CH. 13 - Schizophrenia Spectrum & other Psychotic Disorders -Abnormal Psychology An Integrative Approach by Barlow, Durand, Hofmann, 8th ed.

alogia

Deficiency in the amount or content of speech. Patients with this say little to nothing, often concise answers with little elaboration.

A disturbance often seen in people with schizophrenia.

anhedonia

Inability to experience/feel pleasure (even your favorite things), associated with some mood and schizophrenic disorders.

associative splitting

Separation among basic functions of human personality (cognition, emotion, perception) that is seen by some as the defining characteristic of schizophrenia.

avolition

Lack of drive, an inability to initiate or persist in important activities. Often coexists with apathy (not caring about anything).

brief psychotic disorder

Psychotic disturbance involving delusions, hallucinations, or disorganized speech or behavior, but lasting less than one month; often occurs in reaction to a stressor.

catatonia

Disorder of movement involving immobility or excited agitation.

catatonic immobility

Disturbance of motor behavior in which the person remains motionless, sometimes in an awkward posture, for extended periods of time.

catatonic type of schizophrenia

Type of schizophrenia in which motor disturbances (rigidity, agitation, odd mannerisms) predominate.

delusions

Psychotic symptom involving disorder of thought content and presence of strong/fixed beliefs that are misrepresentations of reality. Very rigid patterns of thought not connected to reality.

Example: Everyone is plotting to rob me of my soul (delusion of persecution).

delusional disorder

Psychotic disorder featuring a persistent belief contrary to reality (delusion) but no other symptoms of schizophrenia.

dementia praecox

Latin term meaning "premature loss of mind," an early label for what is now called schizophrenia, emphasizing the disorder's frequent appearance during adolescence.

disorganized speech

Style of talking often seen in people with schizophrenia that involves incoherence and a lack of typical logic patterns.

disorganized type of schizophrenia

Type of schizophrenia featuring disrupted speech and behavior, disjointed delusions, and hallucinations, and flat or silly affect.

double bind communication

According to an obsolete, unsupported theory, the practice of transmitting conflicting messages that was thought to cause schizophrenia.

expressed emotion (EE)

The hostility, criticism, and overinvolvement demonstrated by some families toward a family member with a psychological disorder; this can often contribute to the person's relapse.

flat affect

Emotionless demeanor (flat facial expression, including toneless speech and vacant gaze) when a reaction would be expected.

folie a deux

Psychotic disturbance in which an individual develops a delusion similar to that of a person with whom he or she shares a close relationship. Also called shared psychotic disorder.

hallucination

Psychotic symptom of a perceptual disturbance in which things are seen or heard or otherwise sensed although they are not real or actually present.

Most common type: auditory halluciantions

hebephrenia

Silly and immature emotionality, a characteristic of some types of schizophrenia.

inappropriate affect

Emotional displays that are improper for the situation.

negative symptoms (depressive symptoms)

Less outgoing symptoms, such as flat affect and poverty of speech, displayed by some people with schizophrenia.

Theses Are:

Anhedonia, Flat affect (of facial expression), Alogia, Avolition, Apathy

positive symptoms

Overt abnormal or bizarre symptoms, such as delusions and hallucinations (perception without sensory input).

paranoia

Person's irrational beliefs that he or she is especially important (delusions of grandeur) or that other people are seeking to do him or her harm.

paranoid type of schizophrenia

Type of schizophrenia in which symptoms primarily involve delusions and hallucinations; speech and motor and emotional behavior are relatively intact.

psychotic disorder

Disorder involving delusions, hallucinations, loss of contact with reality or disorganized speech or behavior.

residual type of schizophrenia

Diagnostic category for people who have experienced at least one episode of schizophrenia, and who no longer display its major symptoms but still show some bizarre thoughts or social withdrawal.

schizoaffective disorder

Psychotic disorder featuring symptoms of both schizophrenia and major mood disorder.

schizophrenia

Devastating psychotic disorder that may involve characteristic disturbances in thinking (delusions), perception (hallucinations), speech, emotions, and behavior.

schizophreniform disorder

Psychotic disorder involving the symptoms of schizophrenia but lasting less than six months.

schizophrenogenic

According to an obsolete, unsupported theory, a cold, dominating, and rejecting parent who was thought to cause schizophrenia in her offspring.

token economy

Social learning behavior modification system in which individuals earn items they can exchange for desired rewards by displaying appropriate behaviors.

undifferentiated type of schizophrenia

Category for individuals who meet the criteria for schizophrenia but not for any one of the defined subtypes.

d. flat affect; avolition

Two negative symptoms that are particularly common in schizophrenia are diminished emotional expression, called _____________, and a lack of motivation and drive, called ________________.

a. anhedonia; flat affect

b. apathy; anhedonia

c. alogia; apathy

d. flat affect; avolition

A. Auditory

What type of hallucination is most common?

a. auditory (hearing)

b. visual (seeing)

c. gustatory (taste)

d. tactile (feel)

e. olfactory (smell)

delusions of persecution

belief that one is going to be harmed by an individual or organization (example: A Beautiful Mind movie)

Delusion of grandeur

belief that one has exceptional abilities, wealth or fame. (Example: believe they can do super human things)

Delusion of Control

belief that one's body or actions are being controlled by some outside force (like a puppet)

Erotomania delusions

False unrealistic and rigid belief that another person is in love with you (ex. Rihanna is in love with me).

Nihilistic Delusions

The rigid conviction that a major catastrophe will occur, like the apocalypse. Spends all their time obsessing & preparing for this catastrophe.

D. Erotomanic delusion

Paul is certain that Julia Roberts, the actress, is in love with him and wants to marry him even though they have never met. He has spent most of the last month preparing for their wedding. Paul is most likely experiencing what type of delusion?

a. nihilistic delusion

b. delusion of persecution

c. delusion of control

d. erotomanic delusion

b. False,A hallucination is defined as an abnormal sensory experience in the absence of normal events, while a delusion is defined as an irrational belief.

A hallucination is defined as an irrational belief.

a. True

b. False

b. Yes, they vary from person to person.

Do symptoms of schizophrenia vary?

a. No

b. Yes

a. True, Although the term psychotic behavior has been used to characterize many unusual behaviors, in the strictest sense, it usually involves delusions and/or hallucinations. Schizophrenia is just one disorder that involves this type of behavior.

One of the characteristics of schizophrenia is psychotic behavior.

a. True

b. False

a. Yes, those with schizophrenia lack a definitive awareness that the symptoms they are experiencing are indeed symptoms and problematic. Therefore, it may be hard to converse with someone with schizophrenia because getting relevant information is difficult.

Do people with schizophrenia lack the awareness that they have a problem?

a. Yes

b. No

b.False, Schizophrenia can be characterized by delusions of grandeur or delusions of persecution. A delusion of grandeur is characterized by the mistaken belief that the sufferer is famous or powerful whereas a delusion of persecution is the sense that others are "out to get you."

Persons with schizophrenia have delusions of security.

a. True

b. False

d. Emil Kraepelin

Which of the following individuals coined the term dementia praecox, which meant "premature loss of mind?"

a. Eugen Bleuler

b. Sigmund Freud

c. Phillipe Pinel

d. Emil Kraepelin

b. associative splitting.

Bleuler described the underlying behaviors of schizophrenia as the destruction of the forces that connect one function to the next. He called this underlying foundation of the disorder:

a. fragmentation.

b. associative splitting.

c. psychosis.

d. hebephrenia

d. Cotard's

Patrice believes that although she is speaking and is aware of herself, she is really dead. She is not able to explain how she continues to exist even though she is deceased, but she maintains this belief even in the face of tremendous evidence that she is wrong. Patrice is experiencing _______________ syndrome.

a. Barlow's

b. Capgras

c. Durand's

d. Cotard's

c. Persecution

A woman diagnosed with a psychotic disorder announces that the local police precinct has been conspiring to catch her in an illegal act. Although she states that she obeys the law, she is convinced that the "dirty cops" are going to frame her so that they can, "toss her in jail and throw away the key." Her thinking is indicative of a delusion of _________.

a. Grandeur

b. Reference

c. Persecution

d. thought insertion

d. avolition

The negative schizophrenic symptom that involves an inability to initiate and persist in activities is called

a. Alogia

b. Agnosia

c. Alexia

b. inappropriate affect

Herman, a man who has been hospitalized with schizophrenia, has a very unusual set of behaviors. He tends to cry when he sees a very funny television show or is told a joke, and laughs out loud when his doctors discuss his illness with him. Which of the following symptoms is Herman demonstrating?

a. schizophrenic movement disorder

b. inappropriate affect

c. aerobic mobility

d. waxy flexibility

a. echolalia

Which of the following symptoms of schizophrenia involves mimicking another person's speech?

a. echolalia

b. clang associations

c. selective mutism

d. echopraxia

a. a mood disorder.

Schizoaffective disorder involves a blending of psychotic symptoms ("schizo") and either depressive or bipolar symptoms ("affective").

Marcel has been diagnosed with schizoaffective disorder. This means that in addition to schizophrenic symptoms, he also has symptoms of...

a. a mood disorder.

b. attention-deficit/hyperactivity disorder (ADHD)

c. schizoid personality disorder

d. post-traumatic stress disorder (PTSD)

d. jealous

Annie has been experiencing growing suspicions that her partner, Lisa, is cheating on her. She has no evidence of the infidelity, but her belief in this issue is growing stronger and stronger by the day. Annie may be experiencing the ________ type of delusional disorder.

a. persecutory

b. erotomanic

c. grandiose

d. jealous

a. Life expectancy is less than average due to suicides and accidents.

Which of the following statements regarding schizophrenia is accurate?

a. Life expectancy is less than average due to suicides and accidents.

b. The lifetime prevalence rate of schizophrenia worldwide is 3%.

c. Women with schizophrenia have a poorer prognosis than men with schizophrenia.

d. The frequency of early life schizophrenia is higher for women, while the frequency of later life onset of symptoms is higher for men.

a. A child's schizophrenic parent has a schizophrenic identical twin

In which of the following situations would the risk of developing schizophrenia be the HIGHEST for a child?

a. A child's schizophrenic parent has a schizophrenic identical twin

b. A child's schizophrenic parent has a non-schizophrenic fraternal twin

c. A child's non-schizophrenic parent has a schizophrenic identical twin

d. A child's non-schizophrenic parent has a schizophrenic fraternal twin

d. Antagonist drugs can prevent neurotransmitters from leaking from synaptic vesicles.

Which of the following is NOT one of the ways in which medications can affect the neurotransmitter activity in a person with schizophrenia?

a. Agonist drugs can activate receptors for neurotransmitters.

b. Agonist drugs can increase the actual production of neurotransmitters.

c. Antagonist drugs can interfere with the release of neurotransmitters.

d. Antagonist drugs can prevent neurotransmitters from leaking from synaptic vesicles.

c. Ketamine

It's actually an animal tranquilizer, can cause psychotic symptoms.

Which of the following drugs causes schizophrenic symptoms?

a. MDMA

b. EDTA

c. Ketamine

d. Heroin

b. a communication style that presented conflicting messages.

The idea that children can be given contradictory messages that leave them unsure of what actions are expected and/or proper has been linked to the development of psychotic symptoms.

In regard to the family interactions among schizophrenic patients, the word "double bind", was first proposed to describe..

a. an abusive and alcoholic father whose child became schizophrenic.

b. a communication style that presented conflicting messages.

c. an emotionally distant mother whose child became schizophrenic.

d. a family in which relatives on both sides were psychotic.

c. Indian

In regard to cultural differences in "expressed emotion," which is thought to be positively correlated with schizophrenia, research has found that _________ families have the lowest percentage of expressed emotion.

a. Mexican

b. Anglo-American

c. Indian

d. British

d. Tardive dyskinesia

Which of the following side-effects of antipsychotic medications involves involuntary chewing, puffing of the cheeks, and a protruding tongue?

a. Apophenia

b. Agranulocytosis

c. Neurofibromatosis

d. Tardive dyskinesia

a. Olanzapine

What is the generic name of the antipsychotic medication Zyprexa?

a. Olanzapine

b. Chlorpromazine

c. Clozapine

d. Risperidone

d. token economy

In the 1970s, Gordon Paul and Robert Lentz set up a(n) ________ system at a mental health center in Illinois. It was used to reward patients for appropriate behaviors and fine patients for disruptive or inappropriate actions. It was among the first to demonstrate that patients with schizophrenia could learn appropriate skills needed to live independently.

a. contingency contracting

b. applied behavioral analysis

c. person-centered therapy

d. token economy

b. deinstitutionalization

Your textbook suggests that the policies of __________ have often been poorly planned because they resulted in many former patients becoming homeless..

a. mainstreaming

b. deinstitutionalization

c. civil commitment

d. transinstitutionalization

d. emergency hospitalization protocols

An integrative treatment approach to schizophrenia would include all but which of the following?

a. integrated dual-disorders treatment.

b. illness management and recovery.

c. supportive employment

d. emergency hospitalization protocols

c. positive

Sherry, who has schizophrenia, experiences delusions. This symptom is classified under which category?

a. negative

b. factitious

c. positive

d. disorganized

b. delusions or hallucinations for two or more weeks in the absence of a major mood episode

Beach Boys lead singer Brian Wilson was diagnosed with schizoaffective disorder. In addition to an uninterrupted period of major mood disorder, diagnostic criteria include _____.

a. an episode of the disorder lasts at least one month but less than six months

b. delusions or hallucinations for two or more weeks in the absence of a major mood episode

c. Criterion A for schizophrenia has never been met

d. level of functioning in one or more major areas is markedly below the level prior to onset

a. motivational

Historical accounts of Isaac Newton suggest that he exhibited symptoms consistent with schizophrenia, including delusions. Several theories have been offered about delusions, including the _____ view that delusions are attempts to deal with and relieve anxiety and stress.

a. motivational

b. behavioral

c. deficit

d. biological

d. one or more positive symptoms such as delusions, hallucinations, or disorganized speech or behavior lasting one month or less

American film director and activist Jason Russell experienced a brief psychotic disorder when his documentary on Joseph Kony and his Lord's Resistance Army became an Internet sensation. Diagnostic criteria for brief psychotic disorder include ____.

a. evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition

b. apart from the impact of the delusion(s) or its ramifications, functioning is not markedly impaired, and behavior is not obviously bizarre or odd

c. the disturbance is not better explained by major depressive disorder or bipolar disorder with psychotic features

d. one or more positive symptoms such as delusions, hallucinations, or disorganized speech or behavior lasting one month or less

a. generally fare better than people with schizophrenia

Kurt Gödel was diagnosed with delusional disorder. Longitudinal research indicates that people with delusional disorder _____.

a. generally fare better than people with schizophrenia

b. are often severely disabled by their disorder

c. typically experience only a brief, single episode of delusions

d. almost always progress to full-blown schizophrenia

b. The symptoms persist for about a month after the cessation of acute withdrawal or severe intoxication.

Review of historical records suggests that Vincent van Gogh's psychotic episodes were associated with consumption of high-proof alcohol as well as camphor, turpentine, and other solvents used in painting, suggesting he had a substance-induced psychotic disorder. How is the relationship between the substance and the psychotic disorder best characterized in this disorder?

a. The psychosis is triggered by the substance, but persists independently of substance use for 6 or more months.

b. The symptoms persist for about a month after the cessation of acute withdrawal or severe intoxication.

c. The substance use must advance to a level at which permanent neurological deficits are found on imaging studies.

d. The psychosis occurs only in conjunction with delirium or other disturbances of consciousness from substance use

Capgra's syndrome:

think someone you know has been replaced by a double.

Cotard's syndrome:

believing you are dead.

Negative Symptoms (4 A's):

Avolition, Alogia, Anhedonia, and Flat Affect (absence of affect).

prodromal phase:

beginning of symptoms, often negative symptoms and some bizarre beliefs or actions. A phase in the progression of alcoholism featuring heavy drinking but few outward signs of a problem.

Active phase:

positive symptoms are prominent and some negative symptoms

Residual Phase:

negative symptoms remain after active phase has ended.

Paranoid type:

primarily involves hallucinations and delusions

-speech, motor, emotional behavior intact

Disorganized Type:

disrupted speech and behavior

-disjointed hallucinations and delusions

-flat or inappropriate affect

Catatonic type:

motor disturbances present

-Rigidity, agitation, odd mannerisms (waxy flexibility).

Undifferentiated Type:

People who meet criteria for schizophrenia, but do not fit one category.

Residual type:

No longer display, major symptoms, but still show bizarre thoughts or social withdrawal.

Prevalence of Schizophrenia:

1% of general population, equally common in both men and women, later onset in women, more commonly diagnosed in ethnic minorities.

Schizophrenia: Genetic influences

Likelihood someone will develop schizophrenia if they are related to someone who has it tracks very well with genes that are shared

-48% ID twins

-46% if both parents have schizophrenia

-17% dizygotic twin has schizophrenia

-15% if one parent

-<5% if other relative

Not a specific gene but a gene that disrupts a basic process that contributes to the disorder; most likely multiple genes that disrupt multiple basic processes.

- endophenotyping (smooth-pursuit eye movement)

What is inherited?

Neurobiological influences: Dopamine

Antipsychotic drugs are dopamine antagonists; amphetamines make psychotic symptoms worse

Brain Structure

- enlarged ventricles;

-spaces in brain that hold cerebral spinal fluid

-enlarged for people with schizophrenia and unaffected same-sex siblings

Stress

like most disorders, onset of schizophrenia is often associated with a major life stressor such as death in the family or job loss.

Expressed Emotion (influence on relapse)

Three aspects:

-Criticism

-hostility

-Emotional Overinvolvement

(individuals that return to families that are EE are more likely to relapse)

Biological treatment Schizophrenia

Antipsychotic medications

-Neuroleptics (block dopamine in brain)

-and medications that work on dopamine and serotonin

- (medications help reduce positive symptoms)

Psychosocial treatments for schizophrenia

Token economies- reward desired behavior , effective in the hospital hard to watch at home settings

-others focus on learning specific skills needed

-social skills training

-independent living skills program

-family interventions to reduce expressed emotion

b. disorganized

Jane has spent the last half hour staring in the mirror. As you approach her she turns away and giggles. When you ask what she's laughing at, she answers, but you're having difficulty understanding what she says. Which symptom or type of schizophrenia is described?

a. schizophreniform

b. disorganized

c. Catatonic

d. attenuated psychosis syndrome

e. delusional disorder

c. residual

Two years ago Drew had an episode of schizophrenia, but he no longer displays the major symptoms of the disorder. He does, however, still have some bizarre thoughts and displays flat affect on occasion. Which symptom or type of schizophrenia is described?

a. schizophreniform

b. disorganized

c. residual

d. attenuated psychosis syndrome

e. delusional disorder

a. schizophreniform

Drew has experienced hallucinations and bizarre delusions for the past 4 months. Which symptom or type of schizophrenia is described?

a. schizophreniform

b. disorganized

c. Catatonic

d. attenuated psychosis syndrome

e. delusional disorder

e. delusional disorder, of the persecutory/ paranoid type

Greg's cognitive skills and affect are relatively intact. He, however, often has delusions and hallucinations that convince him enemies are out to persecute him. Which symptom or type of schizophrenia is described?

a. schizophreniform

b. disorganized

c. Catatonic

d. attenuated psychosis syndrome

e. delusional disorder

c. Catatonic

Alice usually holds an unusual posture and is sometimes seen grimacing. Which symptom or type of schizophrenia is described?

a. schizophreniform

b. disorganized

c. Catatonic

d. attenuated psychosis syndrome

e. delusional disorder

b. disorganized

Cameron suffers from a type of schizophrenia that is identified by disruption and incoherence in his speech and behavior. He also shows inappropriate affect, often laughing in a silly way in sad situations.

a. schizophreniform

b. disorganized

c. Catatonic

d. attenuated psychosis syndrome

e. delusional disorder

d. attenuated psychosis syndrome

Cameron has started to hear voices, and this is very disturbing to him. he told his parents and recognizes that he needs to see a mental health professional for help. What's his diagnosis?

a. schizophreniform

b. disorganized

c. Catatonic

d. attenuated psychosis syndrome

e. delusional disorder

c. delusional disorder

Lately Dom has become more isolated because he believes his coworkers are conspiring to get him fired. He becomes agitated whenever he sees a group of employees talking and laughing, because he believes they are plotting against him. What's the diagnosis?

a. schizophreniform disorder

b. schizoaffective disorder

c. delusional disorder

d. shared psychotic disorder

b. schizoaffective disorder

Natalie reveals to her therapist that she hears numerous voices talking to her and giving her orders. her doctor has just sent her to this therapist for what he believes to be a major depressive episode. She had begun to sleep all the time and contemplated suicide often. What's the diagnosis?

a. schizophreniform disorder

b. schizoaffective disorder

c. delusional disorder

d. shared psychotic disorder