Abnormal Exam 3 Spring 2014Schizophreniao Definition: Major disturbances in thought, emotion, and behavioro Disordered thinking Ideas not logically related Faulty perception and attentiono Lack of emotional expressiveness Inappropriate or flat emotions o Disturbances in movement or behavior Disheveled appearanceo Can disrupt interpersonal relationships, diminish capacity to work or live independently, and significantly increases rates of suicide and death- Describe the criteria for Schizophrenia.o Two or more symptoms lasting for at least 1 month, One symptom should be 1,2, or 3 (e.g. positive symptom)1. Delusions2. Hallucinations3. Disorganized Speech4. Abnormal Psychomotor behavior (catatonia)5. Negative Symptoms (blunted affect, avolition, asociality)o Signs of disorders must last at least 6 months; at least 1 month of the symptoms above; or, if during a prodromal or residual phase, negative symptoms or two or more of symptoms 1-4 in less severe form- Describe positive and negative symptoms of schizophreniao Positive symptom are behaviors not seen in healthy people and usually involve a loss of contact with reality, including delusions and hallucinations.o Negative symptoms refers to reductions in normal emotional and behavioral states, suchas avolition, alogia, anhedonia, blunted affect (Exhibits little or no affect in face or voice),and asociality. - Describe the following terms:o Anhedonia: Inability to experience pleasure Consummatory pleasure Anticipatory pleasureo Avolition: Lack of interest; apathyo Alogia: reduction in speecho Akesthesia: Inner restlessness or the inability to sit stillo Asociality: Inability to form close personal relationships- Describe delusions that are typical of schizophrenics.o Delusions Firmly held beliefs Contrary to reality Resistant to disconfirming evidenceo Types of delusions: Persecutory delusions- “The CIA planted a listening device in my head”- 65% have these Thought insertion- The idea that another thinks through the mind of the person. The person may be unable to distinguish between their own thoughts and those he believes were inserted into his mind. Thought broadcasting- A belief that others can hear or are aware of an individual’s thoughts. Thisdiffers from telepathy in that the thoughts being broadcasted are thought to be available to anybody. Outside control Grandiose delusions- Characterized by fantastical beliefs that one is famous,=omnipotent, wealthy, or otherwise very powerful.= Ideas of reference- Delusions where one interprets innocuous events as highly personally significant. Ex. A woman rarely leaves her house, because she experiences all conversation or laughter she hears as directed at herself.- What are some of the theories regarding causes of schizophrenia?o Genetic causes of schizophrenia (Heston)o Dopamine Theoryo Brain structure and function Enlarged Ventricles (which implies loss of brain cells) Prefrontal Cortex dysfunction Abnormal Interactions between different areas of the brain (disconnection syndrome) Reduced gray matter and volume in temporal cortexo Environmental Factors Damage during gestation or birth (e.g. reduced oxygen supply in delivery) Viral damage to the fetal brain (rates are higher for mothers w/flu in 2nd trimester)o Developmental Factors Stress in adolescence and early adulthood activates HPA system with triggers cortisol secretion, which in turn increases dopamine activity Excessive pruning of synaptic connections Use of cannabiso Stress Factorso Family Factors Expressed Emotion (EE): Hostility, critical comments, emotional over-involvement - Describe Communication deviance (CD)?o A family factor for Schizophreniao Hostility and poor communicationo Inconclusive at this timeo Defined as unclear or incomplete messages and excessive speech rates that result in poor understanding on the part of the receiver- Describe the results of Heston Study in 1966 on genetics of Schizophrenia.o One of the first large adoption studies identified 47 adopted children whose biological mothers had schizophrenia. He compared these children to a group of children from the same foster homes whose biological mothers did not have schizophrenia. o Heston found that 16.6 percent of the children of schizophrenic mothers became schizophrenic as adults, compared to none of the control children. o Thus, even though none of the children were raised by schizophrenic parents, the children who had schizophrenia in their biological families were more likely to develop the disorder- What is the Dopamine Theory of Schizophrenia?o Disorder due to excess levels of dopamine Drugs to alleviate symptoms reduced dopamine activity Amphetamines, which increase dopamine levels, can induce a psychosis.o The dopamine hypothesis of schizophrenia is a model attributing symptoms of schizophrenia (like psychoses) to a disturbed and hyperactive dopaminergic signal transduction. The model draws evidence from the observation that a large number of antipsychotics have dopamine-receptor antagonistic effects. o Revised Theory: Excess number of dopamine receptors or oversensitive dopamine receptors Localized mainly in the mesolimbic pathway- Mesolimbic dopamine abnormalities mainly related to positive symptoms- Describe how social economic status (SES) may influence schizophrenia?o Highest rates of schizophrenia are among the urban poor. o Poverty causes psychological stress- Sociogenic hypothesiso Stress of poverty causes disorder.- Social selection theory o Downward drift in socioeconomic status due to mental illness.o Research supports social selection- What is one of the side effects of anti-psychotic medications? (Extrapyramidal side effects -e.g.,Tardive dyskinesia).o Side effects of first-generation antipsychotics (1950’s) Extrapyrmidal side effects- Tardive Dyskinesia: involves involuntary movements, especially of the lower face. Tardive means "delayed" and dyskinesia means "abnormal movement."- Neurolepric Malignant Syndrome: syndrome is characterized by=high fever, stiffness of the muscles, altered mental status (paranoid behavior), and autonomic (nervous system) dysfunctiono Side effects of second-generation antipsychotics Can impair immune system functioning Siezures, dizziness, fatigue, drooling, weight gain These have fewer motor side effects and reduces relapse. Impacts serotonin receptors- Chapter 14: Late Life and
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