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delusions
beliefs in obvious contrast to fact; common ones include persecution (most common), grandeur, control, reference, thought broadcasting
delusion of reference
a delusion in which the person with schizophrenia believes public information is being directed towards them specifically
delusion of control
a delusion in which the person with schizophrenia believes they are being controlled from outside forces
hallucinations
perceptions of stimuli that are not present
negative symptoms
absence or decrease in some typical behaviors; inability or decreased ability to initiate actions, speech, express emotion, or feel pleasure; diminished emotional expression/blunted affect often precede positive symptoms
false
True or false?
Hallucinations can only be visual.
true
True or false?
Those with more negative symptoms of schizophrenia tend to have a poorer prognosis.
antipsychotic; negative
_________ medications have little effect on __________ symptoms and cause secondary negative symptoms
alogia
poverty of speech
anhedonia
inability to experience pleasure
asociality
lack of interest in social relationships
avolition
lack of motivation for goal-directed behavior
2; 6
To be diagnosed with schizophrenia, an individual must have at least ____ symptoms (delusions, hallucinations, disorganized speech, disorganized/abnormal behavior, or negative symptoms) in a one-month period, persisting for at least ___ months.
prodromal; residual
Subthreshold ________ (preceding active phase) and _________ (following) psychotic symptoms are common in schizophrenia.
schizophreniform disorder
shorter length of presentation and less impaired functioning than schizophrenia; symptoms present for at least one month but not longer than six months; 2/3 continue to experience symptoms and are diagnosed with schizophrenia; intermediate disorder between schizophrenia and brief psychotic disorder
brief psychotic disorder
one symptom of schizophrenia present for less than one month
schizoaffective disorder
psychotic symptoms of schizophrenia plus a concurrent, uninterrupted period of either a major depressive or manic episode
major depressive; schizoaffective
If psychotic symptoms do not persist for at least two weeks after the end of a depressive episode, the diagnosis would be __________ disorder with psychotic features rather than __________ disorder.
delusional disorder
at least one delusion that lasts for at least one month; daily functioning not substantially impaired; if there are any psychotic symptoms in addition to delusions —> schizophrenia or schizophreniform disorder
adolescence; adulthood
Symptoms of schizophrenia typically begin in late __________ or early __________.
false
True or false?
Schizophrenia is the least prevalent disorder within the spectrum at 0.3-0.7% of the population.
false
True or false?
Men with schizophrenia have fewer negative symptoms and later onset of symptoms.
monochorionic
Higher concordance rate in __________ (60%) twins (share a single placenta) than dichorionic (11%) identical twins; oxygen and nutrient environment of the developing fetus seem to play a role.
DISC1; 50
Mutation of gene known as ________ (disrupted in schizophrenia 1) may increase the likelihood of schizophrenia by up to ~_____x.
DISC1
(chromosome 1q42.1) regulates embryonic and adult neurogenesis; mutations found in some families with high incidence of schizophrenia
schizophrenia; orbitofrontal
Brain abnormalities in _________: ventricle enlargement, volume reduction in the medial temporal lobe (amygdala, hippocampus, auditory cortex), volume reduction in ___________ cortex (inhibition)
dopamine hypothesis
hyperactivity of dopamine D2 receptors in subcortical and limbic brain regions contributes to positive symptoms and hypofunctionality of dopamine D1 receptors in the frontal cortex contributes to negative and cognitive symptoms
antagonists
antipsychotics act as dopamine ___________ (blockers)
true
True or false?
Dopamine agonist drugs such as cocaine and amphetamines can produce positive symptoms.
tardive dyskinesia
involuntary movements of the tongue, mouth, and face; chronic blockade of dopamine D2 receptors may cause them to become supersensitive
schizophrenia; affective
________: characterized by disordered thoughts; __________ (mood) disorders: characterized by disordered feelings
mood-related
Women with schizophrenia tend to have more ___________ symptoms
amphetamine; psychosis
Large doses of ___________ can cause amphetamine ________, which resembles schizophrenia: paranoia, delusions of persecution, auditory hallucinations, suspiciousness, and bizarre motor behavior.
psychedelics (hallucinogens)
alter sensory perception and produce peculiar experiences; ex. LSD (acid), mescaline (peyote), and psilocybin (magic mushrooms); most are serotonin receptor agonists, especially the serotonin receptors concentrated in the visual cortex
phencyclidine (PCP); ketamine
Current “best models” of schizophrenia use __________ or __________, which are glutamate NMDA receptor antagonists; both can induce psychosis symptoms in humans, including hallucinations, delusions, and cognitive deficits
hypofrontality hypothesis
schizophrenia may be caused by underactivation of the frontal lobes
increase; hypofrontality; decrease
According to the dopamine hypothesis, one needs to _________ DA activity in the prefrontal cortex to address ________ and negative symptoms and _________ DA activity in the mesolimbic (reward) pathway to address positive symptoms.
typical antipsychotics (1st generation)
act as dopamine antagonists (blockers); often effective on positive symptoms, but many side effects
atypical antipsychotics (2nd generation)
act as partial agonists of dopamine receptors (lower affinity for DA receptors); also stimulate serotonin activity; act as a partial agonist where there is too little dopamine and as a partial antagonist where there is too much dopamine
autoreceptors
signal a neuron to release less of its own neurotransmitter (negative feedback loop)
false
True or false?
Atypical antipsychotics are not effective at reducing negative symptoms.
smoking
Maternal substance abuse increases risk of developing schizophrenia, especially __________.
false
True or false?
Among the mentally ill, smoking prevalence is lowest in patients with schizophrenia.
complex disease
a disease that is caused by a combination of multiple genetic and environmental factors; ex. multiple sclerosis, systemic lupus erythematosus, asthma, inflamed skin lesions, leukemia, breast cancer
genetic risk loci
position of specific genes that increase the risk of developing the disorder
single-nucleotide polymorphisms (SNPs)
variations in a single nucleotide (building block of DNA and RNA) at a specific position in the genome; common and many (over 100) are associated with schizophrenia, but all have very small effects
copy number variants (CNVs)
structural variations, deletions, or duplications of larger chromosomal segments that may affect one or multiple genes; much less common than SNPs, but larger effect size
8
The ____ loci of CNVs linked to schizophrenia are also associated with ASD, ADHD, intellectual disability, and epilepsy (pleiotropy).
false
True or false?
Down syndrome and Williams syndrome are caused by single-nucleotide polymorphisms.
coding regions (exons)
contain instructions for making proteins
noncoding regions (introns)
pieces of DNA between the coding regions that do not make any known proteins; make up the majority of DNA, regulate gene expression, protect chromosomes, and produce some RNA molecules (carry genetic information from DNA to ribosomes)
noncoding (intron)
Most schizophrenia-associated risk variants are located in the _________ regions of the genome.
true
True or false?
Introns make up the majority of the DNA.
telomeres
__________ are sequences of noncoding DNA found at the ends of chromosomes that protect DNA from degradation during replication.
metabolic
Schizophrenia increases the risk of __________ syndrome (and vice versa), a cluster of conditions that increase the risk of heart disease, stroke, and type 2 diabetes.
shortening
Telomere ___________ in schizophrenia could be a marker of accelerated aging and potentially contribute to increased mortality (decreased life expectancy of ~15 years).
cerebral insulin suppression
a mechanism of protecting the brain in times of famine; can be inherited
stressful
Schizophrenia usually appears during a time in life that many people find _________: the transition from childhood to adulthood.
neurodegenerative
Some studies find reduced brain volume and neuronal loss in individuals with schizophrenia, but most people with schizophrenia do not experience the progressive decline in cognitive and motor function that is typical of ____________ disorders.
White matter reduction
Which of the following is not a brain abnormality that has been recognized in schizophrenia?
Ventricle enlargement
White matter reduction
Volume reduction in the medial temporal lobe (amygdala, hippocampus, auditory cortex)
Volume reduction in orbitofrontal cortex (inhibition)
bipolar disorder
periods of depression alternating with expansive mood, or mania; brain imaging shows more activity during manic bouts; has some similarities to schizophrenia, including enlarged ventricles and genetic overlap
bipolar
Individuals with _________ disorder are more likely to have a family member with schizophrenia.
Traumatic brain injury (TBI)
Which of the following is not one of the three main categories of neurocognitive disorders?
Delirium
Mild neurocognitive disorder
Traumatic brain injury (TBI)
Major neurocognitive disorder
Delirium tremens (DT)
Which of the following is not a subtype of minor and major neurocognitive disorders?
Delirium tremens (DT)
Alzheimer’s disease (AD)
Traumatic brain injury (TBI)
Parkinson’s disease
delirium
notable disturbance in attention and reduced awareness of the environment; rapid onset (acute); fluctuates in severity