Stress, Trauma, and Schizophrenia

Conversion Disorder

abnormal sensory experiences and movement

Stressor

External event or situation that places a physical or psychological demand on a person

Stress Response

Person's internal psychological or physiological response to a stressor

Trait Anxiety

General level of arousal and anxiety

State Anxiety

Level of anxiety in specific situations

Trauma

An experience that threaten physical integrity of life and that overwhelms an individuals capacity to cope; can also be repeated or extreme indirect exposure

Acute Stress Disorder

a disorder in which a person experiences fear and related symptoms soon after a traumatic event but for less than a month

Post Traumatic Stress Disorder

an anxiety disorder characterized by haunting memories, nightmares, social withdrawal, jumpy anxiety, and/or insomnia that lingers for four weeks or more after a traumatic experience

Trauma is re-experienced through intrusive and distressing recollections

Avoidance of things that remind you of the event

Negative changes in mood and cognition

Heightened arousal and reactivity

DSM-5 Criteria of ASD/PTSD (4)

Biological Perspective of PTSD

sensitized ANS, increased reactivity, diminished ability to extinguish conditioned fear

Increased norepinephrine and cortisol activity

Biochemical Abnormalities of PTSD

Impaired hippocampus and amygdala

Brain abnormalities in PTSD

SSRIs

PTSD medication

CBT/CPT

Psychoeducation about PTSD and treatment rationale, identify faulty thinking, identify stuck points

Exposure Therapy

Gradually expose patient to the memory of the event and cues associated with trauma to extinguish fear responses

Trauma-Focused Cognitive Behavioral Therapy (TF-CBT)

Kids and non-offending parents have separate and joint sessions on

psychoeducation, cognitive restructuring, coping skills, distress tolerance skills, communication, stress management, parenting

Crisis Intervention

Trauma victims talk extensively about their feelings and reactions within days of the critical incident, usually in a group setting

Tetris

Playing will overload the brain capacity and distract the visual memory circuits, therefore not storing the traumatic visual memories

Psychosis

Loss of contact with reality

Schizophrenia

For at least 1 month, two or more: delusions, hallucinations, disorganized speech, negative symptoms, grossly abnormal psychomotor or catatonic behavior, declining functioning

6 months

How long are signs of disturbance necessary for schizophrenia diagnosis

Positive Symptoms

Excess: Delusions, Hallucinations, Disorganized Speech

Negative Symptoms

Deficits: Alogia, avolition, restricted affect, withdrawal

Delusion

Fixed False Beliefs

Delusions of persecution

the belief that people are out to get you, paranoia

Delusions of reference

the belief that common elements in the environment are directed toward the individual, special messages

Delusions of granduer

Belief that oneself is a great inventor, religious savior, or specially empowered person.

Delusions of control

belief that outside forces are controlling one's body or actions, thought insertion

Hallucinations

sensory experiences in the absence of sensory stimulation

Loose Associations

Derailment, "word salad"

Neologisms

Made-up words

Perseveration

repeating words or statements

Clang

speaking in rhymes

Inappropriate affect

emotional displays that are improper for the situation

Alogia

poverty of speech

Restricted Affect

exhibits little to no emotional expression in face or voice

Avolition

lack of interest and drive, ambivalence about most things

Social Withdrawal

attend to their own ideas and fantasies and withdraw from social environment

Catatonia

a state of unresponsiveness to one's outside environment, usually including muscle rigidity, staring, and inability to communicate

Prodrome

subthreshold symptoms of schizophrenia

Active Phase

Meets criteria for schizophrenia

Residual Phase

back to subthreshold symptoms of schizophrenia

Downward Drift Theory

schizophrenia causes its sufferers to fall from a higher to a lower socioeconomic level or to remain poor because they are unable to function effectively

Schizophrenia as a Neurodevelopmental Disorder

impaired connections in the brain region due to genetic vulnerability and early neurodevelopmental issues

Dopamine Hypothesis

the idea that schizophrenia involves an excess of dopamine activity

Serotonin, Glutamate, GABA

neurotransmitters related to positive symptoms

Abnormal Interconnectivity

Enlarged ventricles

Smaller temporal and frontal lobes

Smaller amounts of gray matter - abnormal blood flow

Neuroanatomy in Schizophrenia (4)

Social Labeling

features of schizophrenia are influenced by the diagnosis itself

Operant Conditioning in Schizophrenia

Lack of reinforcement of appropriate social cues, so attend to other cues

Cognitive Perspective of Schizophrenia

Misinterpretation of unusual sensations, faulty interpretation of symptoms

Conventional Antipsychotics

Block dopamine receptors - reduce positive symptoms

Side Effects of Conventional Antipsychotics

Parkinsonism, Dystonia, Akathesis, Neuroleptic malignant syndrome

Tardive Dyskinesia

abnormal movements of lips, tongue, and jaw - may involve trunk or arms as well

Atypical Antipsychotics

Impact serotonin and dopamine receptors to improve positive and negative symptoms

Side Effects of Atypical Antipsychotics

impaired immune system functioning, seizures, dizziness, drooling, fatigue, weight gain

Psychoeducation

make sure parent and family understand the treatment and safety plan

Individual CBT

Hallucination reinterpretation and acceptance, identify psychotic symptoms and triggers

Milieu Therapy

inpatient settings allow patients to have a sat in their environment and create a community

Token Economics

used in inpatient therapeutic settings, positive behavior is rewarded with tokens