Abnormal Child Psychology - Childhood-Onset Schizophrenia

Flashcards based on lecture notes about Abnormal Child Psychology, specifically focusing on Childhood-Onset Schizophrenia (COS).

Schizophrenia

A debilitating disorder involving cognitive and emotional dysfunction that interferes with functioning in social, vocational, and other contexts.

Epidemiology of Schizophrenia

Affects about 1% of the population, almost equally distributed between males and females (unless early onset), found in most cultures and races, and higher in populations with ethnic minority status and low SES.

Early-onset schizophrenia

Schizophrenia occurring before the age of 18 years.

Childhood-onset schizophrenia

Schizophrenia with onset prior to age 13 years (rare, approx. .04% children).

Precursors and Comorbidities of Childhood-Onset Schizophrenia

Gradual onset with a history of behavioral, social, and psychiatric disturbances before psychosis, including speech and language problems, motor development issues, social impairment, unusual thought content, suspicion/paranoia, substance abuse, and genetic risk. Commonly comorbid with mood disorders or ODD/CD.

Phases of Childhood Onset Schizophrenia

Prodrome phase (functional decline), acute phase (positive symptoms), recovery phase (primarily negative symptoms, may have positive symptoms), and residual phase (complete resolution of positive symptoms).

DSM-5 Criteria for Schizophrenia

Two or more of the following present for a significant portion of the time during a one-month period: delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms. Also requires social/occupational dysfunction and continuous signs of disturbance for at least six months, not attributable to other conditions.

Childhood-Onset Schizophrenia vs. Autism

COS has a later age of onset, less intellectual impairment, less severe social and language deficits, hallucinations and delusions, periods of remission and relapse compared to autism.

Categories of Symptoms in Schizophrenia

Positive, Disorganized, and Negative.

Positive Symptoms

The addition of abnormal experiences/behaviors such as hallucinations and delusions. Experienced by 50-70% of people with schizophrenia.

Negative Symptoms

Deficits in social, emotional, and motivational functioning; the absence of typical behaviors or expression. Associated with a worse prognosis and may be harder to recognize.

Negative Symptoms Examples

Avolition (lack of energy), Anhedonia (inability to feel pleasure), Alogia (lack of meaningful speech), Asociality (social withdrawal), Flat Affect (reduced emotional expression).

Disorganized Symptoms: Thought Disturbance

Derailment/loose associations, perseveration, clanging/word salad in speech.

Disorganized Symptoms: Behavioral Disturbances

Catatonia (immobility & muscular rigidity), agitation, stuporous state (reduced responsiveness), inappropriate affect (incongruent laughing/crying).

Cognitive Deficits in Schizophrenia

Major determinant of quality of life, affecting attention, working memory, episodic memory, and executive functioning.

Genetic Factors in Schizophrenia

Relatives of individuals with schizophrenia are at a significantly higher risk, and concordance increases with genetic similarity. Severity is related to likelihood of inheritance.

Congenital Factors in Schizophrenia

Pregnancy and birth complications (reduced oxygen supply), viral infections and season of birth (winter months), could lead to viral damage to the fetal brain. Schizophrenia rates are higher when the mother had the flu in the second trimester.

Dopamine Hypothesis

Excess in dopamine may be related to schizophrenia. Antipsychotics reduce dopamine activity, but can cause side effects such as tardive dyskinesia and cognitive impairments.

Neurodevelopmental Model of Schizophrenia

A genetic vulnerability and early neurodevelopmental insults result in impaired connections between many brain regions, including the prefrontal cortex and parts of the limbic system.

Treatment for Childhood-Onset Schizophrenia

Antipsychotic medications (e.g., risperidone) combined with psychotherapy, social and educational support programs. Psychosocial treatments include family intervention, social skills training, cognitive behavior therapy, and educational support.

Presentation/Duration of Schizophrenia

Generally chronic with moderate-to-severe impairment. The 'Rule of Fourths' suggests variable outcomes. Typical course is relatively stable functioning with discreet periods of exacerbation. 5% of patients with childhood-onset lose their life to suicide or dangerous behaviors during psychosis.

COS Pharmacological Treatments

Antipsychotic medications used to control psychotic symptoms.

Psychosocial Treatment for COS

Includes Cognitive Behavioral Therapy (CBT) to challenge delusional beliefs and negative expectations, Cognitive Enhancement Therapy (CET) to improve cognitive functions.

Case Management in Psychosocial Treatment

Helps coordinate treatments, provides support for everyday activities, and brokers access to available services. Institutional programs and hospitalization may be indicated for acute psychosis.