Schizophrenia Lecture Notes

Flashcards on Schizophrenia

Schizophrenia

A severe and chronic brain disorder that affects a person's thinking, feeling, and behavior. It is characterized by disturbances in perception, thought processes, reality testing, affect, and motivation. Schizophrenia is present in humans throughout history, affecting approximately 1 in 100 people worldwide, with about 3.2 million Americans currently having the disorder. The symptoms of schizophrenia can vary widely from person to person, but they often include hallucinations, delusions, disorganized thinking, and social withdrawal.

Downward Drift Theory

Suggests that schizophrenia, due to its debilitating effects on cognitive and social functioning, can cause individuals to experience a decline in socioeconomic status. This means that people who initially hold higher-level jobs or come from wealthier backgrounds may find it difficult to maintain their positions or lifestyle as their symptoms worsen. Thus, they 'drift downward' into poverty or lower social classes.

Schizophrenia: Gender Differences

Equal numbers of men and women are diagnosed, but in men, symptoms begin earlier (average age of onset = 23 years, compared to 28 years for women) and are more severe.

Positive Symptoms

Bizarre additions to a person’s behavior, including delusions, disordered thinking and speech, heightened perceptions, hallucinations (sensory perceptions that occur in the absence of external stimuli), and inappropriate affect (displays of emotion that are unsuited to the situation). These symptoms reflect an excess or distortion of normal functions and are often more responsive to treatment than negative symptoms.

Delusions

false beliefs, based on incorrect inference about external reality, that are firmly held despite what almost everyone else believes and despite what constitutes incontrovertible and obvious proof or evidence to the contrary. These can include a variety of themes:

• Persecutory: Believing that one is going to be harmed, harassed, etc., by an individual, organization, or other group.

• Referential: Belief that certain gestures, comments, passages of books, newspapers, songs, or other environmental cues are directed at oneself.

• Grandiose: When an individual believes that he or she has exceptional abilities, wealth, or fame.

• Erotomanic: When an individual believes falsely that another person is in love with him or her.

• Nihilistic: Involves the conviction that a major catastrophe will occur.

• Somatic: Preoccupations regarding health and organ function.

Thought Disorder

Disordered thinking and speech, which may include loose associations, neologisms (made-up words), perseverations, and clang.

Hallucinations

Sensory perceptions that occur in the absence of external stimuli; most common are auditory hallucinations, but can include tactile, somatic, visual, gustatory, or olfactory hallucinations.

Negative Symptoms

Pathological deficits lacking in an individual, including poverty of speech (alogia), blunted and flat affect, loss of volition (apathy), and social withdrawal.

Alogia

Poverty of speech, characterized by long lapses before responding to questions, failure to answer, or reduction of quantity or content of speech.

Psychomotor Symptoms

Awkward movements, repeated grimaces, odd gestures, and in extreme forms, catatonia, which includes stupor, rigidity, posturing, and excitement.

Phases of Schizophrenia

Prodromal (beginning of deterioration; mild symptoms), Active (symptoms become increasingly apparent), and Residual (a return to prodromal levels).

Factors for Better Prognosis in Schizophrenia

High premorbid functioning, disorder triggered by stress, abrupt onset, later onset (during middle age), and receiving treatment.

DSM Criteria for Diagnosing Schizophrenia

Signs of the disorder continuing for six months or more, including a period of a month or more of active symptoms (delusions, hallucinations, and/or thought disorder), and deterioration in work, social relations, and ability to care for oneself.

Type I Schizophrenia

Mostly positive symptoms, good adjustment before illness, starts later in life, and has a better chance of getting better. It might be related to chemical imbalances in the brain.

Type II Schizophrenia

Dominated by negative symptoms and may be tied largely to structural abnormalities in the brain.

Biological Views of Schizophrenia: Genetic Factors

Schizophrenia is more common among relatives of people with the disorder. The closer the biological relationship, the greater the risk.

Dopamine Hypothesis

Certain neurons using dopamine fire too often, producing symptoms of schizophrenia. This theory is based on the effectiveness of antipsychotic medications (dopamine antagonists).

Amphetamine Psychosis

A syndrome similar to schizophrenia that may develop in people who take high doses of amphetamines, which increase dopamine activity in the brain.

Second-Generation Antipsychotic Drugs

Also known as "atypical" antipsychotics; more effective than traditional antipsychotics and bind to D-2 dopamine receptors and many D-1 receptors, and to other neurotransmitters (serotonin, glutamate, & GABA) receptors.

Dysfunctional Brain Circuit in Schizophrenia

Includes the prefrontal cortex, hippocampus, amygdala, thalamus, striatum, and substantia nigra, among other structures.

Schizophrenogenic Mothers

Psychodynamic explanation by Fromm-Reichmann involving mothers who supposedly cause schizophrenia in their children, but this has little research support and has been rejected by most psychodynamic theorists.

Sociocultural Factors Contributing to Schizophrenia

Multicultural factors, social labeling, and family dysfunction, although the precise relationships are not yet clarified by research.

Expressed Emotion

Family members frequently express criticism and hostility and intrude on each other’s privacy; linked to family stress and schizophrenia.

Developmental Psychopathology View of Schizophrenia

An individual’s genetic predisposition implemented by a dysfunctional brain circuit may lead to schizophrenia if he/she experiences significant life stressors, difficult family interactions, and/or other negative environmental factors.

Schizophreniform Disorder

Identical to schizophrenia, except that its duration is at least 1 month but less than 6 months.

Brief Psychotic Disorder

Sudden onset of psychotic symptoms, such as delusions, hallucinations, disorganized speech, or catatonic behavior. The episode lasts at least one day but less than one month, with full return to the premorbid level of functioning. Often triggered by stress.

Schizoaffective Disorder

A chronic mental health condition characterized primarily by symptoms of schizophrenia, such as hallucinations or delusions, and symptoms of a mood disorder, such as mania and depression.

Delusional Disorder

A condition where a person has strong beliefs in things that are not true. These beliefs are not due to odd behavior, hallucinations, mood problems, or schizophrenia.

Psychosis Due to a Medical Condition

Psychotic symptoms (hallucinations or delusions) that arise as a direct result of a medical condition. This is diagnosed when the psychosis is determined to be a consequence of the physiological effects of a medical issue.

Substance/Medication-Induced Psychotic Disorder

Psychosis caused by the use of or withdrawal from substances (drugs or alcohol) or exposure to a medication. Symptoms include hallucinations and delusions, and cessation of the substance typically resolves the psychosis.