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29 Cards in this Set
- Front
- Back
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Emil Kraepelin
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First described schizophrenia as "dementia praecox" noticed earlier than usual cognitive deterioration
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Eurgen Bleuler
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student of Emil Kraepelin. Determined the presence of several types of schizophrenia
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Schizophrenia Affect
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Bizarre, flat
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Four phases of schizophrenia
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Phase I - Premorbid phase
Phase II - Prodromal Phase Phase III - Schizophrenia Phase IV - Residual Phase |
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Premorbid phase
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Social maladjustment
Shy and withdrawn Poor peer relationships Doing poorly in school antisocial behavior (***irritable antagonistic thought - typically early junior high - prefer solitary activities opposed to extracurricular activities) |
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Prodromal Phase
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Lasts from few weeks to 2-5 years
Deterioration in role function Social withdrawal - more reclusive Substantial functional impairment Sleep disturbance, anxiety, irritability Depressed mood, poor concentration, fatigue Perceptual abnormalities, ideas of reference, and suspiciousness herald onset of psychosis |
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Schizophrenia - Stage III
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In the active phase of the disorder, psychotic symptoms are prominent
delusions hallucinations significant impairment in work, social relations, & self-care |
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Diagnostic Criteria of Schizophrenia
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At least two for at least 6 months
Delusions Hallucinations Disorganized speech or behavior |
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Phase IV - Residual Phase
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referred to as remission
Symptoms linger - difficult to function Negative symptoms Symptoms are similar to those of the prodromal phase Flat affect and impairment in role functioning are prominent |
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Predisposing Factors of Schizophrenia
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Biological
Psychological Environmental Transactional - (result of multiple factors) |
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Biological Influences - Schizophrenia
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Genetics: first-degree biologic relatives have 10 times greater risk for schizophrenia. Other relates have higher risk for other psychiatric disorders
Biochemial: Dopamine hyperactivity in limbic symptoms (Positive symptoms) Dopamine hypoactivity in frontal region (executive function; making decisions, abstraction, logic and reasoning) Physiological: endocrine - decreased prolactin, viral infections, anatomical abnormalities (enlarged ventricles), various physical conditions |
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negative symptoms associate with which region of the brain
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frontal region (hypoactive dopamine)
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Positive symptoms associate with which region of the brain
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limbic system (hyperactive dopamine)
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Environmental Influences - Schizophrenia
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Sociocultural - poverty has been linked
Downward drift hypothesis - poor social conditions, seen as consequence of, rather than a cause of schizophrenia Stressful life events - may be associated with exacerbation of schizophrenic symptoms and increased rates of relapse |
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Five categories of Schizophrenia
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Paranoid
Disorganized Catatonic (Catatonic stupor or catatonic excitement) Undifferentiated Residual |
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Delusional Disorder (Five disorders) - prominent, plausible, non-bizarre
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Erotomatic type (Patrick dempsey is in love with me)
Grandiose Type (I'm the queen of England) Jealous Type - sexual partner is unfaithful Persecutory type - world's out to get me Somatic - believes they have physical medical problem/pregnancy |
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Positive Schizophrenia Symptoms
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Hallucinations
Delusions Disorganization |
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Negative Schizophrenia Symptoms
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Avolition - w/out desire or drive
Alogia - poverty of speech Anhedonia - nothing works Flat Affect - lights are on but nobodies home Ambivalence |
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Neurocognitive Impairment of Schizophrenia
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Attention, Memory, and Executive Function
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Thought processes of Schizophrenia
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Concrete thinking - low dopamine function in frontal lobe
Neologism - nonsensical word (Nupher) Clang association - i'm ten, hen a pen… Tangentiality - begins talking and does not come back to the question Circumstantiality - Gives a lot of information and talks in a circle until back to the question Mutism - cannot or will not talk perseveration - repeat: "I'm fine", "Fine", "fine" loose association |
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Loose Association Examples
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IT's all nutrition… muscle development
Meats, steak,… in a 2-2-8 package Meat, cheese is OK colors are changing and then they're gone but they're generally a 64 and a black trans am |
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Thought Content
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Religiosity - excessive demonstration of obsession with religious ideas & behavior.
Paranoia Magical thinking - ability to control others/situation Delusion - fixed, false belief. |
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Thought Content - Delusions: Schizophrenia
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Delusions of persecution - out to get me
Delusions of grandeur - special power or role Delusion of reference - referential thinking Delusion of control - others control him/her Somatic delusion - body problems (pregnant or tracker in my arm) Nihillistic delusion - nothingness; don't exist. |
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Perception of Schizophrenia
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Hallucinations (Anxiety is almost always underneath) - frightening; unpleasant; degrading.
Illusions Hallucinatinos reinforce paranoia and vice versa Assess - command hallucinations are critical |
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Schizophrenia - Hallucinations in order
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Auditory
Visual Tactile - bugs on skin Gustatory - tastes bad Olfactory - smells bad Derealization - external world seems strange or weird |
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Sense of self - Schizophrenia
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Weak ego boundaries
Echolalia - repeats word to relate with person Echopraxia - imitates behavior Indentification - unconscious Imitation - take on the form and behavior of someone else Depersonalization - disconnected, don't know who they are, unstable self ID, feelings of unreality |
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Schizophrenia - negative symptoms
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Less than normal function
Affect - inappropriate and blunted/flat Volition - avolition and abmivalence - just don't want to do anything Impaired interpersonal functioning - autism: inner fantasy world |
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Negative symptoms Schizophrenia - Psychomotor and Associated features
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Psychomotor - anergia - low/no energy, waxy flexibility, pacing and rocking.
Associated features - Anhedonia (cannot feel pleasure) and regression (childlike state - resorting is primary when trying to cope) |
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Outcomes for patient's with Schizophrenia
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FOCUSE ON PT STRENGTHS!
relate satisfactorily to others has not harmed self or others perceives self realistically able to perceive the environment correctly maintains anxiety at a manageable level |
