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Flashcards in Task 8 Schizophrenia Deck (50)
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experiences and beliefs that are not in touch with reality



If you are unable to tell the difference what is real and what not (most prominent is schizophrenia)



ideas that an individual beliefs are true but are highly unlikely and often simply impossible (preoccupied)
o Different types of delusions can cooccur
o Persecutory delusion: False belief that oneself or one’s loved ones are being persecuted, watched, or conspired against by others
o Delusions of reference: Belief that everyday events, objects, or other people have an unusual personal significance
o Grandiose delusion: False belief that one has great power, knowledge, or talent or that one is a famous and powerful person
o Delusions of being controlled: Belief that one’s thoughts, feelings, or behaviours are being imposed or controlled by an external force
o Thought broadcasting: Belief that one’s thoughts are being broadcast from one’s mind for others to hear
o Thought insertion: Belief that another person or object is inserting thoughts into one’s mind
o Thought withdrawal: Belief that thoughts are being removed from one’s mind by another person or by an object
o Delusions of guilt or sin: False that one has committed a terrible act or is responsible for a terrible event
o Somatic delusion: False belief that one’s appearance or part of one’s body is diseased or altered



o Healthy people do sometimes experience hallucinations, but they do not impair their daily function
o In schizophrenia they are more frequent, persistent, complex, bizarre and often entwined with delusions


Auditory hallucinations

most common, e.g. speaking about the individual in third person or giving commands and instructions
 Often negative quality
o Can occur in depression and bipolar too
o Cultural background can influence the content, same as with delusions


Visual hallucinations

seeing not existing things


Tactile hallucinations

involve the perception that something is happening to the outside of the persons body, e.g. bugs crawling up her back


Somatic hallucinations

perception that something is happening inside the persons body, e.g. worms eating the intestines


Disorganized thought and speech

o Formal thought disorder: disorganized thinking of people with schizophrenia
o Loose associations: the tendency to switch to seemingly unrelated topics
o Neologism: making up words that only make sense for them
o Clangs: making up associations because of same sounds of words rather than content
o More common in men because language centrum is only in one site of brain in women its more bilateral


Disorganized behaviour

o May display unpredictable and apparently untriggered agitation , e.g. suddenly shouting
 Might be a response to delusions or hallucinations
o Often show problems with task as getting dressed because of impairments in memory and attention ´



unresponsiveness to the environment
 Negativism: lack of response to instructions
 Mutism: rigid, inappropriate, or bizarre posture, to a complete lack of verbal or motor responses
 Catatonic excitement: purposeless and excessive motor activity for no apparent reason


Negative symptoms

o Labelled this way because it involves the loss of certain qualities
o Tend to be persistent and more difficult to treat compared to positive symptoms


Restricted affect (negative symptom)

 Refers to a severe reduction in or absence of emotional expression in persons with schizophrenia
 People report anhedonia, the loss of the ability to experience pleasure (might be falsified by self-report)
 Might still experience emotions just can’t show them


Avolition (negative symptom)

inability to initiate or persist at common, goal directed activities
• Slowed down in movements and seems unmotivated
• May be expressed as asociality, the lack of desire to interact with other people
o Can only be diagnosed of indviduals have access to welcoming family and friends but show no interest in socializing with them (often they are dropped by family and friends)


Cognitive deficits (negative symptom)

• Deficits in attention, memory, working memory and processing speed
• Might be the underlying cause for the other symptoms (e.g. distinguish real from unreal)
• Cognitive deficits can be used as indication for later development of schizophrenia


Prognosis of schizophrenia

o Between 50 and 80% will be rehospitalized after the first hospitalization
o 10 years shorter life expectancy
o Suffer more form infectious and circulatory disease
o 10 to 15% commit suicide
o 15 year study found 41% had at least one or more periods of complete recovery lasting at least one year


Gender and age factors

o Women tend to have better prognosis than men
 Also show milder negative symptoms
 Also later onset late 20s early 30s (so often already more settled and educated)
 Estrogen may affect dopamine which might protect women
o Males show greater abnormalities in brain
o General decrease with age due to lower dopamine levels


Sociocultural factors

o Less severe in developing countries
 Might be due to social environment, closer and broader family networks


Other psychotic disorders

fall along a continuum of severity. Schizophrenia is worst, followed by schizoaffective disorder, schizophreniform disorder and other psychotic disorders


Schizoaffective disorder

mix of schizophrenia and mood disorder
 Simultaneously experience psychotic symptoms and prominent mood symptoms meeting the criteria for major depressive or manic episodes
 Mood symptoms must be present for the majority of the period of illness and 2 weeks with hallucinations or delusion without mood symptoms


Schizophreniform disorder

: requires that individual meet criteria A,D an E but show symptoms that only last for 1-6 months
 Functional impairment can be present but is not necessary
 2/3 will receive schizophrenia or schizoaffective diagnose


Brief psychotic disorder

 Show sudden onset of delusions, hallucinations, disorganizes speech and/or disorganized behaviour
 Only last between 1 day and 1 month
 Sometimes triggered by major stressor e.g. accident
 Most people show excellent outcome


Delusional disorder

 Have delusions lasting at least 1 month
 No psychotic symptoms and other than reactions to delusions don’t act odd or have difficulties in functioning


Schizotypal PD

 Life long pattern of significant oddities in self-concept, their ways of relating to others and their thinking and behaviour
 Lack of sense of self and trouble setting goals
 Restricted emotionality
 Do not understand other humans behaviour
 Maintain grasp on reality
 Think that random events are related to them
 Cognitive deficits are present but less severe than in schizophrenia


Genetic contributors

different genes are thought to be responsible for different symptoms
 50% percent of shared genes have 10% chance of developing


Structural and functional abnormalities

o Neurodevelopmental disorder, in which a variety of factors lead to abnormal development of the brain in the uterus and early life
o Gross reduction of gray matter in cortex
o Hippocampus differs from the norm (functional and structural)
o Reductions and abnormalities in white matter (present before onset)
 Reduces the interaction between brain regions
o Enlargement of ventricles (also present before onset)
o Abnormal connections


Birth complications

 Perinatal hypoxia: deprivation of oxygen in the few weeks before or after birth
• Might interact with genetic factors and triggers Schizophrenia
 Prenatal Viral Exposure: high rates of desease when mother had a virus while pregnant


Revised theory (davis)

different types of dopamine receptors and different levels of dopamine in various areas of the brain can account for symptoms
 Mesolimbic pathway: excess dopamine activity, Impairs reward and salience
• Might lead to processing salience where non should be, contributing to hallucinations and delusions and deficits in motivation
 Unusual low dopamine activity in PFC, attention, motivation and organization of behaviour
• Might lead to negative symptoms



serotonin neurons regulate dopamine neurons in the mesolimbic system


Social drift

Because schizophrenia symptoms interfere with a person’s ability to complete an education and hold a job, people with schizophrenia tend to drift downward in social class compared to the class of their family of origin