function has not been impaired outside of the delusion’s impact. Depressive or manic episodes don’t last as long as delusions do.

Question 10

Brief Psychotic Disorder

Answer 10

One or more of the following symptoms should be present for atleast a day but less than a month: delusions, hallucinations, disorganized speech, grossly disordered or catatonic behavior.

Question 11

Attuned Psychotic Disorder

Answer 11

One or more of the following symptoms in an “attenuated” form: Hallucinations, delusions, o4r disorganized speech. Symptoms must occur atleast once a week and increase in intensity over tie, to an extent that t he person becomes distressed or disabled.Don’t meet criteria for psychotic or other disorders or medical condition etc.

Question 12

Cognitive Neuroscience of Schizophrenia

Answer 12

Cognitive problems in schizophrenia are a major source of disability and loss of functional capacity. The cognitive deficits that are present in schizophrenia
are widespread and can include problems with episodic memory, working memory, and other tasks that require one to “control” or regulate one’s behavior. Individuals with schizophrenia also have difficulty with what is referred to as “processing speed” and are frequently slower than healthy individuals on almost all tasks. Importantly, these cognitive deficits are present prior to the onset of the illness and are also present, albeit in a milder form, in the first-degree relatives of people with schizophrenia. This suggests that cognitive impairments in schizophrenia reflect part of the risk for the development of psychosis, rather than being an outcome of developing psychosis. Further, people with schizophrenia who have more severe cognitive problems also tend to have more severe negative symptoms and more disorganized speech and behavior

Also are social cognition deficit - Includes problems with the recognition of emotional expressions on the faces of other individuals or inferring other’s intents. PET and FMRI help navigate the brain of schizophrenics. People with schizophrenia also show reduced overall brain volume, and reductions in brain volume as people get older may be larger in those with schizophrenia than in healthy people

Question 13

Risk of developing schizophrenia

Answer 13

Heterogenous disorder - People show different symptoms, making it harder to identify a particular gene. Increased stress, diabetes, malnutrition or hypoxia at birth.

Question 14

Treatments for Schizophrenia

Answer 14

The first line of treatment for schizophrenia and other psychotic disorders is the use of antipsychotic medications. There are two primary types of antipsychotic medications, referred to as “typical” and “atypical.” The fact that “typical” antipsychotics helped
some symptoms of schizophrenia was discovered serendipitously more than 60 years ago. These are drugs that all share a common feature of being a strong block of the D2 type dopamine receptor. Although these drugs can help reduce hallucinations, delusions, and disorganized speech, they do little to improve cognitive deficits or negative symptoms and can be associated with distressing motor side effects. The newer generation of antipsychotics is referred to as “atypical” antipsychotics. These drugs have more mixed mechanisms of action in terms of the receptor types that they influence, though most of them also influence D2 receptors. These newer antipsychotics are not necessarily more helpful for schizophrenia but have fewer motor side effects. However, many of the atypical antipsychotics are associated with side effects referred to as the “metabolic syndrome,” which includes weight gain and increased risk for cardiovascular illness, Type-2 diabetes, and mortality.

Question 15

Alogia

Answer 15

A reduction in the amount of speech and/or increased pausing before the initiation of speech.

Question 16

Functional capacity

Answer 16

The ability to engage in self-care (cook, clean, bathe), work, attend school, and/or engage in social relationships.

Question 17

Neurodevelopment

Answer 17

Processes that influence how the brain develops either in utero or as the child is growing up.

Question 18

Processing speed

Answer 18

The speed with which an individual can perceive auditory or visual information and respond to it.

Question 19

Psychoalanysis

Answer 19

This approach stresses that mental health problems are rooted in unconscious conflicts and desires. In order to resolve the mental illness, then, these unconscious struggles must be identified and addressed. Psychoanalysis often does this through exploring one’s early childhood experiences that may have continuing repercussions on one’s mental health in the present and later in life. Psychoanalysis is an intensive, long-term approach in which patients and therapists may meet multiple times per week, often for many years.

Question 20

Techniques in Psychoanalysis

Answer 20

Free association: Here, the patient shares any and all thoughts that come to mind, without attempting to
organize or censor them in any way. if during therapy a patient begins to express unjustified anger toward the therapist, the therapist may recognize this as an act of transference. That is, the patient may be displacing feelings for people in his or her life (e.g., anger toward a parent) onto the therapist. At the same time, though, the therapist has to be aware of his or her own thoughts and emotions, for, in a related process, called countertransference, the therapist may displace his/her own emotions onto the patient.

Question 21

Advantage and Disadvantage of Psychoanalysis

Answer 21

Advantage: Some patients and therapists find the prolonged and detailed analysis very rewarding.

Disadvantage: The lack of empirical support for their effectiveness.

Question 22

Person Centered Therapy

Answer 22

Rogers, in particular, believed that all people have
the potential to change and improve, and that the role of therapists is to foster self-understanding in an environment where adaptive change is most likely to occur. Therapists do not try to change patients’ thoughts or behaviors directly. Rather, their role is to provide the therapeutic relationship as a platform for personal growth. In these kinds of sessions, the therapist tends only to ask questions and doesn’t provide any judgment or interpretation of what the patient says. Instead, the therapist is present to provide
a safe and encouraging environment for the person to explore these issues for him- or herself.

The unconditional positive regard of therapist is highly emphasized upon.

Question 23

Advantage and Disadvantage of Person-Centered Therapy

Answer 23

It is highly acceptable to patients. In other words, people tend to find the supportive, flexible environment of this approach very rewarding. Furthermore, some of the themes of PCT translate well to other therapeutic
approaches. For example, most therapists of any orientation find that clients respond well to being treated with nonjudgmental empathy. The main disadvantage to PCT, however, is that findings about its effectiveness are mixed. One possibility for this could be that the treatment is primarily based on unspecific treatment factors. That is, rather than using therapeutic
techniques that are specific to the patient and the mental problem (i.e., specific treatment factors), the therapy focuses on techniques that can be applied to anyone.

Question 24

Cognitive Behavior Therapy

Answer 24

A family of therapeutic approaches whose goal is to alleviate psychological symptoms by changing their underlying cognitions and behaviors. The premise of CBT is that thoughts, behaviors, and emotions interact and contribute to various mental disorders.

Thoughts create feelings -> Feelings create behavior -> Behavior reinforces thoughts

Question 25

Techniques of CBT

Answer 25

Help patients identify maladaptive appraisals, or the untrue judgments and evaluations of certain thoughts.

With cognitive restructuring, it is the therapist’s job to help point out when a person has an inaccurate or maladaptive thought, so that the patient can either eliminate it or modify it to be more adaptive. In addition to thoughts, though, another important treatment target of CBT is maladaptive behavior. Every time a person engages in maladaptive behavior (e.g., never speaking to someone in new situations), he or she reinforces the validity of the maladaptive thought, thus
maintaining or perpetuating the psychological illness

CBT-enhancing pharmaceutical agents. These are
drugs used to improve the effects of therapeutic interventions. Based on research from animal
experiments, researchers have found that certain drugs influence the biological processes known to be involved in learning.

Question 26

Advantages and Disadvantages of CBT

Answer 26

Advantage: Cost-effective, can be made to suit different people, brief sessions, abundance of empirical support for this.

Disadvantage: Needs participation from patient.

Question 27

Mindfulness

Answer 27

A process that tries to cultivate a nonjudgmental, yet attentive, mental state, is a therapy that focuses on one’s awareness of bodily sensations, thoughts, and the outside environment.

Question 28

Mindfulness-Based Therapy

Answer 28

MBSR uses meditation, yoga, and attention to physical experiences to reduce stress. The hope is that reducing a person’s overall stress will allow that person to more objectively evaluate his or her thoughts. In MBCT, rather than reducing one’s general stress to address a specific
problem, attention is focused on one’s thoughts and their associated emotions.

Question 29

Dialectical Behavior Therapy

Answer 29

focuses on skills training. That is, it often employs mindfulness and cognitive behavioral therapy practices, but it also works to teach its patients “skills” they can
use to correct maladaptive tendencies.

Question 30

Difference between CBT and DBT

Answer 30

The primary difference between DBT and CBT is that DBT employs techniques that address the symptoms of the problem (e.g., cutting oneself) rather than the
problem itself (e.g., understanding the psychological motivation to cut oneself). CBT does not teach such skills training because of the concern that the skills—even though they may help in the short-term—may be harmful in the long-term, by maintaining maladaptive thoughts and behaviors

Question 31

Congnitive bias modification

Answer 31

Using exercises (e.g., computer games) to change problematic thinking habits.

Question 32

Integrative or eclectic psychotherapy

Answer 32

Also called integrative psychotherapy, this term refers to approaches combining multiple orientations (e.g., CBT with psychoanalytic elements).