Chapter 10: Schizophrenia

Question 1

Are the rates of schizophrenia different across cultures?

Answer 1

No. They are similar in all nations.

Question 2

What is the likelihood of developing schizophrenia if both parents have schizophrenia?

Answer 2

Less than 50%

Question 3

What sort of family environment increases the risk of relapse?

Answer 3

Hostile, critical, and unsupportive environments.

Question 4

Does medication cure schizophrenia?

Answer 4

No, it can only help treat the symptoms.

Question 5

What is schizophrenia?

Answer 5

A chronic psychotic disorder characterized by acute episodes involving a break with reality, as manifested by such features as delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behavior.

Question 6

What was the original term used for schizophrenia?

Answer 6

Dementia Praecox

Question 7

Who first discovered dementia?

Answer 7

Emil Kraeplin

Question 8

What did Eugen Bleuler discover about the clinical features of schizophrenia? (4 A’s)

Answer 8

Associations: relationships disturbed
Affect: inappropriate emotional responses
Ambivalence: conflicted feelings toward environemnt
Autism: withdrawal into private world unbound by logic

Question 9

What are the first rank symptoms of schizophrenia?

Answer 9

Hallucinations and delusions.

Question 10

What are the second rank symptoms of schizophrenia?

Answer 10

Other negative symptoms like social withdrawal that occur with other disorders.

Question 11

What is the prevalence of schizophrenia?

Answer 11

1%

Question 12

What percentage of people with schizophrenia are unemployed?

Answer 12

79%

Question 13

What is the most common diagnosis of individuals who are involuntarily hospitalized?

Answer 13

Schizophrenia.

Question 14

What percentage of people with schizophrenia abuse substances at some point in their lives?

Answer 14

80%

Question 15

What percentage of individuals with schizophrenia attempt suicide? What percentage of people die?

Answer 15

40-60%, 10%

Question 16

What interferes with the ability of schizophrenic people to acquire housing, employment, and treatment?

Answer 16

The stigma of violence.

Question 17

When is the onset of schizophrenia?

Answer 17

Late teens to early 20s.

Question 18

What gender is more at risk for developing schizophrenia?

Answer 18

Men

Question 19

What is the prodromal stage of schizophrenia?

Answer 19

• Stage in which the early features or signs of a disorder become apparent.
• Period of decline in functioning that precedes the development of the first acute psychotic episode.

Question 20

What is the acute phase of schizophrenia?

Answer 20

Psychotic symptoms develop, such as hallucinations, delusions, and disorganized speech and behavior.

Question 21

What is the residual phase of schizophrenia?

Answer 21

Follows the acute phase, characterized by a return to a level of functioning typical of the prodromal phase.

Question 22

What are the four major delusions present in schizophrenia?

Answer 22

Delusion of persecution
Delusion of grandeur
Delusion of reference
Delusion of being controlled

Question 23

What are other common forms of delusions present in schizophrenia?

Answer 23

Thought broadcasting

Thought insertion or withdrawal

Question 24

What is thought broadcasting?

Answer 24

Believing that one’s thoughts are somehow transmitted to the external world so that others can overhear them.

Question 25

What is thought insertion?

Answer 25

The belief that one's thoughts have been planted in one's mind by an external source.

Question 26

What is thought withdrawal?

Answer 26

The belief that thoughts have been removed from one's mind.

Question 27

What is thought disorder?

Answer 27

The breakdown in the organization, processing, and control of thoughts. Major feature of schizophrenia.

Question 28

What are neologisms?

Answer 28

The coining of new words.

Question 29

What is perseveration?

Answer 29

Persistent repetition of the same thought or train of thought.

Question 30

What is clanging?

Answer 30

To string words together that rhyme.

Question 31

What is blocking?

Answer 31

Involuntary abrupt interruption of speech or thought.

Question 32

What are the four major forms of hallucinations?

Answer 32

Visual/Auditory Tactile/somatic Gustatory/Olfactory Command Hallucinations

Question 33

What causes hallucinations?

Answer 33

Excess levels of dopamine and receptors

Question 34

What is catatonia?

Answer 34

Gross disturbances in motor activity and cognitive function

Question 35

What are examples of catatonia?

Answer 35

``` Fixed and rigid postures Odd gestures bizarre facial expressions stupor waxy flexibility ```

Question 36

What are the positive symptoms of schizophrenia?

Answer 36

Hallucinations Delusions Thought disorder Disorganized speech/behavior

Question 37

What are the negative symptoms of schizophrenia?

Answer 37

Social-skill abnormalities/withdrawal Psychomotor retardation Failure to experience pleasure

Question 38

What is the psychodynamic perspective on schizophrenia?

Answer 38

Overwhelming of the ego by primitive sexual or aggressive drives or impulses arising from the id. Hostile parent-child relationships cause individual to take refuge in fantasy world.

Question 39

What is primary narcissism?

Answer 39

A person's regression to an early period in the oral stage. Causes primitive impulses and behavior.

Question 40

What is the learning perspective on schizophrenia?

Answer 40

Behavior results from lack of social reinforcement which leads to detachment from social environment. Inappropriate responses to stimuli

Question 41

What is the biological perspective on schizophrenia?

Answer 41

``` Genetic factors. Dopamine theory. Viral infections. Vitamin D deficiency in prenatal develoment. Brain abnormalities ```

Question 42

What brain abnormalities are correlated with schizophrenia?

Answer 42

Loss/thinning of grey matter in prefrontal cortex. Enlarged ventricles Abnormal functioning

Question 43

What is the family theory about schizophrenia?

Answer 43

1. Schizophrenogenic mother: cold, aloof, overprotective and domineering. 2. Double-bind communications: mixed messages. 3. Communication deviance: fragmented parental communication. 4. Expressed emotion: hostile, critical, unsupportive. 5. Source of stress/cause of stress.

Question 44

How is schizophrenia treated biologically?

Answer 44

Antipsychotic drugs : phenothiazines and haloperidol

Question 45

What is tardive dyskinesia?

Answer 45

Movement disorder characterized by involuntary movements of the face, neck, mouth, and trunk caused by longterm usage of antipsychotics.

Question 46

What are the psychosocial approaches to schizophrenia treatment?

Answer 46

Psychoanalysis (might not be effective) CBT, token economy, social skills training and reinforcement of appropriate behavior.

Question 47

What are forms of psychosocial rehabilitation?

Answer 47

``` Self-help groups Family-intervention Community programs (housing, career opportunities) Early intervention programs. ```

Question 48

What are the Canadian treatment guidelines for schizophrenia?

Answer 48

1. Antipsychotic medication 2. Psychoeducational programs/family therapy 3. Medical care 4. Crisis intervention 5. CBT 6. Housing.