Abnormal Psych Learning Objective Test 3 Schizophrenia Know positive and negative symptoms of Schizophrenia Positive Characterized by the presence of unusual perceptions thoughts or behaviors o Symptoms are salient added experiences Delusions ideas that the individual believes to be true but are highly unlikely or impossible Persecutory being persecuted watched or conspired against Reference random events are directed at ones self Grandiose great power knowledge talent or is a powerful famous person Guilt or sin committed a terrible act or is responsible for a terrible event Somatic appearance or part of body is altered diseased Delusions of being controlled beliefs that ones thoughts feelings or behaviors are being altered or controlled by an outside force o Thought broadcasting thoughts are being broadcasted from ones mind for others to hear o Insertion person or object is inserting thoughts into ones head o Withdrawal thoughts are being removed Hallucinations unreal perceptual experiences very bizarre impairing and distressing Auditory hearing voices music etc o Most common Visual often accompanied by auditory hallucinations o Second most common Tactile feeling like something is happening outside of your body Somatic feeling like something is happening inside your body Disorganized thought or speech Formal Thought Disorder Loosening of Associations or Derailment tendency to slip from one topic to another unrelated topic without coherent transition Word salad extremely disorganized incoherent speech Neologisms made up words Clangs making associations between words based on sounds other than meaning or content Disorganized or catatonic behavior Catatonia unresponsiveness to the world Catatonic excitement person become agitated for no apparent reason Negative Characterized by loss or deficits in certain domains o Refers to loss of behaviors feelings experiences etc Affective flattening or blunted affect severe reduction or loss completely of emotional affective responses to the environment Alogia severe reduction or complete loss of speech Avolition inability to persist at common goal oriented tasks NEGATIVE SYMPTOMS LESS OBVIOUS AND WEIRD BUT MORE IMPAIRING AND DISTRESSING LESS RESPONSIVE TO MEDICATION Cognitive Deficits Attention Working memory Major Subtypes Paranoid 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 the other subtypes Disorganized o Thoughts and behaviors are severely disorganized Disorganized speech Disorganized behavior Flat Inappropriate affect o Do NOT have well formed delusions or hallucinations o Course Prognosis Early onset continuous course Most disabling subtype Catatonic o Two or more of the following are present Motoric immobility catelepsy waxy flexibility or stupor excitement Excessive purposeless motor activity catatonic Extreme negativism or mutism motiveless resistance to all instruction or maintenance of rigid posture Odd voluntary movement posturing stereotyped movements grimacing etc Echolalia senseless repetition of words or Echopraxia repetitive imitation of movements Undifferentiated o Symptoms met for schizophrenia delusions hallucinations disorganized speech negative symptoms o Criteria not met for paranoid disorganized or catatonic Residual 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 Gender Differences Age of onset Women have their later onset than men Women onset late 20s or early 30s Men onset late teens or early 20s Course Women hospitalized less often and for briefer periods of time than Women show milder negative symptoms between period of acute men positive symptoms Women have better social adjustment when not psychotic Cognitive Deficits Women show fewer cognitive deficits Key Criteria for Schizoaffective Disorder Criteria o Schizo symptoms must be present when mood symptoms are absent o Not a Mood Disorder with psychotic features Biological Factors Structured Brain Abnormalities o Schizophrenia as a neurodevelopmental disorder Enlarged Ventricles fluid filled spaces in the brain Causes of Abnormalities Birth Complications Perinatal Hypoxia deprivation of oxygen Prenatal Virus Exposure High rates of schizophrenia associated with flu during the second trimester Neurotransmitters Overactive DA in mesolimbic pathway delusions Underactive DA in prefrontal areas catatonic Family Interactions Role in Development No single gene for Schizophrenia Treatments Issues Biological Treatments o Neuroleptics o Issues Revolutionized treatment of schizophrenia Block receptors of dopamine Reduces positive symptoms 25 of people don t respond at all More effective with positive symptoms than negative symptoms Significant side effects Discontinuation 78 relapse usually almost immediately o Atypical Antipsychotics More effective Reduces negative as well as positive symptoms Fewer side effects Psychosocial Treatments o Expressed emotion Over involvement in life of family member with Hostility towards family member with schizophrenia schizophrenia Outwardly held belief that family member with schizophrenia has control over symptoms o Greater relapse of psychosis in families with high expressed emotion o Interventions to reduce EE reduce the relapse rate o Cognitive interventions help recognize and change demoralizing attitudes o Behavioral interventions teach important skills o Social interventions increase social support Personality Disorders Cluster A Oddcentric Personality disorders Paranoid Personality Disorder o Pervasive distrust suspiciousness of others o Motives interpreted as malevolent o As indicated by 4 of the following W out basis suspects others are exploiting harming or deceiving Preoccupied w unjustified doubts about the loyalty trustworthiness of friends or associates Reluctant to confide because of unwarranted fear that info will be used maliciously against him or her Reads hidden demeaning or threatening meaning in benign remarks events Persistently bears grudges unforgiving Perceives attacks on character or reputation that are not apparent to others and is quick to react angrily or to counterattack Recurrent suspicions w out justification regarding fidelity o Themes unwarranted concerns and chronicity o
View Full Document
Unlocking...