Psy3032 - Abnormal Psychology Week 12 Schizophrenia

Front 1

How many times more likely are people with schizophrenia likely to die from suicide compared to the general population?

Back 1

12 times

Front 2

Prevalence of schizophrenia

Back 2

1%

Front 3

Are the symptoms of schizophrenia heterogenous or homogenous?

Back 3

heterogeneous

Front 4

Is schizophrenia more prevalent in men or woman?

Back 4

men

Front 5

Onset of schizophrenia

Back 5

Typically late adolescence/early adulthood, sometimes in childhood

Front 6

Schizophrenia is a syndrome characterised by what?

Back 6

a collection of signs and symptoms of unknown aetiology, predominately defined by observed signs of psychosis

Front 7

What are the three categories of symptoms in schizophrenia?

Back 7

positive, negative, disorganised

Front 8

Split brain in schizophrenia refers to what?

Back 8

split from reality

Front 9

Describe the course of schizophrenia?

Back 9

typically a number of acute episodes of symptoms, and less severe but still debilitating symptoms between episodes

Front 10

The life expectancy of people with schizophrenia is reduced by how many years?

Back 10

25

Front 11

What are the two positive symptoms of schizophrenia?

Back 11

hallucinations and delusions

Front 12

What are the five negative symptoms of schizophrenia?

Back 12

avolition, alogia, anhedonia, blunted effect, and asociality

Front 13

What are the 2 disorganised symptoms of schizophrenia?

Back 13

disorganised behaviour and disorganised speech

Front 14

Acute episodes of schizophrenia are characterised by what?

Back 14

positive symptoms

Front 15

What type of schizophrenia symptoms are characterised by?

Back 15

excesses and distortions

Front 16

Beliefs contrary to reality and firmly held in spite of disconfirming evidence describe what symptoms of schizophrenia?

Back 16

delusions

Front 17

To diagnose schizophrenia in the DSM-IV-TR 2 or more of what 5 symptoms must be present a significant proportion of the time during a one month period?

Back 17

1. delusions; 2. hallucinations; 3. disorganised speech; 4. grossly disorganised or catatonic behaviour; 5. negative symptoms

Front 18

In the DSM-IV-TR only criterion A is required is delusions are what?

Back 18

bizairre or hallucinations consist of voice keeping a running ocmmentary on the persons behaviour or thoughts, or two or more voices conversing with each other

Front 19

How many criterion for schizophrenia are in the DSM-IV-TR?

Back 19

6

Front 20

What are criterion B to F in the DSM-IV-TR criteria for schizphrenia?

Back 20

B) symptomas must cause clinically isignificant distress or impairment in social, occupational, or other important areas of functioning, C) continuous signs of the disturbance persist for at least 6 months. May include periods of prodromal or residual symptoms, D) symptoms can not be due to either schizoaffective disorder or mood disorder with psychotic features, E) symptoms can not be due to substance abuse or general medical condition, F) if there is a history of PDD then the additional diagnosis od SCZ can only be made in prominent delusions or hallucinations are also present for at least a month (or less if treated successfully)

Front 21

What are the four likely changes to the criteria for schizophrenia in the DSM-5?

Back 21

1. removal of the subtypes; 2. negative symptoms will be described in more detial; 3. addition of criterion that one of the symptoms must be hallucinations, delusions ro disorganised speech; 4. removal of requirement that only one symptom be present if delusion is bizarre

Front 22

What new syndrom is being added to the DSM-5 that is argued to be prodromal psychosis?

Back 22

attenuated psychosis syndrome

Front 23

What are five types of delusions?

Back 23

typically a number of acute episodes of symptoms, and less severe but still debilitating symptoms between episodes

Front 24

Sensory experiences in the absence of any relevent stimulation form the environment describes what symptoms of schizophrenia?

Back 24

hallucinations

Front 25

What are the 5 subtypes of schizophrenia in the DSM-IV-TR that are being removed in DSM-5?

Back 25

paranoid, disorganised, catatonic, undifferentiated, and residual type

Front 26

What are the subtype for shcizophrenia being removed in the DSM-5?

Back 26

little predictive validity

Front 27

What is being proposed in the DSM-5 instead of the subtypes?

Back 27

a dimensional aspect which will alow more individualised descriptions of symptoms and their severity within the diagnosis of schizophrenia

Front 28

Whati cognitive symptoms are associated with schizophrenia?

Back 28

impairments in attention, working memory, and executive function

Front 29

What are the three main reasons why cognitive symptoms associated with schizophrenia have recived considereable attention in the research in the last decade?

Back 29

1. they are present in the prodrome of the illness, 2. they are persistent and resistent to treatment; and 3. they are most associated with functional impairment than other symptoms of schizophrenia

Front 30

What are two cons for the categorical methods or diagnosis utilised in the DSM?

Back 30

medical model implies causation which is not the case and thereis stigma attached to the diagnosis

Front 31

What are five pros for the categorical methods or diagnosis utilised in the DSM?

Back 31

1. categorial approach simplifies complex data; 2. diagnosis guides treatment; 3. diagnosis allows for better prognositic judgement; 4. essential for clinical research; 5. some patients can feel relief at being given a diagnosis

Front 32

There is a strong belief that shcizophrenia may actually be what rather than a single diagnosis?

Back 32

a collection of syndromes

Front 33

What are the six main types of delusions?

Back 33

thought insertion, thought broadcasting, controlled by external force, persecutory, grandiose, and ideas of reference

Front 34

Delusions where a person believes that thoughts are not his or her own but have been placed in his or her mind by an external source is known as what?

Back 34

though insertion

Front 35

Delusions where a person believes that his or her thoughts are broadcast or transmitted so that others know what they are thinking are known as what?

Back 35

thought broadcasting

Front 36

Delusions where a person has an exaggerated sense of his or her own self importance, power, knowledge, or identity are known as what?

Back 36

grandiose delusions

Front 37

Delusions where a person incorporates unimportant events within a delusional framework and reading personal significance into the trivial activities of others is known as what?

Back 37

ideas of reference

Front 38

An example of persetcutory delusion?

Back 38

there are people plotting against me

Front 39

What proportion of people with schizophrenia have delusions?

Back 39

more than half

Front 40

What percentage of people with schizophrenia report auditory hallucinations?

Back 40

74%

Front 41

Many people with schizophrenia experience their hallucinations as what?

Back 41

frightening or annoying

Front 42

What area of the brain has been found on an fMRI when people with schizophrenia report hearing voices?

Back 42

broca's area

Front 43

What are four types of auditory hallucinations?

Back 43

spoken by another person, two voices arguing, voices commenting on their behaviour, and voices telling then to do things

Front 44

Auditory hallucination characterised by voices telling them to do things are known as what?

Back 44

comman hallucinations

Front 45

Auditory hallucination are mostly what?

Back 45

derogatory

Front 46

Negative symptoms tend to endure beyond what?

Back 46

an acute epsiode

Front 47

The presence of many negative symptoms is a strong predictor of what?

Back 47

poor quality of life

Front 48

A lack of motivation and a seeming absence of interest in, or an inability to persist in what are usually routine activities, including work or school, hobbies or social acitivties describes which negative symptom?

Back 48

Avolition or apathy

Front 49

Severe impairments in social relationships characterises which negative symptom of schizophrenia?

Back 49

asociality

Front 50

A loss of interest in or a reported lessening of the experience of pleasure is called what?

Back 50

anhedonia

Front 51

What are the two types of pleasure experiences in the anhedonia construct?

Back 51

anticipatory pleasure and consummatory pleasure

Front 52

Which type of pleasure to people with schizphrenia have a deficit in, and which do they not have a deficit in when they experience the negative symptom of anhedonia?

Back 52

deficit in anticpatory pleasure but no consummatory pleasure

Front 53

The lack of outward expression of emotion characterises which negative symptom of schizophrenia?

Back 53

blunted or flat affect

Front 54

Does blunted affect mean that the perosna inner experience of emotion in impoverished?

Back 54

no

Front 55

A significant reduction in the amount of speech describes which negative symptoms of schizophrenia?

Back 55

alogia

Front 56

Problems with organising ideas and in speaking so that a listener can understand indicates which symptom of schizophrenia?

Back 56

disorganised speech

Front 57

How many patterns of disorganised speech can be found in people with schizophrenia?

Back 57

21

Front 58

In disorganised speech replying a question in an irrelevent manner is known as what?

Back 58

tangentiality

Front 59

In disorganised speech replying a question in a highly detailed roundabout way that is not always relevent but the question is always answered in the end is known as what?

Back 59

circumstantiality

Front 60

In disorganised speech new word formation that may involve combinations of words that are similar in meaning or sound are known as what?

Back 60

neologisms

Front 61

Disorganised speech is assocaited with problems in what cogntive function?

Back 61

executive function - problem solving, planning, and making assocations between thinking and feeling

Front 62

What is the symtoms characterised by the persons inability to organise their behaviour and make it fit with social norms?

Back 62

disorganised behaviour

Front 63

What are some examples of disorganised behaviour?

Back 63

inexplicable bouts of agitation, deressing in unusual clothing, acting in a childlike or silly manner, hoarding food or collecting garbage

Front 64

Which cogntiive symptoms has been shown to be more highly related to functional diasability than positive symptoms?

Back 64

working memory

Front 65

Does twin study research shows a stronger genetic component for positive or negative symptoms?

Back 65

negative symptoms

Front 66

There may be a shared genetic vulnerability between schizophrenia and which other disorder?

Back 66

bipolar

Front 67

Relatives of people with schizophrenia are at what?

Back 67

increased risk of developing schizophrenia and this risk increases the closer the relative

Front 68

What is the inherent confoudn in twin studies of schizophrenia?

Back 68

environment

Front 69

What type of study removes the inherent confound of environment in the genetic vulnerability of schizophrenia?

Back 69

adoption studies

Front 70

Adoption studies have revealed that people are at risk more than the general population of developing schizophrenia if what?

Back 70

if a biological parent has schizophrenia

Front 71

Do you inherit schizophrenia or a predisposition for schizophrenia?

Back 71

a predisposition

Front 72

What constitutes the genetic predisposition for schizophrenia?

Back 72

still not clear as it appears to be transmitted by more than one gene

Front 73

The study of family pedigrees to try and determine the chromosome(s) the schizophrenia henes are located on is known as what?

Back 73

Linkage studies

Front 74

What has been found in linkage studies of schizophrenia?

Back 74

highly inconsistent findings with as many as 11 chromonsomes being implicated

Front 75

The study of of how often a specific gene and a particular phenotype co-occur is known as what?

Back 75

association studies

Front 76

What has been found in association studies of schizophrenia?

Back 76

many non replicated findings however 4 canditate genes appear to be implicated

Front 77

What are the two of the four canditate genes implicated in assocation studies of schizophrenia?

Back 77

COMT - linked with executive functioning; NGRI - associated with glutamates, and NMDA receptor involved in myleination of the brain which is essential for connectivity shown to be disrupted in schizophrenia

Front 78

GWAS stands for what?

Back 78

Genome Wide Association Studies

Front 79

What do GWAS studies involve?

Back 79

rapid scanning of a person's entire genome to allow researcher to conduct a more broad serch for rare mutations in genes

Front 80

What was found in one GWAS study linked to schizophrenia?

Back 80

more than 50 mutations that were 3 times more common in people with schizophrenia than people without, however these mutations were only actually identified in around 20% of people with schizophrenia

Front 81

Linkage, assocaition and GWAS studies hightlight what about schizophrenia?

Back 81

it is highly heterogeneity

Front 82

Chemicals that allow neurons to send a signal across a synapse to another neuron are call what?

Back 82

neurotransmitters

Front 83

What is the Dopamine Theory of Schizophrenia?

Back 83

the theory posits that schizophrenia is related to excess dopamine

Front 84

What is the Dopamine theory os schizophrenia based on?

Back 84

the fact that drugs which act to reduce dopamine acitivty can be effective in treating schizophrenia and vice versa

Front 85

What are three refinements of the dopamine theory that indicate that dopamine is not the only neurotransmitter involved in schizophrenia?

Back 85

1. dopmaine receptors are more likely the area of disorder rather than dopamine; 2. Excess doapmine receptoes are mainly related to the positive symptoms of schizophrenia and not the negative, 3. There are differences in the neural pathways which use dopamine as a neurotransmitter

Front 86

Is dopamine in excess or reduced in the mesolimbic pathway? What about the mesocortical pathway?

Back 86

in excess in the mesolimbic pathways and reduced in the mesocortical pathways

Front 87

Do antipsychotics tend to treat positive or negative symptoms?

Back 87

positive symptoms

Front 88

Antipsychotic medications decrease the levels of which neurotransmitter?

Back 88

dopamine

Front 89

Which neurotransmitter has a role in regulating dopamine neurons in the mesolimbic pathways?

Back 89

serotonin

Front 90

Why has serotonin received focus in schizophrenia?

Back 90

due to the efficacy of some atypical antipsychotics which also target serotonin

Front 91

Which is the brain main excitatory neurotransmitter in which activity has been found to be reduced in people with schizophrenia?

Back 91

glutamate

Front 92

How was glutamate first implicated in schizophrenia research?

Back 92

through the effects of drugs like ketamine and PCP which block the glutatmate receptor NMDA and produce schizophrenia like psychosis

Front 93

Which primary inhibitory neurotransmitter of the brain that has received considerable attention in schizophrenia research over the last 5 to 10 years?

Back 93

GABA

Front 94

Deficits in which neurotransmitter have been repeatedly implicated in the pathophysiology of schizophrenia?

Back 94

GABA

Front 95

In which part of the brain is GABA transmission mostly disrupted in people with schizophrenia?

Back 95

prefrontal cortex

Front 96

Which four neurotransmitter systems are not mutually exclusive in their influence of schizophrenia but appear to exert their changes via complex interactions with each other?

Back 96

dopamine, serotonin, glutamate and GABA

Front 97

Early on in the illness which brain regions show reductions in volume?

Back 97

hippocampus, thalamus, amygdala, insulla and anterior anterior cingulate

Front 98

In the chronic stage of the illness there are more extensive reduction in corticol volume particualrly in which areas of the brain?

Back 98

medial and left dorsolateral prefrontal cortex and the left superior temporal gyrus

Front 99

in schizophrenia is ventrical volume incresed or decreased?

Back 99

increased

Front 100

Overal in schizphrenia there is a rediction in what?

Back 100

grey matter and whole brain volume

Front 101

Brain abnormalities in schiziphrenia are not restricted to dinstinct brain regions they also involve what?

Back 101

connections between these regions

Front 102

DTI stands for what?

Back 102

Diffusion Tensor Imaging

Front 103

There is cosiderable research implicating which area of the brain in schizophrenia?

Back 103

the prefrontal cortex

Front 104

EXplain the neurodevelopmental theory of schizophrenia?

Back 104

that schizophrenia is a neurodevelopmental disorder of brain function that unfolds as the individual grows older

Front 105

There is a recognied overlap between the early signs of schizophrenia and the hallmarks of what?

Back 105

adolescence

Front 106

Which theory asserts that schizophrenia develops from disruptions and errors in processes such as synaptic pruning, organisation of cortical circuits, and neuronal migrations that occur during adolescence?

Back 106

Neurodevelopmental theory of schizophrenia

Front 107

What are the four main environmental risk factors to psychosis?

Back 107

developmental trauma, minority group position, urbanised area, and cannibas use

Front 108

The more trauma experienced the more likely you are to develop what?

Back 108

schizophrenia

Front 109

The minority group position risk factor for psychosis depends of what?

Back 109

the ethinic density of the area the person is living in and not the ethnic group per se

Front 110

The main psychotropic comopnent of cannanis causes what in healthy controls?

Back 110

psychotic symptoms and cogntive deficits similair to those found in schizophrenia

Front 111

What must exist for the risk factors of schizophrenia to impact on the development of schizophrenia?

Back 111

a genetic predisposition

Front 112

Tratment of schizophrenia includes a combination of what three things?

Back 112

medication, hosptial admission, and psychosocial treatment

Front 113

The appropriateness fo a given treatment depends on what?

Back 113

the stage of the illness

Front 114

What were the main two treatments for schizophrenai prior to the development of antipsychotic medication in the 1950's?

Back 114

ECT or lobotomy

Front 115

What three factors form the concept of expressed emotion (EE)?

Back 115

critical comments, hostility, and emotional overinvolvement

Front 116

Does low or high EE predict a relapse?

Back 116

high EE

Front 117

Why were first generation antipsychotic drugs known as neuroleptics?

Back 117

because they produced side effects similar to the symptoms of neurological disorders

Front 118

First Gen antipsychotics had what effects on the different types of schizophrenic symptoms?

Back 118

they reduced positive and disorganised symptoms but had little effects on negative symptoms

Front 119

The primary action of firt gen antipsychotics was to clock what?

Back 119

dopamine receptors

Front 120

What percentage of people did not response to first gen antipsychotics?

Back 120

30%

Front 121

Why did 75% of people quit first gen antipsychotic within 2 years?

Back 121

unpleasant side effects

Front 122

What were the side effects of first gen meds?

Back 122

sedation, blurred vision, dizziness, restlessness, sexual dysfunction, extrapyramidal, tardive dyskinesia and neuroleptic malignant syndrome

Front 123

Involuntary movements of the mouth are caused by what disorder?

Back 123

tardive dyskinesia

Front 124

What is the name of the side effects of first gen meds that resembled the motor symptoms of parkinsons disease?

Back 124

extrapyramidal

Front 125

What is neuroleptic malignant syndrome?>

Back 125

severe muscles rigidity, fever, racing heart, increased blood pressure, coma and even death

Front 126

What was the first second gen drug?

Back 126

clozapine

Front 127

Why was clozapine initially used?

Back 127

for people who didn’t respond to first gen drugs

Front 128

What is the main serious side effects assocaited with taking clozapine?

Back 128

impairment of the immune system

Front 129

atypical antipsychotics are what?

Back 129

sec gen antipsychotics

Front 130

What did the clincial trial called CATie reveal about second gen drugs?

Back 130

found that the sec gen were barely different from the old

Front 131

What effect did CATie have on the antipsychotic supplies?

Back 131

some drug companies pulled out of making them

Front 132

New med research is targeted at what?

Back 132

underlying pathophysiology of schizophrenia

Front 133

What is NEWMEDS?

Back 133

Novel Methods Leading to New Medications in Depresion and Schiziphrenia

Front 134

What are the three main psychological treatments fro people with schizophrenia?

Back 134

social skills training, family therapy, and CBT

Front 135

Which type of psychological treatment is characterised by teaching people with schizophrenia how to successfully manage a wide variety of interpersonal situations?

Back 135

social skills training

Front 136

Which type of psychological therapy used to treat schizophrenia is characterised providing education to family about schizophrenia and about medication treatments, communications skills andproblem solving, social network expansion and hope?

Back 136

family therapy

Front 137

Which type of psychological therapy used to treat schizophrenia is characterised by encouraging the person to test out their delusional beliefs?

Back 137

CBT

Front 138

What are the 6 steps of family therapy used to treat schizophrenia?

Back 138

1. Educate about schizophrenia; 2. Educate about antipsychotic medication; 3. Blame and Avoidance reduction; 4. Comunication and problem solving skills in the family; 5. Social network expansion; and 6. Hope

Front 139

Which non-invasive brain stimulation technique involves pulses of magnetic energy, generated by an electrical current passing through a coil placed on the head?

Back 139

Transcranial Magnetic Stimulation (TMS)

Front 140

Which non-invasive brain stimulation technique uses a very gentle electrical current to change activity levels of cells in particular areas of the brain?

Back 140

Transcranial Direct Current Stimulation (TDCS)

Front 141

What is the only treatment for cognitive symptoms of schizophrenia?

Back 141

cogntive remediation