CLPS 1700- Readings - Chapter 12 Flashcards
(117 cards)
1
Q
What is schizophrenia?
A
Psychological disorder characterized by psychotic symptoms: hallucinations and delusion; that significantly affect emotions, behavior, and mental processes/contents
2
Q
What are positive symptoms of schizophrenia?
A
Delusions, hallucinations, disorganized speech and behavior
3
Q
What are negative symptoms of schizophrenia?
A
Absence/reduction of normal mental processes/contents/feelings/behaviors: includes speech, emotional expressiveness, and movement
4
Q
What are hallucinations?
A
Sensations so vivid that the perceived objects or events seem real, even though they aren’t
5
Q
What impairment may contribute to the presence of auditory hallucinations?
A
Inability to distinguish between internally and externally generated verbal info; misattribution of internal conversations to another person
6
Q
What are delusions?
A
Incorrect beliefs that persist, despite evidence to the contrary
7
Q
List the four types of delusion themes.
A
Paranoid delusions, delusions of control, delusions of grandeur, and delusions of reference
8
Q
Paranoid delusions
A
Theme of being persecuted by others
9
Q
Delusions of control
A
Belief that the person is being controlled by other people/aliens/etc that put the thoughts into his/her head (thought insertion)
10
Q
What is thought insertion?
A
The idea that thoughts are inserted into one’s head by others/aliens/etc; common element of delusions of control
11
Q
Delusions of grandeur
A
Believing oneself to be significantly more powerful, knowledgeable, or capable than is actually the case
12
Q
Delusions of reference
A
The belief that external events have special meaning for the individual; song playing in a movie is a code just for them!
13
Q
What is word salad?
A
Disorganized speech consisting of a random stream of seemingly unconnected words
14
Q
What is disorganized behavior?
A
Behavior that is so unfocused and disconnected from a goal that the person cannot successfully accomplish a basic task, or the behavior is inappropriate in the situation; includes catatonia
15
Q
What is catatonia?
A
A condition in which an individual remains in an odd posture or position with rigid muscles for hours
16
Q
Name three negative symptoms of schizophrenia.
A
Flat affect, alogia, and avolition
17
Q
What is flat affect?
A
A lack of/considerably diminished emotional expression such as occurs when someone speaks robotically and shows little facial expression
18
Q
Do schizophrenics experience emotion?
A
Most likely: just can’t express it
19
Q
What is alogia?
A
Poverty of speech: speaking less that most other people, responding slowly or minimally to questions
20
Q
What is avolition?
A
Difficulty in initiating or following through with activities
21
Q
What are three cognitive deficits in schizophrenia?
A
Deficits in attention, working memory, and executive function; endure over time
22
Q
Explain deficits in attention in schizophrenics.
A
Difficulty sustaining/focusing attention: trouble distinguishing relevant from irrelevant stimuli
23
Q
Due to deficits in working memory, can schizophrenics store things in long term memory?
A
Yes: after presented with information on multiple occasions; can remember it just as well as others if successfully stored in long-term memory
24
Q
What is a consequence of deficits in working memory?
A
Disruptions in reasoning, and disorganized speech, etc.
25
What are executive functions?
Mental processes involved in planning, organizing, problem-solving, abstract thinking, and exercising good judgment
26
Why do the problems in working memory most likely arise?
Because of the deficits in executive function
27
Which typically arises first, the first symptoms of schizophrenia, or neurocognitive deficits?
Neurocognitive deficits
28
Do neurocognitive deficits improve as other schizophrenia symptoms improve, typically?
Unfortunately, no.
29
What are the five DSM IV TR subtypes of schizophrenia?
Paranoid, disorganized, catatonic, undifferentiated, and residual
30
Paranoid schizophrenia
Presence of delusions and auditory hallucinations that are limited to specific topics that have a coherent paranoid or grandiose theme (believing that you're being haunted by the CIA, believing you're God); may have relatively intact cognitive and emotional functioning when the content of their thoughts and experiences does not relate to their delusions
31
Which subtype of schizophrenia has the best recovery rate?
Paranoid subtype
32
Which subtype of schizophrenia is most related to aggressive behavior?
Paranoid subtype
33
Disorganized schizophrenia
Characterized by disorganized speech and behavior, and inappropriate emotional expression; generally poor prognosis: can't café for themselves, so often require constant care
34
Catatonic schizophrenia
Characterized by stiff or frozen postures/poses/bizarre jerky movement, frozen facial expressions; require constant care
35
Undifferentiated schizophrenia
When the symptoms lead to the diagnosis of schizophrenia, but don’t completely match any specifications for the other subtypes
36
Residual schizophrenia
Any subtype when the positive symptoms have subsided but the negative symptoms persist and the full criteria for schizophrenia are no longer met
37
What is the deficit subtype of schizophrenia?
Requires the presence of severe neurocognitive deficits in attention, memory, and executive functioning, as well as the positive and negative symptoms that are manifestations of these deficits, such as disorganized speech and behavior and alogia; generally more impaired that other patients, poorer prognosis
38
What is the non-deficit subtype of schizophrenia?
Requires the presence of primarily positive symptoms, such as hallucinations and delusions, in conjunction with relatively intact cognitive functioning; generally less impaired, better prognosis; includes paranoid subtype of schizophrenia
39
How is psychotic mania distinguished from schizophrenia?
By the presence of other symptoms of mania, such as pressured speech or little need for sleep
40
What is the difference in "depressed" symptoms of depression and schizophrenia? (Little or no interest, staring into space, short or empty replies, social isolation, etc.)
With schizophrenia, these arise from cognitive deficits, but in depression, these arise from anhedonia, difficulty making decisions, lack of energy, feeling of worthlessness, etc.
41
What are psychotic disorders?
Specifically require the presence of psychotic symptoms: considered as a spectrum
42
List five psychotic disorders in addition to schizophrenia.
Schizophreniform disorder, brief psychotic disorder, schizoaffective disorder, delusional disorder, and shared psychotic disorder
43
What personality disorder is thought of as on the schizophrenia spectrum?
Schizotypal PD
44
What is schizophreniform disorder?
Psychotic disorder characterized by symptoms that meet all the criteria for schizophrenia EXCEPT that the symptoms have been present for only 1-6 months and daily functioning may or may not have declined over that period of time
45
What is the main difference between schizophrenia and schizophreniform disorder?
Length of symptoms and depth of deficit: shorter time and less severe in schizophreniform disorder
46
What is brief psychotic disorder?
Psychotic disorder characterized by the sudden onset of positive or disorganized symptoms that last between a day and a month and are follow by a full recovery; no negative symptoms present during the episode
47
What is schizoaffective disorder?
Presence of both schizophrenia AND a mood episode (depressive, manic, or mixed); negative symptoms such as flat affect are NOT common; diagnosis likely to be made on basis of positive symptoms; greatest risk for committing suicide
48
Which psychotic disorder has the greatest risk for suicide?
Schizoaffective disorder
49
Which psychotic disorder commonly does NOT feature negative symptoms, and diagnosis is made on the basis of positive symptoms?
Schizoaffective disorder
50
Which psychotic disorder has the best prognosis of full recovery?
Brief psychotic disorder
51
Which has a better recovery rate, schizophrenia or schizoaffective disorder?
Schizoaffective disorder, especially when stressors or events clearly contribute to the disorder
52
What is delusional disorder?
Characterized by the presence of non-bizarre but demonstrably incorrect beliefs that have persisted for more than a month; non-bizarre delusions include: erotomanic, grandiose, persecutory, somatic, and jealous)
53
Non-bizarre erotomanic delusions
Belief that another person is in love with you; usually focuses on romantic/spiritual union rather than sexual attraction
54
Non-bizarre grandiose delusions
Belief that the patient has a great but unrecognized ability/talent/achievement
55
Non-bizarre persecutory delusions
Belief that the patient is being spied on, drugged, harassed, etc; magnification of small snub
56
Non-bizarre somatic delusions
False belief that patient is experiencing bodily sensations or malfunctions
57
Non-bizarre jealous delusions
Belief that the patient's partner is unfaithful, based on tiny amounts of "evidence"
58
What is the main difference in assessment of schizophrenia and delusional disorder?
Bizarreness of the delusions: the more bizarre, the closer to schizophrenia
59
List the five non-bizarre delusions common to delusional disorder.
Erotomanic, grandiose, persecutory, somatic, and jealous
60
What is shared psychotic disorder?
When an individual develops delusions as a result of close relationship with another person who has delusions as part of a psychotic disorder; folie a deux
61
What is the rate of comorbidity for schizophrenia and other psychological disorders?
90%
62
What percentage of the world population experience schizophrenia?
1%
63
What are the three most common comorbid disorders with schizophrenia?
Substance-related, mood, and anxiety disorders
64
What is the most common comorbid mood disorder with schizophrenia?
Depression
65
What substance-related disorder has a 90% comorbidity with schizophrenia?
Nicotine use: cigarettes; self-medication: effects certain receptors related to schizophrenia in the brain
66
Frequent use of what substance is associated with schizophrenia later?
Marijuana (but correlation doesn't imply causation)
67
What is one potential explanation for why people predisposed to psychotic disorders are more likely to use marijuana?
Interacts with the frontal lobe: counteracts some cognitive deficits and impaired brain functioning that accompanies the disorder
68
What is the prodromal phase?
Precedes the onset of a psychological disorder when symptoms don’t yet meet all the criteria for the disorder
69
What's the difference between premorbid and prodromal phases of schizophrenia?
In premorbid, there's no development of symptoms yet and they might display odd personality characteristics; but in the prodromal phase, the symptoms are evident and suspicious and on their way to becoming eligible to meet diagnostic criteria
70
What gender is slightly more likely to develop schizophrenia?
Males, and at an earlier age, too
71
Which gender usually has fewer negative symptoms of schizophrenia?
Women: but more mood symptoms
72
Among what demographic is schizophrenia more common?
Lower socioeconomic status, urban areas, etc.
73
What is the rule of thirds for schizophrenia?
A third improve significantly, a third stays static, and a thirds becomes chronically ill and disabled
74
What percent of schizophrenics commit suicide?
10-15%
75
What is the most striking brain structure abnormality in schizophrenics?
Enlarged ventricles and atrophied brains, which may be related; brains smaller than normal originally anyway
76
List the four brain areas described in the textbook that may contribute to schizophrenia.
Frontal lobe, temporal lobe, thalamus, and hippocampus
77
Why might there be frontal lobe impairment in schizophrenics?
Excessive "pruning" of neurons from birth to adolescence; elimination of too many neural connections in the frontal lobes
78
What role do the temporal lobes play in schizophrenia?
Enlarged ventricles leaves less room for the temporal loves: process auditory info, some language, and visual recognition: malfunctioning may contribute to hallucinations
79
What role does the thalamus play in schizophrenia?
Transmits sensory information to other brain areas; smaller and abnormal functioning: difficulties focusing attention, distinguishing relevant from irrelevant stimuli, and memory difficulties
80
What role does the hippocampus play in schizophrenia?
Storing new memories: smaller that in controls
81
List three possible causes of brain abnormalities found in schizophrenics.
Maternal malnourishment, maternal illness and stress, oxygen deprivation
82
How might maternal illness affect brain development of infants?
Cell migration (when neurons move to their final destinations to make connections with others) is interrupted with maternal illness: neurons aren't properly positioned and cannot form the proper connections
83
How might oxygen deprivation affect brain development in schizophrenics?
Impairs growth of hippocampus: smaller hippocampus leads to memory deficits
84
What is a biological marker?
A neurological, bodily, or behavioral characteristic that distinguished people with a psychological disorder from those without
85
What is one biological marker for schizophrenia related to vision?
Inability to maintain smooth, continuous eye movements when tracking a light: smooth pursuit eye movements
86
What is one biological marker for schizophrenia related to stimuli filtering?
Sensory gating: schizophrenic brains don’t respond less strongly to second clicks than the first clicks; manifestation of difficulties in filtering out unimportant stimuli
87
What is one biological marker for schizophrenia related to movement?
Excessive involuntary movements
88
What four neurotransmitters likely have a role in schizophrenia?
Dopamine, serotonin, glutamate, and cortisol
89
How does dopamine affect schizophrenia?
Decreased number of receptors in the frontal lobes, but increased dopamine production in the striatum: overproduction responsible for schizophrenia
90
What is the dopamine hypothesis for schizophrenia?
That overproduction of dopamine or increased sensitivity of dopamine receptors contributes to schizophrenia significantly
91
What are delusions, according to the dopamine hypothesis?
An attempt to make sense of the flood of unrelated thoughts/feelings/perceptions triggered by excess dopamine/sensitivity
92
How do serotonin and glutamate affect schizophrenia?
Serotonin enhances the effects of glutamate, which plays a role in learning and memory (through certain glutamate receptor), which may contribute to deficits in working memory; and excessive glutamate in frontal lobe impairs neural timing in frontal lobe
93
What role does cortisol play in schizophrenia?
Increased stress during childhood/adolescence; affects dopamine activity
94
What is the estrogen protection hypothesis?
That estrogen protects against symptoms of schizophrenia by affecting dopamine and serotonin activity
95
How is heritability of schizophrenia demonstrated by identical twins?
Likely to both be predisposed to it
96
What cognitive problem common to schizophrenics is a significant psychological factor?
Lack of insight: don't realize they're impaired
97
What are some other psychological factors of schizophrenia?
Cognitive distortions, ignoring disconfirming evidence, blaming negative events on others, lack of questioning where hallucinations come from, unfounded beliefs, low self-expectations, negative self-appraisals, less intense facial expressions, difficulty identifying facial expressions
98
How do schizophrenics deal with theory of mind?
Poorly: cannot relate to others very well
99
How do social factors affect paranoia and confusion?
Maybe lack of ability to understand social cues leads to paranoia and confusions
100
What family style exacerbates schizophrenia?
High expressed emotion: hostile, overly critical, emotionally overinvolved
101
How does social selection contribute to economic factors of schizophrenia?
Social selection: suggests that mentally ill "drift" to lower socioeconomic levels because of impairments; stressful and exacerbates schizophrenic symptoms
102
How does social causation contribute to economic factors of schizophrenia?
The stressors of being in a lower socioeconomic standing exacerbate the predisposition towards schizophrenia; poverty, financial insecurity, higher crime rates, etc.
103
What kind of culture (individualistic or collectivist) predicts a better prognosis for schizophrenics?
Collectivist: emphasis on needs of the group, group cohesion, and interdependence (more tolerance, less criticism, elevates importance of community and provides social norm that creates more support for schizophrenics and families, higher expectations of people with schizophrenia, believing that they can have a functional role in society, self fulfilling prophecy)
104
What are the four steps for treating schizophrenia?
Reduce positive symptoms, reduce negative symptoms, improve cognitive functioning, reduce disability and increase ability to function
105
Why type of medications are commonly used to treat schizophrenia?
Antipsychotics (traditional and atypical)
106
List a common traditional antipsychotic and explain its effect.
Thorazine: dopamine antagonist (block dopamine action)
107
What is an unfortunate side effect of traditional antipsychotics?
Tardive dyskinesia
108
What is tardive dyskinesia?
Enduring side effect of traditional antipsychotic medication that produces involuntary lip smacking and odd facial contortions as well as other movement-related symptoms
109
What are atypical antipsychotics?
Affect dopamine and serotonin without affecting the motor areas of the brain; no risk of tardive dyskinesia
110
What are the benefits of atypical antipsychotics?
No tardive dyskinesia, may improve comorbid anxiety/depression, improve daily functioning
111
What is one of the main problems with medication for schizophrenia?
Noncompliance: refusal to take the medication because of negative side effects
112
What is another medical treatment for schizophrenia besides medication?
Brain stimulation through ECT and TMS; not as successful as medication
113
How does CBT help treat schizophrenia?
Learn to distinguish hallucinatory voices from real people, highlight importance of taking medication, discuss noncompliance issues, develop coping strategies
114
What is cognitive rehabilitation?
A psychological treatment for schizophrenia that is designed to strengthen cognitive abilities through extensive and focused practice; can help sustain attention, improve mental flexibility, reasoning ability, etc.
115
List some social treatment methods.
Family education and family therapy, group therapy, social skills training, inpatient treatment, community-based interventions, vocational rehabilitation, etc.
116
How does social skills training help with schizophrenia?
Breaks social cues into parts, like making eye contact, etc; repeated to overcome neurocognitive memory problem; applied in therapy with psychiatrist for practice, etc.
117
What is community care?
Programs that allow mental health care providers to visit patients in their homes at any time of the day or night; helps patients live outside of institutions and get re-involved in the community/world
