Chapter 9: Schizophrenia Spectrum and Other Psychotic Disorders

Question 1

Most severe and disabling mental health condition

Answer 1

Schizophrenia

Question 2

Schizophrenia

Answer 2

One of the most serious psychological disorders, characterized by delusions, hallucinations, and disorganized speech. There are overall, adverse changes in thought, perception, emotion, and motor behaviour, and a feeling of depersonalization. Behaviour in some instances appears to be “autistic,” in the sense of being governed by internal stimuli or private events. The individual may be unresponsive to environmental stimuli that would normally prompt reactions, or may respond in a way that suggests a distorted interpretation of the stimuli. Ordinary objects or events seem to take on a marked personal significance. There is pronounced disruption of cognitive transactions: thought and language appear to become loosened from the normal constraints that make for coherent sequences of ideas and distinguish fantasy from reality. Often, some notion or theme involving malevolent forces or inordinate personal power increasingly commands the individual’s attention. Many people with schizophrenia appear to lose their intensity. Language may become impoverished, with little apparent effort or success at communication. They may become withdrawn socially and exhibit little interest in formerly enjoyable pursuits. Attention span may be markedly reduced. From the Greek schizein, “to split,” and phrenos, “mind.”

Question 3

Psychosis

Answer 3

Refers to the loss of touch with reality that is characterized by symptoms such as hallucination and delusions that are observed in schizophrenia

Question 4

Egosyntonic

Answer 4

They do not view their disorder as a problem

Question 5

Egodystonic

Answer 5

They view their disorder as a problem

Question 6

Past and madness

Answer 6

People drew on spiritual interpretations for such behaviour and considered “madness” to be the result of divine punishment or demonic posession

Question 7

German psychiatrist Emil Kraepelin

Answer 7

Introduced the term dementia praecox to describe what is now known as schizophrenia

Question 8

Bleuler then described the heterigeneity of the disorder (variability and diversity of clinical and biological features that are seen)

Answer 8

He believed that schizophrenia is better described as a group of schizophrenias rather than one singular condition

Question 9

Positive symptoms

Answer 9

Abnormal additions to lie, including the hallucinations, delusions, and disorders thought frequently experienced by patients with schizophrenia

Question 10

Basic symptoms

Answer 10

Disorganized communication, motivational impairments, mood disturbance, and withdrawal from the world

Question 11

First rank symptoms

Answer 11

Symptoms included hearing voices conversing with each other or commenting on what the person was doing, believing that one’s own thoughts were being broadcast for other people to hear, or believing that one’s thoughts or behaviour were under the control of an outside source

Question 12

Schizophrenia criteria

Answer 12

These criteria outline a combination of symptoms and clinical features that define the disorder and include core symptoms (Criterion A); problems with work or social functioning (Criterion B); continuous signs of the disturbance for at least six months, including at least one month of active symptoms (Criterion C); the exclusion of concurrent schizoaffective or mood disorders during the active phase of schizophrenia symptoms (Criterion D); the fact that the disturbance cannot be caused by substance use or medical conditions (Criterion E); and consideration of any history of autism spectrum disorder or a communication disorder of childhood onset as contributing to the disorder (Criterion F).

Question 13

Five core symptoms of schizophrenia include

Answer 13

delusions (Criterion A1), hallucinations (Criterion A2), disorganized speech (Criterion A3), grossly disorganized or catatonic behaviour (Criterion A4), and negative symptoms (Criterion A5).

Question 14

The first foe symptom-related diagnostic criteria represent positive symptoms

Answer 14

• delusions, hallucinations, disorganized speech, grossly disorganized or catonic behaviour

Question 15

Negative symptoms

Answer 15

Comprise behavioural deficits, including loss of motivation, lack of emotional expression, and lack of interest in environment

Question 16

Schizophrenia

Answer 16

Is not defined by any one symptom or cluster of symptoms, rather a selection of qualitatively different symptoms are required for a diagnosis

Question 17

Schizoaffective Disorder

Answer 17

Contains the added element of a diagnosed mood episode that occurs at the same time as the symptoms of schizophrenia

This period of co occuring symptoms must have been preceded or followed by at least 2 weeks of delusions or hallucinations without the mood symptoms

Question 18

Two subtypes of schizoaffective disorder

Answer 18

1) Bipolar type= episodes of mania

2) Depressive type= episodes of major depressive episodes

Question 19

Schizophreniform disorder

Answer 19

Same criteria as schizophrenia, yet only lasts between 1-6 months

The symptoms must be present for a significant portion of time during a one month period. There is not requirement for a decline in functioning

Diagnosis is often withheld until at least 6 months, if they do not get better= they have schizophenia

Question 20

Delusional disorder

Answer 20

Characterized by experiencing delusions for at least one month and not experiencing any other psychotic symptoms

-Functioning is not markedly impaired, and behaviour is not that bizarre or odd

Question 21

Brief Psychotic Disorder

Answer 21

Is diagnosed if positive symptoms of schizophrenia are present for more than one day and remit by another month

If symptoms persist for between one and six months= then schizophreniform disorder would be diagnosed, and longer than 6 months would result in a diagnosis of schizophrenia

Question 22

A substance/medication induced psychotic disorder

Answer 22

Diagnosed when the positive symptoms of schizophrenia occur to due the initiation or withdrawal from a drug, medication, or toxin

Question 23

Substance/Medication Induced Psychotic Disorder

Answer 23

can be distinguished by relationship of substance use and substance withdrawal

Question 24

Substance use

Answer 24

Recurrent substance use that results in significant adverse consequences in social or occupational functioning, or use of a substance that impairs one’s performance in hazardous situations, for example drinking and driving

Question 25

Substance withdrawal

Answer 25

Unpleasant and sometimes dangerous symptoms such as nausea, headache, or tremors experienced when an addictive substance is removed from the body.

Question 26

Psychotic Disorder due to Medical Condition

Answer 26

The characteristic features of psychotic disorders due to another medical condition are prominent hallucinations or delusions caused by the physiological effects of a medical condition. For this diagnosis to be considered, a medical condition must be present that is capable of producing psychotic symptoms (e.g., epilepsy) and the symptoms cannot be explained by another mental disorder. Psychotic disorder due to another medical condition is more common in people older than 65 years of age compared to younger people

Question 27

Other Psychotic Disorders

Answer 27

Not enough information to make one of the above diagnoses, but symptoms of psychosis are present

-Other specified schizophrenia-spectrum and other psychotic disorder

Question 28

Typical symptoms of schizophrenia spectrum disorders

Answer 28

The characteristic symptoms of schizophrenia-spectrum disorders may be broadly classified as positive and negative symptoms. However, schizophrenia is also associated with other symptoms including disorganized, motor, affective, and cognitive symptoms.

Question 29

Positive symptoms

Answer 29

Refer to many of the obvious signs if schizophrenia.
They refer to the addition of an experience that is in excess of normal psychological functioning

Question 30

Positive symptoms include

Answer 30

Hallucinations, delusions, and disorganized thinking

Question 31

Hallucinations

Answer 31

Are abnormal perceptual experiences that occur in the absence of external stimuli. They can occur in any sensory modality: hearing, seeing, smelling, tasting, or feeling things that are not actually there

Question 32

Most common type of hallucinations

Answer 32

Auditory hallucinations- up to 80% of people have this kind of hallucination

The experience of hearing sounds like voices that do not actually exist

Question 33

Command hallucinations

Answer 33

When voices give the person commands to do things

Question 34

Visual hallucinations

Answer 34

Very rare for someone to see a fully formed person or animal that interacts with them.

Instead, people may see partially formed images and objects, yet they disappear when person tries to interact with them

-they rarely if ever look exactly like things that are actually in the world around the person and interact with them

Question 35

Clear sensorium

Answer 35

A term referring to a clear mental state not clouded by substance use, fatigue, or a neruological conditions

Question 36

Hypnogogic Hallucinations

Answer 36

Occur as someone is falling asleep

Question 37

Hypnopompic hallucinations

Answer 37

are generally considered a regular part of human experience and are not diagnostic of psychosis

Question 38

Delusions

Answer 38

Are fixed false beliefs that are unfounded and highly resistant to contradictory evidence

-types of delusions are often defined based on the theme of the delusion and include grandiose, persecutory, somatic, and referential delusions

Question 39

Persecutory delusions/paranoid delusions

Answer 39

Involve the belief that one is being conspired against, spied upon, or persecuted

-Most common
-may believe that the government or criminal organizations are monitoring them and intent on harming them

Question 40

Grandiose delusions

Answer 40

Involve the belief that one possesses special powers, abilities, or knowledge

Question 41

Religious delusions

Answer 41

Involve unfounded or unrealistic beliefs regarding religious themes and can often involve the person taking on the role of a religious icon

Question 42

Somatic delusions

Answer 42

Involve beliefs that one’s body is changing

Question 43

Referential beliefs

Answer 43

Involve a belief that common events (song playing on the radio), objects (a tree) or other individuals (stranger sitting in a cafe) hold a personally relevant and significant meaning to the affected individual

-ex someone might think that the way papers are arranged on a desk contain a special message for them

Question 44

Bizarre delusions

Answer 44

Are completely impossible and do not derive from ordinary life experiences

-thinking aliens planted a chip in someone’s head

Question 45

Non bizarre delusions

Answer 45

Involve circumstances that could occur in reality but the likelihood of them being true is extremely low (monitored by government organization)

Question 46

Delusions- thought withdrawal

Answer 46

These include the belief that one’s thoughts have been removed by some outside force

Question 47

Thought insertion

Answer 47

The idea that external thoughts have been put into one’s mind

Question 48

Delusions of control

Answer 48

One’s body or actions are being acted on or manipulated by some outside force

Question 49

Capgras syndrome/Imposter syndrome

Answer 49

Specific type of delusional condition

-Can occur in psychotic disorders as well as neurological conditions such as dementia and stroke

-They believe that people well known to them, such as family members, have been replaced by substitutes

-They may believe they have been replaced by an imposter

Question 50

Thought disorder

Answer 50

Refers to disorganized linguistic communication through verbal or written means

Question 51

Thought- Loosening of associations

Answer 51

Occurs when speech switches from topic to topic with little oblivious connection to them

Question 52

Tangentiality

Answer 52

Occurs when someone’s response is completely unrelated to the topic being discussed

Question 53

Perseveration

Answer 53

is an example of thought disorder in which the person becomes fixated on a specific word or idea and repeats it over and over.

Question 54

Neoliogisms

Answer 54

More severe forms of thought disorder- the use of words that are completely made up or the use of a real word in an irregular context= You can tell the time by looking at the cow

Question 55

Salad

Answer 55

The most severe form of thought disorder occurs when all connections between words in a sentence are lost and speech become incoherent and impossible to understand

Question 56

Negative symptoms

Answer 56

Represent a deficit in psychological functioning

-They can be classified as either experiential or expressive

Question 57

Experiential negative symptoms

Answer 57

involve a decrease in ability to experience enjoyment from situations and to motivate oneself to do things.

Question 58

Expressive negative symptoms

Answer 58

refer to impairments in the ability to interact with the social world as a result of limited speech or difficulty with the nonverbal expression of emotions.

Question 59

Negative symptoms can be summarized by the five A’s

Answer 59

avolition, anhedonia, asociality, alogia, and affective flattening

Question 60

Avolition/Apathy

Answer 60

A lack of motivation (decreased ability to initiate and persist in activities) and lack of interest in daily activities