PSYC 212: Exam 3: Chapt. 13

What are the three types of schizophrenia symptoms?

Positive, Negative, and Disorganized symptoms

What are the three phases of schizophrenia?

Prodromal, active, and residual

What are the positive symptoms for schizophrenia?

Delusions and hallucinations

What are the negative symptoms for schizophrenia?

Anhedonia, blunted affect, alogia, and avolition

What is alogia?

Poverty of speech (speaking less than is typical for people) or thought blocking (incomplete expression of thoughts)

What is avolition?

Lack of motivation or goal-directed behavior

What are the disorganized symptoms for schizophrenia?

Disorganized speech and disorganized or catatonic behavior

What is disorganized speech?

Loose associations/derailment (shifting from topic to topic), Tangentiality (providing an irrelevant response), and Preservation (repeating a word or phrase)

What is disorganized or catatonic behavior?

Unusual motor behavior or movement, inappropriate affect, catatonia

What is the Prodromal phase?

Before first active phase, unnecessary for diagnosis, generally is the emergence of negative symptoms, may include mild versions of positive or disorganized symptoms

What is an Active phase?

At least 1 month, must include a positive symptom or disorganized speech (often includes a positive symptom)

What is a Residual phase?

Generally negative symptoms, may include mild versions of positive or disorganized symptoms (lacking the conviction piece)

What is required for schizophrenia?

All phases together must last for at least 6 months. Only the Active phase is required. Must include at least two symptoms (one of the bolds required): Positive Symptoms: Delusions and Hallucinations, Negative Symptoms: Anhedonia, Blunted affect, Alogia, and Avolition, and Disorganized Symptoms: Disorganized Speech, and Disorganized or Catatonic Behavior

At least one of three schizophrenia symptoms is required for a psychotic break. Which symptoms are these?

Delusions, hallucinations, and disorganized speech

What is required for Brief Psychotic Disorder?

At least 1 day, less than 1 month. Requires 1: Delusions, hallucinations, disorganized speech

What is required for Schizophreniform Disorder?

At least 1 month, less than 6 months. Must include at least two symptoms (one of the bolds required): Positive Symptoms: Delusions and Hallucinations, Negative Symptoms: Anhedonia, Blunted affect, Alogia, and Avolition, and Disorganized Symptoms: Disorganized Speech, and Disorganized or Catatonic Behavior

What is required for Delusional Disorder?

At least 1 month of Delusions (Hallucinations possible) and NO Negative and Disordered Symptoms

What is required for Schizoaffective Disorder?

Schizophrenia with a depressive or bipolar disorder. Positive symptoms must have been present sometime before mood symptoms for at least two weeks.

What is the relationship between gender and schizophrenia?

Possibly more prevalent in men. Age of onset in men: 18-25. Age of onset in women: 25-35. Women have more Positive Symptoms, whereas men have more Negative Symptoms.

How do schizophrenia outcomes vary across cultures?

“Developed” countries = poorer outcomes, because poorer countries need every person more.

What is the relationship between fetal environment and schizophrenia?

Children in gestation during a famine are more at risk of schizophrenia

Differences in brain structures in people with schizophrenia

People with schizophrenia have enlarged, fluid-filled ventricles and have overall less brain tissues, by volume

What is the Dopamine Hypothesis?

Either overproduction of dopamine or increased sensitivity of dopamine receptors causes schizophrenia

What is an endophenotype?

Vulnerability markers

What are the four endophenotypes we discussed in class?

Working memory deficits, eye-tracking dysfunctions, socio-economic status (SES), and expressed emotions

What makes a good endophenotype?

It can distinguish between people who ultimately DO or DON’T develop the disorder, it is stable over time, and it should be found in other family members.

What are the Social Causation vs. Social Selection Hypotheses?

Social Causation: Low Socio-Economic Status creates risk factors for schizophrenia

Social Selection: Schizophrenia leads to low Socio-Economic Status

What is an Expressed Emotion and what does it mean for people with schizophrenia?

Tendency of the family members to display their emotions through either negativity, hostility, and criticism or through over-involvement, intrusiveness, and emotional enmeshment. People with schizophrenia whose families have High EE are more likely to have more severe symptoms and have more active phases (relapse).

How does level of contact interact with Expressed Emotion?

Worst to best: High EE High Contact, High EE Low Contact, Low EE High Contact, Low EE Low Contact

What types of medication are available to treat schizophrenia?

“Older” antipsychotics and (Newer) Atypical Antipsychotics

How effective are “Older” Antipsychotics and (Newer) Atypical Antipsychotics?

Partially effective in reducing Positive Symptoms for about 75%, but 65-70% will relapse if they go off the medication and 40% will relapse even if they stay on medication.

What are the side effects of “Older” Antipsychotics?

Extrapyramidal symptoms: Tremors, involuntary posturing, motor rigidity, & inertia

Tardive Dyskineskia: Involuntary movements of the mouth & face and/or spasmodic body movements

They don’t go away after stopping taking the drug

What are the side effects of (Newer) Atypical Antipsychotics?

Severe weight gain (leads to diabetes, hypertension, heart disease)

What are the psychosocial interventions for schizophrenia?

Social Skills Training, Assertive Community Treatment, and Family Psychoeducation

What is social skills training?

Behavior therapy often in a group format, goal is to teach the individual how to interact in day-to-day situations effectively, trying to over-learn the skill so its almost subconscious.

What is Assertive Community Treatment?

Most common in Australia, a subcommunity that lives together in their own small places and are responsible for their own day-to-day lives. 24/7 providers available, goal is to reduce hospitalization and help patients be active members of the community. Cheaper long-term.

What is Family Psychoeducation?

Educating the family of the individual and decreases likelihood of High EE, reduces relapse & hospitalization, and reduces distress among family members.

What are the course & outcomes of schizophrenia?

1/3 of individuals with schizophrenia improve significantly

1/3 will stay the same over time, or have relapses

1/3 will have a chronic course with more severe disability