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