Abnormal Psychology: Chapter 10: Schizophrenia & Other Psychotic Disorders

Brain Abnormalities Specific to Schizophrenia

1. Mild structural disorganization at the level of the individual brain cells 2. Altered neuronal connections in multiple brain areas.

Adults who develop schizophrenia may have:

1. Situational Anxiety 2. Nervous Tension 3. Depression 4. Psychotic - Like Experiences

Relationship Between Substance Abuse & Schizophrenia

1. Substance abuse might relieve negative symptoms such as anhedonia or apathy, providing support for the self-medication hypothesis. 2. Those with fewer negative symptoms may simply be less likely to abuse these substances.

Genetic Risk of Developing Schizophrenia

15% - 1 parent has it 50% - 2 parents have it

Schizophreniform Disorder

A condition with symptoms that are identical to those of schizophrenia except that its duration is shorter (less than 6 months) and it results in less impairment in social or occupational functioning.

Thought Blocking

An unusually long pause or pauses in a person's speech that occur during a conversation.

Agranulocytosis

Lowering of the white blood cell count that could be fatal if not detected in time.

Recovery Form

The presence of all of the following for one year: 1. No psychotic symptoms 2. No negative symptoms 3. Demonstration of adequate psychological functioning

Shared Psychotic Disorder

1. A condition in which two or more persons who have a close relationship share the same delusional belief. 2. Begins when one person ( the inducer or the primary case) develops a psychotic disorder with delusional content. The inducer is the dominant person in the relationship with a second individual, and over time imposes the delusional belief system on the second person. If the relationship is interrupted the delusional beliefs of the second person quickly disappear.

Early Onset Schizophrenia

1. A form of schizophrenia that develops in childhood or adolescence. 2. Has severe biological and behavioral consequences. 3. These individuals are more impaired; they have additional psychotic episodes, need more continuing psychiatric care, and are more impaired in the area of social functioning and independent living.

Psychotic experiences such as delusional thinking and hallucinations may also occur in people with physical illnesses such as:

1. Brain Tumors 2. Alzheimer's Disease 3. Parkinson's Disease 4. & after physical damage to the brain such as brain injuries or exposure to toxic substances.

Nine Chromosomes & Seven Candidate Genes Have Been Identified As Potentially Contributing to the Development of Schizophrenia Through At Least Two Possible Pathways

1. Direct Transmission of the actual disorder from one family member to another. 2. Indirect Transmission by affecting the functioning of neurotransmitters such as dopamine.

Neuroanatomical Abnormality

1. Enlargement of Brain Ventricles 2. A Reduction in Cortical (Gray Matter) Areas of the Brain 3. The abnormalities are not the result of the illness but are present before the positive symptoms emerge.

To Establish A Relationship Between Dopamine & Schizophrenia Three Possibilities Must Be Considered

1. Excessive dopamine could lead to the development of schizophrenia. 2. Chronic stress created by a disorder as serious as schizophrenia may create many different brain abnormalities including excess dopamine. 3. Both excess dopamine and schizophrenia could result from some third currently unknown variable.

Examples of Cognitive Deteriorations in Schizophrenia

1. Loose Associations 2. Thought Blocking 3. Clang Association

Psychotic - Like Experiences

1. Perceptual Disturbances 2. Magical Thinking 3. Referential Ideas

Factors Uniquely Related to Onset of Schizophrenia

1. Poor Sociability 2. Abnormal Motor Functioning

Common Positive Symptoms of Schizophrenia

1. Presence of delusions, or beliefs that are not based in fact. 2. Hallucinations, hearing voices when no one is there, seeing visions that no one else sees. 3. Abnormality of Speech 4. Unusual sometimes bizarre, behaviors

Blunted Affect

A behavior characterized by diminished or immobile facial expressions and a flat, monotonic vocal tone that does not change even when the topic of conversation becomes emotionally laden.

Antipsychotics

A class of medications that block dopamine receptors at neuron receptor sites.

Expressed Emotion

A concept used to describe the level of emotional involvement and critical attitudes that exist with in the family of patient with schizophrenia.

Delusional Disorder

A condition in which a person has a non bizarre delusion, no other psychotic symptoms, and few changes in overall functioning other than the behaviors immediately surrounding the delusion.

Psychomotor Retardation

A condition in which a person has slowed mental and physical activities.

Catatonia

A condition in which a person is awake but non responsive to external stimulation.

Clang Association

A condition in which a person's speech is governed by words that sound alike rather than words that have meaning.

Waxy Flexibility

A condition in which parts of the body (usually the arms) remain frozen in a particular posture when positioned that way by another person.

Schizoaffective Disorder

A condition in which, in addition to all of the symptoms of schizophrenia, the patient suffers from a major depressive, manic, or mixed episode disorder at some point during the illness.

Delusion

A false belief

Hallucination

A false sensory perception

Atypical Antipsychotics

A group of medications that effectively treat positive symptoms, are much less likely to produce tradeoff dyskinesia, and have some effect on negative symptoms and cognitive impairments.

Positive Symptoms

A group of schizophrenic symptoms including unusual thoughts, feelings, and behaviors that vary in intensity and in many cases are responsive to treatment.

Tardive Dyskinesia

A neurological condition characterized by abnormal and involuntary motor movements of the face, mouth, limbs, and trunk.

Symptoms Vs. Diagnosis

Although symptoms of schizophrenia are common across racial and ethnic groups, rates at which a diagnosis of schizophrenia is given are not equally common at least with in the United States.

Delusions & Hallucinations In Schizophrenia

Distract people with the disorder, leaving them with only limited ability to attend to their environment surroundings.

Children & Adolescents With EOS

Even before delusions and hallucinations begin, these individuals are usually socially withdrawn, have difficulty interacting with peers, and have school adjustment problems.

Lobotomies

First administering anesthesia and then entering the person's brain either through a hole drilled in the skull or by inserting a device similar to an ice prick above the eyeball.

Difference between Brief or Limited Psychotic Experiences & Psychotic Disorders

Individuals without psychotic disorders report that voices are positive; they were not upset by the presence of the voices and felt in control of the experience.

Ideas of Reference

Interpreting casual events as being directly related to you.

Conventional/Typical Antipsychotics

Medications that effectively reduce the positive symptoms of schizophrenia but produce serious side effects.

Social Cognition/ Social Perception

Mental operations underlying social interactions, which include the human ability and capacity to perceive the intentions and dispositions of others. Includes skills such as the ability to perceive when someone s interested in conversation or to interpret eye or contact or a smile from a stranger.

Developmental Factors

Patients' childhood histories are usually collected retrospectively - once the disorder is diagnosed, patients (or perhaps the patients' parents) are asked to recall "how they were" before the symptoms began.

Difference Between Schizophrenia & DID

People with DID have personalities that perceive, deal with, and interact with the environment successfully. This ability to successfully negotiate with the environment is what differentiates people with schizophrenia from people with DID. Schizophrenia results in an inability to perceive the environment appropriately or deal with it adequately.

Dementia Praecox

The original name for schizophrenia coined by Kraepelin to highlight it's pervasive disturbances of perceptual and cognitive faculties (dementia) and it's early life onset (praecox) and to distinguish it from the dementia associated with old age.

Gene - Environment Correlation

The person who contributes to a patient's genetic makeup and provides the environment in which the patient lives.

Residual Phase in Schizophrenia

The psychotic symptoms are no longer present, but the negative symptoms often remain.

Brief Psychotic Disorder

The sudden onset of any psychotic symptom that may resolve after 1 day and does not last for more than 1 month.

Psycho-education

The teaching of patient and families about the patient's disorder in order to reduce familial distress and equip them to work effectively with the patient.

Dopamine Hypothesis

The theory that a cause of schizophrenia is the presence of too much dopamine in the neural synapses.

Self - Medication Hypothesis

The use of alcohol or drugs by people with schizophrenia be a strategy to cope with or escape from negative symptoms such as the inability to feel pleasure.

The More Symptoms of Schizophrenia...

There are, the more severe is the impairment in the person;s ability to function.

Abnormalities in Structural Brain Development May...

Trigger functional abnormalities that in turn result in the onset of schizophrenia.

Women Vs. Men

Women tend to develop schizophrenia at a later age than men do.

Delusions of Reference

You are sure the your interpretation of casual events being directly related to you are accurate.

Persecutory Delusion

A patient's belief that someone is persecuting her or him or that the person is a special agent/individual.

Synaptic Pruning

A process in which weaker synaptic contacts in the brain are eliminated and stronger connections are enhanced.

Psychosis

A severe mental condition characterized by a loss of contact with reality. Usually takes the form of a Delusion or a Hallucination or both.

Schizophrenia

A severe psychological disorder characterized by disorganization in thought, perception, and behavior. People with Schizophrenia do not think logically, perceive the world accurately, or behave in a way that permits normal everyday life and work.

Loose Association

A thought that has little or no logical connection to the next one.

People With Schizophrenia Often Have...

Additional psychological disorders as well; Depression/Anxiety Disorders.

Psychotic Disorders

Characterized by unusual thinking, distorted perceptions, and odd behaviors. People with psychotic disorder are considered to be out of touch with reality and to be unable to think in a logical or coherent manner.

CBT

Consists of psycho-education about psychosis and hallucinations, exploring the individual's beliefs about hallucinations and delusions, education in using coping strategies to deal with the symptoms and improving self esteem.

Characteristics In Determining Diagnosis

Data suggests that a patient's characteristics not just the symptoms may play an important role in determining a diagnosis for schizophrenia.

Acute Phase in Schizophrenia

The individual exhibits the positive symptoms including hallucinations, delusions, and thought disorder.

Psychotic Experiences

Psychotic experiences sometimes occur even when no psychological disorder is present.

Genetic Component of Schizophrenia

Research has established that this disorder has a genetic component and that abnormalities exist in both brain structure and brain function.

Anhedonia

The lack of capacity for pleasure; a condition in which a person does not feel joy or happiness.

Prodromal Phase in Schizophrenia

Social withdrawal or deterioration of personal hygiene, such as not bathing or not changing clothes, may occur.

Antigens

Substance that stimulates production of antibodies

Executive Functioning

The ability to make decisions.

Social Cognition

The ability to perceive, interpret, and understand social information including other people's beliefs, attitudes, and emotions.

Negative Symptoms

The behavior, emotion, or thought process (cognition) that exists in people without psychotic disorder, but are absent ( or are substantially diminished) in people with schizophrenia.

Delusion of Influence

The belief that other people are controlling one's thoughts or behaviors.

Magical Thinking

The belief that thinking about something can make it happen.

Science has determined regarding schizophrenia that...

The cause of the disorder is not necessarily the same as what people believe is responsible for their suffering.

Alogia

The decreased quality and/or quantity of speech.

Cognitive Impairment

The diminishment in the visual and verbal learning and memory, inability to pay attention, decreased speed for information processing, and inability to engage in abstract reasoning, any or all of which may be found in different psychotic disorder.

Avolition

The inability to iniciate or follow through with plans.