chapter 13

Question 1

what is psychosis

Answer 1

• hallucinations and delusions experienced in several disorders
• some degree of psychosis defining feature of schizophrenia spectrum disorders
• more severe in schizophrenia

Question 2

schizophrenia

Answer 2

• disturbances in thought, language, emotion, behaviour
• positive symptoms: exaggerated behavior
• negative symptoms : absence of insufficiency of behavior
• disorganized symptoms: erratic behaviors, affect speech, motor behaviour, emotional reactions
• typically includes psychosis
• functioning: below previously achieved levels

Question 3

delusions

Answer 3

• misrepresentations of reality
• delusions of grandeur, presecution, capgras syndrome, cotards syndrome
• views of delusion: motivation, deficit

Question 4

hallucinations

Answer 4

• sensory experience in absence of environmental stimuli or input
• can involve all senses
• most common: metacognition, own vs others voice, brocas area

Question 5

negative symptoms

Answer 5

• abolition (or apathy): inability to persist in activities
• alogia: relative absence of speech
• anhedonia: lack of pleasure or indifference
• affective flattening: absence of normally expected emotional response
• asociality: severe deficits in social functioning, social impairment

Question 6

disorganized symptoms

Answer 6

• disorganized speech: illogical or incoherent speech, tangiality, loose associations or derailment
• disorganized affect: emotional behaviour
• disorganized behaviour: variety of unusual behaviours like catatonia

Question 7

prevalence and course of schiz

Answer 7

• affects 1/100 people
• chronic, complete recovery rare, lifetime expectancy less than average
• onset late teens to mid 30s
• equal m and f
• f: later age of onset, better outcomes
• m: higher negative symptoms, longer duration

Question 8

schzoaffective disorder

Answer 8

• characterized by symptoms of a mood disorder and schizophrenia
• each disorder exists independently
• delusions/hallucinations present for 2 weeks in absence of mood disorder symptoms
• symptoms for mood disorder present for duration of illness
• prognosis: better than schiz, worse than mood, persistent, no improvement without treatment

Question 9

typical course of schizoaffective

Answer 9

• hallucinations and persecutory delusions for at least 6mo

- major mood episode for at least 2mo

Question 10

schizophreniform

Answer 10

• schizophrenic symptoms and a noticable change in behavior prior to onset of psychosis
• at risk for schiz later
• 1 month but less than 6

Question 11

• bried psychotic disorder

Answer 11

• sudden onset of delusions, hallucinations, disorganized speech
• 1 day to 1 month

Question 12

delusional disorder

Answer 12

• one or more delusions in the absence of other schizophrenia symptoms
• 1 day to 1 month

Question 13

genetic causes

Answer 13

• inherit a vulnerability for developing disorders
• polygenetic
• parent severity increases risk for kids
• twins have a higher risk
• environment has an impact whether or not disorder is developped
• if twins both develop disorders can look different
• genetic markers: smooth pursiut eye movement

Question 14

neurobiological influences: dopamine hypothesis

Answer 14

• DA agonists result in schizophrenic behavior, antagonists reduce
• recent studies say that DA hypothesis too simple bc DA antagonists dont always work and neuroeleptics have a little impact on negative symptoms

Question 15

neurobiological influences:

Answer 15

• dopamine: prefrontal cortex has low activation or D1 receptors, stratium/basal ganglia has excessive activity of striatal D2, mesolimbic pathway has excessvive activity of DA receptors
• serotonine: involved in regulating DA neurons in mesolimbic pathway
• glutamate: low levels of glutamate implicated

Question 16

additional physiological causes

Answer 16

• prenatal viral infection exposure

- birth complications: hypoxia, fetal distress, low birth weight, prematurity, famine

Question 17

psychological causes

Answer 17

• stress: may activate vulnerability
• family interaction: highyl dysfunctional communication, hostility, criticism, related to relapse risk
• other psychological factors only have a small effect

Question 18

conventional antipsychotics

Answer 18

• improve positive symptoms, little effect on negative symptoms
• severe side effects - parkinsons like symptoms
• still used bc some poeple cant take atypical

Question 19

atypical antipsychotics

Answer 19

• improve negative symptoms, decrease positive symptoms

- fewer side effects

Question 20

transcranial magnetic stimulation

Answer 20

• promising results

- more research needed

Question 21

psychological treatments

Answer 21

• early interventions
• behavioral intervention
• CBT that focuses on emotional disturbance, psychotic symptoms, social disabilities, risk of relapse
• behavioural family therapy
• social and living skills
• used in addition to medications bc it improves medical compliance and reduces relapse frequency