Clinical 3

These flashcards cover key vocabulary and definitions related to psychosis and schizophrenia, aiding in understanding important concepts from the lecture.

Psychosis

An umbrella term meaning ‘out of touch with reality’, referring to various clusters of symptoms.

Schizophrenia

A mental disorder characterized by disruptions in thought processes, perceptions, emotional responsiveness, and behavior.

Positive Symptoms

Symptoms that add to normal experience, such as hallucinations, delusions, disorganised speech.

Negative Symptoms

Symptoms that reflect a deficit in normal functions, such as lack of motivation and emotional expression.

Hallucinations

Perceptions in the absence of environmental stimuli, most commonly auditory.

Delusions

Fixed and false beliefs not amenable to change in light of conflicting evidence.

Disorganized Speech

Speech that exhibits frequent derailment or incoherence, a symptom of schizophrenia.

Avolition

A negative symptom characterized by a lack of motivation to achieve goals.

Expressed Emotion (EE)

A measure of family communication patterns that includes criticism, hostility, and over-involvement, linked to relapse rates in schizophrenia.

Biopsychosocial Model

A framework for understanding the interaction of biological, psychological, and social factors in the development of schizophrenia.

DSM-5-TR

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, used for diagnosing schizophrenia.

First Rank Symptoms

Symptoms proposed by Kurt Schneider, including auditory hallucinations and delusional perceptions.

Cognitive Biases

Systematic patterns of deviation from norm or rationality in judgment, often seen in individuals with schizophrenia.

Genetic Vulnerability

The inherited aspect of risk for developing schizophrenia, influenced by multiple genes.

Treatment for Schizophrenia

Includes antipsychotic medications, psychosocial interventions, family support, and lifestyle changes.

Louis Wain

An artist whose works illustrate the changes in perception and reality associated with schizophrenia.

A Beautiful Mind

A film depicting the life of John Nash, a mathematician with psychosis, illustrating the struggles with reality contact.

Schizotypal Personality Traits

Personality traits that predict the risk of psychosis, especially in conjunction with cognitive deficits.

Tangentiality

• a communication disorder where a person's thought process wanders and they fail to answer a question directly.

Word Salad

a jumble of words or phrases that lack coherent meaning, often seen in severe mental illness. It is characterized by disorganized speech.

Neologism

the creation or use of new words or phrases that are often nonsensical or have unique meaning to the individual, typically associated with certain mental disorders.

Thought-Blocking

a temporary inability to continue speaking or a sudden disruption in a train of thought, often observed in certain mental health conditions.

Schizotypy

A multidimensional trait profile including social, perceptual, and magical features

Alogia 

a deficiency in the quantity or quality of speech, often seen in individuals with schizophrenia or other mental health disorders.

• negative symptom

Affective Flattening

a reduction in emotional expressiveness, often observed in individuals with schizophrenia, where facial expressions, voice tone, and gestures are diminished.

• negative symptom

Diathesis

stress model in psychology that explains the interaction between a predisposing vulnerability and environmental stressors in the onset of psychological disorders.

Sociocognitive theory

explains how social and cognitive factors contribute to the development of delusions and hallucinations in schizophrenia.

Catatonic Behaviour

a severe decrease in response to the environment, which may include immobility, excessive motor activity, or abnormal posturing often seen in schizophrenia.

ABC model of emotion and behaviour

A- activating event

B- belief system
C- emotional consequence

Prevalence of Schizophrenia

1%

4 P’s of Case Formulation

Predisposing, precipitating, perpetuating, and protective factors

3 Factors in Diagnosing Psychosis

• symptom configuration: bizarre and non-bizarre

• duration: more than 6 months

• relative pervasiveness

Common Diathesis Profile Associated with Depression

• dependency

• self-criticism

• pessimistic attributional style

Diagnostic Criteria for Schizophrenia

• must present with at least one of : delusions, hallucinations, or disorganised speech

• lasts a significant portion of time during a one-month period

• signs of disturbance for at least six months.

• significant impairment in social, occupational, or self-care functioning for a meaningful portion of time since the onset of the disorder

Brain region associated with hallucinations

Temporal lobes

Brain region associated with disrupted memory

hippocampus

Thalamus 

• responsible for abnormal sensory processing and cognitive disturbances 

Amygdala

• heightened paranoia and blunted emotions

DSM-5-TR Patterns

• pervasive and inflexible

• begin by early adulthood

• stable over time

Bizarre Delusions

• do not make sense in this reality, but excludes cultural or religious reasonings

Non-Bizarre Delusions

• make more sense and can be derived from ordinary experiences

Mood spectrum lowest to highest

• depression, dysthymia, euthymia, hypomania, mania

White matter abnormalities with schizophrenia

• disrupted connectivity between the prefrontal cortex, temporal lobes and hippocampus

• enlarged ventricles which decrease cognitive ability

specific diathesis examples

anorexia- perfectionism

ocd- thought-action fusion

panic disorder- anxiety sensitivity

bipolar disorder- hypomanic temperament

Diagnostic criteria for Panic Disorder

• recurrent unexpected panic attacks (abrupt surges peaking within minutes, usually with ≥4 of 13 symptoms)

• more than 1 month of persistent concern about more attacks or their consequences and/or a maladaptive behavioral change; not due to a substance/medical condition and not better explained by another disorder.

Diagnostic criteria for Major Depressive Disorder (MDD)

• One or more Major Depressive Episodes (≥5 symptoms in the same 2-week period with at least depressed mood or anhedonia; clinically significant distress/impairment; not attributable to a substance/medical condition)

• the episode is not better explained by a schizophrenia-spectrum or other psychotic disorder, and there has never been a manic or hypomanic episode.

Risk factors for Schizophrenia

• Migration and discrimination
  - Urbanicity
  - Expressed emotion
  - Cannabis use
  - Schizotypal personality traits
  - Genetic risk (highly polygenic - needs multiple genes, common and rare genetic variations contribute to risk.)
  - Family history
  - Gene-environment interaction

Bipolar Disorder characteristic

• hyper behaviour indicative of manic episodes 

Schneiders 11 'First-rank symptoms' of Schizophrenia;

• Hearing one's voice out loud

• Hallucinatory voices talking about the patient

• Hallucinations in the form of running commentary

• Somatic hallucinations produced by external agencies

• Thought withdrawal

• Thought insertion

• Thought broadcasting

• Delusional perception (Ideas of reference)

• Made feelings

• Made actions

• Made impulses

Issues with Schneider's Approach

• Symptoms are non-specific to Schizophrenia
• Cross-sectional diagnosis
• Diagnosis is based on criteria that

• Outline signs and symptoms

• Duration of disturbance

• Impact of functioning that is characteristic of schizophrenia

Highlight exclusion factors

Morel and Kraeplin regarding schizophrenia

Morel thought it was early dementia and Kraeplin agreed.

= coined the term Dementia Precox: Characterized by deterioration and early onset.

Corrigan’s paradox self-stigma

the self-stigma pathway may not always lead to damage to self instead it could energise the person leading to self-identification