Week 8 Abnormal: Schizophrenia and other Psychotic Disorders

b. The number of excess synapses are being reduced, or "pruned."

through a lot of structural changes. Which of the following is one of those changes? a. There is a general loss of neuroplasticity, which refers to the brain's ability to change or rewire itself. b. The number of excess synapses are being reduced, or "pruned." c. There is an increase in gray matter volume and a reduction in white matter volume. d. The number of excitatory synapses is increasing.

c. 9, 13

On average about _________ schizophrenia brain and __________ healthy control brains are donated to the tissue brain bank maintained by the National Institute of Mental Health each year. a. 50, 100 b. 90, 130 c. 9, 13 d. 100, 50

d. Schizophreniform disorder

Which of the following could be described as "short-term" schizophrenia? a. Undifferentiated schizophrenia b. Schizoaffective disorder c. Delusional disorder d. Schizophreniform disorder

a. work by blocking dopamine receptors.

First-generation antipsychotics ________ a. work by blocking dopamine receptors. b. are not effective. c. produce few side effects. d. include Risperdal and Zyprexa.

the hormone estrogen

In young adulthood, females have lower rates of schizophrenia than males. The lower rate may be a result of ______ providing a protective factor.

a. they behave relatively normally other than the delusions.

Individuals with delusional disorder differ from those with schizophrenia in that ________ a. they behave relatively normally other than the delusions. b. their delusions are not well-formed. c. they know their delusions are delusions. d. they rarely act on their delusions.

c. may reflect a cognitive error.

Neuroimaging studies of hallucinating patients suggest that auditory hallucinations ________ a. are actually heard. b. are usually drug induced. c. may reflect a cognitive error. d. activate the brain areas involved in speech comprehension.

b. families share both genes and the environment.

"Familial" does not mean the same thing as "genetic" because ________ a. families don't always share genes. b. families share both genes and the environment. c. genes are not expressed in every generation. d. the strength of the correlations seen in familial concordance patterns does not allow any conclusions to be made.

children who were at genetic risk and who lived in adoptive families with high communication deviance showed higher levels of thought disorder when compared to control children.

A Danish adoption study compared at-risk adopted children who had biological mothers with schizophrenia to a control group of adoptees whose biological mothers did not have schizophrenia. When the environmental factor of communication deviance was assessed and compared with the two groups, it was noted that ________

c. being able to function with the help of medication and therapy.

A favorable outcome for someone with schizophrenia would be recovery, which for someone with this disorder would consist of ________ a. living a much better life than prior to the onset of schizophrenia. b. living a normal life just like a person never diagnosed with schizophrenia. c. being able to function with the help of medication and therapy. d. being able to function with therapy alone and no longer requiring medication.

reference

A person experiencing a delusion of ________ might believe that the billboard that she saw while driving down the highway was speaking directly to her instead of simply advertising a product.

schizophreniform disorder.

A person who exhibits schizophrenia-like psychoses that last at least a month but less than 6 months would most likely be diagnosed with ________

b. brief psychotic disorder.

A person who has experiences a sudden onset of psychotic symptoms that last a few days and then pass, often never to return, would be diagnosed with _________ a. temporary schizophreniform disorder. b. brief psychotic disorder. c. provisional schizophreniform disorder. d. schizophrenia praecox.

c. 6

A rigorous study conducted by the Swedish army showed that young men who use cannabis by age 18 are _____ times more likely to develop schizophrenia than those who don't. a. 3 b. 4.5 c. 6 d. 10.3

c. dysregulated dopamine can cause people with schizophrenia to pay too much attention to stimuli that are not actually important.

Aberrant salience means that ________ a. enlarged brain ventricles cause people with schizophrenia to be unable to concentrate. b. a large amount of communication deviance in the family can cause a person with schizophrenia to relapse. c. dysregulated dopamine can cause people with schizophrenia to pay too much attention to stimuli that are not actually important. d. people with schizophrenia often show unusual motor behaviors.

c. a major depressive or manic episode that is concurrent with Criterion A of schizophrenia.

According to DSM-5, one criterion for a diagnosis of schizoaffective disorder is ________ a. a single hallucinatory episode that lasts up to 24 hours. b. a single episode of delusions concurrent with anxiety. c. a major depressive or manic episode that is concurrent with Criterion A of schizophrenia. d. a blood relative who has been diagnosed with schizophrenia and another who has a mood disorder.

a. offer further evidence of the role of the prenatal environment in schizophrenia.

According to the diathesis-stress perspective, being at genetic risk ________ a. does seem to make people more susceptible to environmental insults. b. affects some people while others are subject to environmental insults. c. outweighs any environmental risk. d. establishes a risk to environmental influences.

c. showed lower risk for schizophrenia than those adopted into dysfunctional families—a good environment may protect people with genetic vulnerabilities from developing schizophrenia.

Adopted children who were at high risk for schizophrenia and who were raised in healthy families, ________ a. showed the same risk for schizophrenia as those adopted into dysfunctional families—genes were the most important factor. b. showed higher risk for schizophrenia than those adopted into dysfunctional families—they had trouble fitting in with the family. c. showed lower risk for schizophrenia than those adopted into dysfunctional families—a good environment may protect people with genetic vulnerabilities from developing schizophrenia. d. showed lower risk for schizophrenia than those adopted into dysfunctional families—the environment causes people to develop schizophrenia, not genes.

b. to separate the effects of nature and nurture.

Adoption studies are typically used ________ a. to establish the primary role that the environment plays in most disorders. b. to separate the effects of nature and nurture. c. to assess the effectiveness of long-term treatment protocols. d. in order to isolate the environmental factors that "trigger" a disorder.

b. Genetics increase a person's vulnerability to develop schizophrenia.

Based on current research, which statement can be justified? a. Genetics play such a strong role, they are a sufficient condition for schizophrenia. b. Genetics increase a person's vulnerability to develop schizophrenia. c. Genetics may not be sufficient for schizophrenia, but everyone who develops schizophrenia must have some number of "schizophrenia genes." d. Genetics cannot play a significant role in the cause of schizophrenia because most people with the disorder have no close relatives who have it.

c. the first signs are usually seen in the way children move.

Based on developmental studies of children who later developed schizophrenia, ________ a. it is usually impossible to detect early signs of the disorder. b. the first signs are usually delusions or hallucinations. c. the first signs are usually seen in the way children move. d. the first signs are usually seen in speech problems.

c. Bob, because he has inherited the same susceptibility that his twin is expressing.

Both of Mary's parents have been diagnosed with schizophrenia. Bob has an identical twin, who has schizophrenia. Who is more likely to develop schizophrenia and why? a. Bob, because he is male and has a family history of schizophrenia. b. Mary, because all of her genes come from her parents and they both have the disease. c. Bob, because he has inherited the same susceptibility that his twin is expressing. d. Mary, because females are more susceptible than males to the genetic forms of schizophrenia.

expressed emotion

Brown developed a construct called _______, which measures family environment based on how a family member speaks about the patient during a private interview with a researcher.

d. question their delusions to help reduce their intensity.

Cognitive-behavioral treatment for people with schizophrenia tries to help them ________ a. learn a trade so they can earn a living. b. gain the skills they need for daily living. c. find the services they need in the community. d. question their delusions to help reduce their intensity.

a. may be an environmental risk factor for the development of schizophrenia.

Communication deviance ________ a. may be an environmental risk factor for the development of schizophrenia. b. is an early indication of schizophrenia. c. is not seen in control adoptees. d. and disordered speech are the same thing.

b. have been considered "different" or "odd" in childhood.

Compared to his nonschizophrenic identical twin, Matthew (who is schizophrenic) is more likely to ________ a. have been born with physical birth defects. b. have demonstrated motor abnormalities. c. have a higher intelligence level on IQ tests. d. be artistically or musically talented.

a. schizophrenia

DeJuan sometimes stands in the same strange posture for hours without moving or talking. This type of disorganized behavior is a symptom of _________ a. schizophrenia b. schizoaffective disorder c. schizotypal disorder d. schizophreniform disorder

Answer: Two patterns of symptoms are found in schizophrenia: positive symptoms and negative symptoms. Positive symptoms are abnormal behaviors, unusual perceptions, or thoughts that are present, while negative symptoms involve the absence of something normal. Thus, inappropriate emotion would be a positive symptom and a lack of emotion would be a negative symptom. It should be noted, however, that a single individual is likely to exhibit both types of symptoms

Define positive and negative symptoms for schizophrenia. Give examples of each.

d. erroneous beliefs held despite clear contradictory evidence.

Delusions are ________ a. perceptions with no basis in reality. b. only seen in schizophrenia. c. necessary for a diagnosis of schizophrenia. d. erroneous beliefs held despite clear contradictory evidence.

disturbances in the content of thought.

Delusions are: perceptions with no basis in reality. only seen in schizophrenia. necessary for a diagnosis of schizophrenia. disturbances in the content of thought.

b. is characterized by disorganized speech

Disorganized schizophrenia ________ a. is most commonly seen in women. b. is characterized by disorganized speech. c. usually develops in late adulthood. d. responds well to treatment.

Genome-wide association study (GWAS)

Dr. Mickens is conducting a study in which the entire genetic code of two groups—one with schizophrenia and one without the disorder— is investigated. What kind of study is this?

Answer: Her family may be highly critical or even hostile to Esther because of her illness. Emotional overinvolvement may also be at play, which would be a dramatic or overconcerned attitude toward Esther and her illness. Expressed emotion is a reliable predictor of relapse even when potentially important patient variables are controlled statistically. When families lower their EE (often with clinical intervention), patients' relapse rates decline.

Esther lives with her parents. She frequently has relapses into schizophrenia. If her family is characterized by expressed emotion, what behaviors can we expect of her parents that induce relapse?

Positive symptoms involve the presence of abnormal behavior. Hallucinations, delusions, disorganized speech, and bizarre behavior are all examples of positive symptoms.

Explain and give examples of positive symptoms of schizophrenia.

a. involuntary movements that result mainly from taking first-generation antipsychotic drugs.

Extrapyramidal side effects are ________ a. involuntary movement abnormalities seen in patients taking first-generation antipsychotic drugs. b. often fatal side-effects from second-generation antipsychotic drugs. c. an increase in mood (reduction in depression) that occurs in people with schizoaffective disorder. d. disorganized speech resulting from taking second-generation antipsychotic drugs.

c. Females with schizophrenia have less severe symptoms so may be misdiagnosed.

For every three men diagnosed with schizophrenia, only two women are. Which of the following reasons might explain this? a. Males are more likely to hallucinate than females so may be over diagnosed. b. Men are more likely to seek treatment. c. Females with schizophrenia have less severe symptoms so may be misdiagnosed. d. Women respond better to treatment than men.

d. alterations in glutamate levels can produce schizophrenic-like symptoms in normal subjects.

Glutamate is an excitatory neurotransmitter that researchers suspect might be involved in schizophrenia because ________ a. it makes dopamine. b. it causes the ventricles to enlarge. c. it is missing in the brains of people with schizophrenia. d. alterations in glutamate levels can produce schizophrenic-like symptoms in normal subjects.

a. sensory experiences with no basis in reality.

Hallucinations are ________ a. sensory experiences with no basis in reality. b. only seen in schizophrenia. c. necessary for a diagnosis of schizophrenia. d. disturbances in the content of thought.

a. schizophrenia for Harold; schizophreniform disorder for Tanya.

Harold and Tanya both have a wide range of schizophrenic symptoms. Harold's symptoms have lasted for eight months; Tanya lasted only eight weeks before she recovered. According to the DSM-5, their diagnoses should be _________ a. schizophrenia for Harold; schizophreniform disorder for Tanya. b. disorganized schizophrenia for Harold; schizophrenia for Tanya. c. schizoaffective disorder for Harold; schizophreniform disorder for Tanya. d. schizophreniform disorder for Harold; brief psychotic disorder for Tanya.

d. Not being able to pick up on emotions associated with facial expressions.

Having basic problems in social cognition is one symptom associated with schizophrenia. Which of the following is an example of a lack of social cognition? a. Picking up on implicit rules. b. Being able to follow the speed limit. c. Not being able to follow the speed limit. d. Not being able to pick up on emotions associated with facial expressions.

c. Over 90 percent of those with schizophrenia experience delusions.

How common are delusions in schizophrenia? a. They are experienced by approximately 50 percent of schizophrenics. b. Delusions are an essential feature of schizophrenia; the presence of delusions is required for a diagnosis of schizophrenia. c. Over 90 percent of those with schizophrenia experience delusions. d. While hallucinations are a common occurrence in schizophrenia, delusions are rare.

Dopamine may play a role in how much attention people pay to stimuli. Too much may make people pay too much attention to irrelevant stimuli (aberrant salience) and contribute to thought disorder

How is dopamine theorized to induce psychosis?

c. 150,000

How many schizophrenia samples were combined into a single analysis by the Schizophrenia Working Group of the Psychiatric Genomics Consortium? a. 15 b. 1,500,000 c. 150,000 d. 1,500

b. the concordance rate for monozygotic twins would be 100 percent.

If schizophrenia were exclusively a genetic disorder, ________ a. anyone with schizophrenia in his or her family history would develop schizophrenia. b. the concordance rate for monozygotic twins would be 100 percent. c. marrying a schizophrenic would not increase the likelihood of developing schizophrenia. d. numerous cures would now be available.

urban; rural

In an examination of which environmental factors may contribute to the development of schizophrenia, researchers in Denmark found that children who spent the first 15 years of their lives living in ________ environments were 2.75 times as likely to develop the condition as children who were raised in ________ settings.

d. has the disorder of interest.

In genetic studies, a "proband" or "index case" is someone who ________ a. is related to someone with the disorder of interest. b. shows signs of the disorder of interest. c. shares at least 25 percent of his or her genes with an affected subject. d. has the disorder of interest.

sensory gating

In the area of auditory processing, people with schizophrenia show deficits in a process called ________. This may interfere with their ability to habituate to similar stimuli that are presented in rapid succession.

d. he doesn't admit he could be wrong, no matter what proof he is shown.

Joe has a delusional belief. When people argue with him, ________ a. he admits he could be wrong. b. he only admits he is wrong after being shown more proof than most people would need. c. he doesn't admit he is wrong to other people, but he admits it to himself. d. he doesn't admit he could be wrong, no matter what proof he is shown.

b. schizoaffective disorder.

Julia clearly had psychotic symptoms. As she also showed symptoms of bipolar disorder, she was ultimately diagnosed with ________ a. residual type. b. schizoaffective disorder. c. schizophreniform disorder. d. undifferentiated type.

schizoaffective disorder.

Julia clearly had psychotic symptoms. As she also showed symptoms of bipolar disorder, she was ultimately diagnosed with: schizoaffective disorder. schizophreniform disorder. undifferentiated type. residual type.

brief psychotic disorder.

Kevin was hospitalized after a report from his college that he was hallucinating and delusional. After three days in the hospital with no medication, his behavior returned to normal. He returned to college and has continued in his studies with no further episodes being noted. Kevin's behavior is consistent with the DSM-5 diagnosis of ________

b. mid-twenties.

Kraepelin used the term "praecox" to convey that schizophrenia typically develops early in life. The actual age of onset of the condition in men typically is during the ________ a. early teenage years. b. mid-twenties. c. mid-thirties. d. mid-forties.

c. a group of conditions that all seemed to feature mental deterioration beginning early in life.

Kraepelin's use of the term "dementia praecox," referred to ________ a. a single specific condition now known as schizophrenia. b. a single specific condition now known as precocious dementia. c. a group of conditions that all seemed to feature mental deterioration beginning early in life. d. a group of conditions that all seemed to feature mental deterioration throughout the lifespan.

Answer: b. 10 percent

Lori just found out that she is pregnant. Her husband has schizophrenia. What is her unborn child's risk of developing schizophrenia? a. 3 percent b. 10 percent c. 50 percent d. 90 percent

His mother worked as a dry cleaner.

Marcus is a 19-year-old college sophomore who has recently begun demonstrating the symptoms of schizophrenia. Which of the following details is most likely true of Marcus?

catatonia.

Matthew was hospitalized after being found sitting in a fountain in a park for several hours with his arms extended outward. Since coming to the psychiatric unit, he remains seated in the same position for several hours at a time and is mute. Matthew's behavior is an example of ________

a. her face is less expressive than the control group, but she reports the same emotional responses.

Moira is schizophrenic. When she watches a film clip designed to elicit a strong emotional response, the researchers note that ___________. a. her face is less expressive than the control group, but she reports the same emotional responses. b. her face is less expressive than the control group, and she reports higher emotional responses. c. her face is more expressive than the control group, but she reports the same emotional responses. d. her face is more expressive than the control group, but she reports the same emotional responses.

d. may be caused by a combination of genetic and environmental influences.

Most of the evidence suggests that schizophrenia runs in families. This means that schizophrenia ________ a. is definitely a genetic abnormality. b. is definitely caused by a combination of genetic and environmental influences. c. is definitely caused by environmental influences. d. may be caused by a combination of genetic and environmental influences.

d. neologism.

My father and I swiggered to the beach yesterday." This is an example of a ________ a. delusion. b. auditory hallucination. c. negative symptom. d. neologism.

d. characterized as an absence or deficit of normal behaviors.

Negative symptoms are ________ a. those that are harmful. b. more disturbing to the patient than positive symptoms. c. a common side effect of antipsychotic medications. d. characterized as an absence or deficit of normal behaviors.

a reduction in brain (grey matter) volume in the left hemisphere auditory and speech perception areas

Neuro-imaging studies comparing the scans of hallucinating persons to those of non-hallucinating persons reveal that those who have speech hallucinations tend to have ________

Humor

One aspect of family environment that has been found to be important in schizophrenia is the level of expressed emotion. Which of the following is not one of the expressed emotions found to be predictive of relapse? a. Humor b. Criticism c. Hostility d. Emotional overinvolvement

he level of expressed emotion.

One aspect of family environment that has been found to be important in schizophrenia is: the level of parental grief over their child's illness. the level of expressed emotion. if the mother is cold and aloof. if lots of double-bind communications are used.

cortisol, adrenal cortex

One of the primary manifestations of the stress response in humans is the release of the glucocorticoid ___________ from the ____________.

d. display a mix of positive and negative symptoms

Over the course of the disorder, most individuals with schizophrenia ________ a. show either positive-syndrome or negative-syndrome types. b. show the Type II form exclusively. c. develop the "disorganized" form of the disorder. d. display a mix of positive and negative symptoms.

d. a virtual absence of all movement.

Patients in a catatonic stupor ________ a. are highly suggestible. b. experience overwhelming hallucinations. c. exhibit both echopraxia and echolalia. d. a virtual absence of all movement.

b. seems to be very effective when combined with medication.

Patients with schizophrenia who receive ________ are less likely to relapse or be readmitted to the hospital than those receiving the standard treatment only. a. psychoactive medication b. psychoeducation c. cognitive remediation d. case management

d. 65

People who have had a hospital contact for a head injury have what percentage of an increase in their later risk for schizophrenia? a. 97 b. 5 c. 200 d. 65

c. disorganized speech.

People with schizophrenia may have difficulty with the form of thought—in other words, their thoughts do not make sense. The observable sign of this is ________ a. a delusion. b. a hallucination. c. disorganized speech. d. disorganized behavior.

smooth-pursuit eye movement.

People with schizophrenia often have trouble with a visual task involving tracking the movement of a pendulum. This skill is called ________

d. frontal lobe.

People with schizophrenia often show poor performance on tasks like the Wisconsin Card Sorting Task, which is thought to indicate a dysfunction of the ________ a. parietal lobe. b. occipital lobe. c. temporal lobe. d. frontal lobe.

GABA interneurons and are responsible for regulating the excitability of other neurons.

Persons with schizophrenia are missing particular types of neurons known as "inhibitory interneurons." These are called ________

b. a significant loss of contact with reality.

Psychosis is a striking and essential feature of schizophrenia. Psychosis means ________ a. a tendency to be unpredictably violent. b. a significant loss of contact with reality. c. an inability to know right from wrong. d. an abrupt shift in personality from one pattern to another.

significant loss of contact with reality.

Psychosis is a striking and essential feature of schizophrenia. Psychosis means: a tendency to be unpredictably violent. significant loss of contact with reality. an inability to know right from wrong. an abrupt shift in personality from one pattern to another.

die

Recent data from the United Kingdom show that men with schizophrenia _______ about 15 years earlier than would be expected based on national norms.

mental retardation, neurosis, and psychopathy

Research by Heston in 1966 suggested that a diagnosis of schizophrenia in one's mother was associated with an increased probability of being diagnosed with several other conditions, including ________.

cannabis

Research suggests that using _______ during adolescence more than doubles a person's risk of developing schizophrenia at a later stage of life.

b. genetically influenced multiple gene disorder.

Schizophrenia is best described as a ________ a. genetically influenced single gene disorder. b. genetically influenced multiple gene disorder. c. genetically determined single gene disorder. d. genetically determined multiple gene disorder.

b. 1 out of 100

Schizophrenia occurs in about ________ of the general population. a. 1 out of 1,000 b. 1 out of 100 c. 1 out of 10 d. 1 out of 10,000

erotomania.

Shelby openly expresses her love of Donald Trump. She has covered the walls of her bedroom with Trump photographs and posts long essays about her love for him on her blog and social media accounts. Shelby works full-time, lives alone in an apartment, and exhibits no unusual behavior other than her extreme devotion to and love of Donald Trump. Shelby's behavior is consistent with the DSM-5 diagnosis of ________

c. tries to help people gain the skills they need for daily living outside the hospital

Social-skills training for people with schizophrenia ________ a. has been very successful in reducing symptoms. b. is designed to teach people a trade so they can earn a living. c. is designed to help people gain the skills they need for daily living outside the hospital. d. is effective as a non-medication-based cure for people of schizophrenia.

b. delusion of reference.

Sterling believes that the TV special that was on last night was shown to tell her that she should break up with her boyfriend. She is absolutely certain this is true and plans to do it. This type of belief is an example of a ________ a. thought broadcasting delusion. b. delusion of reference. c. made feelings delusion. d. thought insertion delusion.

delusion of reference.

Sterling believes that the TV special that was on last night was shown to tell her that she should break up with her boyfriend. She is absolutely certain this is true and plans to do it. This type of belief is an example of a: thought broadcasting delusion. delusion of reference. made feelings delusion. thought insertion delusion.

a. Vague, confusing, and unclear communication

Studies of adopted children who were at high-risk for developing schizophrenia found that which of the following appeared to increase the likelihood that these children would show high levels of thought disorders? a. Vague, confusing, and unclear communication b. Physical abuse c. Permissive parenting d. Divorce

d. that the more genetically related you are to someone with schizophrenia, the greater your risk of the disorder.

Studies of family concordance patterns for schizophrenia have found ________ a. little evidence of increased concordance with increased gene-sharing. b. such strong correspondence between gene-sharing and diagnosis that environmental factors have been ruled out. c. strong correspondence between gene-sharing and diagnosis but only for males. d. that the more genetically related you are to someone with schizophrenia, the greater your risk of the disorder.

c. a genetic predisposition to schizophrenia may remain unexpressed in some individuals unless it is released by some unknown environmental factors.

Studies of the offspring of nonschizophrenic co-twins from discordant twin pairs suggest that ________ a. environmental factors play a more important role than genetic factors in the origin of schizophrenia. b. genetic factors cause schizophrenia, while environmental factors are essentially unimportant. c. a genetic predisposition to schizophrenia may remain unexpressed in some individuals unless it is released by some unknown environmental factors. d. the heritability of schizophrenia involves the transmission of a single dominant gene.

schizoaffective

The DSM-5 diagnosis for someone who has features of schizophrenia and a severe mood disorder is __________ disorder.

b. not assessing the child-rearing environments of the index and control groups.

The Danish adoption studies have been criticized for ________ a. not treating the subjects found to have schizophrenia. b. not assessing the child-rearing environments of the index and control groups. c. only studying males. d. not confirming the family history of the subjects.

b. index subjects were more likely to develop schizophrenia than the control subjects

The Finnish Adoptive Family Study of Schizophrenia determined that ________ a. the role of genes was found to be negligible. b. index subjects were more likely to develop schizophrenia than the control subjects. c. environment was found to be a more important determinant of psychological health than family history. d. no significant effects were seen.

dopamine D2

The common factor noted in all of the medications used to treat schizophrenia is their ability to block ___________ receptors in the brain.

A delusion is a thought, a cognition, with no basis in reality. Common delusions involve believing that one's actions or thoughts are being controlled by some external force, that one's thoughts are being broadcast, and that thoughts are being inserted into one's mind. These delusions are all consistent with the disorganized thoughts commonly seen in schizophrenia.

What is a delusion? What type of delusions are most common in schizophrenia?

disorganized speech

The external manifestation of a disorder of thought form is _________, which includes using words and word combinations that sound communicative but make no sense to a listener.

a. we may have overestimated the influence of genetics in schizophrenia.

The fact that a significant number of monozygotic twins share the same placenta, while no dizygotic twins do, suggests that ________ a. we may have overestimated the influence of genetics in schizophrenia. b. being a monozygotic twin is a risk factor for schizophrenia. c. genetic influences are even more important than previously thought. d. monozygotic twins have a form of genetic schizophrenia while dizygotic twins have an environmentally caused form.

b. anything that interferes with normal brain development might lead to a greater risk of schizophrenia.

The finding that prenatal viral exposure, rhesus incompatibility, and early nutritional deficiency are associated with an increased risk of developing schizophrenia indicates that ________ a. genes do not play a role in vulnerability to schizophrenia. b. anything that interferes with normal brain development might lead to a greater risk of schizophrenia. c. environmental factors are more important than genetic factors when it comes to determining who is likely to develop schizophrenia. d. the results of twin studies reflect the impact of a shared prenatal environment, not shared genes.

changes in symptoms begin to occur very quickly after starting the medications, not weeks later as previously thought.

The first-generation antipsychotics seem to work because they block dopamine. This is supported by the new research findings that: patients report they feel better right away, although there isn't any actual clinical changes occurring. changes in symptoms occur without any side effects. changes in symptoms begin to occur weeks after starting to take the medications, rather than immediately. changes in symptoms begin to occur very quickly after starting the medications, not weeks later as previously thought.

d. avolition.

The inability to initiate or persist in goal-directed activity is called _________ a. alogia. b. blunted affect. c. delusions. d. avolition.

b. usually exhibits symptoms of schizophrenia that last for at least a month but less than 6 months.

The individual diagnosed with schizophreniform disorder ________ a. has a mild case of schizophrenia combined with signs of a mood disorder. b. usually exhibits symptoms of schizophrenia that last for at least a month but less than 6 months. c. is likely to take actions based on their delusions. d. experiences a schizophrenia-like psychosis that lasts for less than a month.

b. 108

The latest research has demonstrated how many genetic loci associated with the presence of schizophrenia? a. 18 b. 108 c. 180 d. 1080

one

The lifetime risk for schizophrenia is just under __________ percent.

b. late adolescence or early adulthood.

The majority of cases of schizophrenia begin in ________ a. late adulthood or old age. b. late adolescence or early adulthood. c. late childhood or early adolescence. d. infancy or early childhood.

late adolescence or early adulthood.

The majority of cases of schizophrenia begin: late adulthood or old age. late adolescence or early adulthood. late childhood or early adolescence. there is no age where the majority of cases begin.

dopamine

The most important neurotransmitter implicated in schizophrenia is _________.

dopamine

The most well studied neurotransmitter implicated in schizophrenia is ________.

cytoarchitecture.

The overall organization of cells in the brain is referred to as the brain's ________

b. major histocompatibility complex

The region of the brain known as the ________ (MHC) plays an important role in brain development and neuronal function. a. monozygotic histamine center b. major histocompatibility complex c. minor hysterocompatible complex d. monozygotic hysterocompatible center

d. difference between schizophrenia and dementias of old age.

The term "demence precoce" was used by Benedict Morel to describe schizophrenia and to also explain the ________ a. lack of brain damage that characterizes the brain of most schizophrenics. b. effectiveness of psychological treatments for schizophrenia. c. transient nature of most schizophrenias. d. difference between schizophrenia and dementias of old age.

b. there is no strong evidence that people with schizophrenia have too much dopamine.

There is a new trend to focus on dopamine receptor sensitivity rather than on dopamine itself because ________ a. there is strong evidence that people with schizophrenia have too much dopamine. b. there is no strong evidence that people with schizophrenia have too much dopamine. c. the is strong evidence that people with schizophrenia have used too many drugs. d. there is only one type of dopamine receptor.

b. schizoaffective disorder

There is some debate as to whether ________ is a variant of schizophrenia or a form of mood disorder. a. residual type b. schizoaffective disorder c. schizophreniform disorder d. undifferentiated type

genetically influenced, but not a genetically determined

This chapter stresses the point that schizophrenia is a(n) ____________ disorder.

Genes alone are not what determines the development of schizophrenia.

Torrey and colleagues compiled concordance rates for schizophrenia in monozygotic twins. The overall concordance rate was around 28%. For disorders believed to be exclusively genetic, one would anticipate a concordance rate of 100%. What do these numbers suggest about the genetic base of schizophrenia?

c. The frontal lobes

Ursula has been diagnosed with schizophrenia. If PET scans were done to measure her brain's activity, which area would probably be underactive? a. The visual cortex b. The deepest portions of the brain, the medulla and reticular activating system c. The frontal lobes d. The hypothalamus and pituitary

b. risk factor for developing schizophrenia.

Very recent research suggests that having a lower IQ may itself be an independent ________ a. protection from developing schizophrenia. b. risk factor for developing schizophrenia. c. factor associated with delusional disorder. d. factor associated with gaining hallucinations without delusions.

d. provisional schizophreniform disorder.

Virginia exhibits a variety of schizophrenic symptoms including delusions, auditory hallucinations, and formal thought disorder. She has been symptomatic for a little more than a month. Virginia qualifies for a diagnosis of ________ a. paranoid schizophrenia. b. schizoaffective disorder, manic type. c. undifferentiated schizophrenia. d. provisional schizophreniform disorder.

more motor abnormalities, including unusual hand movements

Walker and colleagues viewed family home movies made during the childhoods of 32 people who eventually developed schizophrenia. Facial, emotional, and motor movements were rated by the viewers. The results revealed that children who later developed schizophrenia showed ________, compared to their healthy siblings.

c. Discrete, stable, and measurable traits thought to be under genetic control

What are endophenotypes? a. Abnormally shaped cells in the brain b. Neurotransmitters of slightly different chemical composition than normal c. Discrete, stable, and measurable traits thought to be under genetic control d. Specific chromosomes thought to be important in the genetic transmission of schizophrenia

Answer: These are not considered formal subtypes of schizophrenia in DSM-5, but distinct disorders Schizoaffective disorder is a category for individuals who have characteristics of both schizophrenia and bipolar or major depressive disorder, such that a differential diagnosis cannot be made. Schizophreniform disorder is diagnosed when schizophrenic symptoms are present but have not lasted for six months. An individual may be rediagnosed as schizophrenic after six months if he or she does not have a remission.

What are schizoaffective disorder and schizophreniform disorder? How do they relate to schizophrenia?

Two of: 1. flu virus—elevated risk in children whose mothers had the flu during the second trimester. 2. Rh incompatibility—elevated risk in children. 3. Early prenatal nutritional deficiency. All compromise fetal development, especially brain development

What are two types of prenatal experience associated with increased risk of schizophrenia?

Cognitive difficulties often occur at the start of the illness, or even before it is diagnosed

What evidence is noted in your textbook to support the following statement: "It is unlikely that the cognitive impairments seen in people suffering from schizophrenia are due to the effects of extended hospitalization or medication"?

Answer: Early studies did not examine child rearing adequacy of the adoptive family. Newer studies found that communication deviance—how understandable and easy to follow the speech of family members was—was related to risk of schizophrenia. Children with a biological risk for schizophrenia who were adopted into families with high communication deviance had an increased risk of the disease. If the child had no genetic predisposition for schizophrenia, communication deviance did not make a difference in risk. Most interestingly, if a genetic risk existed and the child was adopted into a family with low communication deviance, that child's risk for schizophrenia was actually lower than the other groups!

What important aspect of the adoptive family was missing from early studies? What did later studies find when they did include it?

a. People in the early stages of psychosis may just be more inclined to try drugs.

What is a methodological flaw in studies of cannabis use and schizophrenia? a. People in the early stages of psychosis may just be more inclined to try drugs. b. People in the early stages of drug use may just be more inclined to develop schizophrenia. c. These studies ignore the cultural influences on cannabis use among immigrants. d. These studies establish the cultural influences on cannabis use among immigrants.

Answer: This may be because levels of expressed emotions (EE) are much lower in countries such as India than in the United States and Europe. For example, in highly industrialized cultures, more than 50 percent of families are high in EE. In contrast, studies with Mexican American and Hindi-speaking Indian samples show that only 24 and 41 percent of families, respectively, are high in EE.

What is a possible reason why schizophrenia patients in less industrialized countries tend to do better than those in more industrialized countries?

c. Being a recent immigrant

What is a stressor that has been found to increase the risk of developing schizophrenia? a. Being an identical twin b. Being raised in an isolated rural area c. Being a recent immigrant d. Living alone

c. Mild psychotic symptoms that are not severe enough to meet clinical criteria for a full-blown psychotic disorder

What is attenuated psychoses syndrome? a. Another name for schizophrenia b. A form of delusional disorder that involves children c. Mild psychotic symptoms that are not severe enough to meet clinical criteria for a full-blown psychotic disorder d. A psychotic state in which the person having it has olfactory and gustatory hallucinations

Catatonia is a negative symptom of schizophrenia as it is characterized by an absence of normal behavior. The patient with catatonia may have virtually no movement or speech, or he or she may freeze and hold an awkward position for an extended period of time.

What is catatonia? Is catatonia a positive or negative symptom? Explain your answer.

The individual diagnosed with schizoaffective disorder exhibits symptoms of both schizophrenia and an affective disorder; he or she experiences both psychosis and extremes of mood. It is not clear whether this disorder is best thought of as a form of mood disorder or a form of schizophrenia.

What is schizoaffective disorder?

Answer: The most well-studied neurotransmitter implicated in schizophrenia is dopamine. The dopamine hypothesis dates back to the 1960s and was derived from three important observations: (1) the pharmacological action of the drug chlorpromazine (Thorazine), which blocks dopamine receptors; (2) the abuse of amphetamines (which cause excess dopamine) created paranoia and auditory hallucinations; (3) clinical studies that used drugs to increase the availability of dopamine in the brain brought on psychotic symptoms. The glutamate hypothesis challenges the dopamine hypothesis as the neurotransmitter dysfunction responsible for schizophrenia, but since dopamine receptors inhibit the release of glutamate, this actually makes the dopamine hypothesis more credible.

What is the evidence for and against the dopamine hypothesis?

Losing contact with reality, referred to as psychosis.

What is the hallmark of schizophrenia?

d. The duration of symptoms

What is the major difference between a diagnosis of schizophrenia and schizophreniform disorder? a. The presence of delusions and hallucinations b. The age of the person when they develop the disorder c. The degree of emotional instability and disconnection from other people d. The duration of symptoms

The duration of symptoms.

What is the major difference between a diagnosis of schizophrenia and schizophreniform disorder? The presence of delusions and hallucinations. The age of the person when they develop the disorder. The degree of emotional instability and disconnection from other people. The duration of symptoms.

b. It can identify factors that precede breakdown and aid in intervention efforts.

What is the value of research that monitors children at high risk for schizophrenia for a long time? a. It can identify the specific genes responsible for the disorder. b. It can identify factors that precede breakdown and aid in intervention efforts. c. It can separate the impact of genetics from that of subtle neurological impairment. d. It can identify the factors that improve treatment outcome.

Answer: While the peak age of onset of schizophrenia for males is between 20 and 24. For women, there is a lesser peak around that age, a marked drop after about age 35, and another peak in the early 60s. For every three men who develop the disorder, only two women do so. There is some reason to believe that estrogen may serve to protect the female brain. It has been observed that women with schizophrenia experience more psychotic symptoms when estrogen levels are low or dropping, consistent with this hypothesis

What is thought to explain the delayed onset of schizophrenia in women?.

Answer: While it was once thought that features of the home environment "caused" schizophrenia, such simplistic explanations have been discarded. At one time it was believed that inconsistent emotional signals from a parent led to schizophrenia; this "double-bind" hypothesis has not been supported. While there is little or no evidence to support a role for the family environment in the development of the disorder, it has been shown that communication patterns can predict relapse. In other words, familial interactions that are stressful can contribute to relapse. A recurrence of symptoms is more likely in a home that is high in expressed emotion. The elements of expressed emotion are criticism, hostility, and emotional overinvolvement

What role does the family play in schizophrenia?

a. Auditory

What type of hallucinations are the most common? a. Auditory b. Tactile c. Visual d. Gustatory

d. a break with reality.

When Bleuler coined the term "schizophrenia," the kind of split he believed was central to the disorder was ________ a. a division of personality within the person. b. a divergence between the person's chronological age and his or her intellectual performance. c. an inability to make an intimate connection with other people. d. a break with reality.

splitting of the intellect from emotion and external reality.

When Eugen Bleuler used the word schizophrenia to describe a "splitting" he observed in patients, he used the term to represent a ________

Schizoaffective disorder

Which disorder would provide the greatest challenge in distinguishing between a mood disorder and a disorder marked by psychotic symptoms?

b. Prenatal influenza exposure.

Which of the following has been found to lead to an increased risk of developing schizophrenia? a. Prenatal alcohol exposure. b. Prenatal influenza exposure. c. Alcohol use during middle adulthood. d. Influenza exposure between ages 5 and 10.

c. Hippocampus

Which of the following is a brain area that has been shown to be involved in schizophrenia? a. Parietal lobe b. Occipital lobe c. Hippocampus d. Hypothalamus

Personal therapy

Which of the following is a form of individual treatment currently in use that is effective in enhancing the social adjustment and social role performance for discharged patients diagnosed with schizophrenia?

c. Maternal antibodies could cross the placenta and interfere with brain development such that the risk of developing schizophrenia is enhanced later in life.

Which of the following is a plausible explanation for how maternal influenza might lead to schizophrenia later in life? a. The flu virus may lie dormant in the brain until adolescence, when it becomes active and initiates the degeneration that results in the symptoms of schizophrenia. b. The flu exposure may alter the fetal genes such that a susceptibility to schizophrenia is now part of the child's genetic makeup. c. Maternal antibodies could cross the placenta and interfere with brain development such that the risk of developing schizophrenia is enhanced later in life. d. The flu virus frequently has long-term effects on the behavior of affected individuals; maternal infection with influenza may result in an environment that is likely to trigger schizophrenia in the susceptible individual.

Maternal antibodies could cross the placenta such that the viral antibodies could interfere with the foetus' brain development

Which of the following is a plausible explanation for how maternal influenza might lead to schizophrenia later in life? The flu virus may lie dormant in the brain until adolescence when it becomes active and initiates the degeneration that results in the symptoms of schizophrenia. The flu exposure may alter the fetal genes such that a susceptibility to schizophrenia is now part of the child's genetic makeup. Maternal antibodies could cross the placenta such that the viral antibodies could interfere with the foetus' brain development The flu virus frequently has long-tern effects on the behaviour of affected individuals; maternal infection with influenza may result in an environment that is likely to trigger schizophrenia in the susceptible individual.

a. Schizophrenogenic sibling

Which of the following is an environmental influence from the family that can influence a susceptible person's tendency to develop schizophrenia? a. Double-bind communication b. Cold, aloof mother c. Communication deviance d. Schizophrenogenic sibling

a. Bob thought the CIA was controlling his thoughts.

Which of the following is an example of a delusion? a. Bob thought the CIA was controlling his thoughts. b. The voices in Jaimie's head told him not to trust the priest. c. Tracy did not think she could get pregnant the first time she had sex. d. Carla saw and felt bugs crawling up her arm.

b. Karen no longer socialized with her friends.

Which of the following is an example of a negative symptom of schizophrenia? a. Julia heard voices that told her she was evil. b. Karen no longer socialized with her friends. c. Ellen suspected that her husband had poisoned her food. d. Georgia's speech sounded normal, but made no sense.

b. Emotional unresponsiveness

Which of the following is an example of a negative symptom? a. Hallucinations b. Emotional unresponsiveness c. Emotional turmoil d. Delusions

b. Sondra tries to ignore the voices in her head.

Which of the following is an example of the most common type of hallucination seen in schizophrenia? a. Bill is convinced that his mother is inserting evil thoughts into his mind. b. Sondra tries to ignore the voices in her head. c. Ned believes he is Elvis. d. Rachel sometimes thinks she sees her husband, even though he has been dead for several years.

ondra tried to ignore the voices in her head.

Which of the following is an example of the most common type of hallucination seen in schizophrenia? Sondra tried to ignore the voices in her head. Ned believed he was Elvis. Bill was convinced that his mother was inserting evil thoughts into his mind. Rachel would frequently see her husband, even though he had been dead for several years.

b. Peter appears to feel no emotion and tends to make odd facial expressions and movements.

Which of the following is likely a sign of disorganized schizophrenia? a. Dillon believes he is God, but will respond to any direction he is given. b. Peter appears to feel no emotion and tends to make odd facial expressions and movements. c. Kyle constantly is asking for a doctor as he is convinced that his stomach is going to explode. d. Trista fears for her life because the pictures on the wall have told her that she is not safe.

a. Delusions of reference

Which of the following is most likely seen in an individual with paranoid schizophrenia? a. Delusions of reference b. Primarily negative symptoms c. More significant cognitive impairments than are seen in the other subtypes d. Poor response to treatment

They are no more effective than first generation antipsychotics.

Which of the following is true about second generation antipsychotics in the treatment of schizophrenia? They work by decreasing frontal lobe activity. They are more effective than first generation antipsychotics. They prevent prenatal brain damage. They are no more effective than first generation antipsychotics.

d. They are no more effective than first generation antipsychotics

Which of the following is true about second-generation antipsychotics in the treatment of schizophrenia? a. They are more effective than first generation antipsychotics. b. They work by decreasing frontal lobe activity. c. They prevent prenatal brain damage. d. They are no more effective than first generation antipsychotics.

c. A person whose father was over 50 when he/she was born

Which of the following people has the highest risk of developing schizophrenia? a. A person whose father was under 25 when he/she was born b. A person whose mothwe was under 25 when he/she was born c. A person whose father was over 50 when he/she was born d. A person whose mother was over 50 when he/she was born

b. A woman who believes she is being persecuted because she is Helen of Troy

Which of the following people is more likely exhibiting paranoid schizophrenia? a. A teen who has been in a catatonic state for several days b. A woman who believes she is being persecuted because she is Helen of Troy c. A man who shows little emotion and makes no sense when he speaks d. A mother of three who first showed signs of schizophrenia in her teens and now is unable to care for herself or her children.

d. The earlier patients receive these medications, the better they tend to do over the longer term.

Which of the following statements about antipsychotic medications is true? a. Large numbers of clinical trials have failed to demonstrate the efficacy and effectiveness of these drugs. b. Some clinical change can be seen within the first 24 hours, but drops off rapidly after that. c. These medications can take 2 to 4 weeks to have any effect on the patient. d. The earlier patients receive these medications, the better they tend to do over the longer term.

b. Subtypes of schizophrenia were removed but the diagnosis of schizophrenia will remain.

Which of the following statements is correct about changes for the diagnosis of schizophrenia in the DSM-5? a. Schizophrenia will not be included in the DSM-5. b. Subtypes of schizophrenia were removed but the diagnosis of schizophrenia will remain. c. Only the paranoid subtype remains. d. Only the catatonic subtype remains.

Tardive dyskinesia

Which of the following terms, which refers to marked involuntary movement of the lips, tongue, hands, and neck, is a side effect that sometimes accompanies the use of antipsychotic medications?

Dysconnectivity

Which problem, recently identified in the white matter of people with schizophrenia, explains a lot of the clinical features of the disorder?

Some deaf people with schizophrenia experience auditory hallucinations.

Which statement supports the notion that a hallucination is a sensory experience that is internally rather than externally generated?

a. Cognitive remediation training

Which type of training has an emphasis on helping patients deal with their neurocognitive deficits? a. Cognitive remediation training b. Social skills training c. Case management d. Family therapy

up to one month; between 1 and 6 months

While the symptoms of brief psychotic disorder may last for _________, the symptoms of a schizophreniform disorder can persist for ________.

They reduce the amount of time that patients spend in a hospital.

Why are assertive community treatment programs a cost-effective way to provide treatment to those with schizophrenia?

They reflect an excess or distortion in a normal repertoire of behavior or experience.

Why are symptoms such as delusions, hallucinations, and disorganized thinking categorized as positive symptoms?

Answer: Research shows that recent immigrants have much higher risks of developing schizophrenia than do people who are native to the country of immigration. The stress of social disadvantage, social defeat, and discrimination may be sufficient to push someone with a genetic susceptibility toward schizophrenia into psychosis.

Why is immigration associated with an increased risk of schizophrenia?

a. Evidence suggests that there sometimes are progressive changes in brain volume over time in people with schizophrenia.

Why might Kraepelin's idea that schizophrenia was similar to dementia not be as far from the truth as previously thought? a. Evidence suggests that there sometimes are progressive changes in brain volume over time in people with schizophrenia. b. The symptoms of the two disorders overlap tremendously. c. On autopsy, people with schizophrenia show the same smoothing of the brain as is seen in people with dementia. d. The same biological treatments work for both disorders.

When stringent criteria are used to define recovery, only about 14 percent of those with schizophrenia recover.

Why would it be accurate to say that a "cure" for schizophrenia has yet to be uncovered?

Expressed emotion

________ has been a very important topic in the study of psychosocial factors that contribute to schizophrenia. High levels of this quality in families have been found to predict relapse in patients with the disorder.

a. Ketamine

________ is an anesthetic that is safe for use in animals and children but not in adults because it can cause schizophrenia-like positive and negative symptoms. a. Ketamine b. PCP c. Glutamate d. NMDA

Subtypes

________ of schizophrenia were recognized in DSM-IV-TR but were omitted from DSM-5 because this approach did not yield major insights into etiology or treatment.

Candidate

_________ genes are genes that are involved in processes that are believed to be aberrant in schizophrenia.

Cognitive

____________ impairment is regarded as a core feature of schizophrenia.

Endophenotypes

_____________ are discrete, stable, and measurable traits that are thought to be genetic.

Hallucinations

______________ are sensory experiences that seem true to the individual, but are not in the external world.

Delusions

______________are false beliefs that are firmly held despite clear evidence to the contrary.