AbPsy - Chapter 13: Schizophrenia Spectrum Disorders

Schizophrenia

Characterized by a broad spectrum of cognitive and emotional dysfunctions including delusions and hallucinations, disorganized speech and behavior, and inappropriate emotions

psychosis.

hallmark of schizophrenia

psychosis.

significant loss of contact with reality

John Haslam

portrayed schizophrenia as what he called "a form of insanity."

Benedict Morel

the French term démence (loss of mind) précoce (early premature) - of the disorder is often during adolescence.

Emil Kraepelin

Combined several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders

catatonia, hebephrenia, paranoia

several symptoms of insanity that had usually been viewed as reflecting separate and distinct disorders that were combined by emil kraepelin

catatonia

alternating immobility and excited agitation

hebephrenia

silly and immature emotionality

paranoia

delusions of grandeur or persecution

manic-depressive illness (now called bipolar disorder).

emil kraepelin Distinguished dementia praecox from this disorder

Eugen Bleuler

schizophrenia

Comes from the combination of the Greek words for "split" (skhizein) and "mind" (phren)

origin of word schizophrenia

Psychotic behavior

used to characterize many unusual behaviors, although in its strictest sense, it usually involves delusions (irrational beliefs) and/or hallucinations (sensory experiences in the absence of external events)

,,POSITIVE SYMPTOMS

Reflect an excess or distortion of normal function (e.g., delusions, hallucinations); generally refer to symptoms around distorted reality

Delusion, Hallucinations

positive symptoms

Delusion

A belief that would be seen by most members of a society as a misrepresentation of reality; disorder of thought content

Delusion

An erroneous belief that is fixed and firmly held despite clear contradictory evidence.

Delusions of persecution

belief that others are others are "out to get them."

Motivational view of delusions

would look at these beliefs as attempts to deal with and relieve anxiety and stress.

Deficit view of delusion

sees these beliefs as resulting from brain dysfunction that creates these disordered cognitions or perceptions

Hallucinations

sensory experience that seems real to the person having it, but occurs in the absence of any external perceptual stimulus

Broca's area

Hallucinating patients show increased activity in this part of the brain

Broca's area

area of the temporal lobe that is involved in speech production

NEGATIVE SYMPTOMS

reflect an absence or deficit of behaviors that are normally present; usually indicate the absence or insufficiency of normal behavior

Avolition, Alogia, Anhedonia, Asociality, Affective flattening

negative symptoms

Avolition

inability to initiate and persist in activities; apathy; lack of motivation to do tasks, including day-to-day tasks

Alogia

refers to the relative absence of speech; poverty of speech

Anhedonia

indifference to activities that would typically be considered pleasurable; lack of pleasure

Asociality

lack of interest in social interactions; withdrawal

Affective flattening

do not show emotions; may represent difficulty expressing emotion, not a lack of feeling

DISORGANIZED SYMPTOMS

include a variety of erratic behaviors that affect speech, motor behavior, and emotional reactions.

Disorganized speech, Inappropriate affect and disorganized behavior

disorganized symptoms

Disorganized speech

jumping from topic to topic, and at other times they talk illogically

tangentiality

going off on a tangent instead of answering a specific question

loose association or derailment

abruptly changing the topic of conversation to unrelated areas

inappropriate affect

laughing or crying at improper times.

(catatonic immobility).

people hold unusual postures, as if they were fearful of something terrible happening if they moved

waxy flexibility

tendency to keep their bodies and limbs in the position they are put in by someone else.

SCHIZOPHRENIFORM DISORDER

category reserved for schizophrenia-like psychoses that last at least a month but do not last for 6 months and so do not warrant a diagnosis of schizophrenia

SCHIZOAFFECTIVE DISORDER

diagnosis is conceptually something of a hybrid, in that it is used to describe people who have features of schizophrenia and severe mood disorder.

DELUSIONAL DISORDER

persistent belief that is contrary to reality, in the absence of other characteristics of schizophrenia

DELUSIONAL DISORDER

hold beliefs that are considered false and absurd by those around them but may otherwise behave quite normally - behavior does not show the gross disorganization and performance deficiencies characteristic of schizophrenia

erotomanic type, grandiose type, jealous type, persecutory type, somatic delusions,

delusional subtypes:

erotomanictype

delusion is the irrational belief that one is loved by another person, usually of higher status.

grandiose type

involves believing in one's inflated worth, power, knowledge, identity, or special relationship to a deity or famous person

jealous type

delusion believes the sexual partner is unfaithful

persecutory type

delusion involves believing oneself (or someone close) is being malevolently treated in some way

somatic delusions

person feels afflicted by a physical defect or general medical condition

shared psychotic disorder (folie à deux)

present in prev versions of dsm; condition in which an individual develops delusions simply as a result of a close relationship with a delusional individual

BRIEF PSYCHOTIC DISORDER

involves the sudden onset of psychotic symptoms or disorganized speech or catatonic behavior. Even though there is often great emotional turmoil, the episode usually lasts only a matter of days.

ATTENUATED PSYCHOSIS SYNDROME

these people may have some of the symptoms of schizophrenia but are aware of the troubling and bizarre nature of these symptoms.

prodromal stage

1- to 2-year period before the serious symptoms occur but when less severe yet unusual behaviors start to show themselves

late adolescence or early adulthood.

more severe symptoms of schizophrenia first occur in

dopamine

the _____ system is too active in people with schizophrenia

dopamine antagonists

Antipsychotic drugs (neuroleptics) often effective in treating people with schizophrenia are

Parkinson's disease symptoms

side effect of dopamine antagonists

striatal dopamine D2 receptors

schizophrenia is partially the result of excessive stimulation of

(prefrontal D1 receptors

dopamine site in the part of the brain that we use for thinking and reasoning (______) appears to be less active and may account for other.

N-methyl-d-aspartate (NMDA) receptors.

prefrontal activity involving glutamate transmission - the ones being studied for their role in schizophrenia are

striatal dopamine D2 receptors, prefrontal D1 receptors, N-methyl-d-aspartate (NMDA) receptors

three specific neurochemical abnormalities simultaneously at play in the brains of people with schizophrenia.

Hypofrontality

less active frontal lobes

Chronic and early use of marijuana (cannabis)

prenatal and perinatal influence drug that can contribute to schizophrenia

schizophrenogenic mother

used for a time to describe a mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children

Double bind communication

was used to portray a communication style that produced conflicting messages, which, in turn, caused schizophrenia to develop

Expressed emotion (EE)

how to convey feelings and thoughts toward a loved one with schizophrenia

neuroleptics

help people think more clearly and reduce hallucinations and delusions; work by affecting the positive symptoms (delusions, hallucinations, and agitation) and to a lesser extent the negative and disorganized ones, such as social deficits.

conventional or first-generation antipsychotics such as haldol and thorazine

earliest neuroleptic drugs

Atypical or second-generation antipsychotics (e.g. Clozapine)

cause fewer extrapyramidal symptoms than the earlier antipsychotic medications; side effects: drowsiness and considerable weight gain are very common; diabetes

extrapyramidal symptoms

More serious side effects ex. motor difficulties

Akinesia

one of the most common; it includes an expressionless face, slow motor activity, and monotonous speech.

tardive dyskinesia

involves involuntary movements of the tongue, face, mouth, or jaw and can include protrusions of the tongue, puffing of the cheeks, puckering of the mouth, and chewing movements.

transcranial magnetic stimulation

Treatment for hallucinations; uses wire coils to repeatedly generate magnetic fields—up to 50 times per second—that pass through the skull to the brain.

Modafinil

a cognitive enhancer with low abuse potential; may improve emotion processing in schizophrenia - this is taken along with antipsychotics.

"moral treatment,

emphasized improving patients' socialization, helping them establish routines for self-control, and showing them the value of work and religion.

token economy

incentive system - used to promote social, self-care, and vocational skills, and more of them could be discharged from the hospital