Final Exam Study Guide- Abnormal PsychologyPsychotic phenomenon: • Psychosis: inability to tell the difference between what is real and what is not • Psychotic disorder: when that inability is distressing and impairing• Schizophrenia: most common type of psychotic disorderSchizophrenia:• Positive symptoms: characterized by the presence of unusual perceptions, thoughts, or behaviors (positive refers to the fact that symptoms are salient, added experiences) and includes:o Delusions: ideas that a person believes are true, but are highly unlikely or simply impossible (ex: voices in head, aliens are contacting me, radio told me to free the zoo animals) DSM4’s definition: involves phenomenon that one’s culture would regard as implausible Types of delusions: persecutory, reference (random events are directed at oneself), grandiose (great power/talent or is famous/powerful person), guilt or sin (unreasonably), somatic (altered perception of body), being controlled (thoughts/feelings/behaviors controlled by external force) Delusions are different from normal thoughts in bizarreness, preoccupation, & resistance Cultural relativism applies when diagnosing delusions (content differs across cultures) Usually different types of delusions are woven together in a complex belief systemo Hallucinations: unreal perceptual experiences- bizarre and extremely distressing/impairing Auditory hallucinations: most common (and more so in women than men), and sometimes voices talk to each other (can be aggressive, threatening, &/or give orders)o Disorganized thoughts/speech: formal thought disorder (loosening of associations or derailment, word salad, neologism)o Disorganized/catatonic behavior: Disorganized: unpredictable & un-triggered which explains disheveled appearance, inappropriate hygiene/clothing, shouting, swearing, pacing Catatonia: group of disorganized behaviors that resemble extreme lack of responsiveness• Negative symptoms: characterized by losses or deficits in certain domains (negative refers to the absence of behaviors, feelings, and experience) o Affective flattening: diminished or absent emotional responseso Alogia: inability to speak properly or at allo Avolition: general lack of drive or motivationo Negative symptoms are less bizarre/weird but they are associated with more impairment- they areless responsive to medication • Cognitive deficits: deficits in working memory, cognition, and attention that may cause-o Difficulty suppressing unwanted, irrelevant informationo Difficulty paying attention to relevant informationo Overall difficulties in reasoning, communication, and problem solving • Other symptoms:o Inappropriate affect: laughing at sad things, crying at happy thingso Anhedonia: lack of interest in everythingo Impaired social skills: more of a result of a symptom than a symptom itself• Phases of Schizophrenia: o Prodromal phase: symptoms present before full criteria is meto Acute: active psychosiso Residual phase: symptoms present after acute phase• Schizophrenia criteria: o At least 2 of the following for over a month: Delusions Hallucinations Disorganized speech Grossly disorganized or catatonic behavior Negative symptomso Social/occupational dysfunctiono Duration: continuous signs of the disturbance for over 6 months • Schizophrenia subtypes: o Paranoid Most researched type Prominent delusions and hallucinations Involves themes of persecution and grandiosity Often do not have disorganized speech or behavioro Disorganized Do not have well-formed delusions or hallucinations Very disorganized Odd, stereotyped behavior Poor hygiene Early onset, continuous course Often unresponsive to treatment Most disabled by disordero Catatonic Motor behaviors and way of speaking that suggests unresponsiveness to environment Clinical picture dominated by 2 or more of the following:• Motoric immobility• Excessive purposeless motor activity• Extreme negativism• Odd voluntary movement• Echolalia or Echopraxia o Undifferentiated Doesn’t fit into another type Early onset/chronic Difficult to treato Residual Have had one acute episode of positive symptoms Do not have prominent positive symptoms currently Have negative symptoms and mild positive symptoms left Chronic• Prevalence:o 1-2% lifetime prevalence o .5-2% lifetime prevalence worldwideo More common in men• Prognosis & course:o Schizophrenia is debilitatingo Life expectancy is 10 years shortero High relapse- 85% have residual and/or active symptomso Higher rates of infectious and circulatory diseaseso 10-15% die by suicide• Gender differences:o Age of onset: women late 20s to early 30s, men around 21 years oldo Course: women have better prognosis o Cognitive deficits: women show fewer cognitive deficits• Other psychotic disorders: o Schizoaffective o Schizophreniformo Brief psychotic disordero Delusional disorder• Biological theories:o Genetics: Higher concordance rate between MZ twins than DZ twins 50% likelihood to have schizophrenia if both parents have disordero Structured brain abnormalities: Enlarged ventricles Prefrontal cortex, limbic system, hippocampus Causes of abnormalities:• Birth complications: perinatal hypoxia• Prenatal virus exposure: high rate associated with flu in 2nd trimester• Neurotransmitters: overactive DA in mesolimbic pathway, underactive DA in prefrontal area• Psychosocial theories:o Schizophrenia associated with low SESo Social drift vs. Urban birth: social selection results in lower class relative to family (stressful circumstances at birth)o The schizophrenogenic mother: bad parenting can cause schizophrenia in childreno Communication problems: double binds (communicating conflicting messages)o Expressed emotion• The “two-hit” hypothesis: two different yet necessary malfunctions in the brain that cause schizophrenia. The first happens while a baby is still inside the womb. This could be from faulty genetics, bad brain cells, lack of oxygen during birth or even drugs or infections the mother might have in her body. The second hit happens later in life due to the brain changing as it grows, a major life stressor such as a young adult going to college or taking on a job after high school. The brain must be faulty and unable to process stress correctly (1st hit) so that when life stress happens (2nd) hit schizophrenia symptoms begin to come
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