Schizophrenia and Other Psychotic Disorders

A clinician asks Sofia, "Could you tell me more about your concerns with the Post Office?" Sofia chuckles and says, "I love digging; digging makes you stronger, and when I put that tree in there if anyone tries to bother me, I can tell them to get away from me." Sofia appears to be suffering what type of psychotic symptom?

disorganized thinking

Maritza has schizophrenia. She sometimes goes for days without showering or brushing her teeth and mostly keeps to herself, rarely interacting with family and friends. Some think that she is just getting lazy, but others realize that this is what type of symptom of schizophrenia?

negative

Minor symptoms of psychosis, problems at school or work, or a decline in social functioning are all considered ________ of schizophrenia.

prodromal symptoms

29-year old Mary was admitted to the hospital after threatening suicide. In meeting with the psychiatrist, Mary revealed that she suffered from depression for as long as she could remember, but for the past few months, she had been hearing voices telling her to do certain things. What diagnosis will Mary likely receive?

schizoaffective disorder

Jacob's thoughts and perceptions are distorted, and he has a hard time functioning in normal life due to his insistence that he has superpowers. He most likely has ________.

schizophrenia

Devin was convinced that people were following him. He started hearing voices, and would stare out the window for hours without moving. He eventually dropped out of school and lost his job because of the paranoia. Devin most likely has

schizophrenia.

Alan is having a psychotic episode. Which of the following describes his experience?

Alan hears someone speaking to him, but there is no one there or he hears odd sounds like radio static.

Michael was diagnosed with schizophrenia when he was 19 years old. He was hospitalized, and he and his psychiatrist have struggled for many months to find the right antipsychotic medication to help him with the least side effects. He is now ready to be discharged to a residential living facility. A major goal of his time there will be to practice and rehearse interpersonal and communication skills, money management, stress management, and some other behaviors to help him integrate into the community on his own. But Michael is an adult, so why is such a program necessary?

Because schizophrenia disrupted the normal process of learning the life skills to be on his own.

Gustav has been diagnosed with delusional disorder; his brother, Brandt, has been diagnosed with schizophrenia. Which one of the brothers most likely hears someone speaking to him and replies back to them even though no one else is present

Brandt

William has a history of drug use and past episodes of psychosis, but he has now been diagnosed with schizophrenia. Which of the following substances was he most likely using?

Cannabis (marijuana)

After some time in the hospital and in residential treatment, Breyonna has begun to participate in a treatment where she participates in structured group activities to practice interacting with others, being able to understand them, and resolve conflicts; she also spends time on the computer participating in exercises and therapeutic games that are designed to strengthen her ability to concentrate, process information, and problem-solve. What type of treatment program is she in?

Cognitive Enhancement Therapy

Damion thinks that impairments he sees in his patients with schizophrenia like difficulty with explaining moments in their own lives and slow response time in trying to figure things out are actually part of the risk factors for developing the disorder rather than just the effects of the illness. In reaching this conclusion, Damion is making use of which perspective on schizophrenia?

Cognitive perspective

Toby was brought into the Emergency Room with psychotic symptoms after a prolonged binge. After some investigation, the doctor diagnoses him with Alcohol-Induced Psychosis. This is apparently Toby's second episode. After prescribing the use of a second generation antipsychotic drug and evaluating suicidal risk, what would probably be the next best treatment decision for Toby?

Detox followed by residential treatment in a program that deals with dual diagnosis patients

In the emergency room, a physician is examining Dayo who was brought in after she began flinching and screaming that she was seeing flashing lights and thought a truck was going to run her over. She has been in an agitated state but has no history of mental disorders. After some prodding, a friend admits that they were at a party where they were taking PCP. Which question would be the most useful for the doctor to ask that might indicate if Dayo is experiencing a substance-induced psychotic episode?

Does Dayo have family members diagnosed with schizophrenia or schizoaffective disorder?

Richard thinks that schizophrenia might develop as a result of maladaptive parental communication that sends contradictory messages and causes confusion and psychotic symptoms. His friend tells him that this type of reasoning is not supported by the research data. Richard had been considering what debunked previous explanation for schizophrenia?

Double-bind communication

Adhita is writing a paper on schizophrenia for her class. In discussing the differing hypotheses about the cause of schizophrenia, which sentence below would be the most accurate to include in her paper?

Early studies suggested that an excess of dopamine in the brain produced psychotic symptoms.

Every day after classes, Fahari goes and sits at a bus stop across the street from a house where a young married man lives that she is convinced is in love with her. She waits for him to send a signal of his love for her and has started putting love notes in his mailbox. The two of them have never met, and the young man does not know who she is. What type of delusion is Fahari experiencing?

Erotomanic

Lidia is thinking about stopping her antipsychotic medication because of the side effects that she is experiencing. She noticed herself showing her teeth when speaking and times when her tongue sticks out without any effort on her part. Sitting watching TV she has also felt times when her neck started moving on its own. What types of side effects is she experiencing?

Extrapyramidal

For several weeks now Diego has been living on his own, although he receives support from a visiting social worker and participates in a day treatment program where he is part of a group focused on Social Skills Training. What kinds of activities does Diego engage in with this group?

He participates in role-plays and receives feedback and discusses how to use the skills in his life.

Julio just lost his wife yesterday to suicide; although she had experienced periods of depression over the years, he had not expected her to attempt suicide. He now has to care for his three children alone. Which of the following situations would most likely qualify Julio to be diagnosable with brief psychotic disorder?

He shows psychotic symptoms within a couple of weeks that last for 10 days and then stop

Chris's family has been involved in his rehab program after going through a substance-abuse induced psychotic episode; they also participated in family therapy with him to address conflicts and tensions within the family. Chris is going to be released shortly from his residential treatment program and has already received his prescriptions for second generation antipsychotics. What would be the next step in his treatment?

Individual therapy with CBT to determine how to prevent relapse of psychosis and drug use.

Jim and Elaine both live in the same part of the city and grew up in very similar neighborhoods. Each of them has a second-degree relative with schizophrenia. Which of the following statements is most accurate?

Jim and Elaine have about the same risk of developing schizophreniform disorder.

Which of the following persons is most likely to be diagnosed with brief psychotic disorder?

Layla is a woman from Vietnam who recently moved to America and recently gave birth to her first child.

Recently, Terrence enrolled in Acceptance and Commitment Therapy (ACT). Which of the following describes what he will be doing in his sessions?

Learning to balance setting and acting on goals based on his values and accepting his symptoms.

For several years now Terri has struggled with intense depressive episodes. During some of these episodes, she has told her family and others that she is actually dead; even when doctors have pointed out that she has a heartbeat and temperature, she insists that she has already died. During some of these episodes, she also describes feeling her bones cracking as they decay and can hear ghosts speaking to her. When treatment reduces her depression, the psychotic symptoms are no longer evident. Which of the following is the most likely diagnosis for her given this information?

Major depression with psychotic symptoms

In addition to the use of antipsychotics to treat psychotic symptoms, treatment for schizoaffective disorder is more likely to include which forms of treatment compared with schizophrenia?

Mood stabilizing medication and psychotherapy

Leila and John are from the same country and generally have similar life histories in terms of their development, education, and life stressors. Which one of them has a greater risk of receiving a diagnosis of schizophreniform disorder?

Neither; unlike some other disorders, men and women have equal rates of this disorder.

Elena has been suffering from increased difficulty thinking and speaking logically to others as well as talking to people that others don't see for the past couple of weeks. Her family takes her in to see a physician. Can the doctor diagnose her with schizophrenia?

No. Her psychotic symptoms have only lasted for two weeks, which is not enough time for a diagnosis.

For several months, Brooke frequently hears unusual noises like voices babbling, is having trouble speaking to others because they can't understand her, and in the past month had several days where she had periods of pacing back and forth for hours while muttering to herself, sometimes shouting out loud. Can Brooke be diagnosed with Brief Psychotic Disorder?

No; the symptoms have lasted longer than would be expected in order to qualify for the disorder.

Roald is a clinician. A new patient has been admitted to the hospital for evaluation when he threatened his girlfriend and repeatedly telling her that he knew she was cheating on him. Roald has determined that in order to diagnose the patient, he needs to differentiate between delusional disorder and schizophrenia. Which one of the following situations would contribute to Roald diagnosing delusional disorder?

On the unit, the patient functions well, gets along, and does not show any unusual behaviors.

Keyon has been experiencing extrapyramidal side effects from his antipsychotic medication that concern him greatly. What types of side effects is Keyon most likely experiencing?

Pain in his muscles, restlessness, and repetitive shrugging that he can't control.

For several months, Ronda has been involved in Cognitive Enhancement Therapy (CET); she completes daily exercises or games on a laptop at the day treatment center, and also interacts with peers in structured exercises or situations with input from a counselor. What is the goal of this treatment?

Prevent the loss of neurons in the brain while improving cognitive functioning and improve social skills.

The medication that Oluchi has been prescribed for her psychotic symptoms is an antagonist agent. This means that the drug does what?

Prevents a neurotransmitter from sending a signal to the next neuron.

Mario was hospitalized for several weeks after being diagnosed with schizophreniform disorder. He was given an atypical antipsychotic which reduced the severity of his psychotic symptoms and was then transferred to a day treatment facility and group home for further care. What would be the next step in his treatment?

Psychosocial treatments to improve coping skills, educate his family, and occupational therapy.

Ramzi is a refugee who was recently placed in Utah; he is hoping to be able to find work and bring his family to join him. Lazio lives in Massachusetts and is currently a senior at MIT; he is hoping to graduate in the summer and marry his girlfriend. Which of these two men has a higher risk of developing Brief Psychotic Disorder?

Ramzi

Roland is anxious and upset. The psychologist he went to see just explained the assessment results and told him that he has schizoaffective disorder. Roland says, "What caused this? How could this happen?" What is the most accurate answer the psychologist could give?

Right now, we don't have a specific answer; it is probably due to a combination of genetic, biological, psychological, and social factors.

Carlos is concerned that he has inherited the gene that led to his father's development of schizophrenia. As a therapist speaking with Carlos about his anxiety, which statement could you make that would be the most accurate regarding his situation?

Schizophrenia results from the interactions of hundreds of genes and the environment.

If Stevie is showing evidence of positive signs of schizophrenia, what might that look like?

She demonstrates uncommon or unusual thoughts and behaviors.

Moubani's family notices that she appears to be having trouble speaking. She often only responds with one-word answers to questions and rarely starts or engages in conversation. They take her to the doctor, who emphasizes that she has schizophrenia and is experiencing negative symptoms. What does this mean?

She is experiencing a reduction or absence of the ability to converse and engage socially.

Aiko has been studying persons with schizophrenia who seem to have more negative symptoms than others with the illness. They also struggle to understand what other people are feeling during interactions or to understand why people make decisions and choices. Aiko's study participants appear to be impaired in what major area?

Social cognition

Anay has schizophrenia, hears voices, sometimes has difficulty in trying to express himself to others, and shows unusual behaviors at times. He lives in a place where his behaviors are seen as a channel or connection to the spiritual side of life, and he is physically and emotionally supported by his community and even sought out for input and insights to help others. This reduces his stress significantly, and he functions reasonably well in his community. Seeking to understand his situation in its own context is an example of what perspective?

Sociocultural perspective

Sophia is taking a typical antipsychotic for her schizophrenia while Madison was prescribed an atypical antipsychotic for her schizoaffective disorder. What is the major difference between these two drugs?

Sophia's medication is a strong antagonist for D2 receptors while Madison's is a weaker antagonist.

Cooper smoked marijuana at a party over the weekend, and on Monday, he was still experiencing hallucinations and was panicked about going to school. He acted paranoid and mistrustful of everyone, so the point where his family recommended him to a counselor. Which diagnosis best aligns with his symptoms?

Stimulant-induced psychosis

McCoy smoked marijuana for the first time at a recent party, and almost immediately, he felt experienced concerning hallucinations. He thought it was part of the experience, but then several days later, he was still hallucinating and excessively mistrustful of everyone around him. His roommate recommended that he see a counselor. There, his likely diagnosis will be

Stimulant-induced psychosis

What is the most accurate summary of the results of adoption studies in evaluating the impact of genetics on the etiology of schizophrenia?

Studies of adopted children at high risk for schizophrenia supported the diathesis-stress model.

Stefon is being treated in a partial hospitalization setting for schizophreniform disorder. He was placed on an atypical antipsychotic medication, but it does not seem to be working very well. Which of the following is a strategy that is likely to be attempted next by the psychiatrist?

Switch Stefon to another second-generation antipsychotic medication.

Which of the following persons is most likely to be diagnosed with brief psychotic disorder?

Taisha is a woman from Kenya who recently gave birth to her second child.

Felipe was diagnosed with schizophrenia when he was younger and was prescribed a first-generation antipsychotic medication to reduce the intensity of his psychotic symptoms. These drugs were initially developed based on what major idea at the time?

The Dopamine Hypothesis of schizophrenia

Thomas has been experiencing the sensation that spiders are crawling underneath his skin. He also usually lacks emotional expressiveness in his face or voice when he interacts with others, and he can be difficult to understand sometimes due to jumping around in his sentences or using words that do not exist. What would differentiate Thomas's diagnosis between schizophrenia and schizophreniform disorder?

The duration of his symptoms (how long he has been experiencing them).

Horacio is writing a research paper for his Abnormal Psychology course focused on schizoaffective disorder. When he comes to the section explaining the etiology of the disorder, what is the most accurate thing he can write?

There are no conclusive studies on the specific etiology of the disorder, but the origins are clearly biopsychosocial in nature.

Esteban has been very quiet in his interview with the psychiatrist. The psychiatrist says, "Esteban, you haven't said much so far. Can you tell me what you are thinking?" Esteban says, "Doc, you already know. Everyone on this block knows." What type of delusion is Esteban experiencing?

Thought broadcasting

Olivia is interested in research into schizophrenia. In particular, she wants to understand the role of genetics versus environmental influences in the development of the disorder. Which of the following is the best explanation of why she should avoid using the twin study design?

Twins share physical and social environments so this could interfere with separating the two influences.

Santiago is talking to a friend about the module on schizophrenia in his psychopathology course. The friend says, "That's the one they always show in the movies, right? It's the one that's like a disease and you just inherit it and can't do anything about it, right?" What is the most accurate reply Santiago can make to inform his friend?

Well, genetics are involved, but it's complicated and psychological and other influences are also important.

It is now eleven o'clock and Tyrone has not come out of his room nor had breakfast. Slightly concerned, his roommate knocks on the door and peeks into his room to find Tyrone hiding behind his desk. When he asks what is going on, Tyrone says that he knows that the Residential Assistant is monitoring his thoughts and plans to take over his body when he sees him next. What psychotic symptom is Tyrone experiencing?

a delusion

During a clinical interview, Elliott displays clear negative symptoms of schizophrenia. What does this refer to?

an absence or reduction of common behaviors, reactions, and emotions