Ch 14-15

Front 1

How is psychosis defined?

Back 1

A state definedby a loss of contact with reality. The ability to perceive and respond to theenvironment is significantly disturbed; functioning is impaired. Symptoms mayinclude hallucinations (false sensory perceptions) and/or delusions (falsebeliefs)

Front 2

What are the major symptoms of schizoaffective?

Back 2

Significant moodsymptoms
psychosis 
other symptoms of schizophrenia.
occurrence of ≥ 1 episodesof depressive or manic symptoms

Front 3

What are the major symptomsof schizophreniform?

Back 3

Diagnosed when symptoms of schizophrenia arepresent for a significant portion of the time within a one-month period, butsigns of disruption are not present for the full six months required for thediagnosis of schizophrenia. 1-6 months. Disorganized speech, lack of energy,poor hygiene, odd strange behavior, and withdrawal from social life.

Front 4

What are the major symptomsof delusional disorder?

Back 4

Characterizedby delusions (false beliefs) that persist for at least 1 month, without othersymptoms of schizophrenia
Uncommon
Onset middle or later adult life. Psychosocialfunctioning is not as impaired 
Impairment related to delusion.

Front 5

What is the concordance ratefor identical versus fraternal twins for schizophrenia?

Back 5

48%identical vs. 17% fraternal twins or 50% vs .15%

Front 6

What is the prevalence ofschizophrenia in the general population?

Back 6

1%develop this disorder

Front 7

What are the genderdifferences in schizophrenia in terms of prevalence and onset?

Back 7

Thereare no clear gender differences, but symptoms vary across cultures.

Front 8

What is the downward drifttheory of schizophrenia?

Back 8

Schizophreniais more frequent in lower level of poverty it could be that schizophreniacauses victims to be low level, even if they were successful before.

Front 9

Are their social economicstatus differences in the prevalence of schizophrenia? Why? (are the upper orlower class more likely to suffer and why?)

Back 9

Yes;sometimes called the downward drift theory, if they fall from a higher level toa lower level of wealth

Front 10

How do thepositive symptoms of schizophrenia differ from the negative ones?

Back 10

Positive: delusions of persecution, delusionof references, delusion of grandeur, preservation and clang (rhyme).

Negative: show less emotion than mostpeople; avoidance of eye contact 
immobile, expressionless face, monotonousvoice, low and difficult to hear
anhedonia - general lack of pleasure orenjoyment

Front 11

What aredelusions?

Back 11

A strange false belief firmly held despite evidence to thecontrary

Front 12

Delusion ofpersecution

Back 12

A symptom of the paranoid type of schizophrenia which causesthe sufferer to believe that people are trying to harm him

Front 13

Delusion ofreference

Back 13

All events within the environment is referred by thepsychotic person to himself or herself. ("Someone is trying to get amessage to me through the articles in this magazine; I must break the code sothat I can receive the message")

Front 14

Delusion of grandeur

Back 14

An exaggerated false belief about one's importance, wealth,power, or talents

Front 15

Thought insertion

Back 15

Belief that another person orobject is inserting thoughts into one's head.

Front 16

Thoughtwithdrawal

Back 16

Belief that thoughts are being removed from one's head byanother person or object

Front 17

What are thepsychomotor symptoms of schizophrenia?

Back 17

Awkward movements or repeated grimaces. Often have a privatepurpose.

Front 18

Neologisms

Back 18

Madeup words (positive)

Front 19

Clang

Back 19

Rhymes(positive)

Front 20

Preservation

Back 20

Patientsrepeat their words and statements again and again (positive)

Front 21

What are hallucinations andwhat are the most common type with schizophrenia?

Back 21

Hallucinationsare sensory experiences with no basis in reality, the most common one isauditory

Front 22

Understand the types ofhallucinations- know characteristics of each (for example, how do auditoryhallucinations differ from gustatory ones or tactile ones?)

Back 22

Auditoryhallucinations differ from gustatory ones or tactile ones, as it’s one of themost common one experienced. Also auditory is the only one that doesn’t pertainthe thought of being touched by something that isn’t present.

Front 23

How are hallucinationsdifferent than delusions?

Back 23

Ahallucination is a sensorydisturbance, and delusions are a beliefdisturbance.

Front 24

4 subtypes ofschizophrenia

Back 24

Disorganized,catatonic, paranoid, undifferentiated

Front 25

Disorganized

Back 25

Disorganizedspeech, behavior, and flat affect

Front 26

Catatonic

Back 26

Motorimmobility or excessive activity

Front 27

Paranoid

Back 27

Frequentauditory hallucinations, Delusions of persecution or grandeur

Front 28

Undifferentiated

Back 28

Doesn'tfit into above category, May meet criteria for multiple types

Front 29

Auditory hallucinations arerelated to what type of schizophrenia?

Back 29

Paranoidtype

Front 30

Catatonic stupor

Back 30

Peoplewith this symptom stop responding to their environment remaining silent forlong stretches of time

Front 31

Catatonic posturing

Back 31

Assumingawkward, bizarre positions for a long period of time

Front 32

Catatonic Rigidity

Back 32

Maintaininga rigid, upright posture for hours and resist efforts to be moved

Front 33

Loss of volition

Back 33

Apathyfeeling of drained energy and of interest in normal goals and unable to startor follow through on a course of action

Front 34

Poverty of speech (alogia)

Back 34

Areduction in speech or speech content

Front 35

Blunted affect

Back 35

Showingless anger, less sadness, joy and other feelings than most people. Some evenshow no emotions at all. Also known as the flat effect

Front 36

Inappropriate affect

Back 36

Displayof emotions that are suited to the situation

Front 37

What are the 4 phases ofschizophrenia?

Back 37

Anhedonia,prodromal, active, and residual.

Front 38

Anhedonia

Back 38

Ageneral lack of pleasure or enjoyment

Front 39

Prodromal phase

Back 39

Symptomsare not yet showing in this phase but the individual begins to deteriorate

Front 40

Active phase

Back 40

Duringthis phase symptoms become apparent this phase is triggered by stress in theperson's life

Front 41

Residual phase

Back 41

Areturn to a prodromal like level of functioning the striking symptoms of theactive phase lessen, but some negative symptoms such s blunted emotions mayremain

Front 42

Under what conditions areindividuals more likely to recover from schizophrenia?

Back 42

Afull recovery from schizophrenia is more likely in persons who had goodPREMORBID functioning or whose disorder was initially triggered by stress, cameon abruptly, or developed during middle age

Front 43

Explain the neurologicalfactors involved in schizophrenia.

Back 43

Peoplewith schizophrenia tend to have enlarged ventricles, meaning they tend toexperience a poorer social adjustment prior to the disorder, greatercognitive disturbances, and poorer responses to conventionalpsychoactive drugs

Front 44

What genetic factors areinvolved in schizophrenia? What kinds of conclusions can we make about thegenetics of schizophrenia?

Back 44

85%genetic. Cerebral cortex injury (due to anemia, anoxia, ischemia), advancedpaternal age (mutations in the sperm), neurobiology (development,neurochemicals, brain structure; nerve cells travel to the wrong place)

Front 45

What is schizoaffectivedisorder? What are the major symptoms and proposed causes?

Back 45

Markedby both symptoms of both schizophrenia and mood disorders experiencing one ofthe following: delusions, hallucinations, disorganized speech, disorganizedbehavior, or negative symptoms.

Front 46

How did Freud explain thesymptoms of schizophrenia?

Back 46

Believedthat schizophrenia develops from two psychological processes (1) regression toa pre- ego stage. (2) Effects to reestablish ego control etc.

Front 47

What does the term‘schizophrenogenic mother’ refer to?

Back 47

Atype of mother supposedly cold, domineering, and uninterested in the needs ofothers who was once thought to cause schizophrenia in her child

Front 48

What is the concordance rate of schizophrenia inidentical twins? Fraternal twins?

Back 48

50%and 15%

Front 49

How is maternal illness oroxygen deprivation related to the development of schizophrenia? (the viraltheory)

Back 49

Analysisof stored serum from mothers whose children later developed schizophreniashowed evidence of maternal infection.

Front 50

How is dopamine related to schizophrenia?

Back 50

Oversensitivityof dopamine (dopamine theory)-> support comes from the effects of antipsychoticmeds and amphetamines, disruptions during 2nd trimester of pregnancy increaserisk of schizophrenia. Medications that block dopamine receptors, specificallyD2 receptors, reduce schizophrenia symptoms. The brain regions known as thethalamus and the striatum are affected by dopaminergic activity.

Front 51

How did we make the discoverythat schizophrenia was related to dopamine?

Back 51

Reducedpsychotic symptoms by blocking dopamine

Front 52

What recent researchchallenges the dopamine theory of schizophrenia?

Back 52

Atypicalantipsychotic drugs- they also bind to D-1 receptors as well as D-2 (fordopamine) which shows that it may be brain irregularities with dopamine andserotonin

Front 53

Enlarged brain ventricles areusually related to what kind of schizophrenia?

Back 53

Negativesymptoms

Front 54

Understand and be able toidentify the 3 biological markers for schizophrenia?

Back 54

Linkedwith genes that play a role in the development of the central nervous system. Associatedwith prenatal complications. Characterized by changes in brain structure priorto onset.What is the social selectionor social drift hypothesis of schizophrenia?

Front 55

What is the social selectionor social drift hypothesis of schizophrenia?

Back 55

Socialclass is a consequence of mental disorder

Front 56

What are the important socialfactors that must be considered in treating schizophrenia?

Back 56

Multiculturalfactors, social labeling and family dysfunctioning

Front 57

What is meant by double bindfamily communication? How do these dynamics relate to schizophrenia?

Back 57

Doubleblind: a theory that some parents repeatedly communicate pairs of messages thatare mutually contradictory, helping to produce schizophrenia in their children.

Front 58

How do families with highlevels of expressed emotion interact with one another?

Back 58

Expressedemotion members frequently express criticism disapproval and hostility towardseach other and intrude on one's privacy

Front 59

What was the traditionalmethod of dealing with or treating individuals with schizophrenia prior to theadvent of medication?

Back 59

Institutionalization

Front 60

What is milieu therapy and why does it haverelevance for those with schizophrenia?

Back 60

Ahumanistic approach to institutional treatment based on the belief thatinstitutions can help patients recover by creating a climate that promotes self-respect,responsible behavior, and meaningful activity

Front 61

What is the token economysystem that is used by many institutions and treatment centers?

Back 61

Tokeneconomic: a behavioral program in which a person's desirable behaviors arereinforced systematically throughout the day by the awarding of tokens that canbe exchanged for goods or privileges.

Front 62

What are some of thecriticisms of the token economy?

Back 62

Manystudies of effectiveness do not include a control group, confounding thetreatment with attention. Although token economy programs can change patients'delusional statements, they may not be changing delusional thoughts. It isdifficult for patients to make the transition from a token economy program tothe community.

Front 63

What schizophrenic symptom ismost likely to be helped by drug therapy and what are least likely to be helpedby medication?

Back 63

Psychoticsymptoms

Front 64

What was the firstantipsychotic medication introduced in the 1950s?

Back 64

An antihistamine called chlorpromazine in 1954

Front 65

What symptoms did thetraditional antipsychotic medications work to alleviate best?

Back 65

Reducedthe positive symptoms of schizophrenia more completely, or at least morequickly, than the negative symptoms. Positive symptoms include believing that what other people are saying isnot true (delusions), hearing, seeing, tasting, feeling, or smelling thingsthat others do not experience (hallucinations), disorganized speech andbehavior.

Front 66

What is tardive dyskinesia?

Back 66

Extra pyramidaleffects that appear in some patients after they have taken conventionalantipsychotic drugs for an extend time.

Front 67

What is neuroleptic malignantsyndrome?

Back 67

Asevere, potentially fatal reaction. Symptoms include muscle rigidity, fever,altered consciousness, and improper functioning of the autonomic nervous system

Front 68

What are the advantages ofthe atypical antipsychotics?

Back 68

Theyappear more effective than conventional antipsychotic drugs, especially fornegative symptoms and they cause few extrapyramidal side effects and seem lesslikely to case tardive dyskinesia. Lower incidence of EPS (better adherence), possiblelower incidence of tardive dyskinesia, improve negative symptoms & improvepositive symptoms

Front 69

What is the one potential side effect of theatypical drugs for schizophrenia?

Back 69

Carrya risk of agranulocytosis, a life-threatening drop in white blood cells and theyalso may cause weight gain, dizziness, and significant elevations in bloodsugar

Front 70

What is the revolving doorsyndrome in the treatment of mental illness?

Back 70

Peoplecome in and out of treatment centers due to ineffective and incomplete care

Front 71

What is social breakdownsyndrome?

Back 71

Deteriorationof social and interpersonal skills, work habits, and behavior seen inchronically hospitalized psychiatric patients. Symptoms are due to the effectsof long term hospitalization rather than the primary illness, and includeexcessive passivity, assumption of the chronic sick role, withdrawal, andapathy. Such effects are also seen in long-term inmates of prisons orconcentration camps. Called also institutionalism.

Front 72

What is the Community MentalHealth Center Act?

Back 72

Providemedications, psychotherapy, and inpatient emergency care and coordination ofservices are especially important for mentally ill chemical abusers (MICAs)

Front 73

Understand the features ofeffective community care

Back 73

Key features: coordination of patientservices, short-term hospitalization, partial hospitalization, supervisedresidencies, and occupational training.People who are recovering and need medication, psychotherapy, help handlingdaily pressures and responsibilities, guidance in making decisions, socialskills, training, residential supervision, and vocational counseling – a combinationof services sometimes called assertive community treatment.

Front 74

Understand the challenges of treating the MICApopulation

Back 74

Patientstend to hide their drug abuse problems and clinicians may overlook suchproblems. Unrecognized substance abuse may lead to misdiagnosis andmisunderstanding of the disorder. Further complications are that many treatmentfacilities are designed and funded to treat either mental disorders orsubstance abuse; only some are equipped to treat both.

Front 75

How is short-term hospitalizationdifferent from partial hospitalization?

Back 75

Iftreatment on an outpatient and medication are unsuccessful, patients may betransferred to short-term hospital programs. After being hospitalized for up toa few weeks, patients are released to aftercare programs for follow-up in thecommunity.

Partial hospitalization is when people’s needs fall betweenhospitalization and outpatient. There are day centers or day hospitals thepatients go to, spend all day, and then report back to their homes at night.

Front 76

What is a half way house?

Back 76

A placepeople go to who are seek help, do not need to be hospitalized, but cannot liveat home or by themselves. Often referred to as crisis houses or group homes,inhabited by 1-24 people with live-in staff who are usually paraprofessionalsand usually run milieu therapy philosophy (mental support, residentresponsibility, and self-government)

Front 77

Why do some therapistsbelieve that psychotherapy is unsuccessful in treating schizophrenia by itself?

Back 77

Unmedicatedschizophrenics are too far removed from reality to form the relationshipneeded.

Front 78

What might the goal of family therapy be for theschizophrenic patient?

Back 78

Supportand understanding

Front 79

What does MICA stand for?

Back 79

MentallyIll Chemical Abusers

Front 80

What is the most effectivetreatment for schizophrenia?

Back 80

Medication/antipsychotics.