PSYS 318 FINAL EXAM

Schizophrenia
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Terms in this set (30)
Schizophrenia
-schizophrenia: a psychotic disorder in which personal, social, & occupation functioning deteriorate as a result of unusual perception, odd thoughts, disturbed emotion & motor abnormality
-ppl with it experience psychosis: a state in which a person loses contact w reality in key ways
-ability to perceive and respond to the environment becomes so disturbed that they may not be able to function @ home, with friends, in school, /at work
-may have hallucinations (false sensory perceptions) / delusions (false beliefs), / may w/dr into a private world
-"split mind"
-1 in every 100 ppl
-increased risk of physical-often fatal illness
-on average live 20 years fewer than others
-more likely to attempt suicide (25%)
-more frequent in lower levels of socioeconomic groups
-stress -> schizo?/ downward drift: schizo causes its sufferers to fall from a higher to a lower socioeconomic level/ to remain poor because they are unable to function effectively
-average age of onset: M-23 W: 28
-key features: various psychotic symptoms (delusions, hallucination, disorganized speech, restricted/inappropriate affect, and catatonia); 6+ months
brief psychotic disorder
-key features: various psychotic symptoms (delusions, hallucinations, disorganized speech, restricted/ inappropriate affect, and catatonia
-less than 1 month
schizophreniform disorder
-key features: various psychotic symptoms (delusions, hallucinations, disorganized speech, restricted/ inappropriate affect, and catatonia
-1-6 months
schizoaffective disorder
-key features: marked symptoms of both schizo and a major depressive episode/ manic episode
-6+ months
delusional disorder
-key features: persistent delusions that are not bizarre and not due to schizophrenia; persecutory, jealous, grandiose, and somatic delusions are common; 1+ month
psychotic disorder due to another medical condition
-key features: hallucinations, delusions, /disorganized speech caused by a medical illness/brain damage
-no minimum length
substance/medication-induced psychotic disorder
-hallucinations, delusions, / disorganized speech caused directly by a substance, such as an abused drug
-no minimum length
mentally ill chemical abusers
-MICAs (dual diagnosis patients): ppl who display both severe mental disorders and SUD
-Hogue- homeless man who suffered from schizo
and cocaine and alcohol use dis.
-as long as he did not abuse these sub., his schizo dis was responsive to tc
-could not, so this combo caused psychosis
-would roam the streets in a menacing way, scream @ passer by attack & threaten those who crossed his path, commit crimes against property, and strike fear into the hears of the upper west side residents
-arrested more than 30 times and imprisoned at least 6
-~ 20 & 50% of all ppl w chronic mental disorders may be MICAS
-tend to be young & male
-unrecognized substance abuse may lead to misdiagnosed & misunderstanding pf the disorder
-therapists must tailor treatment programs to MICAs unique combo of problems rather then expecting them to adopt to traditional forms of care
What are the symptoms of schizophrenia?: positive symptoms
-"pathological excesses"/bizarre additions to a person's
-delusions, disorganized thinking & speech, heightened perceptions & hallucinations, and inappropriate affect are most common
-delusions: ideas that they believe whole heartedly but that have no basis in fact
-delusions of persecution: believe that they are being plotted/discriminated against, spied on, slandered, threatened, attacked,/ deliberately victimized (most common)
-delusions of reference: attached special and personal meaning to the actions of others/to various objects/events
-delusions of grandeur: believe themselves to be great inventors, religious saviors, / other specialty empowered persons
-delusions of control: believe their feelings, thoughts, & actions are being controlled by other people
What are the symptoms of schizophrenia?: positive symptoms- disorganized thinking & speech
-formal thought dis: disturbance in the production and organization of thought -> causes the sufferer great confusion and make communication extremely difficult; takes form of positive symptoms as in loos association, neologisms, preservation, and clang
-loose association: common thinking disturbances in schizo characterized by rapid shifts from on topic of convo to another, believing their incoherent statements make sense
-neologisms: made up words that typically have meaning only to the person using them
-preservation: repeat their words & statements again and again
-clang: rhyme to think/express themselves
What are the symptoms of schizophrenia?: positive symptoms- heightened perceptions & hallucinations-may feel that their senses are being flooded by all the sights and sounds that surround them -> makes it almost impossible for them to attend to anything important -problems of perception and attention -deficiencies in smooth pursuit eye movement: weakness that may be related to attention problems -attention & perception problems may develop years before the onset of the actual disorder &/ that they further contribute to memory impairments common in the disorder -hallucinations: experiences of sights, sounds, / other perceptions in the absence of external stimulation -auditory hallucination: most common; hear sounds and voices that seem to come from outside their needs; produce nerve signals of a sound in their brains and "hear" them, and then believe that external sources are responsible; found more blood flow in the Brocas area (speech area) during this -tactile hallucinations: may take the form of tingling, burning, / electrical shock sensations -somatic hallucinations: feel as if something is happening inside the body, such as a snake crawling inside one's stomach -visual hallucinations: may produce vague perceptions of colors/clouds/distinct visions of people/objects -gustatory hallucination: regularly find that their food/drink tastes strange -olfactory hallucination: smell odors that no one else does, such as the smell of poison/smokeWhat are the symptoms of schizophrenia?: positive symptoms- inappropriate affect-emotions that are unsuited to the situation -ex: may become upset when told something to make them happy -inappropriate shifts in mood -maybe a response to other features of the disorder -ex: woman smiling while hearing news of her husband's illness- could not be hearing it; instead smiling about a joke from an auditory hallucinationWhat are the symptoms of schizophrenia?: negative symptoms-those that seem to be "pathological deficit," characteristics that are lacking in a person -poverty of speech, blunted and flat affect, loss of volition, & social w/drWhat are the symptoms of schizophrenia?: negative symptoms- poverty of speech-alogia/poverty of speech: reduction in speech/ speech content; say very little/quite a bit but convey little meaningWhat are the symptoms of schizophrenia?: negative symptoms- restricted affect-blunted affect: show low anger, sadness, joy, and other feelings than most ppl -flat affect: show no emotion at all, faces are still, their eye contact is poor, and their voices are monotonous -may have anhedonia: lack of pleasure/enjoyment -may just be the inability to express emotion -in a study where participants watched very emotional films- schizo patients showed less facial expression, but reported feeling just as much +/- emotions and displayed more skin arousalWhat are the symptoms of schizophrenia?: negative symptoms- loss of volition-avolition/apathy: feeling drained of energy and of interest in normal goals and unable to start/follow through o a course of action -ambivalence: conflicting feelings about most thingsWhat are the symptoms of schizophrenia?: negative symptoms-social withdrawal-may withdrawal from social environments and attend only to their own ideas and fantasies -bc the ideas are illogical & confused, the withdrawal has the effect of distancing them further from reality -lead to a breakdown of social skills, including the ability to recognize other ppls needs and emotions accuratelyWhat are the symptoms of schizophrenia? psychomotor symptoms-many more relatively slow, make awkward movements/ repeated grimaces & off gestures that seem to have a private purpose-perhaps ritualistic/magical -catatonia: pattern of extreme psychomotor symptoms, found in some forms of schizo, which may include catatonic stupor, rigidity,/posturing -catatonic rigidity: maintain a rigid, upright posture for hours & resist efforts to be moved -catatonic posturing: assuming awkward, bizarre positions for long periods of time -catatonic excitement: move excitedly, sometimes wildly waving their arms & legswhat is the course of schizo-appears between person's late teens & mid-thirties -many go through 3 phases: 1.predomal phase: symptoms are not yet obvious, but the person is beginning to deteriorate; may withdraw socially, speak in vague/odd ways, develop strange ideas/ express little emotion 2. active phase: symptoms become apparent; sometimes this phase is triggered by stress/trauma 3. residual phase: return to a prodominal-like level of functioning -25%/+ recover completely from schizo, but the majority continue to have at least some residual problems for the rest of their lives -relapses are more likely during times of stressdiagnosing schizo-after sym of disorder continue for 6 months/+ -in at least one of those months, the person must be in an active phase, marked by significant delusions, hallucinations,/ disorganized speech -must also be a deterioration in the person's work, social relations, and ability to are for themselves -type 1 schizo: thought to be dominated by + sym, such as delusions, hallucinations, and certain formal thought disorders; better adjusted prior to dis, later onset of sym, and be more likely to show improvement, especially when treated with meds; + sym may be linked to bio chem abnormality in the brain -type II schizo: have more - sym, such as restricted affect, poverty of speech, & loss of volition; may be tied largely to structural abnormalities of the braiinhow do theorists explain schizo?- bio received most research -diathesis-stress relationship may be at work: ppl w bio predispositions will develop schizo only if certain events/stressors are also presenthow do theorists explain schizo?: bio view- genetic factors-some ppl inherit a bio predisposition to schizo and develop the dis later when they face extreme stress, usually during late adolescence/ early adulthood -supported by studies of 1.relatives of ppl w schizo, 2. twins w schizo, 3. ppl w schizo who are adopted, & 4. genetic linkage & molecular biohow do theorists explain schizo?: bio view- are relatives vulnerable-the more closely related to a person w schizo, the more likely they are to dev it -prevalence increases to 3% among 2nd-degree relatives with this dis (1/2 sib, uncles, aunts, nieces, & grandchildren) -prevalence increases to 10% among 1st degree relatives (parents, siblings, & children) -close family members are exposed to many of the same environmental influences & it may be these influences that lead to the dishow do theorists explain schizo?: bio view- is an identical twin more vulnerable than a fraternal twin?-if both members of a pair of twins have a particular trait -> concordant for that trait -schizo -> identical t. win has a higher concordance rate than fraternal twins -if one identical twin develops schizo -> 48% chance the other twin will too -only a 17% chance for a fraternal twinhow do theorists explain schizo?: bio view- are bio relatives of an adoptee vulnerable?-bio relatives of adoptees w schizo are more likely than their adoptive relatives to develop it/another schizo spectrum dishow do theorists explain schizo?: bio view- what do genetic linkage & molecular bio studies suggest-have 10 possible gene deficits on chromosomes that may predispose a person to dev schizo -could be a polygenic dis.- caused by a combo of gene deficitspostpartum psychosis-sym are triggered by an enormous shift in hormone levels that happen after delivery -signs of losing touch w reality, such as delusions (convinced her baby is the devil), hallucinations, extreme anxious confusion, and disorientation, disturbed sleep, & illogical/chaotic thinking (thoughts of killer her/her child) -women w history of depression, bipolar, / schizo are particularly vulnerable -previous postpartum depression/psychosis creates a higher chancebiochem abnormalities-dopamine hypothesis: theory that schizo results from excessive activity of dopamine -fires too often and transmits too many messages -> produces symptoms of schizo -hypothesis began w the discovery of antipsychotic drugs: meds that help remove sym of schizo -1st group were phenothiazines: group of antihistamine drugs that became the first group of effective antipsychotic meds -found these often produced muscular tremors, identical to Parkinsons disease -drugs lower dopamine activityhow strong is the dopamine-schizo link?-ppl w parkinsons dev schizo-like sym if they take too much L-dopa- a med that increases patients dopamine levels -> produces psychosis -amphetamines (stimulates NS) -take higher does of amphetamines -> amp. psychosis (sim to schizo) -antipsychotic drugs lower amph. psychosis, just like they decrease schizo -means that amph. increases dopamine -> produces schizo like sym -the drugs are dopamine antagonists- bind to dopamine receptors from binding there, and prevent neurons from firing -phenothiazines bind most strongly to D2 receptorsWhat is dopamine's precise role-ppl whose attention is severely disturbed by excessive dopamine might be expected to suffer from the probs of attention, perception, and thought found in schizo -ppl w schizo may have a larger than usual number of dopamine receptors, particularly D-2 receptors, / their dopamine receptors may be too sensitive. operate abnormally in some other way -usually high number of dopamine receptors in ppl w schizo & high levels of dopamine at D-2 receptors -hypothesis problems: atypical antipsychotic drugs/ second-gen antipsychotic drugs: bio action is different from that of the traditional antipsychotic drugs; more effective than traditional ones; bind to D-2, D-1, & receptors for other NTs like sero -may suggest that schizo is related to abnormal activity/interactions of both dopamine & sero & perhaps others nTs, instead of just dopamine alone -some theorists claim that excessive dopamine activity contributes to primarily the positive sym such as delusions and hallucination -positive sym respond well to conventional antipsychotic (D2) where some of the negative sym respond best to second gen (respond less likely to D2)