Exam 3

What is the WHO definition for health?

Health is a complete state of well-being, physical, mental, and social

Health is NOT merely the absence of what two things?

Disease or infirmity

What are the models of health care?

Biomedical and biopsychosocial

Biomedical Model

Focuses on illnesses and how illnesses can be explained on the basis of aberrant physiological processes

Which of the models of health care is the dominant model?

Biomedical Model

What are the limitations of the biomedical model?

Single-factor model, mind-body dualism, emphasis on illness over health, and reductionism

Describe the single-factor model limitation of the biomedical model.

Illness due to one factor, biological malfunction

Describe the reductionism limitation of the biomedical model.

Illness reduced to microlevel processes

Biopsychosocial Model

Focuses on the system with the assumption that health and illness are consequences of the interplay of biological, psychological, and social factors

What are the advantages of the biopsychosocial model?

Macrolevel processes, multiple factors, mind/body cannot be distinguished in matters of health and illness, and emphasizes on both health and illness

Describe the microlevel processes advantage of the biopsychosocial model.

Psychological and social factors are determinants of health

What are behaviors involved in health promotion?

Smoking, healthy eating, and exercise

What are the 3 processes of prevention and treatment of illness?

How to prevent illness, discover what behavior is important in treating an illness, and how to treat a symptom that cannot be treated with mediciation

How do you prevent illness psychologically?

Lower stress

What behavior is important in treating an illness?

Adherence to medicine

When did health psychology emerge?

1970s

What is the largest service industry in the US?

Health care

What was a huge accomplishment with the emergence of health psychology?

Expanded health care services

Research in health care

Conduct research on how satisfied people are with their health care

What are the 4 health psychologist work settings?

Universities, hospitals, industrial/occupational, and independent practices

Mind-Body Dualism

The mind and body are separate entities, and cannot impact one another

What is an example of a micro-level process?

Chemical imbalance

Non-dualism/Monoism

The mind and body interact

What is schizophrenia characterized by?

A deterioration from a normal level of functioning to become ineffective in dealing with the world

Psychosis

Loss of contact with reality

Is schizophrenia chronic?

Yes, it’s life-long illness

Is there a single defining feature of schizophrenia?

No

What is the percent lifetime prevalence of schizophrenia?

1%

What is the age of onset for schizophrenia?

Adolescence

What is the sex ratio for adolescence?

1:1 (males earlier with worse prognosis)

What are the brain systems affected with schizophrenia?

Nearly all

What is the prognosis for schizophrenia?

Poor (Up to 70% will require permanent care

Which gender may have a better prognosis for schizophrenia?

Women

Which gender is more impaired by negative symptoms for schizophrenia?

Men

How much does the US spend annually on schizophrenia treatment?

63 billion

What percentage of schizophrenic patients occupy mental health beds?

50%

Schizophrenia is the leading cause of chronic disability among what age group?

15-44

What percentage of people with schizophrenia attempt suicide?

50%

What percentage of people with schizophrenia commit suicide?

10-15%

What did Kraepelin do? (1899)

Described schizophrenia as dementia praecox and emphasized cognitive deterioration and early onset

What did Bleuler do? (1911)

Coined the term schizophrenia, founded the 3 main components of schizophrenia, and distinguished between types of symptoms

What are the 3 main components of schizophrenia?

A fragmentation of thought processes, a split between thoughts and emotions, and a withdrawal from reality

What are the fundamental symptoms of schizophrenia?

Disturbance of association, affective blunting, ambivalence, and autism

What are the accessory symptoms of schizophrenia?

Delusions and hallucinations

What are traditionally the 2 main types of symptoms of schizophrenia?

Positive and negative

Positive Symptoms

Bizarre additions to a person’s behavior and present in patients but not normal people

What are the types of positive symptoms?

Delusions, hallucinations, formal thought disorder, heightened perception, and inappropriate affect

Delusions

Strange held false belief firmly held despite evidence to the contrary

What are the 4 types of delusions?

Grandeur, ideas of reference, persecution, and control

What is an example of grandeur delusion?

I am Jesus

What is an example of ideas of reference delusions?

The newscaster was talking about me

What is an example of persecution delusions?

Feeling that someone is plotting against him/her

What is an example of control delusions?

Thoughts being controlled by someone

Formal Thought Disorder

A disturbance in the production and organization of speech and thought

What are the 4 common forms of formal thought disorder?

Loose associations, use of neologisms, perseveration, and use of clang

Loose Associations (Derailment)

Characterized by rapid shifts from one topic of conversation to another

Neologisms

Made up words that typically have meaning only to the individuals using them

Perseveration

Repeating words and statements again and again

Clang

Rhyme

Heightened Perceptions

Perceptions from the environment intensify

Hallucinations

Perceptions that occur in the absence of external stimuli

What are the 6 types of hallucinations?

Auditory, visual, tactile, somatic, gustatory, and olfactory

What is the most common type of hallucinations?

Auditory

Inappropriate Affect

Emotions that are unsuited to the situation

Negative Symptoms

Symptoms that are pathological deficits or characteristics that are lacking in an individual. Absent in subjects but present in normal people

What are the 4 types of negative symptoms?

Poverty of speech, blunted/flat affect, loss of volition, and social withdrawal

Alogia

Poverty of speech

Blunted Affect

People show less of an emotion or feeling

Flat Affect

People show almost no emotions at all

Loss of volition (Avolition)

Marked by apathy and inability to start or complete a course of action

Social Withdrawal

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

Psychomotor Symptoms

Awkward movements, odd gestures, and repeated grimaces

Catatonia

Person in a stupor, where they stop responding to environment and remain motionless and silent for long stretches of time

What are the DSM-5 characteristic symptoms of schizophrenia?

Delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms

According to DSM-5 what is the duration of schizophrenia?

Signs of continuous disturbances for at least six months

What are the 5 DSM-4 subtypes of schizophrenia?

Catatonic, disorganized, paranoid, undifferentiated, and residual types

Which subtypes of schizophrenia have the most optimistic prognosis?

Catatonic and paranoid

What are the 3 main phases of schizophrenia?

Prodromal, active, and residual

Prodromal Phrase

Some + and - symptoms; obvious functional impairment

Active Phase

\+ and - symptoms

Residual Phase

Mainly - symptoms; lots of impairments and odd behavior

Over time, which type of symptom becomes more severe over time?

Negative symptoms

Process

Poor prognosis

Reactive

Good prognosis

Schizophreniform Disorder vs. Schizophrenia

Identical except duration of 1-6 months

Brief Psychotic Disorder vs Schizophrenia

May include positive symptoms, no negative symptoms, duration 1 day to 1 month

Schizoaffective Disorder vs Schizophrenia

Positive or negative symptoms of schizophrenia plus meet criteria for major depressive or manic episodes

Delusional Disorder vs Schizophrenia

Delusions present but lack other symptoms of schizophrenia

Shared Psychotic Disorder vs Schizophrenia

One psychotic person influences a normal person who then develops similar symptoms

What are the treatments for schizophrenia with well demonstrated efficacy?

Antipsychotic medications, family psychoeducation, and assertive community treatment

Biological Evidence

Pieces of evidence support biological underpinnings but no dominant theory

Based on genetic evidence, what have studies shown about schizophrenia?

Studies have shown that risk of schizophrenia differs by degree of relation to the index case

Dopamine Hypothesis

Schizophrenia results from too much dopaminergic activity

Pertaining to imaging, people with schizophrenia have enlarged what?

Ventricles

Pertaining to imaging, CT of schizophrenia patients shows decreased volume of what?

Hippocampal volume

What did Leff (1976) do?

Risk of readmission, suggest that emotional over-involvement might be related to relapse, and high expressed emotion (EE)

What did Hogart (1991) do?

Family psychoeducation, social skills training, chemotherapy and studied relapse and adjustments

What did Day et al. (1987) do?

Followed patients with recently diagnosed schizophrenia to study the stressful life events and relapse in schizophrenia

What disorders are included in externalizing psychopathology?

ODD, CD, ADHD, ASPD, plus maybe encopresis

What do all the disorders in externalizing psychopathology have in common?

Impulsivity