Exam 3

4 categories of schizophrenia symptoms

positive symptoms

psychomotor abnormalities

cognitive symptoms

negative symptoms

Phases of Schizophrenia

Prodromal Phase- onset and buildup of symptoms

Active phase-full blown symptoms

residual phase-symptoms no longer prominent

Capgras delusions

Belief in existance of “doubles” who replace significant others. Most common with brief forms of psychosis

Biological dimension of schizophrenia

genes and endophenotypes, Neurotransmitter dysregulation, structural abnormalities in brain, prenatal or birth complications

Differential diagnosis for schizophrenia spectrum disorder

• Substance-induced psychotic disorder

• Mood disorders with psychotic features

• Sleep-related disorders

• Delusional disorder

• Paranoid personality disorder

• Schizotypal personality disorder

• Pervasive developmental disorder

Psychological dimension of schizophrenia spectrum disorder

Childhood trauma

Depression and low self esteem

unusual thoughts

limited empathy

Social Dimension of schizophrenia spectrum disorder

Exposure to abuse

dysfunctional family

expressed emotions

Sociocultural dimension of schizophrenia spectrum disorder

gender

low economic status, poverty

social adversities

Migration

Schizophrenia Spectrum Disorder risk factors

more common in females, higher prevalence among family members

Schizophrenia spectrum disorder protective factors

treatment for schizophrenia

Antipsychotic medication and psychosocial therapy

Steps in assessment (Neurocognitive disorders)

Gather background information
– Evaluate overall mental functioning,

personality characteristics, and coping skills
– Rule out sensory conditions or emotional
factors
– Test to pinpoint areas of cognitive difficulty

Normal aging

Normal aging: Slower to complete mental or physical tasks, occasional forgetfulness, occasional distractibility, undergoes normal changes in mood

Cognitive decline

has difficulty performing familiar tasks, has difficulty or requires assistance with normal day to day activities, is unaware and unconcerned about memory difficulties

Concussion

Symptoms include headache, dizziness,
nausea, and sensitivity to light
– Usually temporary (a few weeks), but
sometimes last much longer
• Many occur in competitive sports and
recreational activities; about half are
unreported

cerebral contusion

Bruising of the brain
– Occurs when brain strikes skull with sufficient
force to cause bruising
– Involves actual tissue damage to both side of
the impact and opposite side
– Symptoms similar to those of a concussion

cerebral laceration

Open head injury
• Brain tissue is torn, pierced, or ruptured
• Immediate medical care involves reducing
bleeding and preventing swelling
• Symptoms vary with severity of laceration

hemorrhagic stroke

Involves leakage of blood into the brain

ischemic stroke

Caused by a clot or severe narrowing of the
arteries supplying blood to the brain

87% of strokes

Transient ischemic Attack

“Mini-stroke” resulting from temporary
blockage of arteries
• Symptoms often precede ischemic stroke

characteristics of alzheimer’s

Progressive decline in cognitive and
behavioral functioning
• Physiological processes that produce AD
begin years before onset of symptoms
– Early symptoms
• Memory dysfunction, irritability, and cognitive
impairment

Treatment of neurocognitive disorders

Cluster A characteristics

-odd or eccentric behavior

-paranoid personality disorder: pervasive distrust & suspicious of others

-schizoid personality disorder

-schizotypal personality disorder

Cluster B Characteristics

dramatic, emotional, or erratic behaviors

• antisocial personality disorder

• BPD

• Narcissistic personality disorder

Cluster C characteristics

anxious or fearful behaviors

• avoidant personality disorder

• dependent personality disorder

• Obsessive Compulsive personality disorder

Treatment for Personality Disorders

Medication: Anti depressants/ SSRI’s

Antipsychotic medication

CBT & DBT

Difference between OCD and OCPD

-OCD involves unwanted, intrusive thoughts and urges

-Individuals with OCPD see their way of functioning as correct

Differential diagnosis for schizotypal personality disorder and schizophrenia spectrum disorder

differences: schizotypal personality disorder does not experience hallucinations and delusions

rather than a full psychotic break for those with schizophrenia spectrum disorder schizotypal personality disorder involves distorted thinking

Externalizing disorders vs internalizing disorders

Externalizing disorders (or externalising disorders) are mental disorders characterized by externalizing behaviors, maladaptive behaviors directed toward an individual's environment, which cause impairment or interference in life functioning. In contrast to individuals with internalizing disorders who internalize (keep inside) their maladaptive emotions and cognitions, such feelings and thoughts are externalized (manifested outside) in behavior in individuals with externalizing disorders.

Risk and protective factors that impact prognosis in ODD and CD

ODD:More common in males

CD: More common in males and urban settings

ADHD

Characterized by inattention and hyperactivity and impulsivity

symptoms begin before age 12 and persist for at least 6 months

Autism spectrum disorders

characterized by social impairment in social communication skills

occurs five times more frequently in boys

PTSD in kids

Youth with PTSD experience recurring,
distressing memories of a shocking
experience
– Direct experience with witnessing death,
serious injury, or sexual violation
– Witnessing or hearing about the victimization
of others can also result in PTSD
• Symptoms
– Distressing dreams, intense reactions to cues,
playacting, or dissociative reactions

Bipolar Disorder in kids

Mood variability, depressive episodes, and
departure from typical functioning that
characterize adult bipolar disorder
– Hypomanic/manic episodes may alternate
with depressive/irritable episodes
• Elevated neurological responsiveness to
emotional stimuli and various brain
abnormalities have been found
• May be overdiagnosed

Ways mental health professionals can interact with the legal system

Psychological evaluation in child protection
matters
– Evaluation for child custody in divorce
proceedings
– Civil commitment determination
– Protecting client rights
– Profiling criminals

Civil vs. criminal commitment

Civil Commitment: – Involuntary confinement of a person judged to
be a danger to self or others
• Even though the person has not committed a crime
– May be viewed as protective confinement

Criminal commitment:Incarceration of an individual for having
committed a crime
• Criminal law
– Some people lack the ability to assist in their
own defense or discern the ramifications of
their actions because they are mentally
disturbed
– Although they may be guilty of a crime, their
mental state at the time of the offense
exempts them from legal responsibility

Confidentiality and when can it be breached

Confidentiality
– Ethical standard that protects clients from
disclosure of information without their consent

Based on Tarasoff ruling
– Obligates mental health professionals to
break confidentiality when clients pose clear
and imminent danger to other person
– Must warn intended victim

rights of patients/clients during a civil commitment process

Addington v. Texas (1979)
– Clear and convincing evidence that person is
mentally ill and potentially dangerous
• Dixon v. Weinberger (1975)
– Least restrictive environment
• Right to least restrictive alternative to freedom that
is appropriate to a person’s condition

definitions of insanity

Bases definition of insanity totally on the
individual’s ability to understand what he or
she did