Chapter 12 Vocabulary
nihilism delusional disorder
"I am dead" "we are all dead"
grandeur delusional disorder
"I am the son of God" "I am a medieval knight"
erotomania delusional disorder
"I know Brad Pit is in love with me"
somatic afflictions delusional disorder
"my brain is moldy" "insects are in my flesh"
jealousy delusional disorder
"my wife has affairs with every man she meets"
reference delusional disorder
"other people or things are giving me signs"
control/influence delusional disorder
"others are controlling my thoughts" -thought broadcasting ("others can hear my thoughts") -thought insertion ("others are implanting thoughts") -thought withdrawal ("others are removing my thoughts")
persecution delusional disorder
"they're plotting against me"
delusional disorder
-"Normal" except for a delusion -Firmly held beliefs that have no basis in reality
Neologisms
-"new words" -eg, Regarding a stomachache: "I have belly bad luck."
sczophrenia DSM
-At least 2 of the following symptoms (must include #1, 2, or 3) : >Delusions >Hallucinations >Disorganized thinking and speech >Grossly abnormal behavior (including catatonia) >Negative symptoms
Paranoid Schizophrenia
-Best premorbid adjustment -Perceive other things/situations/people as dangerous
Cognitive perspective for schizophrenia
-Biology >attention problems (overattention or underattention) >poor coping with environmental stress >overarousal and disorganized thoughts >psychosis -Focus on the diathesis (biological vulnerability) >Biological evidence: rats w/ dopamine injected in subcortical areas responded similarly >Attention problems are present even in remission and at risk people
Brain Imaging Studies (Biological perspective of schizophrenia)
-Chronic schizophrenia: smaller brain, enlarged ventricles -Negative symptoms, difficulties w/ problem-solving and selective attention - poorer metabolism and fewer synapses in frontal lobe -Positive symptoms -abnormal temporal lobes and limbic structures -Both negative and positive symptoms - abnormal basal ganglia and connections among the three brain systems
Behavioral high-risk design (Biological perspective of schizophrenia)
-Compare behavioral high-risk individuals with others eg, College students scoring high on Perceptual Aberration-Magical Ideation Scale or non-smooth eye-tracking
Word salad
-Complete breakdown of associations -eg, "It's all over for a squab true tray and there isn't any music..."
Problems in the Study of Schizophrenia
-Confounding Variables >Antipsychotic drugs >Hospitalization *Poor diet *Poor sleeping conditions *Overcrowding *Lack of exercise *Lack of privacy
Behavioral perspective for schizophrenia
-Explanation: Learned nonresponsiveness >"Crazy" environment *learn not to respond to usual social stimuli *idiosyncratic responses to odd cues *social rejections *feelings of alienation *more bizarre behavior that itself may be rewarded w/ attention, etc. -Treatment: relearning normal behavior >Direct reinforcement and token economy wards >Social-skills training (making friends, eye contact, holding down a job, etc.)
Family systems perspective for schizophrenia
-Focus on the stress part of the equation -"Expressed emotion" >Best predictor of relapse: hi criticism + emotional overinvolvement of a key relative -Communication deviance >Bateson's double-bind communication betw. parent & child >Deviant/idiosyncratic responses of parents predicts later schizophrenia
Psychodynamic explanation for schizophrenia
-Frieda Fromm-Reichmann's (1948) "schizophrenogenic mother" -Mother appears to be self-sacrificing but actually a confusing combination of over-protective and rejecting
Biological perspective of schizophrenia
-Genetic Studies >Family studies *Close relatives? >Twin studies *Monozygotic (MZ) concordance=48% vs. Dizygotic (DZ)=17% *Highest for MZ twins sharing placenta *Especially hi if symptoms are negative and severe >Abnormal genes (probably multiple, interacting) >Brain structure >Problems with dopamine, serotonin, etc.
Genetic high-risk design (Biological perspective of schizophrenia)
-Longitudinal -Get history on genetically high-risk children >Study children born to schizophrenic mothers early, before perceptions/ recollections biased by knowledge of their diagnosis in adulthood
Disorganized Thinking and Speech (DSM Schizophrenia)
-Loosening of associations/derailment >Rambling, disjointed speech w/o apparent logical connections >eg, Regarding his itchy arms: "The problem is insects. My brother used to collect insects. He's now a man 5 foot 10 inches. You know, 10 is my favorite number. I also like to dance, draw, and watch TV."
Underattention(Cognitive perspective for schizophrenia)
-Negative symptoms
Clanging
-Pairing of words only because they rhyme or sound alike -eg, "So hot you know it runs on a cot."
Process-reactive
-Poor premorbid adjustment? -Gradual onset?
Overattention (Cognitive perspective for schizophrenia)
-Positive symptoms (hallucinations, delusions, incoherent speech) >Can't filter out irrelevant stimuli or associations >Poor performance on tasks w/ irrelevant distracting stimuli (but better than normals in attending to these distractions)
Positive-negative symptoms
-Positive: Presence of hallucinations, delusions, bizarre behavior, incoherent thoughts -Negative: Poverty of speech, flat affect, withdrawal, apathy, attention problems
Negative Symptoms (reduction or loss of normal functions) (DSM Schizophrenia)
-Poverty of speech ("poverty of content") >Words that communicate little >eg, "Dear Mother, I am writing on paper. The pen which I am using is from a factory called "Perry & Co." in England. I always liked geography in school..." -Restricted affect >Blunted affect (shows little emotion) >Flat affect (shows no emotion) >Anhedonia (reduced experience of pleasure) -Loss of volition (apathy) -Social withdrawal
Cognitive Therapy for schizophrenia
-Process approach >Give tasks to build up problematic cognitive skills (memory, attention, social perception) >Eg, train eye-tracking -Content approach >Teach cognitive techniques to challenge hallucinations and delusions
Findings from Genetic high-risk design (Biological perspective of schizophrenia)
-Schizophrenics (vs. normals) in childhood: >Poorer home life >Early separation and institutionalization *Mothers hospitalized during child's early years *Mothers had childbirth-related psychoses *Mothers had unstable relationships with men >School problems and criminal behavior >Attention problems *Couldn't filter out noises, etc. >Birth complications *Prenatal viral infection *Birth trauma >Poor motor coordination & negative facial expressions
Viral hypothesis (Biological perspective of schizophrenia)
-Schizophrenics more likely than others to be born in winter (when viruses around) -Finnish flu epidemic (1957) affected babies if in 2nd trimester -Mothers of schizophrenics report more flus during 2nd trimester -Exposure to flu during 2nd trimester is associated with enlarged ventricles in schizophrenics
Grossly Abnormal Behavior (DSM Schizophrenia)
-Stereotypy (purposeless, repetitive motor behaviors--eg, head rubbing, paper tearing, etc.--for long periods of time) -Frenetically high activity (running about, thrashing arms) -Catatonic stupor (mute and immobile for days on end), rigidity, or waxy flexibility
Medication for schizophrenia
-Success of phenothiazines->"dopamine hypothesis" -Neuroleptic drugs >Conventional (traditional) anti-psychotic drugs (helps 65%) *Phenothiazines (eg, chlorpromazine) *Block excessive activity of dopamine *Reduce positive symptoms -Can produce undesired neurological movement effects—"extrapyramidal effects" >Parkinsonian-like symptoms (within days/weeks) >Tardive dyskinesia (after a year or so) (approx. 10%) -Second generation drugs ("atypical drugs") -Reduces dopamine and increase serotonin -Help with both positive and negative symptoms -Egs, Resperdal, Zyprexa, Seroquel, Geodon, Abilify P-referred
Prenatal Brain Injury (Biological perspective of schizophrenia)
-Trauma during 2nd trimester >Normal brain becomes asymmetrical during 2nd trimester but not for schizophrenics >Gliosis (a tissue-repair response) normally occurs before 3rd trimester absent in schizophrenic brain, showing damage occurred before 3rd trimester >Fingerprints normally form during 2nd trimester--differences are greater in discordant MZ twins than in normal MZ twins
Parkinson's Disease
-a disabling neurological illness -low levels of dopamine, causes the uncontrollable shaking -phenodyzenes caused low dopamine -schizophrenia-like symptoms if take too much L-dopa
supported employment
-an alternative work opportunity for individuals with severe psychological disorders -vocational agencies and counselors help people find competitive jobs in the community and provide psychological support while the individuals are maintaining employment -often short in supply
restricted affect
-commonly found in schizophrenia -blunted affect: less anger, sadness, joy and other feelings than most people -flat affect: almost show no emotion at all -still faces, poor eye contact, monotone voice -anhedonia: a general lack of pleasure or enjoyment
national interest groups
-formed in countries around the world that push for better community treatment -made up largely of families of people affected by severe mental disorders
social therapy
-help keep people out of the hospital -techniques that address social and personal difficulties in the clients' lives -clinicians offer practical advice, work with clients on problem solving, decision making, and social skills, make sure clients are taking medications properly, help them find work, financial assistance, appropriate health care, and proper housing
inappropriate affect
Display of emotions that are unsuited to the situation; a symptom of schizophrenia
Sociocultural perspective for schizophrenia
Need for long-term, multifaceted support programs within the community
Dimensions of Schizophrenia
Process-reactive and positive-negative symptoms
token economy program
a behavioral program in which a person's desirable behaviors are reinforced systematically throughout the day by the awarding of tokens that can be exhchanged for goods or priviledges
loose associations
a common thinking disturbance in schizophrenia, characterized by rapid shifts from one topic of conversation to another. Also known as derailment.
case manager
a community therapist who offers a full rage of services for people with schizophrenia or other severe disorders, including therapy, advice, medication, guidance, and protection of patients' rights
alogia
a decrease in speech or speech content; a symptom of schizophrenia. Also known and poverty of speech
formal thought disorder
a disturbance in the production and organization of thought
phenothiazines
a group of antihistamine drugs that became the first group of effective antipsychotic medications
milieu therapy
a humanistic approach to institutional treatment based on the belief that institutions can help patients recover by creating a climate that promotes self-respect, responsible behavior, and meaningful activity
catatonia
a pattern of extreme psychomotor symptoms found in some forms of schizophrenia, which may include cataonic stupor, rigidity, or posturing
aftercare
a program of post-hospitalization care and treatment in the community
day center
a program that offers hospital-like treatment during the day only. also know as day hospital
schizophrenia
a psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of strange perceptions, unusual emotions, and motor abnormalities
atypical antipsychotic drugs
a relatively new group of antipsychotic drugs whose biological action is different from that of the traditional antipsychotic drugs
halfway house
a residence for people with schizophrenia or other severe problems, often staffed by paraprofessionals. Also known as a group home or crisis house
psychosis
a state in which a person loses contact with reality in key ways
delusion
a strange false belief firmly held despite evidence to the contrary
sheltered workshop
a supervised workplace for people who are not yet ready for competative jobs
community mental health center
a treatment facility that provides medication, psychotherapy, and emergency care for psychological problems and coordinates treatment in the community
schizophrenogenic mother
a type of mother-supposedly cold, domineering, and uninterested in the needs of others-who was once thought to cause schizophrenia in her child
semihospital
also known as residential crisis center, are houses or other structures in the community that provide 24-hour nursing care for people with severe mental disorders
avolition
apathy, feeling drained of energy and of interest in normal goals and unable to start or follow through on a course of action -display ambivalence: conflicting feelings about most things
psychomotor symptom
awkward movements or repeated grimaces and odd gestures, these movements have a private purpose like ritualistic or magical
neuroleptic drugs
conventional antipsychotic drugs, so called because they often produce undesired effects similar to the symptoms of neurological disorders
antipsychotic drugs
drugs that help correct grossly confused or distorted thinking
mentally ill chemical abuser (MICA)
dualdiagnosis patient, individual with psychotic disorders as well as substance-related disorder
Inappropriate affect (DSM Schizophrenia)
eg, laughter in response to sad news
tardive dyskinesia
extrapyramidal effects that appear in some patients after they have taken conventional antipsychotic drugs for an extended time
assertive community treatment
people recovering from schizophrenia and other severe disorders need medication, psychotherapy, help in handling daily responsibilities, guidance, in making decisions, training in social skills, residential supervision, and vocational counseling
diathesis-stress relationship
people with a biological predisposition will develop schizophrenia only if certain kinds of events or stressors are also present
state hospital
public mental hospitals in the United States, run by the individual states
polygenic disorder
schizophrenia is caused by a combination of gene defects
conventional antipsychotic drugs
second generation antipsychotic drugs
negative symptoms
symptoms of schizophrenia that seem to be deficits in normal thought, emotions, or behaviors
postive symptom
symptoms of schizophrenia that seem to be excesses of or bizarre additions to normal thoughts, emotions, or behaviors
deinstitutionalzation
the discharge of larger numbers of patients from long-term institutional care so that they might be treated in community programs
hallucination
the experiencing of sights, sounds, or other perseptions in the absence of external stimuli -Perceiving things that are not there -Usually auditory (may hear voices conversing or a running commentary on one's thoughts or behavior) -Visual, olfactory, tactile, etc. possible too -May be understood to be real or not
expressed emotion
the general level of criticism, disapproval, and hostility expressed in a family. People recovering from schizophrenia are considered more likely to relapse if their families rate high in expressed emotion.
dopamine hypothesis
the theory that schizophrenia results from excessive activity of the neurotransmitter dopamine
extrapyramidal effects
unwanted movements, such as severe shaking, bizarre-looking grimaces, twisting of the body, and extreme restlessness, sometimes produced by conventional antipsychotic drugs