EXAM 3 STUDY GUIDEBased off of Learning Objectives and Slide ShowsCLASS: CLP 4143SCHIZOPHRENIA Know the positive & negative symptoms of schizophreniaPositive: 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 BehaviorNegative: 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 Severe reduction or complete absence of speech Avolition Inability to persist at common, goal-oriented tasks Know the characteristics of delusions, hallucinations, and catatonic behaviorDELUSIONSIdeas 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.Delusions of being controlled: Beliefs that one’s thoughts, feelings, or behaviors are being imposed or controlled by an external forceThought Broadcasting: thoughts are being broadcast from one’s mind for others to hear Insertion: Peron or object is inserting thoughts into one’s headWithdrawal: thoughts are being removedHALLUCINATIONSUnreal perceptual experiences. Hallucinations in schizophrenia are more bizarre and are extremely distressing & impairing.Auditory Most common hallucination hearing voices, music, etc.Visual Second most common hallucination Often accompanied by auditory hallucinationsTactile Feeling that something is happening outside your bodySomatic Feeling that something is happening inside your bodyCATATONIC BEHAVIORCatatonia Unresponsiveness to the worldCatatonic excitement Person becomes agitated for no apparent reason Know the cognitive deficits of schizophreniaDeficits in basic cognitive processes: Attention Working memory Know the major subtypes of schizophreniaDifferentiated by specific symptoms Paranoid o Preoccupation with one or more delusions or auditory hallucinations (usually persecutory, grandiose, or both)o Do NOT show grossly disorganized speech or behavioro Prognosis is better than other the other subtypes Disorganizedo Thoughts and behaviors are severely disorganizedo Disorganized speecho Disorganized behavioro Flat/Inappropriate affecto Do NOT have well-formed delusions or hallucinationsCourse & Prognosis:o Early onset & continuous courseo Most disabling subtype CatatonicTwo 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 Undifferentiatedo Symptoms met for schizophrenia (delusions, hallucinations, disorganized speech, negative symptoms) o Criteria not met for paranoid, disorganized, or catatonic. Residualo Previously experience at least one episode of acute positive symptoms of schizophreniao Do not currently show prominent positive symptomso May have negative symptoms and mild positive symptomso May be chronic over several years Know the key criteria for schizoaffective disorderCriteria:o Schizo symptoms must be present when mood symptoms are absent.o Not a Mood Disorder with psychotic features. Understand the gender differences in schizophreniaAge of onset Women have later onset than meno Women: onset late 20s or early 30so Men: onset late teens or early 20sCourse Women hospitalized less often and for briefer periods of time than men Women show milder negative symptoms between period of acute positive symptoms Women have better social adjustment when not psychoticCognitive Deficits: Women show fewer cognitive deficits. Know the biological factors that can influence the development of schizophreniaStructured Brain Abnormalitieso (Schizophrenia as a neurodevelopmental disorder)o Enlarged Ventricles (fluid filled spaces in the brain)Causes of Abnormalities: Birth Complicationso Perinatal Hypoxia Prenatal Virus Exposureo High rates of schizophrenia associated with flu during the second trimester Neurotransmitterso Overactive DA in mesolimbic pathwayo Underactive DA in prefrontal areas Know how family interaction patterns might play a role in schizophrenia Expressed emotiono Over-involvement in life of family member with schizophreniao Hostility towards family member with schizophreniao 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 schizophreniaBiological Neuroleptics:o Revolutionized treatment of schizophreniao Block receptors of dopamineo Reduces positive symptoms Atypical Antipsychoticso More effective o Reduces negative, as well as positive symptomso Fewer side effectsPsychosocial 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 effectso Discontinuation = 78% relapse (usually almost immediately) What is the primary form of treatment for schizophrenia? Neuroleptics (or antipsychotics) are theprimary typeof medication used for the treatmentofschizophrenia. ISSUES are listed above.PERSONALITY DISORDERS Know the three odd-eccentric personality disorders-CLUSTER A Paranoid
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