Chapter 10: Schizophrenia

Question 1

Acute Schizophrenia episodes are characterized by:

Answer 1

delusions, hallucinations, illogical thinking, incoherent speech, bizarre behaviour

Question 2

Emil Kraeplin (1856-1926)

Answer 2

Dementia Praecox

- out (dementia) of ones mind (praecox)

Question 3

Eugen Bleuler

Answer 3

Associations: relationships among thoughts become disturbed

Affect: emotional responses become flattened and inappropriate

Ambivalence: hold conflicting feelings towards others

Autism: withdrawal into a private fantasy wold that is not bound by principles of logic

Question 4

Kurt Schneider

Answer 4

First rank symptoms

• central to the diagnosis
• hallucinations and delusions (not specific to schizophrenia)

Second-rank symptoms

• symptoms associated with schizophrenia that occur in other psychological conditions
• disturbances of mood and confused thinking

Question 5

Phases of Schizophrenia

Answer 5

Prodromal phase

Residual phase

Question 6

Prodromal phase

Answer 6

waning interest in social activities and increasingly difficulty in meeting the responsibilities of daily living

Question 7

residual phase

Answer 7

behavioural returns to the level that was characteristic in functioning prior to the first acute phase

behaviour may not return fully to normal

Question 8

Schizophrenia occurs when?

Answer 8

late teens/early 20s
drug induced/stress induced

can come on fast (acute onset) or gradual onset

Question 9

Major features of schizophrenia

Answer 9

disturbances of thought and speech
other common forms of delusions
disturbances in the form of thought
Attentional deficiencies 
perceptual deficiencies 
emotional disturbances 
oter types of impairment

Question 10

Disturbances of thought and speech

Answer 10

Delusions of persecution
Delusions of reference
Delusions of being controlled
Delusions of grandeur

Question 11

Common forms of delusions

Answer 11

Thought broadcasting
thought insertion
thought withdrawal

Question 12

Disturbances in the form of thought

Answer 12

Thought disorder 
Neologisms
Perseveration 
Clangling
Blocking

Question 13

thought disorder

Answer 13

breakdown in the organization, processing, and control of thoughts

Question 14

Neologisms

Answer 14

words made up by the speaker that have little or no meaning to the others

Question 15

perseveration

Answer 15

inappropriate but persistent repetition of the sane words or train of thought

Question 16

Clanging

Answer 16

stringing together of words or sounds on the basis of rhyming

Question 17

Blocking

Answer 17

involuntary abrupt interruption of speech or thought

Question 18

Younger individuals with schizophrenia vs. older individuals

Answer 18

younger: talk a lot
older: have poverty of speech

Question 19

Hypervigilance

Answer 19

acute sensitivity to extraneous sounds, esp. during the early stages of the disorder

attentional deficiency

Question 20

Perceptual disturbances

Answer 20

Auditory hallucinations and self-talk

• auditory hallucinations in 60% of cases
• commmand hallucinations

Question 21

Causes of hallucinations

Answer 21

too much dopamine

- therefore they are easy to treat with medication

Question 22

Emotional disturbances

Answer 22

flat affect

Question 23

Stupor

Answer 23

state of relative or complete unconsciousness in which a person is not generally aware of or responsive to the environment

Question 24

Schizophrenia can be either ______ or ______

Answer 24

type 1

type 2

Question 25

Type 1 Schizophrenia

Answer 25

Positive symptoms (something is added) - acute onset - presence of abnormal behaviour such as hallucinations, delusions, thought disorders, disorganized speech and inappropriate affect

Question 26

Type 2 Schizophrenia

Answer 26

``` Negative symptoms (something is removed) - gradual onset ``` -absence of normal behaviour, such as social skill deficits, social withdrawal, flattened affect, poverty of speech and thought, psychomotor retardation, failure to experience pleasure in pleasant activities

Question 27

premorbid functioning

Answer 27

poorer in type 2

Question 28

psychodynamic perspective

Answer 28

Primary narcissism - person regresses to an early period in the oral stage Harry Stack Sullivan - mother-child relationships - anxious and hostile interactions between parent and child can lead the child to take refuge in a private fantasy world

Question 29

learning perspective

Answer 29

Ulmann and Krasner - reinforcement - children may grow up in non-reinforcing environments and never learn to respond appropriately to social stimuli

Question 30

Biological perspective

Answer 30

genetic factors - cross-fostering studies: method of determining heritability of a trait or disorder by examining differences in prevalence among adoptives reared by adoptive parents or biological parents Biochemical factors - DA theory: do not appear to produce more dopamine but have a greater than normal # of receptors in their brains or have receptors that are overly sensitive to DA - Neuroleptic drugs: block DA receptors

Question 31

Theoretical perspective

Answer 31

Viral infections - slow acting virus that attacks the developing brain of a fetus or newborn child Brain abnormalities - hippocampus: impairs memory - amygdala: impairs emotions

Question 32

Diathesis-stress model of schizophrenia

Answer 32

diathesis + stress factors -> + potential protective factors -> schizophrenia

Question 33

family theories

Answer 33

Schizophrenogenic mother - cold, aloof, overprotective, domineering Double-bind communication - the transmission of contradictory or mixed messages Communication deviance - unclear, vague, disruptive, or fragmented parental communication Expressed emotion - hostile, critical, and unsupported of the schizophrenic family member - high levels of expressed emotion is BAD Family factors: causes or sources of stress - increase risk is disturbed communication and emotional interaction

Question 34

Biological approaches

Answer 34

antipsychotic drugs sociocultural factors in treatment

Question 35

Phenothiazines; Haloperidol

Answer 35

antipsychotic help with hallucinations and delusions treats tardive dyskinesia (TD)

Question 36

Tardive dyskinesia (TD)

Answer 36

movement disorder characterized by involuntary movements of the face, mouth, neck, trunk, or extremities - treated with phenothiazines, haloperidol

Question 37

psychoanalytic approaches

Answer 37

personal therapy, not well suited to treatment

Question 38

Learning based approaches

Answer 38

selective reinforcement toke economy systems social skills training

Question 39

psychosocial rehabilitation

Answer 39

self help groups: ran by non-professionals or people with schizophrenia community programs: housing, jobs, education

Question 40

Family intervention programs

Answer 40

``` practical aspects of daily living educating members teaching family members how to relate in a less hostile way improving communication problem solving skills ```

Question 41

Early intervention programs

Answer 41

reduced disruption of activities reduced disruption of family and social relationships reduced likelihood of hospitalization reduced disability and fewer relapses reduced risk of suicide improved capacity to maintain self-identity and self-esteem faster and more complete recovery