7. Schizophrenia

1. delusions

2. hallucinations

3. disorganized thinking (speech)

4. grossly disorganized or abnormal motor behavor (including catatonia)

5. negative symptoms

5 domains that define the psychotic disorders (schizophrenia, etc)

Delusions

fixed beliefs that are not amenable to change in light of conflicting evidence

Persecutory Delusions

beliefs that one is going to be harmed, harassed, or conspired against by an individual, organization, or group

Referential Delusions

beliefs that certain gestures, comments, environmental cues, or events are directed at oneself

Grandiose Delusions

beliefs that one has exceptional abilities, wealth, or fame

Erotomanic Delusions

when an individual believes falsely that another person is in love with him or her

Nihilistic Delusions

convictions that a major catastrophe will occur

Somatic Delusions

beliefs that involve preoccupations regarding health and organ function

Thought Withdrawal

these include the belief that one’s thoughts have been “removed” by some outside force

Thought Insertion

belief that alien thoughts have been put into one’s mind

Delusions of control

belief that one’s body or actions are being acted on or manipulated by some outside force

Hallucinations

perception-like experiences that occur without an external stimulus

Auditory hallucinations

most common type of hallucination in schizophrenia and related psychotic disorders

Auditory hallucinations

usually experienced as voices, whether familiar or unfamiliar, that are perceived as distinct from the individual’s own thoughts

Clear Sensorium

hallucinations must occur while the person is fully conscious and alert

Hypnagogic Hallucinations

occur while falling asleep and are considered normal, not indicative of psychosis

Hypnopompic Hallucinations

occur while waking up and are also normal, not indicative of psychosis

Disorganized Thinking (Speech)

manifested in derailment, loose associations, tangentiality, or incoherence

Formal Thought Disorder

another term for disorganized thinking (speech)

Derailment (Loose Association)

a pattern of speech in which a person shifts from one topic to another with little or no logical connection between ideas

Tangentiality

answers to questions may be obliquely related or completely unrelated

Incoherence or “word salad”

rarely, speech may be so severely disorganized that it is nearly incomprehensible and resembles receptive aphasia in its linguistic disorganization.

Grossly Disorganized or Abnormal Motor Behavior

ranges from childlike silliness to unpredictable agitation

Catatonia

a marked decrease in reactivity to the environment, ranging from resistance to instructions to maintaining a rigid posture or a complete lack of movement and speech

Negativism

resistance to instructions or attempts to be moved, showing opposition to external direction without apparent reason

Mutism and Stupor

complete lack of verbal response and absence of motor responses

Catatonic Excitement

purposeless and excessive motor activity without an obvious cause

Diminished Emotional Expression

includes reductions in the expression of emotions in the face, eye contact, intonation, and movements that normally give emotional emphasis to speech

prosody

intonation of speech

Avolition

decrease in motivated self-initiated purposeful activities

Avolition

The individual may sit for long periods of time and show little interest in participating in work or social activities

Alogia

manifested by diminished speech output

Anhedonia

decreased ability to experience pleasure

Asociality

apparent lack of interest in social interactions

continuous signs of disturbance must persist for at least six months, including at least one month of active-phase symptoms

Duration Requirement for Schizophrenia

John Haslam

Superintendent of a British hospital. In Observations on Madness and Melancholy, he outlined a description of symptoms of schizophrenia

Philippe Pinel

A French physician who described cases of schizophrenia

Emil Kraepelin

A German psychiatrist who unified the distinct categories of schizophrenia (hebephrenic, catatonic, and paranoid) under the name dementia praecox

Eugen Bleuler

A Swiss psychiatrist who introduced the term schizophrenia, meaning “splitting of the mind.”

splitting of the mind

meaning of the term schizophrenia, introduced by Bleuler

manic-depressive illness

former term for bipolar disorder

Catatonia

alternating immobility and excited agitation

Hebephrenia

silly and immature emotionality

Paranoia

delusions of grandeur or persecution;delusions of grandeur or persecution

skhizein

Greek word meaning “split”

phren

Greek word meaning “mind”

Functional Impairment

the disturbance must cause significant impairment in one or more major areas of functioning, such as work, interpersonal relations, or self-care

late adolescence or early adulthood

period when severe symptoms of schizophrenia first occur

1. premorbid

2. prodromal

3. onset/deterioration

4. chronic/residual

phases of schizophrenia

premorbid

phase when mild motor, cognitive and social impairments appear in schizo

prodromal

gradual deterioration in functioning. unusual psychotic-like behaviors manifest in this phase

onset/deterioration

positive, negative, cognitive and mood symptoms appear in this phase

chronic/residual

positive, negative, and cognitive symptoms persist in this phase

chromosome 8, 6, and 22

regions of chromosome influences that make one susceptible to schizophrenia

endophenotyping

strategy where researchers try to find basic processes that contribute to the behaviors or symptoms of the disorder and then find the gene or genes that cause these difficulties

dopamine

neurotransmitter involved in schizophrenia

enlarged ventricles

brain structure in people with schizophrenia have in common

hypofrontality

a phenomenon wherein frontal lobes of the brain may be less active in people with schizophrenia than in people without the disorder

schizophrenogenic mother

used for a time to describe a mother whose cold, dominant, and rejecting nature was thought to cause schizophrenia in her children

double bind communication

used to portray a communication style that produced conflicting messages, which, in turn, caused schizophrenia to develop

expressed emotion

meaning of EE, which is an emotional communication style

neuroleptics

meaning “taking hold of the nerves”

neuroleptics

these medications provided the first real hope that help was available for people with schizophrenia.

neuroleptics

these help remove positive symptoms of schizo

Extrapyramidal symptoms

motor difficulties similar to those experienced by people with Parkinson’s disease

Akinesia

expressionless face, slow motor activities, and monotonous speech

Tardive dyskinesia

involves involuntary movements of the tongue, face, mouth, or jaw and can include protrusions of the tongue, puffing of the cheeks, puckering of the mouth, and chewing movements

transcranial magnetic stimulation

this technique uses wire coils to repeatedly generate magnetic fields—up to 50 times per second—that pass through the skull to the brain.

transcranial magnetic stimulation

this technique is used to stimulate the area of the brain involved in hallucinations for individuals with schizophrenia who experienced auditory hallucinations.

modafinil

a cognitive enhancer with low abuse potential, may improve emotion processing in schizo

moral treatment

during the 19th century, inpatient care involved this treatment, which emphasized improving patients’ socialization, helping them establish routines for self-control, and showing them the value of work and religion

milieu treatment

changing the physical and social environment—usually to make institutional settings more homelike

token economy

in which residents could earn access to meals and small luxuries by behaving appropriately

cognitive remediation

its primary goal is to improve cognitive processes for those suffering from schizophrenia in order to increase these individuals’ functioning in the community

collaborative psychopharmacology

using antipsychotic medications to treat the main symptoms of the disorder as well as using other medications for secondary symptoms

Schizoaffective disorder

anosognosia is common in this disorder, but the deficits in insight may be less severe and pervasive than those in schizophrenia