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117 Cards in this Set
- Front
- Back
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Schizophrenia does not involve...
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split or multiple personalities
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"Schizo", "phrenia"
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splintering, mind
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What is schizophrenia
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it involves splintering or fragmenting of mental processes (e.g. - thought, perception, emotion, social functioning, etc.) so that they are no longer coordinated
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Result of schizophrenia
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psychosis - loss of touch with reality
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symptoms of schizophrenia
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1.) thought content 2.)thought form 3.)attention and perception 4.) affect, motivation, social functioning
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thought content
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what the patient is thinking (delusions of persecution, grandeur, thought control)
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thought form
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how the patient is thinking (loosening of associations, incoherence, neologisms - make up words only they know)
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Attention and Perception
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"over-attention", hallucinations
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Affect, Motivation, and Social Functioning
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blunted effect, anhedonia, social withdrawal, avolition
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Positive Symptoms
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Excessive activation or inadequate inhibition of behavior or mental process (delusions, hallucinations, thought disorder)
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Negative Symptoms
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deficits in behavior or mental processes (flat affect, anhedonia, avolition, apathy, social withdrawal)
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5 subtypes of schizophrenia
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paranoid, disorganized, catatonic, undifferentiated, residual
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paranoid schizophrenia
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delusions of persecution or grandeur & auditory hallucinations
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disorganized schizophrenia
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Inappropriate affect (e.g. silliness), incoherence; if delusions or hallucinations are present, content is not well organized
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catatonic schizophrenia
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highly excited or frozen motor behavior
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Undifferentiated schizophrenia
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psychotic symptoms; does not meet criteria for other subtypes
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Residual schizophrenia
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Absence of prominent symptoms, but continued impairment in affect, motivation, and social functioning; milder forms of odd thinking or perceptual experiences may be present
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Psychotic symptoms may also be present in...
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mania and depression, drug abuse, and organic brain syndromes (dementia)
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Psychotic symptoms that occur in mania or depression are...
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never occurring outside a mood episode, are usually mood-congruent
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age of schizophrenia onset in males
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late adolescence to early 20s
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age of schizophrenia onset for females
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22-30
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Onset pattern of schizophrenia
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rapid vs insidious
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course of illness for schizophrenia
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chronic vs. episodic
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Long-term outcome of schizophrenia
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burnout hypothesis, rule of thirds
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Percentage of 1st and 2nd degree relatives compared to general population at risk for schizophrenia
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1st degree: 7-10%, 2nd degree: 2-3%, general population: 1%
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twin studies concordance rate between MZ and DZ twins for schizophrenia
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MZ: 50% DZ: 10%
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What percentage of schizophrenia comes from genetics?
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60-80%
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limitations of family and twin studies
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- share same environment
- twins look alike and may dress alike - MZ twins often share the same placenta |
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2 environmental causes for schizophrenia
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pregnancy or birth complications (maternal viral infection, fetal hypoxia-oxygen level temporarily cut off), disturbed family interactions (Tienari study)
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Current Theory of Schizophrenia
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Schizophrenia results if one has a certain critical number of the predisposing genes and (at least in some cases) particular environmental stressors
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How do genes affect behavior indirectly?
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By producing proteins involved in CNS structure and function
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Original version of Dopamine (DA) Hypothesis
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Excessive DA activity causes schizophrenia
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Clinical efficacy of neuroleptic drugs
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- many patients improve (about 50-70%)
-Efficacy related to effectiveness of blocking DA -most patients require maintenance medication |
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What type of dopamine receptors do neuroleptics block?
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D2 type
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DA agonists (amphetamines, L-dopa, cocaine) can produce...
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psychotic states
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Problems with DA hypothesis
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-timing of peak D2 receptor blockade does to correspond to peak antipsychotic efficacy, not all patients respond to antipsychotics (only 30-50%), n0o evidence of an intrinsic abnormality in DA system, DA can affect and be affected by many neurotransmitter systems
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Current Theory of DA Hypothesis
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Schizophrenia is caused by decreased connections between neurons, affecting the relative balance of dopamine, glutamate, and other neurotransmitter systems
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Symptoms of depression
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inability to experience pleasure, mood disturbance, low self esteem, feelings of guilt and worthlessness, low energy, psycho motor retardation, lack of motivation, poor concentration, focus on self, social isolation, appetite and social disturbances, suicidal thought, many cases: anxiety, irritability & substance abuse
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Types of Mood Disorders
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unipolar and bipolar
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unipolar disorders
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major depressive disorder - at least one major depressive episode, and dysthymic disorder - chronic, mild depression
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Bipolar disorders
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Mania - euphoria, heightened creativity and sexuality, and hypomanic symptoms - excessive elation, increased sociability, sense of humor, talkativeness, irritability, impulsiveness
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hypomanic episode may progress to:
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open expressions of anger, inflated self-esteem, pressured speech, poor judgement
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possible symptoms in final manic stage
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grandiose delusions, reckless and dangerous behavior, flight of ideas
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Bipolar I disordr
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at least one manic episode
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Bipolar II disorder
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at least one major depressive episode and at least one hypomanic episode ( no full blown manic)
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Cyclothymic Disorder
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A chronic, but less sevre, form of bipolar disorder- lasts at least 2 years
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Prevalence of unipolar depression in men and women
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2.6% of men, 7% of women
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prevalence of bipolar disorder
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<1%
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socio-cultural factors of mood disorders
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gender and SES
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cell body
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central region of the neuron containing the cell's nucleus
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axon
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the cell structure that conducts the nerve impulse
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axon terminals (presynaptic terminal)
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the end region of the axon, site of synaptic contact with another cell
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synaptic vesicles
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where neurotransmitters are stored in the axon terminals
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synapse
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point of contact between two neurons
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dendrites
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receive synaptic inputs from other neurons; they form the post-synaptic side of the synapse
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receptors
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specialized protein molecules on dendrites that detect neurotransmitters in the synapse.
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Biogenic amines
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neurochemicals that facilitate neural transmission
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the 4 biogenic amines
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catecholamines, epinephrine, norepinephrine, dopamine
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tricylic Antidepressants
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block the process of reuptake of catecholamines
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Selective Serotonin Reuptake Inhibitors (SSRIs)
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Inhibit reuptake of serotonin, an inhibitory neurotransmitter (ex: prozac, zoloft, paxil)
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2 ways to deactivate a neurotransmitter in the synapse:
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reuptake and chemical breakdown by enzymes
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Monoamineoxisade (MAO)
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breaks down monoamines chemically and renders them inactive
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drug treatment for Bipolar Disorder
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lithium carbonate and anticonvulsant medication
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neuroendocrine systems
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link the brain, hormones, and certain organs
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Underlying idea of the Cognitive Behavioral Model
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Emotions are a result of cognitions and by changing cognitions, you can change emotions
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Who states that 'Depression is a disorder of thinking as much as of mood'
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Aaron Beck
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The Negative Cognitive Triad
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negative thinking of: the self, the world, the future
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depressed schemas
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a general way of thinking that guides perceptions and interpretations of events; underlying negative beliefs
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The Negative Cognitive Triad and depressed schemas combine to create:
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Automatic Negative thoughts and illogical thinking
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goal of cognitive behavioral theory
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Change automatic negative thoughts and illogical thinking associated with depression
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Assumption of Cognitive Behavioral Theory
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By changing relevant beliefs, change in the emotional reaction should follow
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CBT technique - Scheduling of Activities
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increase time for social activites as a way to facilitate pleasurable activities and enhance positive emotions
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3 column technique
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3 questions - A. What is the evidence for and against the belief? B. What are the alternative interpretations? C. What are the real implications, if the belief is correct?
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Electro convulsive therapy (ECT)
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muscle convulsions, often affective on severely unipolar depressed when other options fail, overused in 40s and 50s, modern technology reduce side effects
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diathesis =
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genetic vulnerability
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early hypothesis for onset of schizophrenia
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dysfunctional family environments cause schizophrenia
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family factors for onset of schizophrenia
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schizophrenogenic mother, double bind communication (words different from tone)m communication deviance, Tienari study, expressed emotion, critical comments, hostile remarks, emotional overinvolvement
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Traditional antipsychotic medications
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blocks about 70% of D2 receptors, primarily effects positive symptoms, improves 50-60%
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Side effects of anti psychotic medications on schizophrenia
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1.)extrapyramidal symptoms - effecting motor symptoms, severe muscle stiffness
2.)tardive dyskinesia - uncontrollable lip smacking, tongue protrusions - developed by 25% |
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Atypical psychotic medicines
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may block fewer than 40-50% D2 receptors while also blocking other subtypes of receptors, effective in positive symptoms as well as some negative, less side effects
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others treatments for schizophrenia besides medication
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supportive therapy, skills training, family education
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3 approaches to abnormal behavior
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Statistical, Ideal State Model, and Legal Model
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Statistical Approach
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behavior practiced by the majority is a sign of mental health, behavior that deviates is abnormal
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Ideal State Model
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construct an objective criteria of good or ideal mental health, deviations of the ideal state are interpreted as indicators of underlying pathology,
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Legal Model
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legal definitions of sanity are based on the ability to distinguish right from wrong and understand the consequences of the charges for the crime
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Thomas Szasz
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author of "Myth of Mental Illness"
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2 criteria according to Wakefield that a mental disorder must have
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condition is harmful and condition reflects dysfunction
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problem suppression facilitation model
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culture helps to shape child's behavior
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Adult distress threshold model
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culture helps to shape adult's attitudes towards child behavior
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juvenile delinquency
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Legal term used for children and adolescents who display chronic antisocial behavior
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cognitive behavior factor for aggression
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aggressive boys tend to ascribe hostile motives to other children when cues about the other child's intentions are ambiguous
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goals of cohersion
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to decrease an undesired parent behavior and increase a desired parent behavior
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differential attention
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natural social reinforcer - use hugs to give attention to positive behavior
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4 behavioral treatment interventions
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differential attention, rewarding prosocial behavior, time out, token systems
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Conduct Disorder
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aggression, destruction of property, deceitfulness, theft, serious rule violations, often in adolescents
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Oppositional Defiant Disorder
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negative, hostile, defiant behavior, minor rule violations, often in school aged children
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Attention Deficit Hyperactivity disorder
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hyperactive, attention deficit, impulsiveness
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ADHD treatment
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psycho stimulants such as ritilin
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side effects of psychostimulants
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decreased appetite, increased heart rate, sleep difficulties, motor tics in small percentages of cases, slowed physical growth
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developmental norms
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behavior typical for children at a given age
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Do psychologist prefer private therapy with child or family therapy
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family therapy
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Index offenses
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crimes against people or property that are illegal at any age
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Status Offenses
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acts that are illegal only because of the youth's status as a minor
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what percentage of the 63 million children in the US suffer from a mental disorder
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12%
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6 Family predictors of behavioral problems
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low income, overcrowding in the home, maternal depression, paternal antisocial behavior, conflict between parents, removal of child from home
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temperment
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inborn behavioral characteristics including activity level, emotionality, and sociability
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Authoritative Parenting
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most loving and firm, best for child rearing well-adjusted children
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Authoritarian Parenting
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lacks warmth, the discipline is often strict, harsh, and autocratic
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Indulgent parenting
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affectionate but lacks in discipline
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Neglectful Parenting
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Parent not concerned with child's emotional needs or need for discipline - often seen in children with Conduct Disorder
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coercion
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occurs when parent positively reinforces a child's misbehavior by giving into the child's demands. The child negatively reinforces the parents by ending his or her obnoxious behavior as the parents capitulate
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extinction
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ignoring the child's misbehavior, pushing it, or rewarding positive actions
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ultimate goal of socialization
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self-control
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behavioral family therapy
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treatment based on learning theory principles that teaches parents to be very clear and specific about expectations of their children's behavior, to closely monitor their actions, reward positive behavior, and ignore or mildly punish misbehavior
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Multisystematic therapy
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intervention with conduct disorders that combines family treatment with coordinated interventions in other important contexts such as peer groups, schools, and neighborhoods
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recidivism
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repeat offending
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Achievement Place
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A residential group home that operated according to highly structured behavior therapy principles
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