Abnormal Psych Exam 3 Review Schizophrenia Know the positive and 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 thoughts 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 Know the characteristics of delusions hallucinations and catatonic behavior delusions ideas that an individual believes are true but are highly unlikely or simply impossible delusions v normal self deception differences bizarreness preoccupations resistance persecutory being persecuted watched 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 force thought broadcasting thoughts are being broadcast from one s mind for others to hear insertion person or object is inserting thoughts into one s head withdrawal thoughts are being removed hallucinations unreal perceptual experiences hallucinations in schizophrenia are more bizarre and are extremely distressing and impairing auditory most common hallucination ex hearing voices music etc visual second most common often accompanied by auditory 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 negative 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 negative symptoms are less obvious weird and not exactly bizarre negative symptoms associated with more impairment less responsive to medication Know the cognitive deficits of schizophrenia deficits in basic cognitive processes attention working memory Know the major subtypes of schizophrenia paranoid preoccupation with one or more delusions or auditory hallucinations usually persecutory grandiose or both do not show grossly disorganized speech or behavior prognosis is better than other subtypes disorganized thoughts and behaviors are severely disorganized disorganized speech behavior flat inappropriate affect do not have well formed delusions or hallucinations course and prognosis early onset and continuous course most disabling subtype catatonic type of more of the following are present motoric immobility catelepsy waxy flexibility or stupor excessive purposeless motor activity catatonic excitement 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 symptoms met for schizophrenia delusions hallucinations disorganized speech negative symptoms criteria not met for paranoid disorganized or catatonic residual previously experience at least one episode of acute positive symptoms of schizophrenia do not currently show prominent positive symptoms may have negative symptoms and mild positive symptoms may be chronic over several years Know the key criteria for schizophrenia disorder characteristic symptoms 2 of the following for 1 month delusions hallucinations disorganized speech grossly disorganized or catatonic behavior negative symptoms social occupational dysfunction duration continuous signs of the disturbance for 6 months 1 month of this must meet criterion A acute phase phases prodromal phase symptoms present before full criteria is met acute progressive phase active psychosis residual phase symptoms present after acute phase Know the biological factors that can influence the development of schizophrenia gender difference age of onset course women have their later onset than men women onset late 20s or early 30s men onset late teens or early 20s women hospitalized less often and for briefer periods of time than men women show milder negative symptoms between periods of acute positive symptoms cognitive deficits women have better social adjustment when not psychotic women show fewer cognitive deficits there is no single gene that causes schizophrenia structures brain abnormalities schizophrenia as a neurodevelopmental disorder enlarged ventricles fluid filled spaces in the brain causes of abnormalities the second trimester birth complications perinatal hypoxia prenatal virus exposure high rates of schizophrenia associated with flu during neurotransmitters overactive DA in mesolimbic pathway underactive DA in prefrontal areas Know how family interaction patterns might play a role in schizophrenia expressed emotion over involvement in life of family member with schizophrenia hostility towards family member with schizophrenia 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 EE reduce the relapse rate Know the treatments for schizophrenia prognosis and course schizophrenia is debilitating life expectancy 10 years shorter 10 15 die by suicide long term outcomes most people stabilize within 5 10 years of their 1st episode show few relapses and moderately good level of functioning 20 to 30 of treated recover substantially within 10 to 20 years axis 1 condition the criteria for which include a mix of schizophrenia and mood disorder symptoms criteria schizo symptoms must be present when mood symptoms are absent not a mood disorder with psychotic features controversial diagnosis might be used when difficulties with differential diagnosis not the intended purpose low reliability across clinicians biological treatments neuroleptics revolutionized treatment of schizophrenia block receptors of dopamine reduces positive symptoms atypical antipsychotics more effective reduces negative as well as positive symptoms fewer side effects psychosocial treatments cognitive
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