Sz and Related Disorders Flashcards
(31 cards)
What are the two most common types of hallucinations in schizophrenia?
Auditory hallucinations – Hearing voices or sounds.
Visual hallucinations – Seeing things that aren’t there.
What is the prevalence of schizophrenia in the general population vs. children of two affected parents?
General population: ~1%
With two schizophrenic parents: ~46% risk
What are the “Four A’s” of schizophrenia according to Eugen Bleuler?
Affect – Blunted or inappropriate emotions
Association – Disordered thinking and speech
Ambivalence – Conflicting feelings or thoughts
Autism – Social withdrawal and inward focus
Is “split brain” a better description of DID or schizophrenia? Why?
It’s more accurate for Dissociative Identity Disorder (DID) because DID involves a split in identity or personality, while schizophrenia involves a split in thinking, emotion, and perception, not identity.
How did Kraepelin define dementia praecox, and how did his view differ from Bleuler’s?
Kraepelin: Defined dementia praecox as a progressive, irreversible disorder with early onset and decline.
Bleuler: Renamed it schizophrenia and believed it had a more variable course, not always leading to deterioration .
What environmental circumstances, both in childhood and in later life, hypothesized to be risk
factors for schizophrenia?
Childhood: Prenatal exposure to infection, complications during pregnancy or delivery, and early brain injury.
Later life: Stressful life events, high family expressed emotion, cannabis use in adolescence.
What are thought echoing, insertion, and withdrawal?
Thought echoing: Hearing one’s own thoughts spoken aloud.
Thought insertion: Belief that thoughts are being placed into one’s mind by an external source.
Thought withdrawal: Belief that thoughts are being removed from one’s mind by someone or something else.
What was Kurt Schneider’s objection to Bleuler’s “Four A’s,” and what did he propose instead?
Schneider thought Bleuler’s Four A’s were too broad and hard to diagnose. He proposed focusing on First-Rank Symptoms—specific psychotic features strongly suggestive of schizophrenia.
What are Schneider’s First-Rank and Second-Rank Symptoms?
First-Rank: Include thought insertion, withdrawal, broadcasting; auditory hallucinations (e.g., voices commenting); and delusions of control.
Second-Rank: Include other symptoms like mood changes, social withdrawal, and less specific disturbances.
Are people with treated schizophrenia usually dangerous to others or themselves?
To others: Rarely. Most treated individuals are not violent and are more likely to be victims.
To themselves: Yes—higher suicide risk, especially early in treatment or after relapse.
How can delusions interfere with treating schizophrenia?
Delusions can cause mistrust of doctors, refusal to take medication, and poor insight into illness, all of which make treatment harder.
What are the typical phases in the progression of schizophrenia?
Prodromal Phase – Subtle symptoms (withdrawal, odd thoughts) begin.
Active Phase – Full symptoms appear (delusions, hallucinations, disorganized speech).
Residual Phase – Major symptoms fade, but some impairment remains.
What are the main thought and speech disturbances in schizophrenia?
Loose associations: Ideas shift with little connection.
Neologisms: Made-up words with personal meaning.
Clang associations: Speech driven by rhyme, not meaning.
Perseveration: Repeating words or ideas.
Blocking: Sudden interruption of thought or speech.
Word salad: Jumbled, incoherent speech.
What are cognitive and emotional abnormalities in schizophrenia?
Cognitive: Poor attention, memory issues, impaired executive function (planning, problem-solving).
Emotional: Flat or inappropriate affect, trouble recognizing others’ emotions, poor emotional regulation.
What’s the difference between positive and negative symptoms of schizophrenia?
Positive symptoms: Excesses or distortions (e.g., delusions, hallucinations, disorganized speech).
Negative symptoms: Losses or deficits (e.g., flat affect, lack of motivation, social withdrawal).
What subtypes of schizophrenia were in earlier DSM versions but removed in DSM-5?
Paranoid: Dominated by delusions or hallucinations.
Disorganized: Disorganized speech, behavior, flat/inappropriate affect.
Catatonic: Motor immobility or excessive movement.
Undifferentiated: Mixed symptoms that don’t fit one subtype.
Residual: Fewer active symptoms, but still impaired.
What is Crow’s distinction between Type I and Type II schizophrenia?
Type I: Dominated by positive symptoms (e.g., delusions, hallucinations); better treatment response; may involve excess dopamine.
Type II: Dominated by negative symptoms (e.g., flat affect, withdrawal); poorer prognosis; linked to brain structural abnormalities
What does “lack of ego boundaries” mean in schizophrenia?
It refers to difficulty distinguishing the self from others or the external world—leading to confusion between inner thoughts and external reality.
What are the main DSM-5 diagnostic criteria for schizophrenia?
Two or more symptoms for 1 month, with signs lasting at least 6 months:
Delusions
Hallucinations
Disorganized speech
Disorganized or catatonic behavior
Negative symptoms (e.g., flat affect)
What’s the difference between schizophrenia and schizophreniform disorder?
Schizophrenia: Symptoms last at least 6 months.
Schizophreniform disorder: Same symptoms, but last more than 1 month and less than 6 months .
How do we distinguish between schizophrenia and schizoaffective disorder? Why is it hard?
Schizophrenia: Mood symptoms are brief or secondary.
Schizoaffective disorder: Mood symptoms (depression or mania) are present for a substantial part of the illness, with at least 2 weeks of psychosis alone.
Hard to distinguish: Because mood and psychotic symptoms often overlap or fluctuate
A man in his 40s suddenly shows psychotic symptoms with no prior history or substance use. Is it likely schizophrenia? If not, what is more likely?
Unlikely schizophrenia—it usually starts earlier and builds gradually. A brief psychotic disorder or medical condition is more likely, given the sudden onset in midlife with no prior history
What is the relationship between schizotypal personality disorder and schizophrenia?
Schizotypal personality disorder shares features with schizophrenia (odd thinking, paranoia, social anxiety), but symptoms are less severe and do not include full psychosis. It’s considered part of the schizophrenia spectrum
What is primary narcissism, and how does Harry Stack Sullivan’s psychodynamic theory explain schizophrenia?
Primary narcissism: A regression to an early stage where the self is the focus, common in psychodynamic views of schizophrenia.
Sullivan’s view: Schizophrenia arises from interpersonal failures and withdrawal due to early mistrust and anxiety, leading to distorted self-perception and social disconnection
