Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
21 Cards in this Set
- Front
- Back
|
Persective on schizophrenia Psychosis |
Psychosis •ability to perceive and respond to the environment is significantly disturbed and functioning is impaired •may be substance-induced or caused by brain injury •hallucinations •delusions Schizophrenia is a form of psychosis with heterogeneous symptoms and course. Disturbances and disorganisation of: •Thought •Emotion •Speech •Behaviour |
|
|
Positive symptoms |
These "pathological excesses" are bizarre additions to a person's behaviour. •Delusions •Hallucinations •Active manifestations and obvious signs •Distortions of normal behaviour •Exaggeratios or excesses |
|
|
Positive symptoms Delusions |
Delusions Gross misrepresentations of reality (improbable) Disorder of thought content •Grandeur •Persecution •Reference •Control •Religiosity Ethological views •Motivational views - attempts to deal with and relive distress •Deficit- result of brain dysfunction |
|
|
Positive symptoms Hallucinations |
Hallucinations•Faulty sensory experince in absence of environment stimuli or input. •Can involve all senses •Most common: auditory Ethological views•Attribution to own vs other voice•Brock's area activation |
|
|
Negative Symptoms |
Absense or insufficiency of normal behaviour Symptom cluster •Avolition (or apathy) absense of motivation •Alogia (lack of speech) •Anhedonia (lack of pleasure and interest) •Affective flattening (absense emotional reactivity) •Social withdrawal |
|
|
Disorganised symptoms |
•Erratic behaviours that affect many domains •Disorganised speech -Cognitive slippage -Tangentiality -Loose associations/derailment •Inappropriate affect/emotional expression Unusual behaviours •Catatonia: wild agitation, waxy flexibility, immobility. |
|
|
Schizophrenia subtypes Type I and type II schizophrenia |
Type I and type II schizophrenia Type I is dominated by positive symptoms. •Better adjustment prior to onset of symptoms •Later onset of symptoms •More positive outcome •Symptoms tied to biochemical abnormalities Type II is dominated by negative symptoms •Poorer adjustment prior to onset symptoms •Less positive outcome •Earlier onset of symptoms•Less positive outcome•Symptoms tied to structural abnormalities •Symptoms tied to structural abnormalities |
|
|
Other psychotic disorders Schizophreniform Disorder |
Schizophreniform Disorder •Symptoms of Schizophrenia •Few months only •Associated with good premorbid functioning •Most resume normal lives |
|
|
Other psychotic disorders Schizoaffective Disorder |
•Symptoms of Schizophrenia plus a mood disorder. •Disorders are independent -Delusions for 2 weeks in absense of mood. •Prognosis: similar to Schizophrenia l -Persistent -No improvement without treatment |
|
|
Other psychotic disorders Delusion disorder |
•Delusions contrary to reality (more plausible) •Lack other positive and negative symptoms Types •Erotomanic •Grandiose •Jealous •Persecutory •Somatic |
|
|
Other psychotic disorders Brief psychotic disorder |
•One or more positive symptoms •Lasts 1 month or less •Usually precipitated -Extreme stress -Trauma •Typically return to premorbid baseline |
|
|
Other psychotic disorders Schizotypal personality disorder |
•Symptoms are similar to schizophrenia •Less severe •Genetic relationship to schizophrenia "Schizophrenia spectrum" |
|
|
Prevelance and cause of Schizophrenia Predormal phase |
Predormal phase •85% experince •1-2 years before full expression of symptoms •Less severe, yet unusual Ideas of reference Magical thinking Illusions Increased anxiety/irritability Lack os initiative or interests Social withdrawal Obsessive behaviours |
|
|
Gentic influence |
•Inherited vulnerability for schizophrenia •Polygenetic influences •Risk increases with genetic relatedness •Interaction with environment |
|
|
Neurobiological Influences The dopamine hypothesis |
•Agonists (eg . L-Dopa, amphetamines) Increases schizophrenic-like behaviour •Antagonists (Neuroleptics) Reduce schizophrenic-like behaviour •This relationship between symptoms suggests that symptoms of schizophrenia were related to excess dopamine. The dopamine hyoothesis •Overly simplistic •Problematic -D2 antagonists don't always work -Medications that aren't D2 antagonists work -Slow repsonse to meds -Little impact on negative symptoms |
|
|
Neurobiological Influences Current theories |
•Several neurotransmitters involved •Excess of Striatial D2 receptors •Deficient prefrontal D1 receptors •Glutamate |
|
|
Neurobiological Influences |
Brain structure •Reduced volume tissue (cause or effect) •Enlarged ventricles Brain function •Reduced activation in the dorsolateral prefrontal cortex Stress •Stress activates vulnerability (diathesis) Increase relapse risk Family factors •Schizophrenogenic mother Cold, dominant, rejecting Expressed emotion EE •Criticism, hostility, intrusiveness |
|
|
Treatments: biological treatments |
•Insulin coma therapy •Psychosurgery Prefrontal lobotomies (remove sections of the brains) •Electroconvolsive therapy (electrical currents in the brain) |
|
|
Treatment - Antipsychotic Medications (Neuroletptics) |
Antipsychotic Medications (Neuroletptics) -First line treatment -Began in the 1950s -Decrease positive symptoms -Side effects: common, acute, permanent. Sedation, weight gain, motor impairment, metabolic syndrome, mental dulling Compliance problems-50% within on year-Majority within two years |
|
|
Treatment- Psychsocial interventions |
Psychosocial approaches •Behavioural (modelling reinforcment) •Community care programs •Social and living skills training •Bhevaioural family therapy •Vocational rehabilitation •Necessary adjunct to medication CBT-Psychosis (CBT-p) •De-arousing techniques •Increased activity levels •Attention switching and narrowing •Modifying self-statements •Re-attributions |
|
|
Treatment- Psychsocial interventions CBT-Psychosis (CBT-p) |
Psychosocial approaches •Behavioural (modelling reinforcment) •Community care programs •Social and living skills training •Bhevaioural family therapy •Vocational rehabilitation •Necessary adjunct to medication
CBT-Psychosis (CBT-p) •De-arousing techniques •Increased activity levels •Attention switching and narrowing •Modifying self-statements •Re-attributions Prevention - Target at risk populations - Increasing parenting skills - Intervention at the prodormal stage |
