PSYCHOSIS SPECTRUM FINAL EXAM

What symptoms usually prompt treatment for psychotic illness?

Delusions and hallucinations.

Why is schizophrenia considered neurodevelopmental?

Brain abnormalities and subtle symptoms appear long before psychotic symptoms begin.

What major shift occurred in schizophrenia research during the 1990s?

Schizophrenia began to be recognized as a cognitive disorder.

Approximately what percentage of people with schizophrenia experience cognitive impairment?

About 80%.

Why are positive symptoms alone poor predictors of recovery?

Functional recovery depends more heavily on cognition and daily functioning skills.

What does the cascade model describe?

Early perceptual abnormalities affect neurocognition which then impacts social cognition and functioning.

What is perception in cognitive processing?

The initial stage where sensory information is received and processed.

What are ERPs (Event-Related Potentials)?

Brain responses measured with EEG that are time-locked to stimuli or responses.

What is a strength of EEG/ERP methods?

High temporal resolution for studying information processing over time.

What is P50 sensory gating?

The brain’s ability to suppress responses to repeated auditory stimuli.

What abnormality is seen in schizophrenia during P50 testing?

Reduced suppression of the second click stimulus.

What does impaired sensory gating suggest?

Difficulty filtering redundant information.

What is MMN?

An ERP response showing detection of unexpected auditory changes.

What paradigm is used to measure MMN?

The oddball paradigm.

Is MMN an automatic or attention-dependent process?

It is largely pre-attentive and automatic.

How is MMN affected in schizophrenia?

MMN amplitude is reduced.

What does reduced MMN suggest?

Impaired deviance detection.

What neurotransmitter system is associated with MMN?

NMDA receptor functioning.

How do people with schizophrenia perform on tone matching tasks?

They need larger pitch differences to detect changes accurately.

What does impaired tone discrimination reflect behaviorally?

Difficulty processing subtle auditory information.

What is contrast sensitivity?

The ability to detect light-dark differences.

What visual spatial frequency impairment is common in schizophrenia?

Difficulty processing low spatial frequencies.

What do low spatial frequencies represent?

Global shapes and overall configurations.

What is visual masking?

A process where one visual stimulus interferes with perception of another.

How is visual masking altered in schizophrenia?

Longer stimulus onset asynchronies are needed to detect the target.

What Gestalt-related difficulty occurs in schizophrenia?

Impaired perceptual organization.

What is impaired in motion perception tasks?

Detecting coherent motion direction.

What does MATRICS stand for?

Measurement and Treatment Research to Improve Cognition in Schizophrenia.

Why was the MATRICS initiative developed?

To standardize cognitive assessment in schizophrenia research.

What is the MCCB?

MATRICS Consensus Cognitive Battery.

What does speed of processing measure?

How quickly and accurately simple information is processed.

What is working memory?

Holding and manipulating information briefly.

What are executive functions?

Reasoning planning and problem-solving abilities.

What does social cognition involve?

Understanding emotions intentions and social cues.

Are cognitive impairments present at illness onset?

Yes impairments are already present at onset.

Do most studies support progressive cognitive decline in schizophrenia?

No cognition is generally relatively stable after onset.

Are cognitive impairments present before psychosis develops?

Yes subtle impairments often appear during the clinical high-risk phase.

How is cognition related to community functioning?

Better cognition is associated with better daily functioning.

What kinds of functioning are impacted by cognition?

Work relationships independent living and social participation.

Why is cognition an important treatment target?

It predicts long-term functional outcomes.

What is social cognition?

Mental processes involved in understanding and interacting with others.

What are the four major domains of social cognition?

Emotion perception theory of mind social perception and attributional style.

How is facial emotion recognition affected in schizophrenia?

It is significantly impaired.

What brain regions show altered activation during emotion processing?

Amygdala fusiform gyrus ACC mPFC and others.

What is prosody?

Emotional meaning conveyed through tone of voice.

Is prosody perception impaired in schizophrenia?

Yes.

Are body movement and gesture perception impaired in schizophrenia?

Yes.

What is theory of mind?

Understanding other people’s thoughts intentions and emotions.

What task commonly measures theory of mind?

Reading the Mind in the Eyes Task.

How is theory of mind affected in schizophrenia?

Significant impairment is commonly observed.

What is social perception?

Understanding social roles rules and contexts.

What is an externalizing attributional style?

Attributing events to outside causes rather than oneself.

What is jumping to conclusions?

Making quick judgments based on limited evidence.

What is an endophenotype?

A measurable trait associated with genetic risk for a disorder.

Are perceptual and cognitive abnormalities seen in relatives of people with schizophrenia?

Yes milder impairments are often present.

Why are these findings important?

They suggest underlying biological vulnerability markers.

What major areas are impaired in schizophrenia?

Perception neurocognition and social cognition.

How do early perceptual abnormalities affect later functioning?

They may cascade into broader cognitive and social difficulties.

Why are cognition and social cognition major treatment targets?

Improving them may improve real-world functioning and quality of life.

What is corollary discharge?

A copy of a motor command sent to sensory systems to predict self-generated actions.

Why is corollary discharge important?

It helps distinguish self-generated sensory experiences from external events.

What is reafference?

Sensory effects caused by one’s own actions.

What is exafference?

Sensory effects caused by external environmental events.

How might corollary discharge deficits relate to psychosis?

They may contribute to hallucinations and disrupted sense of agency.

What happens in the auditory system during normal self-vocalization?

The auditory cortex suppresses responses to self-generated speech.

What may happen if corollary discharge fails in psychosis?

People may mistake their own thoughts or speech as external voices.

What ERP finding supports corollary discharge deficits in schizophrenia?

Patients show less suppression of N1 amplitude during speaking.

What brain circuit abnormality may underlie global corollary discharge deficits?

Thalamocortical circuit dysfunction.

What is predictive coding?

A theory that the brain constantly generates predictions about sensory input.

According to predictive coding what is perception?

Perception equals prediction plus sensory input.

What is a prediction error?

A mismatch between expectations and incoming sensory information.

What is the brain’s main goal in predictive coding?

To minimize prediction error over time.

Why is predictive coding relevant to schizophrenia?

Psychosis may involve disrupted prediction-error processing.

What abnormalities are proposed in predictive coding models of psychosis?

Imprecise predictions aberrant salience and noisy prediction error signals.

How can predictive coding explain hallucinations?

Internal signals may be misinterpreted as external perceptions.

What contributes to hallucinations in predictive coding models?

Aberrant sensory processing strong expectations and abnormal prediction error signaling.

What does MMN measure in predictive coding research?

Neural prediction error responses.

What causes MMN in an oddball task?

A deviant stimulus violates expectations created by repeated standard stimuli.

How is MMN altered in schizophrenia?

Prediction error responses are blunted especially for deviant tones.

What perceptual abnormalities occur during active psychosis?

Altered sensitivity to illusions and abnormal sensory integration.

What may improve prediction error abnormalities in psychosis?

Antipsychotic treatment can partially normalize them.

What is the normal sequence in predictive coding?

Prediction comparison error and updating.

How are predictive coding and corollary discharge related?

Both rely on internal prediction comparison with outcomes and error correction.

What symptoms may predictive coding abnormalities explain?

Hallucinations delusions and aberrant salience.

What is the dopamine hypothesis of schizophrenia?

Excess dopamine activity contributes to psychotic symptoms.

What pharmacological evidence supports the dopamine hypothesis?

Drugs increasing dopamine can cause psychosis-like symptoms and antipsychotics block dopamine receptors.

What roles does dopamine normally play?

Reinforcement learning attention and motivational salience.

What is motivational salience?

The feeling that something is important and deserves attention.

What happens to dopamine signaling in psychosis?

Dopamine release becomes context-inappropriate.

What is aberrant salience?

Irrelevant stimuli become perceived as unusually important.

How can aberrant salience contribute to hallucinations?

Internal thoughts or perceptions may feel externally generated and highly meaningful.

How can aberrant salience contribute to delusions?

People create explanations for persistently meaningful but irrelevant experiences.

What example is used to explain aberrant salience?

Repeatedly noticing black cars and believing they are connected to surveillance.

What occurs during the early phase of delusion formation?

Heightened awareness anxiety and perplexity.

What occurs during the progression phase of delusion formation?

Pattern-seeking and meaning-making.

What occurs during the chronic phase of delusion formation?

Stable delusional belief systems develop.

How do antipsychotics reduce psychotic symptoms?

They block D2 dopamine receptors and reduce aberrant salience.

Why do symptom improvements take weeks despite rapid dopamine blockade?

Cognitive restructuring and relearning take time.

What trade-off can occur with antipsychotic treatment?

Reduced motivation reward sensitivity and emotional engagement.

Why might psychotherapy help alongside medication?

Therapy can help restructure maladaptive beliefs while medication reduces salience.