EXAM 3 STUDY GUIDE Based off of Learning Objectives and Slide Shows CLASS CLP 4143 SCHIZOPHRENIA Know the positive negative symptoms of schizophrenia Positive Characterized by the presence of unusual perceptions thoughts or behaviors Positive refers to the fact that symptoms are salient added experiences Delusions Hallucinations Disorganized Thought and Speech Disorganized or Catatonic Behavior Negative Characterized by losses or deficits in certain domains Negative refers to the absence of behaviors feelings experiences etc Affective Flattening or Blunted Affect Severe reduction or complete absence of affective emotional responses to the environment Alogia Avolition Severe reduction or complete absence of speech Inability to persist at common goal oriented tasks Know the characteristics of delusions hallucinations and catatonic behavior DELUSIONS Ideas that an individual believes are true but are highly unlikely or simply impossible Persecutory being persecuted watched and or conspired against Reference random events are directed at oneself Grandiose great power knowledge talent or is a famous powerful person Guilt or Sin committed a terrible act or responsible for a terrible event Somatic appearance or part of body is diseased altered Beliefs that one s thoughts feelings or behaviors are being imposed or controlled by an external force thoughts are being broadcast from one s mind for others to hear Insertion Peron or object is inserting thoughts into one s head Delusions of being controlled Thought Broadcasting Withdrawal thoughts are being removed HALLUCINATIONS Auditory Most common hallucination hearing voices music etc Visual Second most common hallucination Often accompanied by auditory hallucinations Unreal perceptual experiences Hallucinations in schizophrenia are more bizarre and are extremely distressing impairing Tactile Feeling that something is happening outside your body Somatic Feeling that something is happening inside your body CATATONIC BEHAVIOR Catatonia Unresponsiveness to the world Catatonic excitement Person becomes agitated for no apparent reason Know the cognitive deficits of schizophrenia Deficits in basic cognitive processes Attention Working memory Know the major subtypes of schizophrenia Differentiated by specific symptoms Paranoid Disorganized o Preoccupation with one or more delusions or auditory hallucinations usually persecutory grandiose or both o Do NOT show grossly disorganized speech or behavior o Prognosis is better than other the other subtypes o Thoughts and behaviors are severely disorganized o Disorganized speech o Disorganized behavior o Flat Inappropriate affect o Do NOT have well formed delusions or hallucinations Course Prognosis o Early onset continuous course o Most disabling subtype Catatonic Two or more of the following are present o Motoric immobility catelepsy waxy flexibility or stupor o Excessive purposeless motor activity catatonic excitement o Extreme negativism or mutism motiveless resistance to all instruction or maintenance of rigid posture o Odd voluntary movement posturing stereotyped movements grimacing etc o Echolalia senseless repetition of words or Echopraxia repetitive imitation of movements Differentiated by acute vs attenuated mix of symptoms Undifferentiated Residual o Symptoms met for schizophrenia delusions hallucinations disorganized speech negative symptoms o Criteria not met for paranoid disorganized or catatonic o Previously experience at least one episode of acute positive symptoms of schizophrenia o Do not currently show prominent positive symptoms o May have negative symptoms and mild positive symptoms o May be chronic over several years Know the key criteria for schizoaffective disorder o Schizo symptoms must be present when mood symptoms are absent o Not a Mood Disorder with psychotic features Understand the gender differences in schizophrenia Criteria Age of onset Women have later onset than men o Women onset late 20s or early 30s o Men onset late teens or early 20s Course symptoms Cognitive Deficits Women hospitalized less often and for briefer periods of time than men Women show milder negative symptoms between period of acute positive Women have better social adjustment when not psychotic Women show fewer cognitive deficits Know the biological factors that can influence the development of schizophrenia Structured Brain Abnormalities o Schizophrenia as a neurodevelopmental disorder o Enlarged Ventricles fluid filled spaces in the brain Causes of Abnormalities Birth Complications o Perinatal Hypoxia Prenatal Virus Exposure o High rates of schizophrenia associated with flu during the second trimester Neurotransmitters o Overactive DA in mesolimbic pathway o Underactive DA in prefrontal areas Know how family interaction patterns might play a role in schizophrenia Expressed emotion o Over involvement in life of family member with schizophrenia o Hostility towards family member with schizophrenia o Outwardly held belief that family member with schizophrenia has control over symptoms Greater relapse of psychosis in families with high expressed emotion Interventions to reduce expressed emotion reduce the relapse rate Know the treatments for schizophrenia Biological Neuroleptics o Revolutionized treatment of schizophrenia o Block receptors of dopamine o Reduces positive symptoms Psychosocial Atypical Antipsychotics o More effective o Reduces negative as well as positive symptoms o Fewer side effects Cognitive interventions help recognize and change demoralizing attitudes Behavioral interventions teach important skills Social interventions increase social support Understand the issues associated with drug therapies for schizophrenia Issues with Neuroleptics o 25 of people don t respond at all o More effective with positive symptoms than negative symptoms o Significant side effects o Discontinuation 78 relapse usually almost immediately What is the primary form of treatment for schizophrenia Neuroleptics or antipsychotics are the primary type of medication used for the treatment of schizophrenia ISSUES are listed above PERSONALITY DISORDERS Know the three odd eccentric personality disorders CLUSTER A Paranoid Personality Disorder Schizoid Personality Disorder Schizotypal Personality Disorder What are the key characteristics of paranoid PD schizoid PD and schizotypal PD Paranoid Personality Disorder o Pervasive distrust suspiciousness of others o Motives interpreted as malevolent Schizoid Personality
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