Psy 474

Front 1

DSM criteria

Back 1

Significant impairment in reality testing (psychosis)
Do not evaluate accuracy of thoughts correctly and makes gross incorrect references about reality
(delusions, hallucinations, disorganized speech, disorganized/catatonic beh, negative symptoms)

Front 2

Delusions

Back 2

Irrational beliefs that are not based in reality. Impairment in reality testing.
Persecution (teacher trying to kill me)
Somatic (my fingers are fusing together)
Grandeur (i can fly, president calls me)

Front 3

Hallucinations

Back 3

Most common= auditory (white noise, water running, crickets)
Visual (age appropriate)
Tactile (feel something biting at leg)
Olfactory (smell things that arent there)

Front 4

Disorganized speech

Back 4

Thinking is disturbed so speech is moved by sound of words, rather than meaning.
Clang or rhyming
Neologisms (make up words)
Loos associations/ derailment

Front 5

Disorganized behavior

Back 5

Odd facial expressions, disheveled dress, odd motor movements
Catatonic behavior: very marked lack of reactivity, immobility. (frozen in place, waxy fexibility)

Front 6

Categories of symptoms

Back 6

Postivie= delusions, hallucinations, thought problems
Negative= absense of psychotic symptoms; social isolation, lack of pleasure, flat affect, loss of energy (low mood, no expression)
Disorganized Behavior= bizarre behavior, attention problems, odd speech patterns

Front 7

Subtypes

Back 7

Disorganized: silliness, incoherence, poor self care. maybe have delusions/hallucinations but not systematic. most often seen in children, worst outcome
Paranoid: delusions of persecution or grandeur (systematized and complex), best prognosis, rare in child
Catatonic: moteor beh either enormously excited or frozen. rare w/ use of antipsychotic medications.
Residual: absense of prominent symptoms, doesnt meet criteria but at 1 time did. negative symtpoms predominate

Front 8

Phases

Back 8

Premorbid: typical functioning
Prodromal: starts subtly, social isolation, loss of self care, alterations in sleep
Acute: 1-6 mos;in children presense of negative symptoms and disorganized beh, in adults presense of postive symptoms
Recovery: continued impairment but less severe. negative symptoms
Residual/Chronic: continued improvement, some negative symptoms still present

Front 9

Characteristics

Back 9

Very rare; 1/10,000
does not vary by SES/Ethnicity
Onset after 10 more common; childhood- <14 more males, >15 males=females
High rates of suicidal thought/ behavior; paranoia and depression

Front 10

Diathesis-Stress model

Back 10

Biological predisposition to a disorder-> develop if under some kind of enviornmental stressor.

Front 11

CNS dysfuntion

Back 11

Smaller brain volume (loss of grey matter), increased size of ventricles
Neurochem: dopamine hypothesis (someone on speed, increased dopamine in brain) Neuroleptics reduce amound of dopamine, tardive dyskinesia: abnormalities in motor movement, becomes permanent side effect
Neuropsych: attention, EF, speed of processing, poor performance

Front 12

Family factors

Back 12

Does not cause schizo. but is a related stressor in vulnerable child
Fragmented/diffuse communication (loose association, hard to talk to parent)
Enmeshed family boundaries
Expressed Emotion : high levels; critism and overinvolvment. caregiver burden (financially and psychologically)

Front 13

Dev't course

Back 13

Poor prognosis: w/ treatment there is improvement but high rate of future episodes following 1st psychotic episode
Chronic disorder requiring chronic treatment
Adolescence: secondary problems indepedent living and social relationships

Front 14

protective factors

Back 14

early intervention, short duration of psychotic episodes, later onset.
Earlier, stop acute phase, the better