long-lasting; extreme; rigid; maladaptive; ego-syntonic; treat; others; the person with the disorder; Axis I; early adulthood; presentation
What is a personality disorder?
* _______, _______, ____ patterns of behaving
*personality and behavior are _______
*________ - serving to ego; that person serves a real purpose. Everyone else may be annoyed but this personality to that person is needed at some point.
*Difficult to _____
*More distressing for ___________ than _________.
*Often comorbid with ________ disorders.
*Tend to appear in ______ _______.
*Could be hard to diagnosis depending on _______.
culture; two; cognition; affectivity; interpersonal functioning; inflexible; pervasive; distress; impairment; adolescence; adulthood; stable; long; mental; substance; medical; permanent; stigma; Axis II: Diagnosis Deferred
General Criteria for Personality Disorders:
*Enduring pattern of inner experience and behavior that deviates markedly from the individuals _______ in ___ or more of:
*_______ and _______
*Leads to clinically significant ______ or _______.
*Onset in ________ or early ________; _____ and _____ duration.
*Not better accounted for my another _____ disorder, _______ abuse, or a _______ condition.
*Very unusual for someone to complain about a personality disorder.
*Usually these patients are very draining to the clinician, they almost wear you out.
*When in doubt, you don't diagnose an Axis II disorder due to:
*______ with these disorders.
*_____________________ - basically says to the clinician "I think something going on but not sure, keep your eyes open".
A; Paranoid; schizoid; schizotypal
Odd/Eccentric Disorders: Cluster ___
distrust; suspiciousness; doubts; loyalty; threatening; benign; tense; sensitive
Paranoid Personality Disorder
* ______ and ______ of others.
*Preoccupation with _____ about _____
*Reads _____ meanings into _____ remarks.
* ____ and over _____ to criticism
trauma; abuse; generalized psychological; trust; negative beliefs; Empirically Supportive treatment
Causes and Treatments
* ______ or ______? maybe neglect.
*______ ______ Vulnerability - maybe all people are dishonest.
*Focus on developing _____ and correcting ____ ___ about others.
*No ESTs - ______ _____ ______ - always long term work like CBTs.
social; expression; emotions; friends; confidants; praise; criticism
Schizoid Personality Disorder
* Detachment from _____ relationships
*Restricted range of _____ of _______
-Blunted affect; "visine guy"
*Lacks _____ or _______.
*Indifference to _____ or ________
-Don't need friends or feel a need for relationships
-Very few interest
-may come to a clinician for other concerns
shyness; relationships; social skills; empathy; role; EST's
Causes and Treatments
* Childhood ______?
-We don't really know the cause.
*Focus on ______ and ___ _____ therapy.
*_____ and _____ playing - emotions, so they can have an idea how to operate socially.
* No ____.
cognitive; perceptual; psychosis; odd; eccentric; inappropriate; constricted; anxiety; relationships; MDD
Schizotypal Personality Disorder
*______, ______ distortions (like _____)
-not hallucinations, but _______.
*_____, _____ behavior and speech.
-Still able to function really well, but have cognitive impairments.
*_______ or ______ affect.
*Intense social _______ and lack of close ________.
-might have a strange pattern of speech
-do things that do not fit social norms.
*May be comorbid with _____, because they want to be close to people and want relationships but don't have the social skills.
schizophrenia; social skills; community; antipsychotic; depression; ESTs
Causes and Treatments
*Closely related to ___________
*_______ and ______ treatment combined with ________ medications if magical thinking is getting in the way of their life too much.
*Treat comorbid ______.
-These people can really freak others out from their inappropriateness and they don't understand why.
schizoid - don't want relationships
schizotypal - really want relationships but don't have the social skills to make or maintain them.
Explain the difference between schizoid personality disorder and schizotypal personality disorder.
B; antisocial; histrionic; borderline; narcissistic
Dramatic/Emotional/Erratic - Cluster __
disregard; violation; 18; conduct; social norms; deceitfulness; cunning; conscience; empathy; remorse
Antisocial Personality Disorder
-_____ for and ______ of the rights of others singe age ___.
-Previous diagnosis of _____ disorder.
-Disregard for _____ ____.
-______ and ______ - to get something they want, and they don't care if they get caught.
-Lack of _____, _____, _____
*Basically do whatever they want.
-Before 15 y/o - arisen, weapons, abuse pets.
charm; stimulation; pathological; self-worth; caught; rules
*glibness, ______, need for ______, ________ lying; grandiose sense of ____-____.
*inability to avoid getting _____.
-Psychopaths and antisocial personality can avoid getting caught whereas criminals get caught and feel they are above social ______.
inconsistency; criminality; violence; Arousal hypotheses; Behavioral Inhibition; recidivism; incarceration; prevention; treatment
Causes and Treatments of Antisocial Personality Disorder
*Family history of ______, ______ and _______.
- underarousal + fearlessness - need more excitement to "get off" added to the " I don't care" attitude.
* Impaired ______ ______ System - system that keeps us from getting in danger.
* High _____ and high ______ - likely to stay in the legal system.
* _____ is better than _______.
-Jail is suppose to serve as a punishment but since these people have no " System, it doesn't work.
interpersonal; self-image; affect; females; males; abandonment; emptiness; suicidal; self-mutilating.
Borderline Personality Disorder
-One of the most stigmatized Personality disorders.
*Instability of _______ relationships, ___-____, and _____ beginning in early adulthood.
*More _____ than ______.
* Frantic efforts to avoid ________.
*chronic feelings of _______
*_______ and/or ____-_______ thoughts or behaviors.
-extreme measures of thinking and actually hurting themselves so they won't be left.
"you don't want me to die, but I'm going to die if you leave me."
-distress tolerance is low so they are very high risk for suicide or hurting themselves.
neglect; trauma; Limbic; emotion; seek treatment; Dialectical behavior therapy (DBT); antidepressant
Causes and Treatments
*Early childhood ____ or _____?
*_____ system dysfunction (_____ regulation).
-Can't tolerate negative feelings.
*HIGHLY likely to ___ _____ due to the feelings of distress.
*____ ____ _____ - managing bad feelings; brings them stability in the emotional experience.
-These people don't think their feelings are ever going away.
-Anything self-mutilating is an Axis II "go-to".
emotionality; attention; sexual; seductive; dramatic; theatrical; gullible; suggestible; naive; intimacy; women; men; childlike
Histrionic Personality Disorder
*Excessive ______ (shallow and inappropriate) and _____ seeking.
*Inappropriately _____ or ______ interaction with others.
*______, _____ presentation and demonstration.
*_____, ______ and _____.
*False judgments about the ______ or relationships.
*More _____ than _____.
ASPD; Interpersonal; ESTs
Causes and Treatments
* Sexual version of _____?
* ______ skills development.
-Teach them how they can begin to get attention in more appropriate ways, and get what you want differently.
-How to begin to make accurate judgments about the intimacy of
relationships or build real relationships.
grandiosity; admiration; empathy; entitlement; arrogant; haughty; special; understood; brilliance; beauty; power; love
Narcissistic Personality Disorder
*Pattern of _____, need for ______, and lack of ______.
-"think they are awesome"
-Perceived as "collosal jerks"
*Sense of _______.
*______ or _____ attitudes.
*Believes that they are "_____" and cannot be _____ by others.
* Preoccupation with ______, _____, _____, or _____.
*Psychoanalytic thoughts are extreme insecurity.
altruism; empathy; me; empathy; sensitivity; ESTs
Causes and Treatments
*Deficits in learning of ______ and ______.
-Stage of childhood is missed when kids learn to be nice to others.
*" ____ generation"?
*Treatment focuses on lack of _____ and _____ to evaluation.
* No ____.
"Lashing out" after neg. comments leads to impairment.
C; Avoidant; Dependent; Obsessive-Compulsive; Personality Disorder NOS
Anxious/Fearful - Cluster ___
inhibition; inadequacy; hypersensitivity; rejection; criticism; incompetent; inept; criticism; rejection
Avoidant Personality Disorder
*Pattern of social _____, feelings of ______, and ______ to negative evaluation.
*Avoiding activities where _____ and ______ are possible.
*View of self as _______ or _____.
*Preoccupation with ______ or _______
"I am not enough, I don't know how to do things"
-Different from social phobia. Social phobia - more social or performance elements (no audience, and they're fine).
-Avoidant - self image is inept; all situations are avoided and problematic.
Temperament; rejection; isolation; conflict; social; anxiety; Therapeutic Alliance
Causes and Treatments
* ______ and early parental _______
"Easy babies" - always happy
"Hard babies" - cry all the time.
*Interpersonal _____ and ______.
"It's my fault that my relationship failed."
*Treatment - Increase _____ skills.
*Reduce _____. CBT - correcting negative self-thoughts.
** ____ _____ - Relationship with Therapist is extremely important; provide a positive self-image.
submissive; clinging; separation; decisions; disagreement; support; nurturance;
Dependent Personality Disorder
*The need to be taken care of leads to _______, and _____ behavior and fears of ______.
*Difficulty making _______ or expressing _______.
*Go to excessive length to obtain _____ and _______ for others.
*Feels unable to take care of _____.
Ex: 55 year old who lives at home with parents. Doubts ability making decisions on her own.
attachment; rejection; independence; responsibility; therapeutic alliance; EST's
Causes and Treatments
*_____ problems (anxious ambivalent).
*Early _____ or had lots of failures in early childhood.
*We want to gradually increase _______ and _______
** caution about ______ _______ - can latch onto therapist so they must be careful giving advice because patient will do EXACTLY what therapist says.
* No ____
orderliness; perfectionism; control; flexibility; openness; efficiency; "do it right", Rules; organization; relationships; rigidity; OCD
Obsessive-Compulsive Personality Disorder
*Preoccupation with _______, _______, and mental and interpersonal _____ at the expense of ____, _____, and ______.
*Need to " _____"
*____, ____, and order.
*Little interest/capacity for interpersonal _______ - people are not predictable; person must deal with emotions and emotions can be messy.
"Organize notes for so long that they don't have time to study."
genetic; OCD; rumination; inadequacy; ESTs
Causes and Treatment
-Once again we really don't know.
*Similar to ____.
*Decrease ______ and feelings of _______.
* No ____
With OCPD it's not necessarily about obsessions and compulsions, it's more about preference. If they are unable to do everything their way, they wouldn't get anxiety like someone with OCD, instead they would actually become angry.
What is the difference between OCD and OCPD?
particular disorder; several
Personality Disorder NOS
*Enduring pattern of behavior that doesn't fit the criteria for any ______ _____.
* May have criteria for ______ different disorders.
"Something is going on, but we don't know what it is."
10; personality; A; A; B; B; C; A; B; diagnosis; validity/reliability;
*High rates of co-morbidity overall (__% total of the population).
-It is very common that someone is diagnosed with 2 _____ disorders.
*Cluster ___ disorders with cluster ____.
*Cluster ____ disorders with cluster _____.
*Cluster ____ disorders with cluster ____ and _____.
*Is this a real co morbidity or a _______ problem?
*Maybe this is a ______/______ problem with the way that we diagnose.
Severity; Type; Trait; Stability; time; situation; Categorical Dimensional
Proposed DSM-5 revisions to PD's
*DSM-5 Personality Disorders
-_______ - level of personality functioning
-_______- match to personality type or match to personality ____ domain.
-______ ( across ____ and ______).
The DSM-5 will have a _______ ________ System of Approach for Personality disorders.
Depressive Personality; pessimism; anxiousness; low-self esteem; Passive Aggressive; oppositional; hostile
Disorders under consideration
* _______ personality disorder
"think of Eore from Pooh Bear"
*______ ______ Personality disorder
"difficult to work with by default"
-Both of these were under consideration for DSM III and IV, and will probably remain under consideration for DSM V.
If the patient meets some symptoms of a personality disorder but does not meet enough of them to be diagnoses with that disorder they will be given the "trait disorder" title in the DSM Axis.
Example: Personality disorder: Trait disorder detachment.
Example: Personality disorder: Trait disorder psychoticism
Describe what the categorical-dimensional diagnosis of personality disorders will be like.
III; Health psychology; psychological; social; autoimmune; 50; smoking; lack of exercise; not wearing a seat belt; poor eating habits.
Health and Health Related Behavior
*Medical disorders coded on Axis ____
*_____ ______ - a sub field of behavioral medicine - factors important to the promotion and maintenance of health
* _______ and ____ factors: biological processes leading to disease, and risk factors for physical disorders.
Ex: ______ diseases are exacerbated by stress. Also, HIV, rheumatoid arthritis, getting sick after exams.
-Psychological choices may lead to physical illness and vise versa.
*__% of deaths from the 10 leading causes of death canbe traced to lifestyle choices.
eustress; Hans Selye; 1.) Alarm response - identify that there is a stressor present, then decide if it is good or bad; 2.) Resistance - coping, the type depends on if it is good or bad, if resistance stage goes on too long without terminating we move on to the; 3.) Exhaustion stage - All of our resources are used up and we can't do anymore, we are done trying because we no longer have the energy to fight the stressor.
The Nature of Stress
____ - positive stress
*____ _____'s General Adaptation Syndrome
*Describe the three stages of the General Adaptation Syndrome.
SNS; endocrine; cortisol; cortisol; noreepinephrine; hippocampal; infectious; immune; WBC;
Physiology of Stress
* ____ activation
*_____ system activation - response for production of _____ (exercise triggers this hormone).
*______ and ________ (hormones)
-Can lead to _______ damage (cell death) - memor, STM to LTM, emotional functioning.
-Susceptibility to ______ disease (_____ system supression).
-Lower ____ count.
emotion focused; problem focused; CONTROL
Coping with Stress
___ ___ coping - dealing with your stress by changing your emotions about it.
Ex: pay bills, someone dies.
____ ____ coping -change it. Do something about it.
Ex: I have a test that's bumming me out, but I think I'll study and feel better when it's over.
The strategy of coping depends on the ______ over the situation.
controllability; social support; self-efficacy; perception; negative affect; life events; pre-existing conditions
Factors Influencing Stress
* _____ sense of control or ability to cope.
*____ ____ - quality and quantity.
*_____ _____ - it is all about the ______, whether or not you can handle something.
*______ ____ - chronic negative attitude.
* _____ _____
* ___________ - think about learned helplessness.
Mediates; stress; Antigens - foreign materials that enter the body (virus; any foreign material); Antibodies - (also called humeral branch) B-cells they seek antigens and neutralize them - think eliminates harm (vaccines); Cellular branch; T4 (helper cells); Memory B & T cells speed future antigen neutralization so that next time your body is exposed to viruses or foreign material you can react more quickly.
Immune System Activity
*_____ the impact of _____ on health.
*Define antigens and antibodies.
*_____ _____ - killer T cells destroy viral infections and cancerous processes. - think destroys
-____ (____) cells signal B cells to reproduce antibodies and T cells to destroy.
*Describe the function of Memory B & T cells.
Psychoneuroimmunology (PNI); Cohen's cold; heal
________ (___) - the study of psychological influences on the neurological rsponding implicated in our immune system.
Ex: _____ ___ study - ground breaking study (seminal) - Participants rated their levels of stress, then were injected with a cold virus and observed. Findings: Those that had experienced long term stress and high stress developed symptoms of a cold much quicker than those who claimed lower levels.
2nd study - Gave participants small wound, those with more stress took longer to _____.
Highly active anti-retro viral treatment; increased immune system functioning; survival time; depression; pain; lack of control
Psychosocial Effects on Physical Disorders
-HAART - _________
-Stress-reduction strategies lead to _______________.
-Therapy leads to longer ________
-Therapy or group support can reduce _____ and ____ related to illness.
A; coronary heart; essential; lifestyle; coping; negative
*Type __ personality associated with ______ _____ disease.
* _______ hypertension - we don't know why medically they have high BP.
*Chronic ______ emotions.
somatization; healed; control; coping; anxiety; depression; social; environmental
*Chronic Pain (form of ______)
-Pain after the injury has _____ - no medical reason for pain.
-sense of _____ - these people feel like their is nothing they can do to resolve the pain.
-______ or _______.
-Low _____ support.
-______ conditions (ex: family)
*they truly still hurt, but it's all in their head.
biofeedback; relaxation; meditation; cognitive; attributions; expectancies; denial; risky; prevention
Psychosocial Treatment of Physical Disorders
* _______ - making clients aware of physiological responses and then work to control the responses.
* _____ and ______ to limit stress.
*Exploring _____ distortions related to pain or disease. ( _______ and ______) value judgement, what we believe will happen.
*_____ as an initial coping mechanism.
*Limiting ____ behaviors.
-Teaching people that they can control their bodies.
body; health; bodily; functioning; physical; medical
Soma - "the ___"
*Preoccupation with ____ or ____ appearance or ______.
*_____ symptoms but no identifiable _____ condition.
anxiety; disease; misinterpretation; sensations; illness; anxiety; anxiety;mood; 1;14; doctor hop; resistant
-We think they misinterpret symptoms for average aches and pains.
*Severe _____ about the possibility of having a severe _____.
* ________ of normal bodily ______ as ____
Ex: slight headache - they think they have a brain tumor.
*Reassurance of physicians does not ease ______.
*Often comorbid with ____ and ____ disorders.
*Between __% and ___% of medical patients - they often " ___ ___"
-Hypochondriacs are very treatment ________
koro - the belief, accompanied by severe anxiety and sometimes panic, that the genitals are retracting into the abdomen. Most victims of this disorder are Chinese males. Typical sufferers are guilty of excessive masturbation, unsatisfactory intercourse, or promiscuity.
Dhat - Prevalent in India, is an anxious concern about losing semen, something that obviously occurs during sexual activity. This disorder is associated with a vague mix of physical symptoms, including dizziness, weakness, and fatigue.
*Culture bound symptoms.
Koro - _________________
Dhat - _________________
physicalk; sensitivity; focusing; symptom -free; genetic; psychological; exposure; childhood
Causes of Hypochondriasis
*Faulty interpretation of _____ signs - will dwell on headache instead of trying to ignore it.
*Enhanced perceptual _____ and increased _____.
*Concept of health as being " _____-___"
*_____ contributions - vulnerability to anxiety.
* _______ vulnerabilities bc they think healthy means no symptoms.
*Have this idea that since they were highly _______ to disease during ______ they have a high chance of getting a chronic disease.
reassurance; education; symptoms; life stress; stress management; expenses
Treatment of Hypochondriasis
*_______ and ______ about normal sx in SOME cases - in most cases this does not work.
*Help client understand connection between ___ and ____ stresses. "maybe your headache is from high stress"
*General _____ _____
-It's hard for hypochondriacs to believe that it's all in their head. Our best bet is education but they are very resistant.
-Consequences: they have a lot of medical _____ (ex: MRI)
8; Briquet *2; weakness; illness; sick; physical; years; cause; rare; attention
* Have to have ___ sx of different disorders.
* Originally called _____ syndrome after French physician Pierre ____.
*Continual feeling of _____ or ______, without efforts to rid themselves of the symptoms.
*Take on the "___ role"
*History of many, various ____ complaints over several ____.
* Symptoms have no known organic _____.
-They don't seem to be trying to get better
-They get a gain out of being sick - maybe _____.
undifferentiated somatoform; illness; injurty; antisocial personality disorder; Disinhibition; impulsive; attention
Causes of Somatization disorder
*"______ ______ disorder" - somatization disorder with fewer than eight sx.
*History of family ____ or _____.
*Possible genetic contributions? Strongly linked to _________ disorder.
-_______ syndrome/ _____ behavior - not being able to inhibit behaviors and impulses.
*Need for ______
difficult; CBT; help-seeking; sick role
Treatment of Somatization Disorder.
*Very ____ to treat - different because its a great way to get attention and these people think its real.
* ____ strategies are most effective in limiting sx.
* Limit ___-____ visits.
* Find other ways to interact with significant others rather than the "____ ___" - get attention in more adaptive ways.
physical; neurological; causer; awareness; la belle indifference; women; religious; healing
*_____ malfunctioning (often ______) with no organic ____.
*Believed to be the result of psychological dilemma outside of ________.
* " _______" - these people don't seem to be to concerned.
Ex: think of professor's hands not working although her dissertation is due soon.
* Found primarily in ______.
*Conversion symptoms could be common in some ____ or ______ rituals.
-Benefit: put off their obligations - more of a defense mechanism against anxiety.
Malingering; lawsuits; manipulative; Factitious; attention; Muchausen's syndrome
-usually outside motivation such as _______.
-clearly, purposefully ________.
-Symptoms are under voluntary control, but there is no obvious motive.
-Perhaps increased ______.
-Ex: ______ _______ - delibertly creating symptoms in an effort to get attention. This is a conscious behavior whereas in somatization it is unconscious.
unconscious; unbearable; reduction of anxiety; increased attention and sympathy; unwanted act, desire, etc.
Causes of conversion disorders
-______, ______ conflict.
-Primary gain = ___________
-Secondary gain - _______________; and avoidance of the _______________
identify; attend; Catharsis; reinforcing; supportive; CBT
Treatment of Conversion Disorders
*_____ and _____ to stressful event.
_____ - if you express the emotion it will go away. Think of the expression "you just need to have a good cry".
* Reduce _____ or _____ consequences (secondary gain).
-reduce attention, problem, and behavior.
*____ techniques - develop a more balanced approach to deal.
one; more; maintaining; causing; feigned; intentionally; 5-12%
* Pain in ____ or ____ sites in the body.
*Psychological factors play a major role in ______ the pain (perhaps not ______ it)
*Not ______ or _____ produced.
*______ % of the population.
ugly; deformed; defect; appearance; checking; compensating; reference; suicidal; chronic; face; head; somatoform; OCD; SSRI's; Exposure; prevention
Body Dysmorphic Disorder
*Inappropriate fear that one is _____ or _____ in some way.
*Preoccupation with an imagined ____ in _____.
*May engage in ____ or _____ rituals
*Ideas of _____
*Frequent ______ ideation.
* _____ course
Ex: constantly looking in the mirror, wear a lot of makeup in that area maybe very closed related to eating disorders.
* Mostly the ____ and _____
*Often co-morbid with other _____ disorders.
*High co-morbidity with ____.
-____ and response ______.
Ex: have a person walk by a mirror without looking at themselves.
Somamtic Symptom; Pain Disorder Specifier; Illness Anxiety; Functional Neurological Symptom
DSM 5 Changes
-_______ ______ disorder - anything that your having bodily symptoms about that cannot be medically explained.
-Symptoms and worry.
- _____ _____ ______.
* Hypochondriasis > ____ ____ Disorder.
*Conversions Disorder > _______ ______ ______ disorder.
1900s; Kraeplin; dementia praecox; bipolar; Catatonia; Hebephrenia; Paranoia
Early Figures in Diagnosing Schizophrenia
*Early ____ - ______ connected what were previously disjointed symptoms ( _____ _____).
-Distinguished from ______ disorder (manic depression).
-______- rigidity or difficult moving (Ex: don't swing arms when they walk).
-______-inappropriate affect (Ex: laughing at funneral).
-______-believe people are out to get you.
Eugene Bleuler; separation/disconnection
_____ _____ - coined the term "schizophrenia" - believed that unusual behaviors were an indication of associative splitting (two or more personalities).
*_____/______ of the basic components of human personality.
*Currently they think that the internal voice everyone has, cannot be distinguished between an external voice to someone who has schizophrenia.
hallmark symptom; delusions; hallucinations; auditory
*Differs from other disorders in that there is no one _______ symptom.
- irrational belief that cannot be changed.
-________ - intrusive thoughts that cannot be identified as self-initiated.
* _______ is the most common
Examples: client believes she has sex with God.
-Cannot reason with people about their delusions they will always believe in beginning stages. So, instead of treating the delusion, we treat the anxiety or depression that is caused from the delusion.
*The most dangerous voices are the ones who demand acts. Ex: client's voice was telling her to kill her therapist.
avolition; alogia; monosyllabic; paucity of speech ; anhedonia; flattened affect (feeling vs. expressing); prodiomal;
-______-inability to initiate and persist in activities. (Ex: not being able to remain on task for 20 min or more.)
-______- deficits in speech; tend to be low energy because it takes so much mental energy to find words and communicate with others.
*________ - one syllabus responses
*________- have very little to stay; can't find the words to express.
-_______- inability to experience pleasure.
*not sure whether they have difficulty feeling of difficulty expressing
*________ - symptoms building before schizophrenia is diagnosed (sometimes for years).
Tangentiality; loose-association; derailment; inappropriate affect; waxy flexibility
*_________ - stay on topic for long time.
*_______ or _______ - isn't making sense. May say one sentence talking about several different topics that don't add up.
-________ ____ - Ex: laughing at a funeral.
-_____ ______: tendency to remain in any physical position you are placed in. (Prof. Brown demonstrated this; looks like 'Whose Line Is It Anyway?')
2;one; Paranoid; cognitive; disorganized; catatonic; Undifferentiated; Residual
Diagnosis and Types
*___ or more positive, negative, or disorganized sx for at least ____ month.
Essential Characteristics "Types" but can deviate from these (Prototypical)
*______ type: marked by hallucinations or delusions with _______ skills basically intact.
*______ type: Disruption in speech and behavior, inappropriate affect, disorganized hallucinations if present.
Ex: loose associations frequency; for example if they have hallucinations, they won't be normal or "story like" they would be similar to an LCD trip story.
*______ type: predominately motor disturbances
-Waxy flexibility and avulision
*_______ Type: Major symptoms of the disorder but don't meet criteria for a specific type. (No predominant sx).
*_______ Type: have had at least one episode, but no longer manifest major sx. May have "leftover sx". - voices may be softer.
fixed; absence of other sx of schizophrenia; Erotomanic; grandiose; jealous; persecutory; Somatic
*Persistent (_____) delusions in the _________________.
*Types of delusions:
-_______: believing someone is in love with you.
-_______: Belief that you are someone important.
Ex: Prof. Brown's Pt. "I am f****** Jesus"
-______: Believing that you are being cheated on.
-______: Belief that someone is out to get you, torture you etc.
-______: Problems with the body.
Ex: Pt. believed foods he was eating was shooting posin throughout the body.
Folie a Deux; close relationship; delusional individual; women; cognitive impairment
Shared Psychotic Disorder (____ __ _____)
*An individual develops delusions as a result of a ____ _______ with a ______ ______.
*More common in ________.
* The secondary member may frequently have some _____ _______.
.2-1.5%; earlier; later; adolescence; adulthood; Prodromal; 1-2 years; treatment; episodes; medications
Stats about Schizophrenia
* __-___ prevalence rates.
*Men affected ______ in life, women more likely to have onset _____ in life.
* Development of Schizophrenia
-Usually occur in late ______ or early _______.
-______ stage - 1 to 2 year period during which less severe, unusual sx occur.
-Can take another ______ to be diagnosed after sx develop.
-Usually get better with ______, but usually multiple ______.
-Once pt. starts _____, not ever recommended to stop.
abnormal; racial; cultural; Western; ethnic; diagnosis; bias
Cultural Factors Related to Schizophrenia
*Does it exist? (cultural definitions of ________).
*Universally affects various _____ and ____ groups.
*In ______ countries, people from _____ minority groups may be more likely to receive the ______.
*Possible ___? - Almost always. "normal" is different across cultures.
predisposition; type; genetics; dysfunctional; likely; Genain quadruplets; unshared; shared; markers; endophenotyping
*Can inherit a general ________, but nor for a specific ____.
*______ combined with a ______ home environment make the disorder more ____.
Ex: the ______ _______: All four sisters had schizophrenia but the three different types. Genetic shared trait but different experiences with chaotic upbringing and home environment as well as different relationship with parents.
*______ environment - just as important as _____ environment.
*There may be genetic "_____" for schizophrenia
-_______: there maybe a specific gene that determines schizo.
active; antipsychotics; antagonists; Parkinsonian; antagonists; limited; sx; positive; negative
*The dopamine hypothesis
-Possibly too _____ in people with schizophrenia
-_______ are often dopamine _____.
-______ side effects.
-dopamine ______ don't always work.
-dopamine is ______ quickly but _____ are not.
-dopamine antagonist work better for _____ than ____ sx.
D2; movement; balance; walking; D1; thinking; reasoning; prefrontal; glutamate; damage; infection; pregnancy; delivery
A more complex hypothesis
*Excessive stimulation of ____ receptors
_____, _____, _____.
*Deficiency in the stimulation of ____ receptors
_____ and _____
*Alterations in ______ activity: _____ transmission is decreased.
*Evidence for neurological _____.
*Fetal exposure to ________, complications with ______ and ______ (influenza).
brain trauma; vulnerability-stress; schizophrenogenic mother; double bind; involvement; hostility; criticism
Psychological and Social Influences
*Early ____ _____ (either in utero or during birth)
*_______-___ model of schizophrenia
*Historical theories (We don't follow these anymore)
-________ ______: odd, dominant, and rejecting in nature.
-______ ______ communication - produces conflicting messages - communication in the family sends conflicting messages. (This is real, but we now know that it doesn't cause schizophrenia).
*Emotional over ______, _____, and _____ can lead to relapse (high expressed emotion.)
trial; error; neuroleptics; extrapyramidal; tardive diskinesia; social support; doctor-patient; high costs
Treatment of Schizophrenia
-A lot of medication is ____ and _____.
-Antipsychotic medications (_______)
* High noncompliance with medication
-_______ symptoms (issues with motor activity nerves)
-______ ______: involuntary movements of the face and jaw.
-Low ____ _____
-Poor _____-______ relationships
-___ ____ of medications
medication; evidence; psychological; Paul & Lentz; Token economy; working; communities; family; social skills; assertiveness; relationship building; managing meds; recognizing sx
Treatment of Schizophrenia
-Primary treatment is ________
-Not much ______ for ________ causes of schizophrenia
-____ &____ - _________ - earn "prizes" by behaving appropriately.
-_______ to support people in their ______ and among _____ rather than being institutionalized.
-Re-teach _____, ______, ______ _____, __________, and _______