PSYC 410 1st EditionFinal Exam Study GuideChpater 11 - Schizophrenia and Related DisordersReality testing – the ability to perceive the world accurately and distinguish reality from fantasy-3 spheres: who, where, and what time or day-Out of touch with reality includes having delusions or hallucinationsFirst psychotic break – the first time that an individual has delusions or hallucinations-Usually happens between late adolescence (16) and early adulthood (25)3 Phases: prodromal phase, acute phase, residual phaseA) Schizophrenia-Characterized by delusions, hallucinations, disorganized speech, grossly disorganized or catatonic behavior, and negative symptoms (prodromal symptoms)-Must have two or more of these symptoms, but one must be either delusions, hallucinations, or disorganized speech-An individual cannot properly manage day-to-day life-Continuous symptoms persist for at least 6 monthsHallucinations – sensory perceptions in the absence of external stimuliDelusions – fixed false beliefsa) Delusions of persecution or paranoia – thinking that someone is out to get you or is making fun of youb) Delusions of reference – something ordinary is specifically intended for youc) Delusions of control – belief that external forces are controlling youd) Delusions of grandeur – belief that you are a very important or special personDisorganized Speech- Poverty of speech – slow, limited, vague speech- Complete incoherence- Neologisms – made-up words- Perseveration – repetition of words or phrases- Clanging – rhythmic, rhyming speech (“psychotic rap”)- Blocking – involuntary interruption of speech or thought- Ecolalia – repetition of the last part of a sentence or word- Derailment – completely lose track of one’s thoughtEtiology of Schizophrenia- Genetic component – in a family where someone has schizophrenia, there is a higher occurrence of other mental disorders- Level of dopamine – associated with hallucinations- Ventricles (spaces) in brain are larger- Less gray matter in brain- Viral theory – exposure to virus in vitro may contribute to schizophrenia- Positive correlation between low birth weight and schizophreniaCatatonic behavior – an individual is relatively unresponsive may exhibit rigidity and waxy flexibility (if you move them, they stay in the position)Heightened expressed emotion – low levels of empathy, tolerance, flexibility, and warmth-causes conflict eruption-people with schizophrenia living in this type of environment are more than 2 times as likely to have a relapseSchizophrenogenic mother – cold, aloof, overprotective, and domineering-Used to be thought that this type of mother could cause her children to develop schizophrenia, but this theory has been discredited.Treatmenta) Anti-psychotic medication – is highly sedatingb) Atypical psychotic medication – not as many side effects and tends to be more effectivec) Psychotherapy – more successful in highly functioning schizophrenicsa. Family therapy is also importantB) Schizophreniform-Same diagnostic criteria as for schizophrenia-Symptoms must be present for at least 1 month, but not last more than 6 monthsC) Brief Psychotic Disorder-Characterized by delusions, hallucinations, disorganized speech, and grossly disorganized or catatonic behavior (must have at least 1 of the first 3 symptoms)-Duration is at least 1 day, but less than 1 monthD) Schizoaffective-Uninterrupted period of illness concurrent with schizophrenia-Delusions or hallucinations for 2 or more weeks-Major mood episode symptoms present for majority of illness-Similar to bipolar and major depressive disorder with psychotic featuresE) Delusional Disorder-The presence of one or more delusions within 1 month or longer-Functioning is not impaired or bizarre apart from the delusion6 Different types:a) Erotomanic – delusional beliefs that someone else is in love with youb) Grandiose – inflated beliefs about one’s own worth, importance, powerc) Jealous – delusions of jealousy in which the person believes their spouse is unfaithfuld) Persucatory – beliefs that a person is being conspired against, followed, spied on, etc.e) Somatic – delusions involving bodily functions and sensesf) Mixed – a combination of several types of delusionsChapter 6Dissociative DisordersA) Dissociative Identity Disorder-Used to be called Multiple Personality Disorder before 1994 (DSM-3)-Did not meet reliability criteria to be included in the DSM-5, but was anyways due to the influence of one specific person-A rare and controversial disorderDiagnostic Criteria-Disruption of identity characterized by two or more distinct personality states-Marked discontinuity in sense of self-Alterations in affect, behavior, cognition, etc.-Gaps in the recall of everyday events or important personal information-Since dissociation is a defense mechanism, the disorder is thought to originate from a traumatic childhood event.B) Dissociative Amnesia Disorder-The inability to recall important autobiographical information-Tends to occur around a traumatic or stressful eventDissociative Fugue – a person suddenly forgets all past memories and assumes a new identity-The purpose of treatment is to integrate all personalitiesC) Depersonalization/Derealization DisorderDepersonalization – experiences of being an outside observer to oneselfDerealization – experiences of unreality with respect to one’s surroundings-Reality testing remains intact during experiences of depersonalization or derealizationSomatic Symptom and Related DisordersA) Somatic Symptom Disorder-Excessive concern over troubling physical symptoms that it disrupts daily life-Characterized by persistent thoughts about symptoms, anxiety about symptoms, and excessive time and energy devoted to symptoms-Patient may visit many different doctors in an effort to explain symptoms (doctor shopping)B) Illness Anxiety Disorder-Preoccupation with having or acquiring a serious undiagnosed illness-Physical symptoms are either very mild or not present-Characterized by high level of anxiety about healthC) Conversion Disorder-Characterized by symptoms which affect voluntary movements (like walking) or impair sensory functions (like sight or hearing)-There is no medical explanation for symptoms-Is thought to be a defense mechanism as a result from traumatic experiences and/or emotionaldistressD) Factitious Disorder-Physical or psychological symptoms are made up with no apparent motive-Is also