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SchizophreniaSpectrum

Terms in this set (57)

1. Which of the following characterize the disorder known as schizophrenia?
broad impairments
delusions and hallucinations
inappropriate emotions
disorganized speech and behavior
<<<<<all of these>>>>>
Psychosis
Broad term referring to hallucinations and/or delusions
~ Schizophrenia
Schizophrenia
Type of psychosis with disturbed thought, language, and behavior
Typical Presentation for schizophrenia:
* onset can be abrupt or isidious
* Most undergo a prodromal phase marked by a slow and gradual development of symptoms:
Such as social withdrawal, loss of interest in school/work, deterioration in hygiene, unusual behavior, outbursts of anger.
* Family members can find behavior disturbing and difficult to interpret - may assume that the person is 'just going through a phase'
*Eventually, the appearance of active-phase symptoms (e.g., psychosis) marks the disturbance as schizophrenia
Active Phase Symptoms (Positive):
* Active manifestations of abnormal behavior and/ or distortions of normal behavior. (e.g., delusions, hallucinations, disorganized speech)
* 50 - 70 % of individuals w/ schizophrenia experience these symptoms.
* Hallucinations/ Delusions/ Disorganized Speech
2. Which of the following is the definition of catatonia?
immobility or agitated excitement
Positive Symptoms
Delusions
~ Strange and steadfast beliefs that are held only by the observer and that remain despite obvious evidence to the contrary
~ Gross misrepresentations of reality
~ It is of no use to argue that the delusion is not real

Hallucinations
~ Thought to be a result of over sharpening of senses & of the brain's inability to interpret and respond appropriately to incoming messages
~ Person may hear voices or see visions that are not there, or experience unusual sensations on or in his or her body

Essentially...
~ Sensory experiences in the absence of external sensory stimulation
~ May involve any of the senses
~ Most common: auditory
~ Own vs. others voice
~ Broca's area (The part of the brain that is most active during hallucinations is the Broca's area)
~ Prosody
Active Phase Symptoms
Disorganized Symptoms
~ Include severe & excess disruptions in speech, behavior & emotion
~ Examples includes rambling speech, erratic behavior, & inappropriate affect

> Disorganized speech
- Difficulty in communication
> Disorganized behavior
- Includes a variety of unusual behaviors
- Catatonia - spectrum from wild agitation, waxy flexibility, to immobility
> Disorganized affect
- Inappropriate emotional behavior (e.g., crying when one should be laughing)
Disorganized Symptoms
Refers to problems in the way that a person with schizophrenia processes and organizes thoughts and behaviors
Negative Symptoms
Absence or insufficiency of normal behavior
(Examples are emotional/social withdrawal, apathy, & poverty of thought/speech
~ 25% experience
> Avolition (or apathy) - Refers to the inability to initiate and persist in activities (may be confused with laziness. May not do much more than sleep & pick at meals. Life is devoid of interest.)
> Alogia - Refers to the relative absence of speech
> Anhedonia - Lack of pleasure, or indifference to pleasurable activities
> Affective flattening - Show little expressed emotion, but may still feel emotion. (Person seems unable to feel or
show any emotion at all.)
> Depression - Involves feelings of helplessness & hopelessness, & may stem in part from realizing that schizophrenia has changed one's life, from realizing that the "special feeling" experienced in the psychotic state is an illusion & that the future looks bleak.
> Social Withdrawal - May occur as a result of depression, a result of a feeling of relative safety in being alone, or a result of being so caught up in one's own feelings & fearing that one cannot manage the company of others.
3. Which of the following is the definition for hebephrenia?
silly and immature behavior
4. If an individual is diagnosed as psychotic it usually means that the person has:
hallucinations
delusions
<<<<both of these>>>>
5. In the textbook case of Arthur, he said that he had a "secret plan to save all the starving children in the world." After Arthur showed other bizarre behavior and also said he was going to climb the fence of a government building, his parents tried to have him admitted to a psychiatric hospital. They were not able to do that because:
he was not considered a danger to himself or others
6. In working with schizophrenic patients, mental health professionals typically distinguish between ____ symptoms (an excess or distortion of normal behavior) and ____ symptoms (deficits in normal behavior).
positive, negative
7. Which of the following is the persecutory type of psychotic delusion?
people are out to get you
8. The most common type of hallucination experienced by psychotic individuals is:
auditory
9. Research using brain imaging techniques has localized auditory hallucinations in the part of the brain called:
Broca's area
10. The negative schizophrenic symptom called alogia is defined as:
lack of speech content and/or slowed speech response
11. The negative schizophrenic symptom called anhedonia is defined as:
inability to experience pleasure
12. Marta, a hospitalized schizophrenic patient, shows an unusual form of catatonia. If someone moves one of her arms or legs into a different position, it just stays that way. Marta's bizarre behavior is called:
waxy flexibility
13. A potential sign of schizophrenia in children is the experience of:
reduced positive and enhanced negative emotions
14. The DSM-5 criteria for the disorganized type of schizophrenia include all of the following EXCEPT:
echolalia or echopraxia
15. One of the subtypes of schizophrenia is termed residual. Which of the following individuals would be diagnosed with this condition?
Miss L. has had an episode of schizophrenia but has no active symptoms at this time.
16. The positive symptoms of schizophrenia are most closely associated with ____ activity.
dopamine
17. Which of the following statistical data are NOT accurate regarding schizophrenia?
men with schizophrenia have a better prognosis than women with schizophrenia
18. Callie has been diagnosed with schizoaffective disorder. This means that in addition to schizophrenic symptoms, she also has symptoms of:
a mood disorder
19. At various times individuals have been arrested for stalking celebrities who they believed were in love with them. This condition is called a(n) ____ delusion.
erotomanic
20. A woman diagnosed as schizophrenic announces that she has a plan to end poverty and homelessness in the world and that the Pope has given her secret instructions on how this can be accomplished. Her thinking is indicative of a delusion of ____.
grandeur
21. Which of the following defines the jealous type of delusional disorder?
falsely believing that one's sexual partner is unfaithful
24. Which of the following is true in regard to the genetic basis of schizophrenia?
Genes are responsible for making some individuals vulnerable to schizophrenia.
25. When using correlational research to look for abnormalities in the brain as clues to the influences of schizophrenia, it is important to keep certain questions in mind. For example, if a schizophrenic person was found to have an excess of dopamine, a researcher would need to ask all of the following questions EXCEPT:
D. Why is the dopamine system active in the schizophrenic brain?
26. In regard to the ways that drugs affect neurotransmitters, which of the following is true?
a. A drug that is an agonist occupies the receptor sites, blocking the neurotransmitter.
b. A drug that is an antagonist helps increase the release of the neurotransmitter.
c. Both of these are correct.
d. <<<<<<Neither of these is correct??????.>>>>>
27. Which of the following neurotransmitters has recently been linked to schizophrenia?:
alterations in prefrontal activity involving glutamate transmissions
28. Which of the following drugs causes schizophrenic symptoms?
PCP
29. The prodromal phase of schizophrenia occurs:
1-2 years before serious symptoms emerge
30. Current research suggests that:
a. environmental stress may trigger schizophrenia
b. genes cause schizophrenia
c. genes carried by a fetus may make it vulnerable to schizophrenia
d. <<<<<<<<all of the above>>>>>>
31. Type II schizophrenia is associated with "negative symptoms" including all of the following EXCEPT:
hallucinations and delusions
32. Which of the following is NOT one of the typical minor side effects of antipsychotic medications?
headaches
33. Tardive dyskinesia, a severe side effect of antipsychotic medications, includes all of the following involuntary movements EXCEPT:
tooth grinding
34. In the latter half of the 20th century, the routine institutionalization of schizophrenic patients was significantly reduced because of:
a. the effectiveness of antipsychotic medications
b. court rulings limiting involuntary hospitalization
c. <<<both of these>>>
d. neither of these
35. Research suggests that the benefits of social skills training for schizophrenics:
decrease over time
36. Which of the following is characterized of paranoid schizophrenia?
delusions of grandeur or persecution
37. Which of the following defines the erotomanic type of delusional disorder?
believing that one is loved by an important person or celebrity
38. The prognosis for schizoaffective disorder is:
b. similar to that of schizophrenia
39. Making the diagnosis of schizophrenia is controversial because:
the symptoms can vary as a function of culture or race
41. Schizophrenic patients who take antipsychotic medications sometimes develop severe side effects such as akinesia, a Parkinsonian-like condition that produces all of the following EXCEPT:
hand tremors
Schizophreniform disorder
~ Schizophrenic symptoms
~ Few months only
~ Associated with good premorbid functioning
~ Most resume normal lives
~ Prevalence = 0.2% (life)
Shared psychotic disorder
Delusions from relationship with delusional person
Schizoaffective disorder
Symptoms of schizophrenia plus a mood disorder
> Disorders are independent
~ Delusions for 2 weeks in absence of mood

>Prognosis = similar to schizophrenia
~ Persistent
~ No improvement without treatment
Delusional disorder
> Delusions contrary to reality
> Lack other positive and negative symptoms
> Types:
- Erotomanic
- Grandiose
- Jealous
- Persecutory
- Somatic
> Rare: 26-60 per 100,000
> Later age of onset
- Between 35 - 55
> Female > Male
- 55% to 45%
> Prognosis
- Better than schizophrenia
- Worse than other psychotic disorders
> Conflicting evidence about the biological or the psychosocial influences
Two new disorder added to the DSM-5
~ Substance-induced psychotic disorder
~ Psychotic disorder associated with another medical condition
Four primary causes of schizophrenia
> The possible genes involved in schizophrenia
> The chemical action of the drugs that help many people with this disorder
> Abnormalities in the working of the brains of people with schizophrenia
> Environmental risk factors that may precipitate the onset of the symptoms
Brief psychotic disorder
> One or more positive symptoms
> Lasts 1 month or less
> Usually precipitated
- Extreme stress
- Trauma
> Typically return to premorbid baseline
Schizotypal personality disorder
> Symptoms are similar to schizophrenia
> Less severe
> Genetic relationship to schizophrenia
> "Schizophrenia spectrum"
Prevalence of Schizophrenia
> Prevalence = 0.2% to 1.5% (life)
> Course = Chronic
> Moderate-to-severe lifetime impairment
> Life expectancy = less than average
~ Suicide
> Female : Male = ~1:1
> Females
~ Later age of onset
~ Better outcomes
Development of Schizophrenia
Early childhood clinical features
~ Mild physical abnormalities
~ Poor motor coordination
~ Mild cognitive problems
~ Social problems

Prodromal phase
~ 85% experience
~ 1-2 years before serious symptoms
~ Less severe, yet unusual
+ Ideas of reference
+ Magical thinking
+ Illusions
+ Isolation
+ Marked impairment in functioning,
+ Lack of initiative, interests, or energy

Diagnosis and treatment typically occur 1-2 years after symptom onset

Relapse and recovery

Most (78%) experience several episodes

Poor overall prognosis
Genetic Research for Schizophrenia
# Inherited vulnerability for schizophrenia
# Polygenetic influences
# Risk increases with genetic relatedness
# Risk is transmitted independently of diagnosis
# Interaction with environment
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