Chapter 13
What is the lifetime prevalence of Schizophrenia worldwide? Are there gender differences in prevalence?
.2 - 1.5% no gender differences
What is the prevalence of Schizoaffective Disorder? Are there differences in gender prevalence?
.5 - .8% prevalence more common in women
What does schizophrenia literally translate to?
"split mind"
What parts of the brain are active in auditory hallucinations? What does this suggest?
-Broca's area (speech production) is most active -Wernicke's area (language comprehension) is also involved -Suggests they are listening to their own thoughts/voices and can't tell the difference
What are Disorganized Symptoms?
-Disorganized speech: tangential, using loose associations -Inappropriate affect and disorganized behavior: laughing at sad things, crying at happy things
What are some ways that schizophrenia is debilitating/affects life expectancy?
-Life expectancy is 10 yrs shorter -Higher rates of infectious and circulatory diseases -Approximately 5% die by suicide
What are the gender differences in Schizophrenia cases?
-Men have an earlier age of onset -Women have better, more favorable outcomes than men -Women show fewer cognitive deficits -Men have more severe negative
Positive Symptoms vs. Negative Symptoms
-Negative symptoms are less obvious/weird and not exactly -Negative symptoms associated with more impairment -Negative symptoms are less responsive to medication
How does a genetic relationship to someone with schizophrenia affect a person's risk for schizophrenia? Specifically a parental relationship?
-Parent's severity increases likelihood for children -Do inherit: general predisposition -Do not inherit: specific forms -Risk increases with genetic relatedness
What are the different types of delusions?
-Persecutory: being persecuted, watched, conspired against -Reference: random events are directed at oneself -Grandiose: great power, knowledge, talent, or is a famous/powerful person -Guilt or Sin: committed a terrible act or responsible for a terrible event -Somatic: appearance or part of body is diseased or altered -Being Controlled: thoughts, feelings, behaviors are being imposed, controlled by an external force
What is the difference between positive and negative symptoms?
-Positive: characterized by the presence of unusual perceptions, thoughts, or behaviors. Refers to the fact that symptoms are salient, added experiences (delusions and hallucinations). -Negative: characterized by losses or deficits in certain domains. Refers to the absence of behaviors, feelings, experiences.
What is Delusional Disorder?
-Presence of delusion for 1 month or greater -Criterion A of schizophrenia not met -specifiers: erotomanic (someone is in love with me), grandiose, jealous, persecutory, and somatic -pretty rare
How prevalent are visual hallucinations in schizophrenic patients?
-Present in about 10 - 15% of schizophrenic patients -Much higher rates found in chronic schizophrenic patients (approx. 60%) -3% prevalence in general population
What is the general age of onset for a "psychotic break" in women? men?
-Women have their "psychotic breaks" late 20s to early 30s -Men usually before or close to 21
What is Schizoaffective Disorder?
-a condition with a mix of schizophrenia and mood disorder (depression or manic) symptoms -criteria: schizophrenia symptoms (delusions or hallucinations) must be present when mood symptoms are absent
What can cause the brain abnormalities associated with schizophrenia?
-birth abnormalities: perinatal hypoxia (lack of oxygen) -prenatal virus exposure: high rates of schizophrenia associated with flu during second trimester -neurotransmitters: overactive dopamine in striatum, underactive dopamine in prefrontal areas
What are structured brain abnormalities associated with Schizophrenia?
-enlarged ventricles (fluid filled spaces in the brain) -frontal lobe: less active in people w/ schizophrenia
What is affective flattening? What percent of schizophrenics experience this symptom?
-severe reduction in, or complete absence of overt emotional responses -Doesn't necessarily mean lack of internal experience of emotions -Flat affect may instead represent difficulties expressing emotion Occurs in 25% of schizophrenics
How does treatment for Schizophrenia affect the progression of the disorder?
-treatment prevents progressive deterioration in most people -duration of episodes and number of re-hospitalizations declines as individuals get older -20 - 30 % of treated improve substantially within 10 to 20 years
What are the four examples of negative symptoms mentioned in the power points?
1.) Affective Flattening (aka blunted affect) 2.) Alogia 3.) Avolition 4.) Anhedonia
What is the prevalence of hallucinations?
37% of college students report auditory hallucinations (Barrett and Etheridge, 1992) 6% thought transmission Often related to sleep deprivation, drugs, and stress
What are delusions?
A belief that would be seen by members of a society as a misrepresentation of reality
What is the diagnostic criteria for schizophrenia?
A.) Characteristic Symptoms: 2+ of the following for > 1 month. At least one must be 1, 2, or 3 1.) Delusions 2.) Hallucinations 3.) Disorganized speech 4.) Grossly disorganized or catatonic behavior 5.) Negative symptoms B.) Social/Occupational Dysfunction c.) Duration: continuous signs of the disturbance for > 6 months. > 1 month of this must meet Criterion A (acute phase)
Which type of hallucination is most common for schizophrenia?
Auditory Hallucinations
How do the costs of schizophrenia compare to the costs of cancers? What about money spent on research?
Costs for Schizophrenia exceed those of all cancers combined ($60 billion annually) -$300 per patient on cancer research -$14 per patient spent on schizophrenia research
Who are the Genian quadruplets and what did their case show about the environmental factors of schizophrenia?
Quadruplets, each with schizophrenia. Same genetics and (general) environment. They each had different ages of onset, symptoms, diagnoses, courses, and outcomes. Their case showed the importance of their unshared environments and experiences.
How present are negative symptoms in schizophrenic patients?
Present in 25% of people with schizophrenia
What is the most common psychotic disorder?
Schizophrenia
What are hallucinations?
Unreal perceptual experiences; more bizarre and extremely distressing and impairing.
Are auditory hallucinations more common in men or women?
Women
What is Anhedonia?
absence of pleasure from activities that would normally give pleasure
What is Alogia?
absence of speech could be lack of thinking OR lack of motivation
What is Avolition?
inability to initiate and persist in common, goal-directed activities
What are required symptoms for catatonia?
must have 3 of 12 symptoms, including: -abnormalities -postures -extreme mutism or negativism (not responding) -mimicking speech or movements
What is Schizophreniform Disorder?
symptoms of schizophrenia lasting 1 - 6 months