mental illness - personality and schizophrenia Flashcards

1
Q

what is a personality disorder? formal diagnosis? (adolescence, stable, variet, distress)

A
  • deeply ingrained and inflexible pattern of thinking, feeling and relating to others or controlling impulses that cause distress or impaired functioning
  • Adolescence: symptoms appear in adolescence – if they appear in adulthood you don’t have PD
  • Inflexible
  • Stable: stable pattern of reacting
  • variety of situations: behave the same way in different places, to strangers, etco
  • Distress/impairment
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2
Q

3 categories of personality disorders to know?

A
  • Odd/eccentric: others exploiting them, trying to harm them or lying to them, trustworthiness so can’t relationships, introversion, hidden meanings in everything, weird ways of speaking and dressing, strange beliefs
  • Dramatic/erratic: disregards social norms, illegal things, lies ,lack of remorse, unstable moods, attention seeking, inflated ego, physical fights not uncommon, high risk for substance abuse, alcoholism
  • Anxious/inhibited: obsessive compulsive, avoid interpersonal contact because they are afraid of criticism, rejection, disapproval]
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3
Q

Borderline Personality Disorder - what? growing up?

A
  • instability in mood, identity and impulse control
    o calm and pleasant one moment, aggressive the next
  • Self-destructive: cutting themselves, suicide attempts
  • Dangerous promiscuity – numerous sexual partners, over eat, over indulge in drugs and alcohol
  • While growing up, had cold unempathetic mothers or overreacting mothers & difficulty with emotions  made them angry and frustrated, left with no coping skills
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4
Q

Antisocial Personality Disorder (APD) - what? characteristics?

A
  • pervasive pattern of disregard for & violation of others’ rights that begins in childhood or early adolescence & continues into adulthood
  • aggressive, violent, dangerous
  • constant lying, lack of remorse, narcissism, bored very easily, need constant stimulation, violent tendencies
  • So impulsive, hard to hold down a job
  • But can appear to be very charming
  • Dangerous because of complete disregard for safety
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5
Q

APD: diagnose how? %? biological cause? risk factors?

A
  • To be diagnosed: have to have symptoms arise in adolescence
  • History of conduct disorder before age 15: aggression, destruction of property, rule violations, lying, stealing, setting fire, cruelty to animals
  • Diagnosis of APD if at least 3/7 signs: illegal behaviour, deception, impulsivity, physical aggression, recklessness, irresponsibility, lack of remorse
  • Characteristics: constant lying, lack of remorse, narcissism, bored very easily, need constant stimulation, violent tendencies
    o So impulsive, hard to hold down a job
    o But can appear to be very charming
    o Dangerous because of complete disregard for safety
    o American Psycho video clip example
    o “sociopath”, “psychopath”
  • 3.6% of general population, male rate three times higher
  • No clear biological cause  but suggested by early onset and lack of success in treatment
    o Less sensitivity to fear: psychopaths show less activity in amygdala and hippocampus in response to negative emotional words
    o
  • Risk factors: substance abuse, ADHD, conduct disorders, childhood abuse or neglect, antisocial peers, antisocial or alcoholic parents
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6
Q

Psychopathy - what? combination of? characteristics?

A
  • specific form of APD, a controversial category
  • like a stronger, more extreme APD
  • combination of antisocial behaviours and lack of remorse or guilt
  • Guiltless, dishonest, manipulative, unempathetic, self-centered, highly paranoid but at the same time: charming, personable & engaging
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7
Q

Schizophrenia - what? not the same as?

A
  • psychotic disorder marked by severely impaired thinking, emotions and/or behaviours
  • profound disruption of basic psychological processes – distorted perception of reality, altered or blunted emotion, disturbances in thought, motivation and behaviour
  • “Split mind” not split identity
  • not the same as dissociative identity disorder
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8
Q

Schiz - % canadians? living where? gender? develops when?

A
  • 1% population over 18 in Canada is schizophrenic
  • One half of schizophrenics live at home/group home, one quarter are in jail, and the other quarter live on the streets
  • Slightly more common in men
  • Rarely develops before early adolescence - first episode usually late adolescence/early adulthood
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9
Q

Schiz - DSM requirements?

A
  • DSMIVTR: diagnosed when two or more of the following symptoms emerge during a continuous period of at least one month, with signs of disorder persisting for at least 6 months:
    o Delusions, hallucinations, disorganized speech, grossly disorganize behaviour or catatonic behaviour, and negative symptoms
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10
Q

Schiz - Positive Symptoms?

A
  • doesn’t mean good or nice, present in the schizophrenic mind but not in a normal mind
  • Aka the “haves” – things added to a normal mind
  • Delusions, paranoia, persecution, thought broadcasting, thought disorder, grandiose thinking, mind reading, being controlled/controlling, movement problems: motionless, clumsy, repetitive actions, hallucinations,
  • anosognosia: lack of insight, not denial
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11
Q

Schiz - Hallucinations?

A
  • False perceptual experience that has a compelling sense of being real despite absence of external stimulation
  • sensory in nature, when you see/hear something that’s not there
  • Most common form of hallucination is not visual but auditory (65%)
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12
Q

Schiz - Delusions - persecution? grandeur? control? jealousy? identity?

A
  • Patently false belief system, often bizarre and grandiose, that is maintained In spite of its irrationality
  • unusual thought process – ex thinking that the neighbour’s dog is controlling your mind
  • persecution: person thinks that other people are out to get them
  • grandeur: thinks that he/she is destined to do something incredibly important alike saving humanity
  • control: someone else is controlling their mind or behaviour – recurrent obsessive thoughts because someone is controlling their mind
  • jealousy: absolutely convinced that their loved one is cheating on them, conspiring against them, loving someone else
  • identity (think that they’re some famous person)
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13
Q

Schiz - negative symptoms?

A
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14
Q

Schiz Types - Paranoid

A
  • preoccupied with delusions and hallucinations that revolve around a common organized theme, usually one of persecution
  • great deal of time thinking about how to protect themselves
  • impairs critical judgment -> erratic, unpredictable and occasionally dangerous behaviours
  • Most highly functioning of all schizophrenics – can have a job, attend university, very intelligent
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15
Q

Schiz Types - Catatonic?

A
  • mmobility/ stupor or agitated/purposeless motor activity
  • psychomotor disturbance
  • alternating periods of extreme withdrawal and extreme excitement
  • Withdrawal: sudden loss of all animation, tendency to remain motionless in a single position
  • Abrupt change to excitement: shouting, pacing, uninhibited, impulsive and frenzied behaviour =potentially dangerous
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16
Q

Schiz types - disorganized?

A
  • disorganized speech, behaviour, flat/inappropriate emotion
  • Usually occurs at an earlier age, most severe
  • Emotional distortion and blunting: inappropriate laughter and silliness, peculiar mannerisms, bizarre and obscene behaviour
  • Disorganized thinking: illogical thoughts, nonsensical thinking process
  • Clang associations: when they talk they spew out a bunch of words that have nothing in common except they rhyme
17
Q

Schiz Types - undifferentiated? residual?

A
  • U: don’t fall into any category
  • Pattern of symptoms with a rapidly changing mixture of all of most of the primary indicators of schizophrenia
  • R: recovering but with lingering symptoms
18
Q

Schiz - genetic factors?

A
  • Probably a strong genetic component
  • 48 vs. 17% MZ vs DZ twins concordance rates
  • Closer genetic relatedness to schizophrenic = greater likelihood of developing S
  • Genetics a strong predisposing role, but prenatal/perinatal environment also affects it
19
Q

Schiz - biochemical?

A
  • Biochemical factors
    o Discovery that lowering levels of dopamine (NT) reduces symptoms
    o Dopamine hypothesis: idea that schizophrenia involves an excess of dopamine activity
    o Amphetamines increase dopamine levels, usually aggravate symptoms
    o Evidence that this hypothesis is inadequate
     Too much dopamine in schizophrenics – too much activity
     Excessive dopamine is the cause of positive symptoms in the mesolimbic pathway
     Too little dopamine in the mesocortical pathway associated with negative symptoms
     Drugs that block dopamine receptors help
  • Neuroanatomy
20
Q

Schiz - neuroanatomy?

A
  • Ventricles : abnormally larger (hollow areas filled with CSF)
  • Suggests loss of brain tissue mass, maybe from prenatal development anomalies
  • Brain tissue loss in adolescent S: parietal areas continuing on to most of the cortex
21
Q

Dissociative Disorders

A
22
Q

Dissociation - depersonalization and derealization?

A

Depersonalization: problem with self-awareness – a feeling of watching yourself act, you have no control, your body is acting and you are just watching, numbness to sensory qualities

o Derealization: feeling that the external world is not quite real, dream like quality to everything, characterized by feeling of emotional flatness, greyness, like real world is 2D,

23
Q

Dissociative Identify Disorder (DID) - what? prevalence %? genders?

A
  • presence of two or more distinct identities within one person that can control the person’s behaviour at different times
  • 0.5-1.0% Canadians have it
  • Female:male= 9:1
  • Most patients diagnosed in 20s or 30s but actual onset probably during childhood
24
Q

Dissociative Amnesia

A
  • sudden loss of memory for personal information - name, address, life events but otherwise, you’re still you
  • memory loss is typically for traumatic specific events or a period of time, but can involve extended periods of a person’s life too – like months or years
25
Q

Dissociative Fugue

A
  • Like DA, but more severe: loss of memory of personal history and sudden departure from home followed by assuming of a new identity
  • Fugue states don’t typically last very long – hours, weeks, months