Week 9: PSYC251 Psychopathology - Psychosis and Schizophrenia Spectrum Disorders

Vocabulary flashcards covering diagnostic criteria, symptomatology, phases, aetiological models, and treatments for schizophrenia spectrum and psychosis-related disorders from PSYC251 Week 9.

Psychosis

A mental state that causes a disconnection from reality, where an individual finds it difficult to differentiate between what is real and what is not, characterised by disrupted thoughts and perceptions (such as hallucinations and delusions) that form part of a spectrum rather than a standalone diagnosis.

Dementia Praecox

Kraepelin's early diagnostic term introduced in $1899$ (meaning 'premature dementia') for psychoses characterised by symptom onset in adolescence or early adulthood, deficits in emotional expression, volition, and attention, and catatonic, paranoid, or hebephrenic presentations.

Bleuler's Basic Symptoms

Fundamental disruptions of thought and associative splitting introduced by Bleuler in $1908$, consisting of Associations (thought and speech derailment), Affect (blunted, inappropriate, or disturbed emotional responses), Ambivalence (volitional indeterminacy), and Autism (withdrawal from reality into an inner world).

Bleuler's Accessory Symptoms

Symptoms identified by Bleuler that are not the fundamental core root of schizophrenia itself, but represent psychological reactions or coping attempts to associative splitting, specifically delusions and fluctuating hallucinations.

Hallucinations

Positive psychotic symptoms involving sensory perceptions of things that do not exist in reality, occurring in the absence of an external stimulus (such as hearing voices, seeing visions, smelling odours, or feeling sensations on the skin).

Delusions

Strongly held beliefs that do not change when presented with factual proof to the contrary or logical reasoning, including persecutory, referential, or grandiose themes.

Bizarre Delusions

Delusional beliefs that are deemed clearly implausible, not understandable, and not derived from ordinary life experiences.

Derailment

A formal thought disorder symptom of disorganised thinking and speech characterised by abruptly switching from one topic to another.

Tangentiality

A form of disorganised thinking and speech where an individual provides answers to questions that are completely unrelated to what was asked.

Incoherence ('Word Salad')

A severe form of disorganised thinking and speech in which language is incomprehensible and substantially impairs effective communication.

Catatonia

A marked decrease in reactivity to the environment, featuring resistance to instructions, lack of responsivity, purposeless motor activity, odd posturing, or echoing of speech.

Blunted Affect

A negative symptom of psychosis characterised by speaking in a flat, monotonous voice and exhibiting a blank face with very few facial expressions.

Alogia

A negative symptom termed 'poverty of speech', characterised by speaking very little, giving one-word answers, and struggling to hold a conversation.

Avolition

A negative symptom termed 'lack of motivation', marked by lacking the drive to initiate, complete, or show concern for daily tasks and personal goals.

Anhedonia

A negative symptom defined as the loss of interest in or loss of the ability to experience pleasure and enjoyment from hobbies and social interactions that were previously enjoyed.

Asociality

A negative symptom termed 'social withdrawal', characterised by wanting to avoid interactions, withdrawing from friends and family, and showing little interest in relationships.

Prodromal Phase

A pre-psychotic phase lasting months to years characterized by vague, non-specific changes in thoughts, feelings, and behaviours that are frequently mistaken for general stress or major depressive disorder.

Acute Phase

A phase of psychosis lasting days to months during which overt positive psychotic symptoms emerge, reality testing is compromised, insight is lost, and significant functional disruption occurs.

Residual Phase

A phase lasting months to years wherein acute positive symptoms subside with treatment, while negative and cognitive symptoms persist as the person undergoes rehabilitation.

Schizophrenia

A chronic psychotic disorder characterized by continuous signs of disturbance for at least $6\text{ months}$, including at least $1\text{ month}$ of active phase symptoms (at least one being delusions, hallucinations, or disorganized speech) and marked functional decline.

Schizoaffective Disorder

A condition characterized by an uninterrupted period of illness with concurrent active-phase schizophrenia symptoms and a major mood episode, alongside delusions or hallucinations persisting for $2\text{ or more weeks}$ in the absence of a major mood episode.

Delusional Disorder

A disorder defined by the presence of one or more persistent delusions lasting for $1\text{ month}$ or longer, where Criterion A for schizophrenia has never been met and functioning is not markedly impaired outside the impact of the delusion.

Erotomanic Delusion

A delusional subtype in which the central, unshakeable belief is that another person is in love with the individual.

Grandiose Delusion

A delusional subtype centred on the conviction of possessing great, unrecognized talent or insight, or having made a major discovery.

Jealous Delusion

A delusional subtype in which the core belief revolves around the unfaithfulness of one's spouse or lover without factual basis.

Persecutory Delusion

A delusional subtype where the central theme is the belief that one is being conspired against, spied on, cheated, poisoned, drugged, harassed, or obstructed in pursuing goals.

Somatic Delusion

A delusional subtype in which the core conviction revolves around abnormal bodily functions or physical sensations.

Dopamine Hypothesis of Psychosis

The biological hypothesis proposing that dysregulation and hyperactivity of mesolimbic dopamine circuits result in hyperdopaminergic states that drive acute positive psychotic symptoms.

Aberrant Salience Model (Kapur et al., 2003)

An aetiological model positing that altered striatal dopamine firing causes neutral or internal stimuli to be assigned exaggerated emotional significance; delusions then form as cognitive constructs to explain these neurochemical surges.

Diathesis-Stress Model of Psychosis

A framework stating that psychosis emerges when an individual with an underlying biological or psychological vulnerability (diathesis) encounters environmental stressors that exceed their coping capacity.

1st Generation (Typical) Antipsychotics

Antipsychotic medications (e.g., Haloperidol) that strongly block dopamine ($D_2$) receptors globally across the brain, demonstrating high efficacy for positive symptoms.

2nd Generation (Atypical) Antipsychotics

Antipsychotic medications (e.g., Olanzapine, Risperidone, Clozapine) that weakly block dopamine receptors while strongly blocking serotonin receptors, addressing both positive and negative symptoms.

3rd Generation (Novel) Antipsychotics

Antipsychotic medications (e.g., Aripiprazole) that act as partial dopamine agonists (functioning like a 'dimmer switch') or target alternative neurotransmitter pathways such as acetylcholine.

The Staging Model (Hickie et al., 2013)

A clinical framework conceptualising psychosis as a continuum across illness severity stages (from Stage $0$ at-risk up to Stage $4$ severe, unremitting illness) to deliver matched, preventative interventions.

Acceptance and Commitment Therapy for Psychosis (ACT-P)

A tailored psychological intervention ($4\text{ to }6\text{ sessions}$ of $30\text{ minutes}$) that helps individuals change how they react to hallucinations and delusions using defusion, acceptance, and values-based actions, rather than attempting to eliminate symptoms.

Brief Psychotic Disorder

A transient psychotic disturbance involving the sudden onset of at least one psychotic symptom (delusions, hallucinations, disorganised speech, or catatonic behaviour) lasting at least $1\text{ day}$ but less than $1\text{ month}$, with a complete return to premorbid baseline functioning.

Schizophreniform Disorder

A psychotic condition presenting with symptoms identical to schizophrenia that last for at least $1\text{ month}$ but less than $6\text{ months}$, without strictly requiring functional decline.

Substance/Medication-Induced Psychotic Disorder

A psychotic disorder where delusions or hallucinations emerge within $1\text{ month}$ of substance intoxication, substance withdrawal, or medication exposure capable of precipitating psychosis, without evidence of primary psychosis.