Psychopathology unit 3

schizophrenia

a severe, chronic psychotic disorder that is characterized by a range of cognitive, behavioral, perceptual, and emotional dysfunction

positive symptoms

symptoms that are added to a disorder

negative symptoms

symptoms that are absent in a disorder

what are positive symptoms of schizophrenia

break from reality, hallucinations, and delusions, disorganized thinking and speech

what are negative symptoms of schizophrenia

lack of emotional responses, withdrawal, isolation, lack of volition, diminished speech output, anhedonia, associality

when does schizophrenia arise?

early adulthood or adolescence

possible causes of schizophrenia

-brain has not been fully myelinated
-unable to exclude external stimuli

delusions

false beliefs; fixed beliefs that are not amenable to change in light of conflicting evidence; represent disturbed thought content

what are the types of delusions?

persecutory, referential, grandiose, erotomanic, nihilistic, somatic

persecutory delusion

believes the person is going to be harmed or harassed by individual (most common)

referential delusion

believing there is a special meaning in gestures or comments or something that happened outside of themselves (ex. someone on television is looking at them through the screen)

grandiose delusion

having exceptional skills, fame, wealth (ex. they believe they're Jesus Christ)

erotomanic delusion

believes someone is in love with them

nihilistic delusion

involves conviction or preoccupation that has a major catastrophe will occur

somatic delusion

preoccupation with bodily symptoms

thought broadcasting

believes their thoughts are transferred to the external without one speaking; people can overhear their thoughts

thought insertion

believes their thoughts are planted in their mind by some external

thought withdrawal

when an individual believes their thoughts have been removed by their minds by some external sources

hallucinations

sensory perception-like experiences that occur without an external stimulus

what are the forms of hallucinations?

auditory, visual, olfactory, gustatory, tactile, command, somatic

disorganized thinking and speech

thought disorder: a disturbance in thinking characterized by the breakdown of logical association between thoughts

three types of disorganized thinking and speech

derailment or loose associations (switching topic to topic fast); tangentiality (answer questions but responses are not answers to the questions asked); incoherence/ 'word salad' (words don't make sense)

grossly disorganized and catatonic behavior

various presentations, catatonia, stereotyped movements

catatonia

marked decrease in reactivity to the environment; limbs becomes stiff and swollen; unaware of the environment and maintain a fixed posture; more minimal or stringent to the instructions

what are the diminished emotional expression negative symptoms of schizophrenia?

"flat affect," poor eye contact, lack of gesturing and intonation

anhedonia

not experiencing pleasure

asociality

lack of interest in social events

one must have two of the following symptoms in order to be diagnosed with schizophrenia

delusions, hallucination, disorganized speech, grossly disorganized or catatonic behavior, negative symptoms

what are other symptoms of schizophrenia?

disturbance in sleep (eye movement dysfunction), lack of having an appetite, phobias or anxiety, memory problems, slow processing speed

who is at higher risk of developing schizophrenia?

males

what are the phases of schizophrenia?

prodromal phase, acute phase, residual phase

prodromal phase

when the person begins to develop the disorder
-lack of attention to one's appearance
-unusual thoughts or abnormal perceptions
-impaired cognitive functions
-delusions

acute phase

a break from reality; active

residual phase

return to a level of normal symptoms (returns to prodromal phase)
-fragrant behaviors are absent but person is still impaired cognitively, socially, and emotionally

psychodynamic theory of schizophrenia

-impaired mother-child relationships
-ego is overwhelmed by the sexual drives of the id
-extreme regression of oral stage

learning theory of schizophrenia

proposed that individuals learn to inhibit those behaviors affiliated to schizophrenia through modeling (hospital patients)

old family theory of schizophrenia

individuals have "bad" mothers or having a schizophrenic mother; when fathers are passive

new family theory of schizophrenia

quality of communication is poor, low levels of tolerance and empathy, may go back to active phase

biological theories of schizophrenia

dopamine system is overactive or too responsive to stimulation of dopamine receptors; neuroleptics; viral infections (prenatal rubella); loss in neural connection; less brain tissue; abnormally enlarged ventricles

schizoaffective disorder

may be combined with severe mood disorders (major depressive disorder or manic episode)

erotomania

delusional disorder that they are loved by someone who is not really in love with them

what are the three schizophrenia spectrum disorders?

brief psychotic disorder, schizophreniform disorder, delusional disorder

brief psychotic disorder

not a chronic disorder; experience hallucinations and delusions, may be due to stressors

schizophreniform disorder

lasts less than six months

delusional disorder

hallucinations are not prominent anymore; only delusions; may be paranoid nature (most common symptoms)

societal treatment approaches to schizophrenia

psychosocial rehabilitation and family intervention

psychosocial rehabilitation

interventions provided by a variety of professionals to assist an individual who has schizophrenia
-strengthens their cognitive skills and read social cues better
-become independent with job
-clubhouses is a self-contained community that provides members with social support and help find paid employment

family intervention

working with families to reduce stress; can reduce relapse rates

antipsychotic medications for schizophrenia

block dopamine receptors (decreases positive symptoms); reduces dopamine

side effects of antipsychotic medications

tardive dyskinesia

tardive dyskinesia is more common in...

women and older people

what is tardive dyskinesia

frequent eye-blinking, involuntary chewing motions, involuntary lip movements, facial grimacing, tremors in hands

learning-based treatments to schizophrenia

selective reinforcement, token economy, social skills training

selective reinforcement

increase behavior that is more functional or appropriate

token economy

operant conditioning (positive reinforcement) institutions or hospital settings

social skills training

learning how to communicate better; increasing behavior participation in society

multi-axial system in DSM-IV

axis I: mental health and substance-use disorders
axis II: intellectual disabilities
axis III: medical issues
axis IV: psychosocial stressors
axis V: 1-100 scale of how the person's feeling

impulsive control disorders

category of disorders characterized by failure to control impulses, temptations, or drives, resulting in harm to oneself or others

kleptomania

repeated acts of compulsive stealing

kleptomania is more common in...

women

intermittent explosive disorder

repeated episodes of impulsive, uncontrollable aggression; destroying others or strike out at others

pyromania

repeated acts of compulsive fire setting; motives: anger and feels a sense of empowerment and relief

personality disorder

an enduring pattern of inner experience and behavior that deviated markedly form the expectations of the individual's culture; pervasive and inflexible; has an onset in adolescence or early adulthood; stable over time; leads to distress or impairment

three clusters of personality disorders

A: odd or eccentric
B: dramatic, emotional, or erratic
C: anxious or fearful

Cluster A: odd or eccentric

paranoid, schizoid, and schizotypal

Cluster B: dramatic, emotional, or erratic

antisocial, borderline, histrionic, and narcissistic

Cluster C: anxious or fearful

avoidant, dependent, and obsessive-compulsive

paranoid personality disorder

suspects others are exploiting, harming or deceiving; acts secretive

schizoid personality disorder

social isolation, emotional coldness, detachment, or flat affect (distant from others, aloof)

schizotypal personality disorder

ideas of reference; odd beliefs or magical thinking, lack of coherent sense of self

antisocial personality disorder

failure to conform to social norms; associated with risk of criminality; to gain power and control

borderline personality disorder

frantic efforts to avoid real or imagined abandonment; affects the sense of identity; idealize potential caretakers

histrionic personality disorder

excessive emotionality and attention-seeking behavior; modeling or acting

narcissistic personality disorder

grandiose sense of self-importance; requires excessive admiration; modeling or acting or politics

avoidant personality disorder

feelings of inadequacy; avoids occupational activities involving interpersonal contact

dependent personality disorder

requires excessive advice from others in decision-making; lack of confidence ; feels uncomfortable or helpless when alone

obsessive-compulsive personality disorder

more compulsive behaviors and pervasive behaviors of perfection; workaholics

obsessive-compulsive personality disorder is more common in...

men

sociocultural perspectives of personality disorders

lower socioeconomic groups may develop these personality disorders due to lack of cultural influences

genetic factors of personality disorders

antisocial, narcissistic, paranoid, borderline
-chromosome linking; parents and siblings
-interactions between genetic factors and life experiences

brain abnormalities of personality disorders

pertains to borderline and antisocial personality disorder
-affects prefrontal cortex area

biological perspective on antisocial personality disorder

lack of emotional responsiveness and exaggerated cravings for stimulation

family perspective on personality disorders

disturbances in family relationships

learning perspectives on personality disorders

focus on maladaptive behaviors; childhood experiences shape personality

learning-based treatments for personality disorders

CBT and DBT

DBT (dialectica behavior therapy)

Linehan; specific approach to treatment of borderline personality disorder; involves CBT and working on the individual's problem-solving skills and ability to regulate emotions and mindfulness

Margaret Mahler

borderline personality disorder; childhood separation from the mother figure; in this case, the mother may refuse to let go of the child

Otto Kernberg

borderline personality disorder; individuals fail to develop a sense of consistency in unity in their own self-image and has difficulty synthesizing themselves and other people

Hans Kohut

narcissistic personality disorder; self-psychology; involves deep feelings of inadequency due to lack of parental support

Freud (personality disorders)

phallic stage; children normally resolve the oedipus coplex by forsaking incestuous wishes for the parent of the opposite gender and identifying with the parent of the same gender

when does abnormal behavior in childhood and adolescence?

affects children at ages when they little capacity to cope

anxiety disorder in children

separation anxiety disorder

separation anxiety disorder

persistent, developmentally inappropriate fear or anxiety concerning separation from attachment figure (s) like primary caregiver or home

what will help buffer the effects of later stressful events in separation anxiety disorder?

having a strong attachment to the mother

depression in childhood

irritability or low mood; low self-esteem; insomnia, fatigue; distorted thinking patterns

treatments for depression in childhood

CBT and antidepressant drugs

what are the five neurodevelopmental disorders?

intellectual disability, autism spectrum disorder, specific learning disorder, communication disorders, attention-deficit hyperactivity disorder

intellectual disability

-deficits in intellectual functioning
-deficits in adaptive functioning

the diagnosis of intellectual disability is solely based on what?

based on a person's level of adaptive functioning rather than solely an IQ score

down syndrome

-uncoordinated and lack muscle tone
-extra chromosome on the 21st pair of chromosome (trisomy 21)
-physical deformities and problems