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62 Cards in this Set

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The potential for ____ is a major concern for patients with schizophrenia and this is the primary cause of premature death among people with the disorder.

When does the disorder typically develop?

The potential for suicide is a major concern for patients with schizophrenia and this is the primary cause of premature death among people with the disorder
(About 10% of schizophrenics die this way)

adolescence to early adulthood

Schizophrenia causes disturbances in ____ processes, per_____, and a___ which invariably result in severe deterioration of ____ and _____ functioning, significantly impairing the individual's ability to function in daily life, form interpersonal relationships, and maintain employment.

Schizophrenia causes disturbances in thought processes, perception, and affect which invariably result in severe deterioration of social and occupational functioning, significantly impairing the individual's ability to function in daily life, form interpersonal relationships, and maintain employment.

Psychosis is a severe mental condition in which there is dis______ of the per______, deterioration in social functioning, and loss of contact with or distortion of ____. There may be evidence of ____ and ____ thinking. Psychosis can occur with or without the presence of ____ impairment.

Psychosis is a severe mental condition in which there is disorganization of the personality, deterioration in social functioning, and loss of contact with or distortion of reality. There may be evidence of hallucinations and delusional thinking. Psychosis can occur with or without the presence of organic impairment.

Schizophrenia typically develops in late adolescence or early adulthood, but sometimes can develop in middle or late adult life. Some studies have indicated that symptoms of schizophrenia develop earlier in men/women. The pattern of development of schizophrenia involves what 4 phases?

Schizophrenia typically develops in late adolescence or early adulthood, but sometimes can develop in middle or late adult life. Some studies have indicated that symptoms of schizophrenia develop earlier in men than women. The pattern of development of schizophrenia involves the 4 phases:
premorbid
prodromal
active psychotic (schizophrenia)
residual

The premorbid personality (phase 1- premorbid phase of schizophrenia) often indicates s____ mal________, s___ w______, ir____, and ______ thoughts and behaviors. Traits include being very ___ and w_____, having poor ___ r_______, doing poorly in ____, and demonstrating a_____ behavior. In the typical, but not invariable premorbid history of schizophrenia, pateients had ____ or ____ personalities characterized as q___, passive/aggressive, and introverted/extroverted. As children, they had few/many friends or dates and avoided team sports. They often enjoyed _____ activities and avoided social activities.

The premorbid personality (phase 1- premorbid phase of schizophrenia) often indicates social maladjustment, social withdrawal, irritability, and antagonistic thoughts and behaviors. Traits include being very shy and withdrawn, having poor peer relationships, doing poorly in school, and demonstrating antisocial behavior. In the typical, but not invariable premorbid history of schizophrenia, patients had schizotypal or schizoid personalities characterized as quiet, passive, and introverted. As children, they had few friends or dates and avoided team sports. They often enjoyed solitary activities and avoided social activities.

The ____ of an illness refers to certain signs and symptoms that precede the characteristic manifestations of the acute, fully developed illness.

prodrome

Phase II: Prodromal Phase of schizophrenia begins with a change from premorbid functioning and extends wuntil the onset of frank psychotic symptoms. This phase can be as a brief as a few weeks or months, but most studies indicate the average length of the prodromal phase is between __ and ___ years. During the prodromal phase, the person experiences substantial functional impairment and nonspecific symptoms such as ___ disturbance, a____, i____, ____ mood, poor c_______, f____, and behavioral deficits such as deterioration in r___ functioning and social _____. Positive/negative symptoms such as perceptual abnormalities, ideas of reference, and suspiciousness develop late in the prodromal phase and are basically an omen to the imminent onset of ___.


Define catatonic, alogia, and avololition
Recognition of the behaviors associated with the prodromal phase provides an opportunity for early intervention, with a possibility for improvement in long-term outcomes. Current treatment guidelines suggest therapeutic interventions that offer support with identified problems, cognitive therapies to minimize functional impairment, family interventions to improve coping, and involvement with the schools to reduce the possibility of failure. It is still not known for sure whether treating symptoms with antipsychotic medications below the threshold of psychosis is effective at delaying the onset of psychosis.

Phase II: Prodromal Phase of schizophrenia begins with a change from premorbid functioning and extends wuntil the onset of frank psychotic symptoms. This phase can be as a brief as a few weeks or months, but most studies indicate the average length of the prodromal phase is between 2 and 5 years. During the prodromal phase, the person experiences substantial functional impairment and nonspecific symptoms such as sleep disturbance, anxiety, irritability, depressed mood, poor concentration, fatigue, and behavioral deficits such as deterioration in role functioning and social withdrawal. Positive symptoms such as perceptual abnormalities, ideas of reference, and suspiciousness develop late in the prodromal phase and are basically an omen to the imminent onset of psychosis.

Recognition of the behaviors associated with the prodromal phase provides an opportunity for early intervention, with a possibility for improvement in long-term outcomes. Current treatment guidelines suggest therapeutic interventions that offer support with identified problems, cognitive therapies to minimize functional impairment, family interventions to improve coping, and involvement with the schools to reduce the possibility of failure. It is still not known for sure whether treating symptoms with antipsychotic medications below the threshold of psychosis is effective at delaying the onset of psychosis.

Phase III: Schizophrenia
In this ___ phase of the disorder, ___ symptoms are prominent. The DSM IV TR diagnostic criteria for active schizophrenia includes:
1. Characteristic symptoms....
2. dysfunction of...
3. Duration...
4. exclusion of...
5, exclusion of..
6. relationship to a pervasive developmental disorder

Describe each criteria : )

Phase III: Schizophrenia
In this active phase of the disorder, psychotic symptoms are prominent. The DSM IV TR diagnostic criteria for active schizophrenia includes:
-characteristic symptoms: 2 or more of the following, each present for a significant portion of time during a 1- month period (or less if successfully treated)
a. delusions
b. hallucinations
c. disorganized speech (frequent derailment or incoherence)
d. grossly disorganized or catatonic behavior
e. negative symptoms (flat affect, alogia, avolition)
(4
2. Social/occupational dysfunction: For a significant portion of time since the onset of disturbance, one or more areas of functioning is markedly below the level achieved before onset such as in work, relationships, or self-care (or when the onset is in childhood or adolescence, failure to achieve expected level of interpersonal, academic, or occupational achievement).
3. Duration: Continuous signs of the disturbance for at least months. This period must include at least 1 month of symptoms (or less if successfully treated that meet criteria 1 (active-phase symptoms) and may include periods of prodromal or residual periods, the signs of the disturbance may be manifested by only negative symptoms or two or more symptoms listed in criteria 1 in an attenuated (weak, lessened) form (odd beliefs, unusual perceptual experiences).
4. Schizoaffective and mood disorder exclusion: Schizoaffective disorder and mood disorder with psychotic featrues have been ruled ou because a.) no major depressive, manic, or mixed episodes have occurred concurrently with the active-phase symptoms or b.) if mood episodes have occurred during active-phase symptoms their total duration has been brief relative to the duration of the active and residual periods.
5. Sybstance/general medical condition exclusion: the disturbance is not due to the direct phsyiological effects or a substance (drug) or general medical condition
6. Relationship to a pervasive developmental disorder: If there is a history of autistic disorder or another pervasive developmental disorder the additional diagnosis of schizophrenia is made only if prominent delusions or hallucinations are also present for at least 1 month (or less if successfully treated)

4 a's
affect- flat
autism- disconnect with reality or external world
ambivalence
association/associative looseness

Phase IV: Residual Phase
Schizophrenia is characterized by periods of _____ and ______. A residual phase usually follows an active phase of the illness. During the residual phase, symptoms of the acute stage are either ___ or no longer prominent. Positive/negative symptoms may remain, and ___ affect and impairment in role functioning are common. Residual impairment often decreases/increases between episodes of active ___.

Phase IV: Residual Phase
Schizophrenia is characterized by periods of remission and exacerbation. A residual phase usually follows an active phase of the illness. During the residual phase, symptoms of the acute stage are either absent or no longer prominent. Negative symptoms may remain, and flat affect and impairment in role functioning are common. Residual impairment often increases between episodes of active psychosis.

True or False: A return to full premorbid function after onset of schizophrenia is common

false, uncommon

Several factors have been associated with a more positive prognosis such as good ____ adjustment, earlier/later age at onset, male/female gender, ___ onset of symptoms precipitated by a stressful ___ (as opposed to gradual insidious onset of symptoms), associated ___ disturbance, long/brief duration of active-phase symptoms, good interepisode functioning, minimal ____ symptoms, absence of structural ___ abnormalities, normal neurological functioning, a family history of ___ disorder, and no family history of ____.

Several factors have been associated with a more positive prognosis such as good premorbid adjustment, later age at onset, female gender, abrupt onset of symptoms precipitated by a stressful event (as opposed to gradual insidious onset of symptoms), associated mood disturbance, brief duration of active-phase symptoms, good interepisode functioning, minimal residual symptoms, absence of structural brain abnormalities, normal neurological functioning, a family history of mood disorder, and no family history of schizophrenia.

No single factor can be implicated in the etiology of schizophrenia, but the disease probably results from a combination of influences including biological, psychological, and environmental factors.
Review the theories and various implications p. 319-323

...

The DSM-IV-TR identifies various types of schizophrenia and other psychotic disorders. Differential diagnosis is made according to the total symptomatic ____ _____ presented.

clinical picture
Which type of delusion is described?

individual believes that someone, usually of a higher status, is in love with him or her. Famous persons are often the subjects of the delusions. Sometimes the delusion is kept secret, but some individuals may follow, contact, or otherwise try to pursue the object of their delusion
erotomanic
Which type of delusion is described?

individual believes they have some physical defect, disorder, or disease

What are some of the most common examples of this delusional disorder?
somatic

-emits a foul odor from skin, mouth, rectum, or vagina
-has an infestation of insects in or on the skin
-has an internal parasite
-has misshapen and ugly body parts
-has dysfunctional body parts
Which type of delusion is described?

Individuals believe they are being malevolently treated in some way. Frequent themes include being conspired against, cheated, spied on, followed, poisoned or drugged, maliciously maligned, harassed, or obstructed in the pursuit of long-term goals
Individual may obsess about and exaggerate a slight rebuff (insult or rejection), which is either real or imagined, until it becomes the focus of a delusional system. Repeated complaints may be directed at legal authorities, lack of satisfaction from which may result in violence toward the object of the delusion
persecutory
Which type of delusion is described?
Centers on the idea that the person's sexual partner is unfaithful
The idea is irrational and without cause, but the individual with the delusion searches for evidence to justify the belief
Sexual partner is confronted (and sometimes physically attacked) regarding the imagined infidelity
the imagined "lover" of the sexual partner may also be the object of the attack
Attempts to restrict the autonomy of the partner in an effort to stop the imagined infidelity are common
jealous
Which type of delusion is described?
Irrational ideas regarding their own worth, talent, knowledge or power
They may believe that they have a special relationship with a famous person or even assume the identity of the famous person (believing the actual person is an imposter)
delusions of a religious nature may lead to assumption of the identity of a deity or religious leader
grandiose
Most clients with schizophrenia exhibit a mixture of both positive and negative symptoms. Positive/negative symptoms are associated with abnormal/ normal brain structures on CT scan and have a relatively good response to treatment. Positive/negative symptoms are difficult to treat and respond more/less to neuroleptics than do the opposite type of symptoms, and they also are the most de______ because they render the patient inert and un______.
Most clients with schizophrenia exhibit a mixture of both positive and negative symptoms. Positive symptoms are associated with normal brain structures on CT scan and have a relatively good response to treatment. Negative symptoms are difficult to treat and respond less to neuroleptics than do the opposite type of symptoms, and they also are the most destructive because they render the patient inert and unmotivated.
Behavioral disturbances of schizophrenia are categorized as positive or negative and considered in eight areas of ____: ____ of thought, ____ of thought, p_______, a____, sense of ____, v____, impaired inter____ functioning and _____ to the external world, and ______ behavior. Additional impairments outside the limits of these 8 areas are also presented.
Behavioral disturbances of schizophrenia are categorized as positive or negative and considered in eight areas of functioning: content of thought, form of thought, perception, affect, sense of self, volition, impaired interpersonal functioning and relationship to the external world, and psychomotor behavior. Additional impairments outside the limits of these 8 areas are also presented.
Positive symptoms include-
____ of _____: delusions, religiosity, paranoia, and magical thinking

______ of ______: associative looseness, neologisms, concrete thinking, clang associations, word salad, circumstantiality, tengentiality, mutism, perseveration

_______: hallucinations, illusions

Sense of ____: echolalia, echopraxia, identification and imitation, depersonalization
Positive symptoms include-
content of thought: delusions, religiosity, paranoia, and magical thinking

form of thought: associative looseness, neologisms, concrete thinking, clang associations, word salad, circumstantiality, tengentiality, mutism, perseveration

Perception: hallucinations, illusions

Sense of Self: echolalia, echopraxia, identification and imitation, depersonalization
The positive symptoms involving content of thought include d______, r_______, p______, and m____ t_____.
The positive symptoms involving content of thought include delusions, religiosity, paranoia, and magical thinking.
The positive symptoms involving form of thought include a_______ _____ness, n______s, _____ thinking, ______ associations, word _____, c______, t_____, m______, and p______.
The positive symptoms involving form of thought include associative looseness, neologisms, concrete thinking, clang associations, word salad, tangentiality, mutism,, and perseveration.
The positive symptoms involving perception include ____ and _____. Those involving sense of self include, e____, e____, identification and i______, and de_______.
The positive symptoms involving perception include hallucinations and illusions. Those involving sense of self include, echolalia, echopraxia, identification and imitation, and depersonalization.
false personal beliefs that are inconsistent with a person's intelligence or cultural background.
delusions
In assessing positive/negative symptoms of schizophrenia in regard to content of thought, delusions can be of many types. Delusions are false personal beliefs that are _______with a person's intelligence or cultural background. The individual continues to have the belief in spite of obvious proof that it is false or irrational. Delusions are subdivided according to their ____. The most common delusions includes delusions of persecution, of grandeur, of reference, of control or influence, somatic delusions, and nihilistic delusions.
In assessing positive symptoms of schizophrenia in regard to content of thought, delusions can be of many types. Delusions are false personal beliefs that are inconsistent with a person's intelligence or cultural background. The individual continues to have the belief in spite of obvious proof that it is false or irrational. Delusions are subdivided according to their content. The most common delusions includes delusions of persecution, of grandeur, of reference, of control or influence, somatic delusions, and nihilistic delusions.
In a delusion of ______ the individual feels threatened and believes that others intend to harm or go after him or her in some way (e.g. "the FBI has bugged my room and wants to kill me" or "I can't take a shower in this bathroom, the nurses have put a camera in there so that they can watch everything I do.")
In a delusion of persecution the individual feels threatened and believes that others intend to harm or go after him or her in some way (e.g. "the FBI has bugged my room and wants to kill me" or "I can't take a shower in this bathroom, the nurses have put a camera in there so that they can watch everything I do.")
In a delusion of ____ the individual has an exaggerated feeling of importance, power, knowledge, or identity. They may say, "I am Jesus Christ" or "I am the president of the United States."
In a delusion of grandeur the individual has an exaggerated feeling of importance, power, knowledge, or identity. They may say, "I am Jesus Christ" or "I am the president of the United States."
A delusion of ___ is when all events within the environment are referred by the psychotic person to himself or herself. (e.g. "Someone is trying to get a message to me through the articles in this magazine, TV program etc." or "I must break the code so that I can get the message.")
A delusion of reference is when all events within the environment are referred by the psychotic person to himself or herself. (e.g. "Someone is trying to get a message to me through the articles in this magazine, TV program etc." or "I must break the code so that I can get the message."
___ of reference are more/less rigid than delusions of reference. An example of this is irrationally thinking that one is being talked about or laughed at by others.
Ideas of reference are less rigid than delusions of reference. An example of this is irrationally thinking that one is being talked about or laughed at by others.
When an individual believes certain objects or persons are determining his or her behavior is a delusion of ___ or ____. (e.g. "The dentist put a filling in my tooth and now I receive transmissions through the filling that control what I think and do.")
When an individual believes certain objects or persons are determining his or her behavior is a delusion of control or influence. (e.g. "The dentist put a filling in my tooth and now I receive transmissions through the filling that control what I think and do.")
A ____ delusion is when a person has a false idea about the functioning of his or her body (e.g. "I'm 70 years old and I will be the oldest person ever to give birth." or "The doctor says I'm not pregnant but I know I am.")
A somatic delusion is when a person has a false idea about the functioning of his or her body (e.g. "I'm 70 years old and I will be the oldest person ever to give birth." or "The doctor says I'm not pregnant but I know I am.")
A nihilistic delusion is when a person has a false idea threat the self, a part of the self, others, or the world is nonexistent. What is an example?
A nihilistic delusion is when a person has a false idea threat the self, a part of the self, others, or the world is nonexistent. An example would be a person saying, "The world no longer exists" or "I have no heart."
An excessive demonstration of or obsession with religious ideas and behavior is known as _____. This can be an aspect of ____ of thought, which is part of the positive/ negative symptoms of schizophrenia. Because individuals vary greatly in their religious beliefs and level of spiritual commitment, this is something difficult to assess. The individual with schizophrenia may use religious ideas ideas in an attempt to provide rational meaning and structure to his or her ____. Religious preoccupation in this sense may be considered a manifestation of the illness. Clients who derive comfort from their religious beliefs should not/should be discouraged from employing this means of support. An example of religiosity is an individual who believes the voice he or she hears is ___ and incessantly searches the ___ for interpretation.
An excessive demonstration of or obsession with religious ideas and behavior is known as religiosity. This can be an aspect of content of thought, which is part of the positive symptoms of schizophrenia. Because individuals vary greatly in their religious beliefs and level of spiritual commitment, this is something difficult to assess. The individual with schizophrenia may use religious ideas ideas in an attempt to provide rational meaning and structure to his or her behavior . Religious preoccupation in this sense may be considered a manifestation of the illness. Clients who derive comfort from their religious beliefs should not be discouraged from employing this means of support. An example of religiosity is an individual who believes the voice he or she hears is God and incessantly searches the Bible for interpretation.
Another aspect of content of thought in the positive/negative symptoms of schizophrenia is ____, in which individuals have extreme suspicion in others and of their actions or perceived intentions. (e.g. "I won't eat this food. I know it's been poisoned.")
Another aspect of content of thought in the positive symptoms of schizophrenia is paranoia, in which individuals have extreme suspicion in others and of their actions or perceived intentions. (e.g. "I won't eat this food. I know it's been poisoned.")
____ thinking is an aspect of content of _____, which is a part of positive/negative symptoms of schizophrenia. The person believes that his or her thoughts or behaviors have control over specific situations or people. This is common thought process in young children (e.g. "Step on a crack and you break your mama's back, an apple a day keeps the doctor away)
Magical thinking is an aspect of content of thought, which is a part of positive symptoms of schizophrenia. The person believes that his or her thoughts or behaviors have control over specific situations or people. This is common thought process in young children (e.g. "Step on a crack and you break your mama's back, an apple a day keeps the doctor away)
What aspect of schizophrenia do the following fall into? associative looseness, neologisms, concrete thinking, clang associations, word salad, circumstantiality, tangentiality, mutism, and perseveration.
positive symptoms:
form of thought
an individual's inability or refusal to speak.
mutism
group of words that are put together randomly without any logical connection
word salad
literal interpretations of the environment which represents a regression to an earlier level of cognitive development. Abstract thinking is very difficult. (e.g. Client would have trouble describing the abstract meaning of saying "It's raining cats and dogs.")
concrete thinking
person never really gets to the point of the communication. Unrelated topics are introduced, and the focus of the original discussion is lost.
tangentiality
- delay reaching the point of a communication because of unnecessary and tedious details. The point or goal is usually met, but only after many interruptions by the listener to keep the person on topic.
circumstantiality
thinking is characterized by speech in which ideas shift from one unrelated topic to another, unaware that the topics are unconnected. When the condition is severe, speech may be incoherent (e.g. "We wanted to take the bus, but the airport took all the traffic. Driving is the ticket you want to get somewhere. No one needs a ticket to heaven. We have it all in our pockets.")
associative looseness
(3 different terms)

-new, made up words that are meaningless to others but have symbolic meaning to the psychotic person

-choice of words is based on sounds and often take the form of rhyming

- person persistently repeats the same word or idea in response to different questions
neologisms

clang associations

perseveration
Certain aspects about form of ____ are considered positive/negative symptoms of schizophrenia.
These include associative looseness, neologisms, concrete thinking, clang associations, word salad, circumstantiality, tangentiality, mutism, and perseveration. Briefly explain each aspect.
(Yes, again!)
Associative Looseness- thinking is characterized by speech in which ideas shift from one unrelated topic to another, unaware that the topics are unconnected. When the condition is severe, speech may be incoherent (e.g. "We wanted to take the bus, but the airport took all the traffic. Driving is the ticket you want to get somewhere. No one needs a ticket to heaven. We have it all in our pockets.")
Neologisms- new, made up words that are meaningless to others but have symbolic meaning to the psychotic person
Concrete Thinking- literal interpretations of the environment which represents a regression to an earlier level of cognitive development. Abstract thinking is very difficult. (e.g. Client would have trouble describing the abstract meaning of saying "It's raining cats and dogs.")
Clang Associations- choice of words is based on sounds and often take the form of rhyming
Word Salad- group of words that are put together randomly without any logical connection
Circumstantiality- delay reaching the point of a communication because of unnecessary and tedious details. The point or goal is usually met, but only after many interruptions by the listener to keep the person on topic.
Tangentiality- different from above in that the person never really gets to the point of the communication. Unrelated topics are introduced, and the focus of the original discussion is lost.
Mutism- an individual's inability or refusal to speak.
Perseveration- persistently repeats the same word or idea in response to different questions
false sensory perceptions not associated with real external stimuli and can involve any of the 5 senses. Which type is the most common in psychiatric disorders?
hallucinations

auditory
Perception is part of the positive/negative symptoms associated with schizophrenia and includes hallucinations and illusions. Hallucinations are false ___ perceptions that are associated/not associated with real external stimuli and can involve any of the 5 senses. Auditory hallucinations are false perceptions of sound. Most commonly they are ____, but could be reported as clicks, rushing noises, music, or other noises. ___ hallucinations may place the individual or others in a potentially dangerous situation, telling the person to act violently on himself or others.
Visual hallucinations are false visual perceptions. They may consist of formed images, such as people, or unformed images, such as flashes of light. Tactile hallucinations are false perceptions of the sense of touch, often of something on or under the ___. One specific tactile hallucination is ____, the sensation that something is crawling on or under the skin. A gustatory hallucination is a false perception of ___ usually described as pleasant/unpleasant. ____ hallucinations are false perceptions of the sense of smell. Illusions are mis______ or mis_______ of ___ ___ stimuli.
Perception is part of the positive symptoms associated with schizophrenia and includes hallucinations and illusions. Hallucinations are false sensory perceptions not associated with real external stimuli and can involve any of the 5 senses. Auditory hallucinations are false perceptions of sound. Most commonly they are voices, but could be reported as clicks, rushing noises, music, or other noises. Command hallucinations may place the individual or others in a potentially dangerous situation, telling the person to act violently on himself or others.
Visual hallucinations are false visual perceptions. They may consist of formed images, such as people, or unformed images, such as flashes of light. Tactile hallucinations are false perceptions of the sense of touch, often of something on or under the skin. One specific tactile hallucination is formication, the sensation that something is crawling on or under the skin. A gustatory hallucination is a false perception of taste usually described as unpleasant. Olfactory hallucinations are false perceptions of the sense of smell. Illusions are misperceptions or misinterpretations of real external stimuli.
Because of extremely weak ego boundaries, the individual with schizophrenia lacks the feeling of uniqueness as a person and experiences a great deal of confusion regarding his or her identity.

Characteristics of echolalia, echopraxia, identification and imitation, and depersonalization regarding the___ of ____ are considered positive symptoms of schizophrenia.
Characteristics of echolalia, echopraxia, identification and imitation, and depersonalization regarding the sense of self are considered positive symptoms of schizophrenia.
When a client repeats words that he or she hears, it is called _____. This is an attempt to ___ with the person speaking.
Example-
Nurse: "John, it's time for lunch."
John: "Lunch, lunch, lunch."

When the patient imitates the movements or positions made by others, it is called ____.
When a client repeats words that he or she hears, it is called echolalia. This is an attempt to identify with the person speaking.


When the patient imitates the movements or positions made by others, it is called echopraxia.
Example-
Nurse: "John, it's time for lunch."
John: "Lunch, lunch, lunch."
Identification (on a conscious/unconscious level) and imitation (on a conscious/unconscious level) are ego defense mechanisms used by schizophrenics and reflect their confusion regarding self-identity. Because they have difficulty knowing where their ego boundaries end and another person's begins, their behavior often takes on the form of that which they see in the other person.
Identification (on an unconscious level) and imitation (on a conscious level) are ego defense mechanisms used by schizophrenics and reflect their confusion regarding self-identity. Because they have difficulty knowing where their ego boundaries end and another person's begins, their behavior often takes on the form of that which they see in the other person.
The unstable self-identity of an individual with schizophrenia may lead to feelings of unreality, such as feeling that one's extremities have changed in size, or a sense of seeing oneself from a distance. These kinds of feelings are described as ______.
The unstable self-identity of an individual with schizophrenia may lead to feelings of unreality, such as feeling that one's extremities have changed in size, or a sense of seeing oneself from a distance. These kinds of feelings are described as depersonalization.
Positive/negative symptoms of schizophrenia include affect, volition, impaired interpersonal functioning & relationship to the external world, autism, psychomotor behavior, and some associated features.
Negative symptoms of schizophrenia include affect, volition, impaired interpersonal functioning & relationship to the external world, autism, psychomotor behavior, and some associated features.
Affect describes the behavior associated with an individual's feeling state or emotional tone. Describe what kinds of affects are associated with negative symptoms of schizophrenia.
inappropriate- individual's emotional tone or affect is incongruent with the circumstances (e.g. a young woman laughs when told of the death of her mother)

bland or flat- emotional tone is very weak, person appears to be void of emotional tone or feelings

apathy- indifference to or disinterest in the environment
The bland or flat affect of a person with schizophrenia is a manifestation of ____ ____.
The bland or flat affect of a person with schizophrenia is a manifestation of emotional apathy.
Volition has to do with impairment in the ability to initiate ___-___ activity. This may take the form of inadequate interest, motivation, or ability to choose a logical course of action in a given situation. Emotional _______ in the client with schizophrenia refers to the coexistence of ___ emotions toward the same object, person, or situation. These opposing emotions may interfere with the person's ability to make even a very complex/simple ____. (i.e. coffee or tea?) Underlying this emotional conflict is the difficulty the client with schizophrenia has in fulfilling a satisfying ______. This difficulty is based on the need-___ dilemma-- the simultaneous need for and fear of ____.
Volition has to do with impairment in the ability to initiate goal-directed activity. This may take the form of inadequate interest, motivation, or ability to choose a logical course of action in a given situation. Emotional ambivalence in the client with schizophrenia refers to the coexistence of opposite emotions toward the same object, person, or situation. These opposing emotions may interfere with the person's ability to make even a very simple decision. (i.e. coffee or tea?) Underlying this emotional conflict is the difficulty the client with schizophrenia has in fulfilling a satisfying relationship. This difficulty is based on the need-fear dilemma-- the simultaneous need for, and fear of intimacy
Some clients with acute schizophrenia may cling to others and intrude on their personal space, behaviors that aren't socially or culturally acceptable. Impairment in social functioning may also be reflected in social is___, emotional de_______, and lack of regard for social convention. This may be manifested by ____, the condition created by the person with schizophrenia who focuses inward on a fantasy world, while distorting or excluding the external environment. Another manifestation regarding interpersonal functioning in which personal grooming and self-care activities are neglected, is known as deteriorated _____. The client may appear untidy and may need to be reminded of the need for personal hygiene.
Some clients with acute schizophrenia may cling to others and intrude on their personal space, behaviors that aren't socially or culturally acceptable. Impairment in social functioning may also be reflected in social isolation, emotional detachment, and lack of regard for social convention. This may be manifested by autism, the condition created by the person with schizophrenia who focuses inward on a fantasy world, while distorting or excluding the external environment. Another manifestation regarding interpersonal functioning in which personal grooming and self-care activities are neglected, is known as deteriorated appearance. The client may appear untidy and may need to be reminded of the need for personal hygiene.
Autism and deteriorated appearance are part of the category "impaired interpersonal functioning and relationship to the external world" and are negative symptoms.
Certain types of psychomotor behavior characterized by schizophrenia are considered negative symptoms and include anergia, waxy inflexibility, posturing, and pacing & rocking. Briefly describe each.
Anergia- lack of energy, may impair ability to carry out ADL's or interact with others

Waxy inflexibility- body parts are placed in bizarre or uncomfortable positions and remain for long periods of time, regardless of the discomfort.
Posturing- voluntary assumption of inappropriate or bizarre postures
Pacing & Rocking- pacing back and forth and slow, rhythmic swaying (rocking)
Associated features of schizophrenia include anhedonia, which is the _____ to experience _____. This is a particularly distressing symptom that compels some clients to attempt ___.
Another associated feature is ____, the retreat to an earlier level of development. This is a primary defense mechanism of schizophrenia and is a dysfunctional attempt to reduce ___. It provides a basis for many of the behaviors associated with schizophrenia.
Associated features of schizophrenia include anhedonia, which is the inability to experience pleasure. This is a particularly distressing symptom that compels some clients to attempt suicide.
Another associated feature is regression, the retreat to an earlier level of development. This is a primary defense mechanism of schizophrenia and is a dysfunctional attempt to reduce anxiety. It provides a basis for many of the behaviors associated with schizophrenia.
Although intensive psychodynamic- and insight-oriented psychotherapy is generally not recommended, individual psychotherapy that psychiatrists use when providing drug treatments typically involves a synthesis of various psychotherapeutic strategies and interventions. These include problem ____, ___ testing, psychoeducation, and supportive and cognitive-behavioral techniques . The goals include improving medication ______, enhancing social and occupational ____, and preventing ____.
Although intensive psychodynamic- and insight-oriented psychotherapy is generally not recommended, individual psychotherapy that psychiatrists use when providing drug treatments typically involves a synthesis of various psychotherapeutic strategies and interventions. These include problem solving, reality testing, psychoeducation, and supportive and cognitive-behavioral techniques . The goals include improving medication compliance, enhancing social and occupational functioning, and preventing relapse.
____-oriented individual therapy is the most suitable approach to individual psychotherapy for schizophrenia. The primary focus in all cases must reflect efforts to decrease ______ and increase ____. Establishing a relationship is very difficult because the individual is desperately lonely yet rejects closeness and trust. He is likely to respond to attempts at closeness with suspiciousness, anxiety, aggression, or regression. Successful intervention may be achieved with h___, simple directions, and a manner that ____s the client's privacy and human dignity. Exaggerated warmth and attempts at achieving friendship are likely to be met with confusion and suspicion. After a therapeutic relationship is established, reality orientation is maintained through exploration of the client's behavior within _____. Education is provided to help the client identify sources of real or perceived ___ and ways of reacting appropriately. Methods for improving interpersonal communication, emotional expression, and frustration tolerance are attempted.
Reality-oriented individual therapy is the most suitable approach to individual psychotherapy for schizophrenia. The primary focus in all cases must reflect efforts to decrease anxiety and increase trust. Establishing a relationship is very difficult because the individual is desperately lonely yet rejects closeness and trust. He is likely to respond to attempts at closeness with suspiciousness, anxiety, aggression, or regression. Successful intervention may be achieved with honesty, simple directions, and a manner that respects the client's privacy and human dignity. Exaggerated warmth and attempts at achieving friendship are likely to be met with confusion and suspicion. After a therapeutic relationship is established, reality orientation is maintained through exploration of the client's behavior within relationships. Education is provided to help the client identify sources of real or perceived danger and ways of reacting appropriately. Methods for improving interpersonal communication, emotional expression, and frustration tolerance are attempted.
Antipsychotic medications are also called ________ or major _____. They are effective in the treatment of acute and chronic manifestations of schizophrenia and in maintenance therapy to prevent exacerbation of symptoms.
Antipsychotic medications are also called neuroleptics or major tranquilizers. They are effective in the treatment of acute and chronic manifestations of schizophrenia and in maintenance therapy to prevent exacerbation of symptoms.
One thing all antipsychotics have in common is some degree of _____ of ___ receptors in the brain, which decreases the ____ concentration in the CNS. Some common side effects include agranulocytosis, hemolytic anemia, drowsiness, NML, extrapyramidal symptoms, and tardive dyskensia. Extrapyramidal symptoms are in_____ m__ symptoms similar to those associated with ____ disease. This drug-induced state is known as pseudoparkinsonism and is characterized by symptoms such as _____ (distressing motor restlessness) and acute ____ (painful muscle spasm.) What 2 medications are used to treat these symptoms?
One thing all antipsychotics have in common is some degree of blockage of dopamine receptors in the brain, which decreases the dopamine concentration in the CNS. Some common side effects include agranulocytosis, hemolytic anemia, drowsiness, NML, extrapyramidal symptoms, and tardive dyskensia. Extrapyramidal symptoms are involuntary motor symptoms similar to those associated with Parkinson's disease. This drug-induced state is known as pseudoparkinsonism and is characterized by symptoms such as akathisia (distressing motor restlessness) and acute dyskinesia (painful muscle spasm. )

Cogentin (benztropine) & trihexyphenidyl (Artane)