Flashcards in Chapter 10 - Schizophrenia Deck (30):
What is schizophrenia?
- one of the most puzzling and disabling clinical syndromes
- acute episodes are characterized by delusions, hallucinations, illogical thinking, incoherent speech, and bizarre behaviour
What was Emil Kraeplin's theory of schizophrenia?
Dementia praecox - referred to premature impairment of mental abilities (he thought it was a precursor to dementia)
What was Eugen Bleuler's contribution to the study of schizophrenia?
- renamed dementia praecox schizophrenia
- believed that schizophrenia could be identified by four primary features
What are the 4 As that Bleuler theorized about schizophrenia?
1. Associations: associations or relationships among thoughts becomes disturbed
2. Affect: affect or emotional response becomes flattened or inappropriate
3. Ambivalence: ambivalent feelings towards others, such as loving and hating them at the same time
4. Autism: withdrawal into a private fantasy world that it not bound by principles of logic
What do we mean when we talk about thought disorder?
Thought disorder is the stringing along of ideas that are not connected to each other, whilst the speaker is unaware that they are making little to no sense.
What was Kurt Schneider's contribution to the study of schizophrenia?
He thought the 4 As were too vague as diagnosing criteria
- he distinguished between two sets of symptoms: first-rank symptoms and second-rank symptoms
What are first rank symptoms?
Hallucinations and delusions (these are central to the diagnosis, cannot have schizophrenia without these two)
What are second-rank symptoms?
confusion and disturbances in mood (these exist in other disorders as well, thus, are not the key features of diagnosis)
What is the prevalence of schizophrenia in Canada?
1% of the population suffers or has suffered from schizophrenia
What are the two phases of schizophrenia?
1) prodromal phase
2) residual phase
What constitutes the prodromal phase?
This phase begins with subtle changes in speech and behaviour and is a precursor to the first acute psychotic episode
What constitutes the residual phase?
the phase of the disorder that follows an acute phase, characterized by a return to a level of functioning typical of the prodromal phase
Describe the path schizophrenia follows
1) prodromal phase: bizarre and eccentric behaviour, failing to take care of one's self, vague or rambling speech
2) acute phase: increasingly bizarre behaviour such as hoarding food, collecting garbage and talking to oneself on the street
3) psychotic symptoms appear: hallucinations and delusions
4) residual phase: reverting back to level of functioning typical of the prodromal phase
What is the first major feature of schizophrenia?
1) disturbances of thought and speech
a) disturbances in the content of thought
- delusions of persecution
- delusions of being controlled
- delusions of grandeur
- other delusions (thought broadcasting, thought insertion, thought withdrawal)
b) disturbances in the form of thought
- thought disorder (breakdown in the organization, processing and control of thoughts)
- neologisms (words made up by the speaker that have no meaning to the hearers)
- preservation (inappropriate but persistent repetition of the same words or train of thought)
- clanging (stringing together of words or sounds on the basis of rhyming
- blocking (involuntary abrupt interruption of speech or thought)
What is the second major feature of schizophrenia?
2) attentional deficiencies
a) hyper vigilance
What is the third major feature of schizophrenia?
3) Perceptual disturbances
a) auditory hallucinations (60% of cases)
- command hallucinations
b) visual hallucinations
What is the fourth major feature of schizophrenia?
4) emotional disturbances
- blunted affect
- inappropriate affect
What are the 4 subtypes of schizophrenia?
- disorganized (grossly inappropriate affect)
- catatonic (may remain in unusual or difficult positions for hours, oblivious to their environment)
What are some positive symptoms of schizophrenia?
hallucinations and delusions
What are some negative symptoms of schizophrenia?
apathy, lack of emotions and poor social functioning
What kind of symptoms are more presented in type 1 schizophrenia?
What kind of symptoms are more presented in type 2 schizophrenia?
What is the psychodynamic perspective on schizophrenia?
Schizophrenia represents the overwhelming of the ego by primitive sexual or aggressive drives or impulses arising from the id. The person, trying to control it, reverts back to an early period in the oral stage known as primary narcissism. Because the ego mediates between the id and the outer world, a breakdown in this functioning causes one to mistake fantasy for reality.
What is the learning perspective on schizophrenia?
Observational learning may play a role in the development of some forms of schizophrenic behaviour (some of the behaviours may be reinforced rather than normal behaviour)
What is the biological perspective on schizophrenia?
- genetic factors
- biochemical factors (the dopamine theory)
- viral infections?
- brain abnormalities (enlargement of brain ventricles, reduced activity in the prefrontal cortex, defects in the hippocampus and amygdala)
How can one tie together all the perspectives?
using the diathesis-stress model
What are some family theories of schizophrenia?
1) schizophrenergic mother (a cold, aloof and domineering mother who created overdependency in her children)
2) double blind communications (a message that conveys two mutually incompatible messages - such as stiffening on physical contact and then asking why the person won't approach (what do you mean by justin beiber))
3) communication deviance (characterized by unclear, vague, disruptive or fragmented communication and the parent's inability to attend to focus on the child's communication)
4) expressed emotion (the tendency of the family members of people who suffer from schizophrenia to be hostile, critical and unsupportive)
What is the biological approach to treating schizophrenia?
antipsychotic medication like phenothiazines and haloperidol (possible side effect is tardive dyskinesia, an involuntary movement that can affect any part of the body)
What is the learning approach to treating schizophrenia?
1) token economies
2) social skills training (role playing in a group setting)
3) CBT (showing how to manage stress in life and symptoms) - this combined with social skills training can dramatically improve one's condition