Schizophrenia

Question 1

What are acute episodes characterized by?

Answer 1

Delusions, hallucinations, illogical thinking, incoherent speech and bizarre behaviour

Question 2

What do people experience between episodes?

Answer 2

May still be unable to think clearly and may lack appropriate emotional responses to people and events in their lives

Question 3

Schizophrenia affects…

Answer 3

thoughts, speech and behaviour

Touches every facet of a person’s life

Question 4

Emil Kraeplin originally called schizophrenia by this name…

Answer 4

Dementia Praecox- out of one’s mind, general deterioration of your abilities, attributed to some physical or mental cause

Question 5

Eugen Bleuler changed the name to schizophrenia and referred to the 4 A’s

Answer 5

Associations: relationships among thoughts become disturbed
Affect: emotional responses become flattened or inappropriate
Ambivalence: hold conflicting feelings toward others
Autism: withdrawal into a private fantasy world that is not bound by principles of logic

Question 6

Kurt Schneider came up with the concept of First-rank symptoms and second-rank symptoms. What are they?

Answer 6

First rank: central to the diagnosis, have to have these to be diagnosed (hallucinations and delusions)

Second rank: symptoms associated with schizophrenia that also occur in other psychological conditions (disturbances in mood and confused thinking)

Question 7

What is the problem with first and second rank symptoms?

Answer 7

Other people can experience hallucinations and delusions in other disorders as well

Question 8

The earlier you are diagnosed, the more….

Answer 8

severe the disorder will be

Question 9

What is the Prodromal phase?

Answer 9

Deterioration phase- waning interest in social activities and increasing difficulty in meeting the responsibilities of daily living

Question 10

What is Residual phase?

Answer 10

Behaviour returns to the level that was characteristic in functioning prior to the first acute phase

Question 11

Is full return to normal behaviour common?

Answer 11

No, but it may occur

Question 12

What are the 4 disturbances in the CONTENT of thought?

Answer 12

• Delusions of persecution: “police are out to get me”
• Delusions of reference: “the people on the bus are talking about me”
• Delusions of being controlled: believing thoughts and feelings are being controlled by external forces such as agents or devils
• Delusions of Grandeur: believing oneself to be Jesus or be on a special mission

Question 13

What are some common forms of delusions?

Answer 13

1) Thought Broadcasting- believing that one’s thoughts are somehow transmitted to the external world so that others can overhear them
2) Thought Insertion- believing that one’s thoughts have been planted in one’s mind by an external source
3) Thought Withdrawal- Believing that thoughts have been removed from one’s mind

Question 14

Disturbances in FORM of thought

Answer 14

• Thought disorder: breakdown in organization and control of thoughts
• Neologisms: words made up by speaker, have no meaning to others
• Perseveration: inappropriate but persistent repetition of the same words or train of thought
• Clanging: stringing together of words or sounds that rhyme
• Blocking: involuntary abrupt interruption of speech or thought

Question 15

What is hyper-vigilance?

Answer 15

An attentional deficit characterized by acute sensitivity to extraneous sounds, especially during the early stages of the disorder

Question 16

What perceptual disturbances are experienced?

Answer 16

Auditory hallucinations in 60% of cases

Command hallucinations- belief that there are commands you have to obey

Question 17

What are the causes of hallucinations?

Answer 17

Increased dopamine because receptors are overactive

Question 18

What type of emotional disturbances are experienced?

Answer 18

Flat affect: minimal emotions, neutral, low energy

Question 19

What is Stupor?

Answer 19

State of relative or complete unconsciousness in which a person is not generally aware of or responsive to the environment

Question 20

What is Type 1 Schizophrenia?

Answer 20

Type 1 involves Positive symptoms: the presence of abnormal behaviour
- such as hallucinations, delusions, thought disorder, disorganized speech and inappropriate affect

Question 21

What is Type II Schizophrenia?

Answer 21

Type II involves Negative symptoms: absence of normal behaviour
- such as social skills deficits, social withdrawal, flattened affect, psychomotor retardation, failure to experience pleasure

Question 22

Which type is more likely to respond to medication?

Answer 22

Type 1

type 2 is more difficult to treat

Question 23

What is the first line of treatment for schizophrenia?

Answer 23

Medications

Question 24

Is Premorbid functioning better in Type 1 or 2?

Answer 24

Better in Type 1

Question 25

Psychodynamic Perspective

Answer 25

Primary narcissism: person regresses to early period in the oral stage because we are too overwhelmed Harry Stack Sullivan: mother-child relationships that were anxious and hostile so the child takes refuge in fantasy world

Question 26

Learning Perspective

Answer 26

Ulmann and Krasner: Reinforcement, children may grow up in non-reinforcing environments and never learn to respond appropriately to social stimuli

Question 27

Biological Perspective

Answer 27

Used the cross fostering studies the examine differences in prevalence among adoptives 10x more likely to get schizophrenia if you have a biological relative with it. Closer the relative, higher the risk

Question 28

Biochemical factors

Answer 28

Dopamine: do not produce more dopamine, just have a greater than normal number of receptors that are overly sensitive to dopamine Neuroleptic drugs: block dopamine receptors --> side effect makes you crave sugar

Question 29

Theories that schizophrenia is a viral infections

Answer 29

A slow acting virus that attacks the developing brain of a fetus or newborn

Question 30

Brain Abnormalities as a cause of schizophrenia

Answer 30

Hippocampus: impairs memory Amygdala: impairs emotions

Question 31

What is the Schizophrenogenic Mother?

Answer 31

Family theory: a cold, aloof, but also overprotective and domineering mother. Father is more passive

Question 32

What is Double-bind communications theory?

Answer 32

Family theory: The transmission of contradictory or mixed messages

Question 33

What is Communication Deviance?

Answer 33

Family theory: Unclear, vague, disruptive, or fragmented parental communication

Question 34

What is Expressed Emotion-negative?

Answer 34

Family Theory: hostile, critical, and unsupportive of the schizophrenic family member which is more harmful for the treatment and outcome

Question 35

Families can be seen as either causes or sources of stress

Answer 35

Increase risk is disturbed communication and emotional interaction

Question 36

Biological treatments

Answer 36

Antipsychotic drugs: Phenothiazines (Haldol) help with hallucination and delusions

Question 37

What is a bad side effect of phenothiazine antipsychotics?

Answer 37

Tardive Dyskinesia: movement disorder characterized by involuntary movements of the face, mouth, neck, extremities. -most common is eye blinking 25% develop this If you stop the drugs once you get TD, 40% will relapse

Question 38

Psychoanalytic approach to treatment

Answer 38

Personal therapy: not well suited for schizophrenia..

Question 39

Learning based approaches to treatment

Answer 39

- Selective reinforcement of desired behaviours - Token Economy - Social skills training

Question 40

Psychosocial rehabilitiation

Answer 40

Self-help groups: usually run by non professionals, people with schizophrenia Community programs: housing, jobs, education

Question 41

Family Intervention programs

Answer 41

Practical aspects of daily living, educating family members, improving communication

Question 42

Early Intervention Programs

Answer 42

Reduced disruption of activities, reduced likelihood of hospitalization, reduced disability, improved self-identity and self-esteem

Question 43

Schizophrenia Video: - Why did they first seek help? - What was the treatment used to help manage it? - What were some of the barriers to treatment? - What is the prognosis of individuals with schizophrenia?

Answer 43

1) Seek help when they have first psychotic break, hallucinations, usually when they committed a crime 2) Medications and therapy were used (respiratol), support groups, social skills training 3) Barriers = stigmas and medication compliance 4) Living dysfunctional lives