Abnormal Psychology Exam 4 Module 8

Delusions

False belief that is firmly held, contrary to evidence and the consensus of other people

All EXCEPT which of the following treatment approaches have been shown to be effective? a Insight-oriented psychotherapy b Behavioral therapy c Cognitive-behavioral therapy d Family therapy

a - Insight-oriented psychotherapy

Etiology of Schizophrenia Brain circuits

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TAKE PHOTO OF TABLE 11.1 IN SLIDES

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*LOOK IN PHOTOS TABLE 10-1 OF DSM-5 PSYCHOTIC DISORDERS*

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Psychological views: Stress/Trauma, ----- social class (sociogenic hypothesis (social drift), ----- social-selection theory, ----- family influences (expressed emotion)

----- Class differences in rates Sociogenic hyp: Lower class -> Stress -> Schiz Social selection theory: Schiz -> movement to lower class Social drift ----- ----- Psychodynamic: schizophrenogenic mother Traumatic experiences risk factors: accident is .5 bullying is 2.5 maltreatment is 3.1 bullying and maltreatment is 5.8-5.9 Expressed Emotion: Criticism, disapproval, hostility

Other related disorders - Symptoms and diagnosis Brief Psychotic Disorder,

> 1 day < 1mo Symptoms Delusions Hallucinations Disorganized speech Disorganized or cattonic behavior

Other related disorders - Symptoms and diagnosis Schizophreniform Disorder,

> 1 mo < 6 mo Two or more Delusions Hallucinations Disorganized speech Disorganized behavior Negative symptoms Good prognostic features -Quick onset -Good premorbid functioning -No flat affect W/o good prognostic features

Family therapy Behavioral,

Aims to reduce expressed emotion (hostility, overly critical) Psychoeducation Communication/problem solving Hope Coping/social network

Treatment Typical and atypical antipsychotics

Block dopamine receptors Side effects Extrapyramidal side effects include: Parkensonism (muslce tremmors, shakiness) Dystonia (muscle contractions) Akethesis (motor restlessness) Neuroleptic malignant syndrome (muscle regidity) Tardive Dyskinesia:(tic-like involuntary movements) Metabolic syndrome: Obesity, diabetes, high cholesterol, and hypertention Atypical Antipsychotics Combination of neurotransmitters

Etiology of Schizophrenia Brain differences

Brains of patients with schizophrenia Reduced volume of TEMPORAL and FRONTAL cortex Enlarged Ventricles Reudced metabolic activity within prefrontal cortex -Involved in speech, decision-making willed action

CBT treatments, ACT Treatments

Coping Mindfulness Changing demoralizing thoughts Most beneficial: combination of medication and psychotherapy

What is a Freudian term for the anxiety-driven condition that results when id impulses threaten to overwhelm the ego? A man who believes he can fly on his own, which is obviously not plausible, may be suffering from what type of delusion?

Neurosis Bizarre delusion

Other related disorders - Symptoms and diagnosis Delusional Disorder,

Delusional Disorder 1 or more delusions 1mo or longer Common themes: Erotomanic type Grandiose type Jealous type Persecutory type Somatic type

Symptoms of Schizophrenia Positive,

Excesses or distortions of normal functioning Delusions: Beliefs that are contrary to reality: see chard Hallucinations: False or distordetd perceptions that seem vividly real to the person experiencing them -visual -auditory -tactile -olfactory -gustatory Most commonly auditory Disorganized symptoms: Disorganized thought and speech -incoherance -loose associations or derailment -tangential speech -perservation -severe fragmentation -hyper abastraction Bizzare Behavior - inability to organize behavior and have it conform to standards

Symptoms of Schizophrenia Psychomotor,

Extremes in activity levels -catatonia

Which of the following is true about the genetic basis of schizophrenia? a Researchers have discovered the gene responsible for causing schizophrenia. b Children of schizophrenic adoptive parents are at a higher risk of developing schizophrenia than children of schizophrenic biological parents. c Genes are responsible for making some individuals more vulnerable to schizophrenia. d A mentally healthy individual with a schizophrenic parent cannot pass on a genetic predisposition for the disorder to his or her offspring.

Genes are responsible for making some individuals more vulnerable to schizophrenia.

If an individual experiencing psychosis has false sensory experiences, including hearing voices, seeing visions, smelling odors, or has sensations of touch, what may they be experiencing?

Hallucinations

Which set of symptoms would meet the criteria for schizophrenia? Which was NOT a reason subtypes of schizophrenia were discontinued in the DSM-5? a They were shown to be unstable. b They had low reliability and consistency. c Most individuals met more than one subtype. d They had poor validity. Which type of schizophrenia is characterized by an early and gradual onset of symptoms, little social and intellectual competence, and more withdrawal and disorganization? _____ schizophrenia includes more active symptoms such as hallucinations and delusions, while ____ schizophrenia includes more negative symptoms such as flat affect, avolition, and alogia.

Hallucinations, delusions, or disorganized speech Most individuals met more than one subtype. Process schizophrenia Type I; Type II

Alogia ----- Echolalia

Impoverished speech that conveys little information. speech may be repetitive, stereotyped, and nonspontaneous. Sometimes, psychotic language appears to be overgeneralized and hypermetaphorical. Ex: Hypermetaphorical speech is a form of overgeneralization—instead of reporting, "My arm fell asleep," a psychotic person might report, "My arm died" (taking the sleep metaphor too far). ----- Repetition of words or phrases spoken by another person

Emotional Disturbance: Affective Flattening Anhedonia

Lack of range of emotions Loss of interest or pleasure in all aspects of life

When do most cases of schizophrenia begin? The person with an acute onset of schizophrenic symptoms who is severely disturbed, delusional, and confused, but has a good chance of recovery, would be classified with which type of schizophrenia? Due to discontinuing subtypes for the DSM-5, what was suggested that clinicians use instead in the diagnostic process? Which of the following can help in finding risk indicators either in predicting onset or prognosis of schizophrenia?

Late teens to mid-30s. Reactive schizophrenia Utilize a dimensional rating of severity of symptoms. Endophenotypes

Brain pathology in Schizophrenia

Loss of gray matter does not mean less neurons Loss of dentriditc spines -results in impaired communication -Disconnection syndrome Pausible causes: Damage during gestation or birth -more birth complications in patients Virus in brain during fetal development -exposure to flu during second trimester

Course of Schizophrenia: Prodromal, Active, and Residual phases ----- Do patients recover or continue to have symptoms?

Onset and buildup of symptoms Full-blown symptoms Symptoms no longer prominent ----- Prognosis: Poor: rehosptalization rates: 50-80% Suicide: 5-10% Some stabilized 5-10 years after first episode Other problems: Medical problems Substance use disorders

Symptoms of Schizophrenia Cognitive,

Poor executive function Inability to sustain attention Difficulty retaining and using recently learned information

Etiology of Schizophrenia Dopamine Hypothesis

Positive symptoms result from excessive activity Support for theory: Antipsychotics Amphetamines Problems: Antipsychotics -weeks to work -levels below normal More recent views Dopamine receptors: Indiv has either too many or ones that are oversensitive Overactivity n Mesolimbic pathway -Positive symptoms -Serotonin neurons regulate dopamine neurons here --Interaction of serotonin and dopamine important Unveractivity in Mesocortical pathway -Negative symptoms

Psychological and social treatments

Psychosocial therapy: SOcial skill training -social communication -Address deficit in emotional perception -Understanding others Life skills Difficulties with employment Lack of social networks

Schizophrenia: Spectrum:

Psychotic disorder involving disturbance of thought, emotion and behaviors Several disorders on a continuum Schizophrenia most severe

Symptoms of Schizophrenia Negative,

Reflect defects or deficits in normal functioning flat affect Alogia Avolition Anhedonia Asociality

Etiology of Schizophrenia Genetic Influences

Research suggests genetics are important Identical twin study and offspring of two schizophrenic parents have 46 % risk

Other related disorders - Symptoms and diagnosis Schizoaffective disorder

Schizoaffective Disorder Symptoms of schizophrenia Symptoms of major mood episode (major depressive or manic) Positive symptoms alone for at least 2 weeks

Hallucinations Illusions

Sensation or perception in the absence of an external source The incorrect perception of sensory stimuli

Definition of Psychosis Definition of Neurosis

Severe psychological disturbance involving personality disorganization and loss of contact with reality / Inability to Differenciate between what is real and what is not Freudian term for the anxiety-driven condition that results when id impulses threaten to overwhelm the ego

What is commonly seen in families where the onset of schizophrenia is MORE likely to occur? Several well-controlled double-blind studies supported the effectiveness of _____ to reduce the symptoms of schizophrenia. _____ is an occasional long-term side effect of phenothiazine treatment of schizophrenia that involves rhythmical, stereotyped movements and lip smacking.

The mother and child relationship may include overprotectiveness and intrusiveness that may contribute to the development of schizophrenia. Thorazine Tardive dyskinesia

Clanging Neologisms

The use of a word because of its sound rather than its meaning New word that a speaker invents

Diagnosis of Schizophrenia DSM-5 Criteria *LOOK IN PHOTOS*

Two or more present over a month Delusions* Hallucinations* Disorganized speech* Grossly disorganized or catatonic behaviors Negative symptoms one of them HAS to be one of the asterisked * Impaired functioning 6mo or more of disturbance

Disturbances in Motor Behavior: Catatonia Mutism Echopraxia

Unusual movement or immobility associated with psychosis Refusal to speak Repetitively imitating the movements of others

The most common type of hallucination experienced by psychotic individuals is____.

auditory

All of the following are characteristic of hallucinations EXCEPT: Select an answer and submit. a. Tactile hallucinations may often be more characteristic of drug withdrawal. b. Drug-induced psychoses can involve strong, visual hallucinations. c. Hallucinations are not mood-congruent or mood incongruent. d. The hallucinations most commonly reported in schizophrenia are auditory.

c. Hallucinations are not mood-congruent or mood incongruent.

All EXCEPT which of the following statements are true regarding the role of culture and schizophrenia? a Religious delusions and delusions of destruction were positively correlated with the extent to which religions induce a sense of guilt and schizophrenic symptoms. b For some women, according to Murphy (1968), the conflict of satisfying the expectations of community and pursuing interests of their own could precipitate schizophrenic reactions. c Schizophrenia exists in all cultures, from the most "primitive" to the most "advanced." d There is little difference in the onset, symptom presentation, and course of schizophrenia across different cultures.

d - There is little difference in the onset, symptom presentation, and course of schizophrenia across different cultures.

Process schizophrenia Reactive schizophrenia,

is further characterized by an early and gradual onset of symptoms; the person develops little social or intellectual competence and shows, eventually, more and more withdrawal and disorganization. on the other hand, is marked by relatively normal social and intellectual development and appears abruptly in the form of an acute reaction, frequently in response to known life stressors. The person with such an acute reaction may be severely disturbed, delusional, confused, and disorganized but has a good chance of recovery.

In working with schizophrenic patients, mental health professionals typically distinguish between _______ symptoms (an excess or distortion of normal behavior) and _______ symptoms (deficits in normal behavior).

positive negative

Research suggests that treatments like social skills training and CBT treatments The neurotransmitters most implicated in the positive symptoms of schizophrenia are:

reduce relapses of schizophrenia Dopamine and serotonin