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Abnormal Psychology > Exam 3 > Flashcards

Exam 3 Flashcards

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1
Q

What is Schizophrenia?

A

A prototypical psychotic disorder in DSM

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2
Q

How can you characterize Schizophrenia?

A

-A deterioration from a normal level of functioning to becoming ineffective in dealing with the world
-Loss of Contact with reality
-A chronic life-long illness
-Impacts multiple aspects of human cognition, emotion, and behavior

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3
Q

What is the lifetime prevalence of Schizophrenia?

A

1%

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4
Q

What is the age of onset of Schizophrenia?

A

-adolescence; occurs during the late teenage years
-peak ages: M (15-25) F (25-35)
-first break usually occurs under stress

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5
Q

What is the sex ratio of Schizophrenia?

A

1:1 (males are diagnosed earlier with a worse prognosis)

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6
Q

What brain systems are affected by Schizophrenia?

A

Nearly all

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7
Q

What is the prognosis of Schizophrenia?

A

-poor (up to 70% will require permanent care)
-women may have a better prognosis
-men more impaired by negative symptoms
-20-30% lead fairly normal lives
-20-30% continue to experience moderate symptoms
-40-60% remain significantly impaired for the rest of their lives; much poorer outcome than mood disorders

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8
Q

Does Schizophrenia lead to increased mortality?

A

-Yes
-50% attempt suicide
-10-15% commit suicuide

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9
Q

Who is Kraepelin (1899)?

A

-he described schizophrenia as dementia praecox
-emphasized cognitive deterioration and early onset
-chronic, deteriorating course

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10
Q

Who is Bleuler (1911)?

A

-combined greek words that mean “split” and “mind”
-distinguished between types of symptoms; fundamental (negative) and accessory (positive)

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11
Q

What are fundamental (negative) symptoms?

A

-disturbance of association
-affective blunting
-ambivalence
-autism

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12
Q

What are accessory (positive) symptoms?

A

-delusions
-hallucinations

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13
Q

How would you define positive symptoms?

A

-present in patients but not normal people
-bizarre additions to a person’s behavior

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14
Q

What are delusions (positive symptoms)?

A

-a strangely held false belief firmly held despite evidence to the contrary
-often help to make sense of hallucinations
-must make sure that delusions are an individual’s own beliefs and not those of a specific group

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15
Q

What are the types of delusions?

A

-grandeur – e.g., “I am Jesus”
-ideas of reference – e.g., “the newscaster was talking about me”
-persecution – e.g., feeling that someone is plotting against him/her
-control – thoughts being controlled by someone else

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16
Q

What are disorganized speech and thought (positive symptoms)?

A

-formal thought disorder: a disturbance in the production and organization of speech and
thought

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17
Q

What are common forms of formal thought disorders (positive symptoms)?

A

-loose associations (a.k.a. derailment)
* characterized by rapid shifts from one topic of conversation to another
* a common thinking disturbance in schizophrenia
-use of neologisms
* made-up words that typically have meaning only to the individuals using them
-perseveration can also add to disorganized speech and thought
* in which they repeat their words and statements again and again
-use of clang (i.e., rhyme) to think or express themselves

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18
Q

What are heightened perceptions (positive symptoms)?

A

-heightened perceptions: perceptions from the environment intensify; leading to attention and perception problems

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19
Q

What are hallucinations (positive symptoms)?

A

-perceptions that occur in the absence of external stimuli
-perceptual distortions, frequently accusatory

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20
Q

What are the types of hallucinations?

A

-auditory: most common, frequently out of nowhere, sometimes from inanimate objects
-visual
-tactile
-somatic
-gustatory
-olfactory

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21
Q

What are inappropriate affects (positive symptoms)?

A

-emotions that are unsuited to the situation
-examples: Smiling while receiving bad news; upset by something that should make them happy

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22
Q

How would you define negative symptoms?

A

-absent in patients but present in normal people
-symptoms that are “pathological deficits” or
characteristics that are lacking in an individual

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23
Q

What is alogia (poverty of speech) (negative symptom)?

A

-impoverished mental activity
-the poverty of speech and of speech content
-a reduction in speech or speech content
-considered a formal thought disorder
-volume of speech and number of ideas expressed are reduced

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24
Q

What is blunted and flat affect (negative symptom)?

A

-blunted affect: people show less of an emotion or feeling
-flat affect: people show almost no emotions at all
-still faces; poor eye contact, monotonous voice; anhedonia (general lack of pleasures or enjoyment)

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25
What is loss of volition (a.k.a avolition) (negative symptom)?
-marked by apathy and inability to start or complete a course of action -common in people who have had schizophrenia for many years
26
What is social withdrawal (negative symptom)?
-may withdraw from the social environment and only attend to their own ideas and fantasies
27
What are psychomotor symptoms?
-awkward movements, odd gestures, repeated grimaces -often private purposed behind gestures (e.g., ritualistic, magical)
28
What is catatonia?
-person is in a catatonic stupor -stop responding to the environment -remain motionless and silent for long stretches of time
29
What are the characteristic symptoms of Schizophrenia according to the DSM-5?
-must have 2 or more symptoms in 1 month: -delusions -hallucinations -disorganized speech -disorganized/catatonic behavior -negative symptoms (flat affect, alogia, avolition)
30
What are the social/occupational diagnostic criteria for Schizophrenia?
one or more areas of major functioning are markedly impaired
31
How long do symptoms have to last to be diagnosed with Scihzphrennia according to the DSM-5?
-signs of continuous disturbance for at least six months
32
What are the exclusions to being diagnosed with Schizophrenia according to the DSM-5?
-mood disorders -substance abuse/general medical conditions -pervasive developmental disorders
33
Among the DSM-IV subtypes, which two categories had the most optimistic prognosis?
catatonic and paranoid have the most optimistic prognosis
34
What are the three main phases of Schizophrenia?
-prodromal: some (+) and (–) symptoms; obvious functional impairment -active: (+) and (–) symptoms -residual: mainly (–) symptoms; lots of impairment and odd behavior *positive symptoms ted to decrease over time while negative symptoms become more severe
35
What are the levels of functioning among patients with Schizophrenia?
-premorbid phase: cognitive, motor, or social deficits -prodromal phase: non-specific SxS mild psychotic symptoms, functional decline -acute phase: florid psychotic symptoms, tendency to relapse, period of relative remission -chronic residual phase: negative symptoms, cognitive/social deficits, functional disabilities, psychotic SxS less prominent
36
What is the difference between process vs reactive prognosis?
-poor prognosis IF process: poor premorbid functioning, introverted, young onset, not married -good prognosis IF reactive: late onset, married, positive symptoms, good support system
37
What is Schizophreniform Disorder (differential diagnosis)?
identical except duration is 1-6 months; do not exceed 6 months
38
What is Brief Psychotic Disorder (differential diagnosis)?
may include positive symptoms, no negative symptoms, duration 1 day to 1 month
39
What is Schizoaffective Disorder (differential diagnosis)?
positive or negative symptoms of schizophrenia plus meet criteria for major depressive or manic episodes
40
What is delusional disorder (differential diagnosis)?
non-bizarre delusions but lack other symptoms of schizophrenia; delusions may be of any type
41
What is shared psychotic disorder (differential diagnosis)?
One psychotic person influences a "normal" person who then develops similar symptoms
42
What is the stress-diathesis model?
the idea that the environment, genetics, and develop all contribute to neuroanatomical, neurofunctional, and neurochemical abnormalities
43
What are some treatments to help manage Schizophrenia?
-antipsychotic medications -family psychoeducation: teaching family how to act is extremely important -assertive community treatment: health care professionals wrap services around individuals; go to home to administer medicine, therapy, etc.
44
What are some additional services to help individuals with Schizophrenia?
-educational/vocational adjustments -housing and financial assistance -supportive therapy: individual and group -cognitive-behavioral psychotherapy
45
What are the biological etiological theories surrounding the onset of Schizophrenia?
-biological evidence: pieces of evidence support biological underpinnings but no dominant theory -birth complications: if lead to fetal anoxia/hypoxia seems to increase the risk for schizophrenia -viral hypothesis: schizophrenia found to be more common in people born in winter/early spring; taken to indicate a viral infection factor -Helsinki, 1957: big flu outbreak; rates of schizophrenia much higher for children exposed to flu virus during the second trimester -Rubella, HSV2, toxoplasma gondii
46
What are the genetic etiological theories surrounding Schizophrenia?
-Adoption Studies: -assess heritability by examining the resemblance of adopted children with biological and adoptive parents -Heston (1966): 18% of adopted children (n = 50) from mothers with schizophrenia developed schizophrenia themselves at the 20- year follow-up; none of those with non-schizophrenia mothers (n = 47) developed schizophrenia Twin Studies -assess the resemblance between monozygotic and dizygotic twins -Hilker et al. (2017) found the heritability of schizophrenia among identical twins to be .79 when using a new statistical method.
47
What is the dopamine hypothesis?
-basic hypothesis: Schizophrenia results from too much dopaminergic activity -evidence: -antipsychotic drugs decrease dopamine levels -amphetamines, which increase dopamine, mimic psychotic symptoms
48
What are structural abnormality etiological theories regarding Schihzphhrena?
abnormalities are diffuse; no specific, focal region is affected. Must also account for environmental factors
49
What are the environrmatal factors of Schizophrenia?
-migration/immigration -urban upbringing; stimulus overload; stress that comes with living with a lot of people -traumatic events early in life -illicit drug use (cannabis and amphetamines) -stressors -other emotional triggers -relevant for re-manifestation of psychotic episodes: -psychosocial stress -expressed emotion
50
What is the relationship between Schizophrenia and income level?
-schizophrenia causes lower SES: as Sz develops, the person drifts into poverty and low SES (downward drift theory) -lower SES causes Schizophrenia: stress of low SES contributes to disease onset
51
What is the Leff (1976) study?
-schizophrenia and sensitivity to family - Risk of readmission: -30% if with spouse/parents ¡ 11% if alone -Suggests that emotional over-involvement might be related to relapse -High Expressed Emotion (EE) -Over-involvement + hostility = higher relapse -High EE Homes = 51% ÷ Low EE Homes = 13%
52
What is Hogarty's (1991) study?
-family psychoeducation, social skills training, chemotherapy; Studied relapse and adjustment -103 patients in high Expressed Emotion homes, 4 conditions -intervention; 1-year relapse rate -medication only - 40% -medication and family psychoeducational - 20% -medication and social skills training - 20% -medication, family psychoeducation, and social skills training - 0%
53
What is Day et al. (1987) study?
-30 patients with recently diagnosed Sz (mean age =23 years; 73% males; mean educ = 12 years) -followed for one year prospectively -found a significantly higher number of stressful life events in the month prior to psychotic relapse when compared to months without relapse. -thus, life events can trigger the return of psychosis.
54
What are examples of externalizing psychopathology disorders?
-oppositional defiant disorder (ODD) -conduct disorder (CD) -AD(H)D -antisocial personality dsioder
55
What do all externalizing psychopathology disorders have in common?
impulsivity
56
How can you differentiate antisocial behavior through the lifespan?
-toddlerhood (1-2 age): irritable, difficult temperament -preschool (3-4 age): harshly defiant, argumentative behavior -school-age (5-11): fighting, lying, petty theft -preadolescence (junior high): assault, sexual activity -adolescence: robbery, substance abuse -adulthood: repetitive criminal activities, callous relationships, and spousal/child abuse
57
What is oppositional defiant disorder?
-a fairly common disorder of childhood, with estimates ranging from 2-16% -males > females before puberty; equal rates after puberty -males have more confrontational and more likely to have persistent symptoms -ODD is the developmental precursor of conduct disorder when symptoms become more serious
58
How would you define ODD according to the DSM?
-pattern of negativistic, hostile, and defiant behavior lasting at least 6 months. 4 or more of the following symptoms need to be present: -often loses temper -argues with adults -actively defies or refuses to comply with adults requests/rules -deliberately annoys people -blames others for own mistakes/misbehavior * touchy or easily annoyed by others -angry and resentful -spiteful or vindictive
59
How would you describe the behavior of a patient with ODD?
-behaviors must occur more frequently than typically observed in individuals of comparable age and developmental level (use caution during adolescence and preschool age) -affects the ability to function in school, home, or community -behaviors do not occur exclusively during a psychotic or mood disorder -criteria are not met for conduct disorder (CD trumps ODD)
60
What is conduct disorder (CD)?
-persistent pattern of behavior in which the basic rights of others and major age-appropriate societal norms or rules are violated -CD is the most common reason for referral to inpatient clinics and hospitals in the U.S
61
What is the prevalence of Conduct Disorder?
-prevalence = 4 to 10% -more prevalent in boys (3:1): -boys – direct aggression (physical), confrontation -girls – indirect aggression (mental), group affiliation -genetic and environmental etiology -heritability of aggressive behavior = .52 to .94

Abnormal Psychology (1 decks)

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