Chapter 9 - Schizophrenia Flashcards Preview

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Flashcards in Chapter 9 - Schizophrenia Deck (84):
1

Heterogeneity

Tendency for people with disorder to differ from each other in symptoms, family, personal background, response to treatment and ability to live outside the hospital

2

What is the first formal onset of first episode of schizophrenia?

development of psychotic/positive symptoms

3

What is the age onset?

15-45 years of age

4

How do the symptoms show up?

can be gradual or abrupt

5

what is the gender differences in developing the disorder

equal rates in both men and women
if disorder develops after 45 years of age, more common in women

6

is schizophrenia a relapsing disorder?

yes, and tends to be chronic

7

What groups is schizophrenia most common in?

lower socio-economic groups - developing countries

8

ratio of recovery

1/7 patients

9

positive symptoms

exaggerated, distorted adaptions of normal behaviour

10

what are examples of psychotic/positive symptoms

hallucinations, delusions, thought and speech disorder, catatonic behaviour, grossly disorganized

11

negative symptoms

absence or loss of typical behaviours and experiences

12

what are examples of negative symptoms

avolition, alogia, anhedonia, associality

13

avolition

loss of motivation

14

alogia

speaking loss

15

anhedonia

inability to feel pleasure/lack of emotional responsiveness

16

hallucination

Perception like experiences that occur without external stimuli - auditory is most common

17

delusions

Fixed beliefs that don't change even in light of conflicting evidence

18

persecutory delusions

paranoid delusions - individuals believe that they are being pursued or targeted for sabotage, ridicule, or deception (ex. strangers on street are undercover agents)

19

referential delusions

a belief that events, objects, or other individuals have personality relevant meaning (ex. songs that a DJ is playing have special meaning in life)

20

somatic delusions

perception of a change or disturbance in personal appearance or bodily function (ex. aliens in body causing headaches)

21

religious delusions

unusual religious experiences or beliefs (ex. Satan is leaving messages for me via TV)

22

grandiose delusions

possession of special or divine powers, abilities, or knowledge (ex. "I have the power to change the course of history")

23

affective flattening

negative symptom - a lack of emotional expressiveness, failing to convey any feeling in their face, tone of voice, or body language

24

what symptoms are involved with schizophrenia?

1) delusions
2) hallucinations
3) disorganized speech
4) grossly disorganized or catatonic behaviour
5) negative symptoms - ex. alogia, anhedonia, avolition etc.

25

how long must these symptoms be present?

1 month active period - 1 out the 3 symptoms (delusions, hallucinations, disorganized speech) and the other can be anything - total of two, and a total of 6 month period with disturbance inclusive of 1 month active period

26

disease markers

biological or behavioural traits or features of an individual that reliably reflect the presence of a medical or psychiatric disease or a predisposition to develop such a disease

27

endophenotypes

Stable and enduring trait of the disorder that occurs before the onset of symptoms ex. Eye tracking and deficits on performance tests in schizophrenics

28

Schizophrenogenic

the unsupported theory that cold and rejecting behaviour causes schizophrenia

29

collective unconscious

the concept that symbols and myths are shared among people in a culture but remain beneath awareness - ex. swinging penis

30

social drift

the tendency for people vulnerable to schizophrenia to "drift" down to lower social and economic levels

31

hypokrisia

biological diathesis that occurs throughout the brain making nerve cells abnormally reactive to incoming stimulation

32

cognitive slippage

information is disorganized, incoherent, and "scrambled"

33

aversive drift

in Meehl's theory, the tendency for people with a genetic predisposition for schizophrenia to be perceived negatively and subjected to personal rejection, leading progressively to social withdrawal and alienation

34

schizotype

suffer from "primary" cognitive slippage, difficulty feeling pleasure, social alienation, and other consequences of aversive drift

35

vulnerability

diathesis - hereditary

36

disorder-promoting events

stress - environmental

37

neuropsychological tests

activate and depend on frontal region of brain - impairment on this test supports hypothesis that frontal brain is defective in the disorder

38

FAS technique

20-25 words that began with F,A,S in 3 one minute trials - results showed that schizophrenic patients produced fewer words than healthier people

39

Wisconsin Card Sorting Test

shown 4 key cards and patient is asked to match each card out of a deck of cards to a key card - results showed is easier for healthy people and schizophrenic patients make more mistakes and frequent mistakes

40

brain structure in schizophrenics (CT/MRI)

larger ventricles, reduced grey matter volumes

41

blood flow in schizophrenics (PET/fMRI)

less reduced blood flow or metabolism in the frontal region when engaged in a mental "activation" task

42

Paul Meehl

hypokrisia , cognitive slippage, aversive drift - brain is overstimulated (too much info) causing info to be unorganized and then it interferes with how important/rewarding you find relationships

43

Daniel Weinberger

biological vulnerability and surging stress hormones - person could inherit genetic defect that creates vulnerability for the disorder, also believed it was possible that subtle brain injuries during fetal development or birth could become a diathesis

44

diathesis - stress model

genetic vulnerability/predisposition (diathesis) interacts with the environment/life events (stressors) to trigger behaviours or psychological disorders

45

Elaine Walker

people with biological vulnerability for schizophrenia cannot cope with the effects of surging stress hormones on brain chemistry and begin to develop symptoms and clinical illness

46

dopamine receptors hypothesis

dopamine is central to schizophrenia - antipsychotic drugs reduce symptoms by blocking dopamine receptors since dopamine increases activity

47

insulin-coma

a seizure and loss of consciousness induced by administration of insulin

48

psychosurgery

use of brain surgery to alter behaviour especially in relation to psychiatric disorders

49

frontal lobotomies

the surgical cutting of connecting fibres within the frontal brain

50

how does biological treatment help?

control/manage symptoms, less time in hospitals, few relapses, better life functioning

51

where does biological treatment fall short?

discontinuation of medication, side effects, not helpful in providing occupational/daily living skills or social support

52

what four elements did CBT focus on

1) emotional disturbances
2) psychotic symptoms
3) social disabilities
4) risk of relapse

53

CBT theory

emotional and behavioural disturbances are influenced by subjective interpretation of life and illness experiences

54

what is done in CBT therapy

patients are taught how to interpret correctly relevant environmental events and how to respond appropriately to social cues while interacting and communicating with other people

55

results of CBT

gains in their psychosocial functioning, motivation and experienced reduced positive symptoms

56

social skills training

learning-based intervention model for the development of practical social skills in schizophrenics - effective with younger patients

57

CBBST

individual or group based treatments

58

family therapy

conceptualizes the patient as a member of a family system and tailors treatment to the family as a whole

59

prodrome

period before the appearance of psychotic symptoms when vulnerable adolescents often become withdrawn and suspicious

60

Schizoaffective disorders

co-occurence of a major mood episode with schizophrenic symptoms (2 or more)

61

how long must the delusions/hallucinations be present for in schizoaffective disorder?

2 weeks without the mood symptoms, mood symptoms are present for the majority of the total time meeting criteria for schizophrenia

62

how long should the symptoms be present in schizoaffective disorders?

1 month period

63

what is one symptom that must be present in schizoaffective disorders?

pervasive low mood

64

what gender is schizoaffective disorders more common in?

females

65

cannabis and psychosis

use is associated with twice the higher risk of psychosis

66

what are the four psychotic disorders?

delusional disorder, brief psychotic disorder, schizophrenia, schizoaffective disorder

67

how long must delusional disorder symptoms be present

1 month without any other psychotic symptoms

68

what are some other categories that need to be met for delusional disorder

- behaviour is not bizarre
- has never had schizophrenia
- if mood symptoms are present, they are brief compared to duration of delusions

69

what are the delusional disorder types

erotomanic, grandiose, jealous, persecutory, somatic, mixed, unspecified, with bizarre content

70

gender differences for delusional disorder

equally common in men and women, more prevalent in older adults

71

which type of delusional disorder type is the most common

persecutory

72

what is the most common delusional disorder type in males

jealous

73

brief psychotic disorder symptoms

delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior

74

how long must the symptoms for brief psychotic disorder be present

from 1 day to a month - can occur after a severe stressor or during/after pregnancy

75

gender differences for brief psychotic disorder

twice as common in women

76

average age onset for brief psychotic disorder

mid-thirties, more common in developing ocuntries

77

Bizzare delusion

Clearly implausible, not understandable, not related to real world content

78

Disorganized or catatonic behaviour

Ranges from child like silliness to unpredictable agitation
Catatonic behaviour - negativism

79

Outcomes of brief psychotic disorder

High risk of relapse and usually excellent outcome

80

What happens if schizophrenics don't have an insight on their disorder?

Non-adherence to medication, relapse, involuntary treatment, aggression, poor course of illness

81

What is more associated with increased risk of aggression for schizophrenia?

Young makes, past history of violence, non-adherence to treatment, substance abuse, impulsivity

82

Schizophrenia and age expectancy

10-25 years shorter lifespan for schizophrenics and 2-3x higher mortality rate than general population

83

Causes of excess mortality in schizophrenia

1) physical illness is common but are detected later and treated poorly
2) antipsychotic medications have negative side effects
3) unhealthy lifestyle ex. Smoking
4) lifetime suicide risk

84

Cognition remediation training

Targets cognitive skills (ex. Memory, attention), medium range effect that are maintained over time