Chapter 14 Schizophrenia
Negative symptoms
"pathological deficits;" symptoms of schizophrenia that seem to be deficits in normal thought, emotions, or behaviors
Positive symptoms
"pathological excesses" - symptoms of schizophrenia that seem to be excesses of bizarre additions to normal thoughts, emotions, or behaviors
_____ of every 100 people in the world suffers from schizophrenia during his or her lifetime
1
Postpartum psychosis affects ____ of every 1,000 mothers who have recently given birth
1 or 2
Hallucinations affect _____% of the population, occur every ____ days on average, last for _________ minutes, can be controlled around ______% of the time, and cause little distress or disruption unless ________________
10-15%; 3 days; 2-3; 60%; misinterpreted
_____% of the homeless population may be MICAs
10-20%
If twins are fraternal, the second twin has approximately a ______% chance of developing the disorder
17%
On average, schizophrenics live __________ fewer years than other people
20
Between _____ and _____% of all people with chronic mental disorders may be MICAs
20-50%
What is the average age of onset for men? Women?
23; 28
How many people worldwide are afflicted with schizophrenia? How many in the US?
24 million; 2.5 million
______% of people with schizophrenia attempt suicide
25%
__________% of more of patients recover completely from schizophrenia, but the majority continue to have residual problems for the rest of their lives
25%
Schizophrenia can be diagnosed when an individual displays at least _____ of the appropriate symptoms. Which symptoms are these? How long must these be present for schizophrenia to be diagnosed?
2; delusions, hallucinations, disorganized speech, very abnormal motor activity (e.g. catatonia), and negative symptoms; 1 month
What is the prevalence of schizophrenia among second-degree relatives with the disorder? first-degree relatives?
3%; 10%
____% of those who are divorced or separate suffer from schizophrenia sometime during their lives, compared to ______% of married people and _____% of people who remain single
3; 1; 2
If one identical twin develops schizophrenia, there is a _____% chance that the other twin will do so as well
48%
Beyond a month of intense symptomology, schizophrenics continue to display some degree of impaired functioning for at least _________ additional months
5
_______________ drugs can reduce the symptoms of amphetamine psychosis, just as they reduce the symptoms of schizophrenia
Antipsychotic
Some people with Parkinson's disease develop schizophrenia-like symptoms if they take too much ___________, a medication that raises Parkinson's patients' dopamine levels
L-dopa (raises dopamine activity so much that it produces psychosis)
(More, less) blood flow is seen in Broca's area while patients were having auditory hallucinations
More
Has the dopamine hypothesis been supported?
Yes
Loose associations (derailment)
a common thinking disturbance in schizophrenia, characterized by rapid shifts from one topic of conversation to another
Alogia
a decrease in speech or speech content; a symptom of schizophrenia
Formal thought disorders
a disturbance in the production and organization of thought
Anhedonia
a general lack of pleasure or enjoyment
Phenothiazines
a group of antihistamine drugs that became the first group of effective antipsychotic medications
Flat affect
a marked lack of apparent emotions
Catatonia
a pattern of extreme psychomotor symptoms, found in some forms of schizophrenia, which may include catatonic stupor, rigidity, or posturing
Schizophrenia
a psychotic disorder in which personal, social, and occupational functioning deteriorate as a result of unusual perceptions, odd thoughts, disturbed emotions, and motor abnormalities
Psychosis
a state in which a person loses contact with reality in key ways
Delusions
a strange false belief firmly held despite evidence to the contrary
Avolition
a symptom of schizophrenia marked by apathy and an inability to start or complete a course of action
People who take high doses of amphetamines may develop _____________________--a syndrome very similar to schizophrenia
amphetamine psychosis
Support for the dopamine hypothesis has also come from research on ________________, drugs that stimulate the CNS
amphetamines
Phenothiazines and other antipsychotic drugs are dopamine ______________--drugs that bind to dopamine receptors, prevent dopamine from binding there, and so prevent the neurons from firing
antagonists
Catatonic posturing
assuming awkward, bizarre positions for long periods of time
Delusions of reference
attaching special and personal meaning to the actions of others or to various objects or events
Smooth pursuit eye movement is another area of difficulty for those schizophrenics; what kind of problem could this be related to?
attention problems
PET scans revealed increased activity near the surface of brains, in the tissues of the ____________________, the brain's ______________ center, whenever schizophrenics had an auditory hallucination
auditory cortex; hearing
What are the common kinds of hallucinations in schizophrenia?
auditory; hearing sounds and voices that seem to come from outside their heads (others on p. 473)
Delusions of control
belief that feelings, thoughts, and actions are being controlled by other people
Delusions of grandeur
belief that you are a great inventor, religious savior, or other specially empowered person
Delusions of persecution
belief that you are being plotted or discriminated against, spied on, slandered, threatened, attacked, or deliberately victimized
The positive symptoms of Type 1 schizophrenia may be linked more closely to ______________ abnormalities in the brain, while the negative symptoms of Type II schizophrenia may be tied largely to _______________ abnormalities in the brain
biochemical; structural
Ambivalence
conflicting feelings about most things
Antipsychotic drugs
drugs that help correct grossly confused or distorted thinking
Psychosis is commonly seen in schizophrenia, and is characterized by what 3 things?
hallucinations (false sensory perceptions) or delusions (false beliefs) or withdrawal into a private world
The problem of falling through the cracks (not receiving treatment in either substance abuse or mental health programs) is perhaps most poignantly seen in the case of _____________ MICAs
homeless
Most common formal thought disorder?
loose associations
Formal thought disorders often take the form of positive symptoms, such as?
loose associations, neologisms, perseveration, and clang
Neologisms
made-up words that typically have meaning only to the person using them
Catatonic rigidity
maintaining a rigid, upright posture for hours and resisting efforts to be moved
Researchers have repeatedly found that the biological relatives of adoptees with schizophrenia are (more, less) likely than their adoptive relatives to develop schizophrenia or another schizophrenia spectrum disorder
more
Type II schizophrenia
more negative symptoms, such as restricted affect, poverty of speech, and loss of volition
Catatonic excitement
moving excitedly, sometimes wildly waving their arms and legs
What 3 phases are usually seen in schizophrenia?
prodromal, active, and residual
Visual hallucinations
produce vague perceptions of colors or clouds or distinct visions of people or objects
What studies have supported the idea that some people inherit a biological predisposition to schizophrenia and develop the disorder later when they face extreme stress, usually during late adolescence or early adulthood?
relatives of schizophrenics, twins with schizophrenia, people with schizophrenia who are adopted, and genetic linkage and molecular biology
Perseveration
repeating words and statements again and again
Residual phase
returning to a prodromal-like level of functioning (retain some negative symptoms, but have a lessening of the striking symptoms in the active phase)
Clan
rhyming to think or express yourself
Downward drift theory
schizophrenia causes its sufferers to fall from a higher to a lower socioeconomic level or to remain poor because they are unable to function effectively
What are all psychotic disorders, including schizophrenia, collectively called?
schizophrenia spectrum disorders
Blunted affect
showing less sadness, anger, joy, and other feelings than most people
Olfactory hallucinations
smell odors that no one else does, such as the smell of poison or smoke
Inappropriate affect
displays of emotion that are unsuited to the situation; a symptom of schizophrenia
Because schizophrenic's ideas are illogical and confused, social withdrawal tends to have what effect?
distances them further from reality
Type I schizophrenia
dominated by positive symptoms, such as delusions, hallucinations, and certain formal thought disorders
Prodromal phase
symptoms are not yet obvious, but the person is beginning to deteriorate (social withdrawal, vague or odd speech, strange ideas, express little emotion)
Active phase
symptoms become apparent (triggered by stress or trauma)
Dopamine hypothesis
they theory that schizophrenia results from excessive activity of the neurotransmitter dopamine
Tactile hallucinations
tingling, burning, or electric-shock sensations
In schizophrenia, messages traveling from dopamine-sending neurons to dopamine receptors on other neurons, particularly to the D-2 receptors, may be transmitted too ___________ or ___________
too easily or too often
MICAs tend to be (old, young) and (female, male)
young and male
People with which type of schizophrenia seem to have been better adjusted before the disorder, to have later onset of symptoms, and to be more likely to show improvement with medications?
Type I
DSM-5 calls for a diagnosis of schizophrenia only after symptoms of the disorder continue for ___________ or more
6 months
Schizophrenia usually first appears between what ages?
late teens and mid-thirties
Early antipsychotic drugs often produce troublesome muscular tremors, symptoms that are identical to the central symptom of __________________
Parkinson's disease
What are the most common kinds of delusions in schizophrenia?
delusions of persecution
Examples of positive symptoms?
delusions, disorganized thinking and speech, heightened perceptions and hallucinations, and inappropriate affect
At least one of the symptoms must be _____________, ________________, or __________________
delusions, hallucinations, disorganized speech
What are the various psychotic symptoms in schizophrenia? What is the duration of schizophrenia?
delusions, hallucinations, disorganized speech, restricted or inappropriate affect, and catatonia; 6 months or more
In postpartum psychosis, within days or a few months of childbirth, women develop signs of losing touch with reality, such as?
delusions, hallucinations, extreme anxiety, confusion, and disorientation, disturbed sleep, illogical or chaotic thoughts
A ______________ relationship may be at work, in that people with a biological predisposition will develop schizophrenia only if certain kinds of events or stressors are also present
diathesis-stress
Mentally ill chemical abusers (MICA) are aka _________________; they display both a severe mental disorder and a substance use disorder
dual diagnosis
What are the symptoms of postpartum psychosis triggered by?
enormous shift in hormone levels that takes place after delivery
Are more men or women diagnosed with schizophrenia?
equal numbers
Although doctors consider delusions as nothing but delusional, people who have had such experiences often claim that delusions have their origin not solely in the illness, but also in _________________, that, once understood, can help sustain recovery after they receive treatment
fears, longings, and psychological wounds
Somatic hallucinations
feel as if something is happening inside the body, such as a snake crawling in one's stomach
Gustatory hallucinations
find that their food or drink tastes strange
Catatonic stupor
people stop responding to their environment, remaining motionless and silent for long stretches of time
Premorbid functioning
people who functioned quite well before the disorder
The _______________ and ________________ of schizophrenics seem to intensify
perceptions and attention
Schizophrenia is most likely a ___________ disorder, caused by a combination of gene defects
polygenic
What are the 3 categories of schizophrenic symptoms?
positive symptoms (excesses of thought, emotion, and behavior), negative symptoms (deficits of thoughts, emotions, and behaviors), and psychomotor symptoms (unusual movements or gestures)
Socioculturally, the stress of ____________ could be a cause of schizophrenia
poverty
Examples of negative symptoms?
poverty of speech, blunted and flat affect, loss of volition, and social withdrawal
Hallucinations
the experiencing of sights, sounds, or other perceptions in the absence of external stimuli
Relationship between relatedness and schizophrenia?
the more closely related relatives are to the person with schizophrenia, the more likely they are to develop the disorder
