Psychopathology Exam 2

Delusions

False beliefs that are firmly held despite overwhelming evidence against them.

Hallucinations

Sensory experiences in the absence of sensory stimulation.

Grandiose delusions

People view themselves as important or special in some way. Can be either bizarre or non-bizarre.

Persecutory delusions

sometimes called paranoid delusions; the idea that someone imagines they are being unfairly treated or pursued by others.

Disorganized speech

characterized by loose associations, clang speech, word salad, and neologisms.

loose associations

jumping from topic to topic in a conversation

clang associations

a speech pattern where words are chosen based on sound rather than meaning or context. “well hell, its well to tell”

word salad

A jumble of random words that don’t mean anything put together.

Neologisms

made up words that sound like they could be a word.

disorganized thinking

inferred from how people talk and what they say.

disorganized behavior

characterized by a disruption in goal-directed behavior, lack of hygiene, disregard for safety, and unusual dress.

catatonic behavior

Absence of all movement and speech. People who are catatonic are often rigid or hold unusual postures.

Abnormal motor behavior

Can be reflected in physical agitation or restlessness, and difficulty performing daily activities.

Positive Symptoms

An addition to personality that occurs in psychosis. ex. hallucinations and delusions.

Negative Symptoms

A decrease to personality that occurs in psychosis. ex. avolition, alogia, anhedonia, asociality, apathy.

Avolition

Severe lack of motivation to start or finish a goal.

Alogia

reduced or lack of verbal communication.

Anhedonia

A person experiences little pleasure from previously entertaining activities.

Asociality

Lack of interest in social contact.

Apathy

lack of emotional engagement.

Flat affect

Someone speaks in an unemotional voice with few inflections and little expressive body language.

Delusional Disorder

Characterized by delusional thinking. In the DSM, delusions last a month or more before diagnosis. In the ICD delusions last three or more months before diagnosis. Besides delusions, functioning is not significantly impaired.

brief psychotic disorder

Sudden onset of psychotic symptoms that last at least one day, but less than one month.

Schizophrenia symptoms

two or more of the following for at least one month: delusions, hallucinations, disorganized speech(must have one of these), disorganized or catatonic behavior, negative symptoms.

There is impaired functioning and the total disturbance lasts at least 6 months.

Type I Schizophrenia

Includes more positive than negative symptoms. Better prognosis.

Type II Schizophrenia

Includes more negative than positive symptoms. Poorer prognosis

Schizophreniform Disorder

DSM disorder that has similar symptoms to schizophrenia, but with symptoms lasting only 1-6 months.

Schizoaffective Disorder

Combines elements of psychosis and depression. In addition to schizophrenic symptoms, patients will also experience at least one manic or depressive episode.

Schizotypal Disorder

Included in ICD-11. Characterized by a longstanding pattern of odd and eccentric talking, perceiving, and behavior, that doesn’t rise to the level of schizophrenia, delusional disorder, or schizoaffective disorder.

Schizotypal personality disorder

A personality disorder in DSM similar to the psychotic disorder, Schizotypal Disorder, in ICD-11.

Psychosis

A broad term involving disturbed thinking and communication, perception, and behavior. Results in an inability to meet life demands.

The Hallmark of Psychosis

Being unable to tell what is real and unreal. John Nash

delusions of reference

false, fixed beliefs that insignificant events, objects or behaviors of others have a special meaning or message, specifically for an individual.

Group 1 Schizophrenia

Single episode of impairment, with no further impairment.

Group 2 Schizophrenia

Repeated episodes, with no impairment between episodes.

Group 3 Schizophrenia

Repeated episodes, with some impairment between episodes.

Group 4 Schizophrenia

Repeated episodes, with gradually increasing impairment between episodes.

Biological Causal Factors

Prenatal issues, brain abnormalities, psychosocial and cultural.

Viral Theory of Schizophrenia

People whose mothers had a virus while pregnant with them are at greater risk for developing schizophrenia.

HiTOP Psychosis

HiTOP offers a dimensional way to diagnose psychosis.

Dementia Praecox

Means “premature dementia”; first term for schizophrenia; was thought to have originated from physiological symptoms.

Insulin Coma Therapy

An early treatment for schizophrenia that included bringing patients in and out of a coma daily for weeks.

Electroconvulsive Therapy

An early treatment for schizophrenia that included administering electric shocks to the brain that induced epileptic seizures. It was thought to neutralize psychotic symptoms.

Lobotomy

A psychosurgery that disconnected the prefrontal cortex from the rest of the brain. Seriously impaired cognitive and emotional functioning of patients.

Hydrotherapy

Wrapping patients in wet sheets of varying temperatures for several hours at a time.

When were first generation antipsychotic drugs invented

the 1950s

Dopamine Hypothesis of Schizophrenia

Holds that schizophrenia and other forms of psychosis result from too much of the brain neurotransmitter dopamine.

Antipsychotics

Prescribed to treat psychosis. Alleviates positive symptoms by decreasing dopamine receptivity.

Amphetamines

In large doses, amphetamines produce psychotic symptoms. It is thought that this is because amphetamines increase dopamine, however they also increase other neurotransmitters.

Aberrant Salience Hypothesis

Says that psychosis is caused when the mesolimbic dopamine pathway is overactive, which leads to excessive dopamine. The high level of dopamine causes the brain to assign high importance(salience) to neutral or mundane events, leading patients to form delusions to explain this heightened, strange feeling.

Extrapyramidal Side-effects

side-effects of first generation psychotics including muscle tremors, shuffling gait, and drooling.

Tardive Dyskinesia

Effects of antipsychtics that have been taken for many years and cause irreversible side-effects.

Second Generation Antipsychotics

Invented in the 1990s. Binds more loosely to dopamine and also blocks serotonin.

Third Generation Antipsychotics

Developed in the 2000s and impact both dopamine and serotonin in a more targeted manner.

Glutamate Hypothesis

Deficient transmission of the excitatory neurotransmitter glutamate is implicated in schizophrenia. Researchers suspect that glutamate dysfunction is related to both GABA and dopamine issues in psychosis.

Ventricles

Human brains have four ventricles, which are empty spaces filled with cerebrospinal fluid.The fluid serves as a pathway both to remove waste material and transport hormones. It also cushions the brain.

Ventricles and schizophrenia

Researchers have consistently found a connection between schizophrenia and enlargement in these four ventricles, particularly the third one. Having larger ventricles suggests that schizophrenia patients have less brain cells.

Brain Abnormalities and Schizophrenia

Specific abnormalities in the brain connected to schizophrenia include in the prefrontal cortex and in and around the temporal cortex.

Theory of Mind

Evolved human ability to view the world through others’ eyes and generate interpretations of why others behave as they do.

Cliff-edge Fitness Theory

Proposes that psychosis occurs when theory of mind ability shifts from exceedingly sensitive to over interpretive.

Biopsychosocial Model

holds that presenting problems arise from an interaction among biological, psychological, and social factors.

Schizophrenogenic Mothers

Fromm-Reichmann’s term for cold, demanding, and domineering mothers, whose parenting style she blamed for their children’s schizophrenia.  

Expressed Emotion

Family interactions characterized by hostility, criticism, and emotional over-involvement. Leads to increased stress cortisol which is linked to dopamine and glutamate activity.

Pros of newer antipsychotics

Improved cognitive function, alleviate negative symptoms, fewer motor side-effects, patients may do better overall.

Cons of newer antipsychotics

Weight gain, and increased risk of diabetes

First generation antipsychotics names

neuroleptics, Thorazine.

Second Generation Antipsychotics names

Clozapine, Olanzapine, Qiuetiapine, Risperidone

Third Genereation Antipsychotic Names

Aripiprazole, Cariprazine

Trauma

An experience, event, or outcome, not a diagnosis.

Type I Trauma

single traumatic events

Type II Trauma

chronic sustained traumatic events

Complex Trauma

Developmental, complex, or repeated trauma.

Characteristics of PTSD

Fear, shame, disgust, hostility, sadness/loss/grief, moral injury. Specific event tied to the onset of symptoms.

Adjustment Disorder

A short-term, stress related disorder occurring within three months of a specific life change or event. Causes excessive emotional or behavioral symptoms that hinder daily functioning.

PTSD Symptoms

Trauma exposure, intrusion symptome(nightmares/flashbacks), persistent avoidance of stimuli associated with trauma, negative alterations in mood and cognitions, alterations in arousal and reactivity, clinically significant stress, dissociative subtype. Symptoms last for at least one month.

Criterion A

Actual threatened death, serious injury, or sexual violence.

Intrusion Symptoms

recurrent intrusive, distressing thoughts or memories.recurring distressive dreams, intense psychological distress at exposure to trauma linked cues.

Persistent Avoidance

efforts to avoid talking, thoughts, or feelings about trauma. As well as avoiding, people, activities, and places.

Arousal

Irritability or outbursts of anger; recklessness or disruptive behavior; hypervigilance; exaggerated startle response; difficulty concentrating; sleep disturbance.

dissociative subtypes

depersonalization, derealization

dissociation

Heightened depersonalization/derealization, with autonomic hypoarousal.

Internalizing Manifestation

self defeating behaviors, avoidance, and withdrawal; depressive disorders; anxiety disorders; OCD; personality disorders

Externalizing Manifestation

express distress outward through antagonistic interactions, elevated anger/aggression, and emotional lability/impulsivity. substance abuse disorders; personality disorders

Acute Stress Disorder

Similar symptoms to PTSD with onset occurring within 4 weeks of trauma, and symptoms lasting between 2 and 30 days.