Abnormal Psych Final Exam Study Guide Chapter 8 Schizophrenia and Psychotic Disorders Schizophrenia disorder consisting of unreal or disorganized thoughts and perceptions as well as verbal cognitive and behavioral deficits At times may think and communicate clearly w accurate view of reality and function Other times thinking and speech disorganized lose touch w reality difficulty taking normally care of self Schizophrenia Spectrum 5 domains of symptoms that define psychotic disorders number severity and duration distinguish disorders from each other DSM 5 Positive Symptoms overt expressions of unusual perceptions thoughts and behaviors Delusions ideas that an individual believes are true but that are highly unlikely and often simply impossible Persecutory delusions false persistent beliefs that one is being pursued by other people Delusion of Reference false belief that external events such as other people s actions or natural disasters relate somehow to oneself Grandiose delusions false persistent beliefs that one has superior talents Delusions of though insertion beliefs that one s thoughts are being control Guilt or Sin responsible for terrible event Delusions vs Normal Self Deception and or traits by outside forces Bizzareness Preoccupation Resistance stress or drugs Auditory hallucinations Hallucinations unreal perceptual experiences not caused by sleep deprivation Most common hallucinations May consist of voices that speak the individual s thoughts aloud or carry a running commentary on the person s life Often have negative quality may criticize or threaten individual Tactile hallucinations perception that something is happening to the outside of the person s body Somatic hallucinations perception that something is happening to the inside of the person s body Disorganized Though and Speech Formal Though Disorder Disorganized thinking common in schizophrenia Tendency to slip from one topic to a seemingly unrelated topic Speech may sometimes be completely incoherent word salad May make up words that mean something only to themselves neologisms May make associations between words based on the sounds of the words rather than on content clang Schizophrenic men more likely to show language deficits that woman Disorganized or Catatonic Behavior May display unpredictable and apparently untriggered agitation sudden shouting swearing pacing May occur in response to hallucinations or delusions Catatonia disorganized behavior that reflects unresponsiveness to the environment Negativism lack of response to instructions Mutism showing rigid inappropriate or bizarre posture to a complete lack Catatonic excitement purposeless and excessive motor activity for no of verbal motor responses apparent reason Negative Symptoms deficits in functioning that indicate the absence of a capacity present in people without schizophrenia less responsive to medication than positive symptoms Restricted affect severe reduction in or absence of emotional expression in people with schizophrenia Fewer facial expressions no eye contact flat voice tone Avolition Associality inability to initiate or persist at common goal directed activities including those at work school and home Alogia inability to speak because of mental deficiency mental confusion Cognitive Deficits Deficits in attention memory and processing speed Relatives of people with schizophrenia also show such cognitive deficits to a lesser degree Cognitive deficits show before development of schizophrenia symptoms Emotional Social deficits Inappropriate affect laughing at sad things crying at happy things Anhedonia lack of interest in everything Impaired social skills Phases of Schizophrenia Prodromal Phase symptoms present before full criteria is met Acute active psychosis Residual Phase symptoms present after acute phase may relapse back into acute Diagnosis At least 2 of the previous symptoms for longer than 1 month Social occupation dysfunction Continuous signs of the disturbance for or equal to 6 months The Schizophrenias symptom heterogeneity subtypes no longer recognized in DSM 5 Prevalence 1 2 lifetime prevalence in US 5 2 lifetime prevalence worldwide More common in men women show less cognitive deficits Estrogen may affect dopamine regulation Age of onset Women late 20s early 30 s Men around 21 yrs Prognosis Life expectancy is 10 years shorter High relapse 85 have residual and or active symptoms Higher rates of infectious and circulatory diseases 10 15 die by suicide 40 60 still receive little to no care in a given year Course Group 1 15 have only single episode of illness w o subsequent impairment Group 2 25 have repeated episodes no impairment in between episodes Group 3 30 have repeated episodes with some impairment between Group 4 30 have repeated episodes with gradually worsening impairment Other Psychotic Disorders Schizoaffective Disorder mix of schizophrenia and a mood disorder Simultaneously experience psychotic symptoms and prominent mood symptoms that match criteria for a major depressive or manic episode Requires at least 2 weeks of hallucinations w o mood symptoms Schizophreniform Disorder schizophrenia symptoms preset 1 6 months more rare Functional impairments not necessary for diagnosis Brief Psychotic Disorder sudden onset of delusions hallucinations disorganized speech and or disorganized behavior but only lasts between 1 day 1 month May emerge following major stressor 1 in 10 000 women experience brief psychotic episodes shortly after giving birth Delusional Disorder delusions lasting at least 1 month regarding situations that occur in real life such as being following having a disease or being cheated on Rare only 2 lifetime prevalence and affecting females more than males Biological Theories Genetics Enlarged ventricles deterioration in brain tissue 50 concordance rate in monozygotic twins vs 14 in dizygotic twins 50 likelihood of having schizophrenia if both parents have the disorder Structured Brain Abnormalities Gross reduction in gray matter in cortex abnormality in white matter Abnormality in prefrontal cortex especially for those w family history Abnormal hippocampal activity when doing tasks that require encoding retrieving information Damage to Developing Brain Birth complications Perinatal hypoxia oxygen deprivation at birth or in the few weeks before or after birth As many as 30 with schizophrenia have history or perinatal hypoxia Prenatal Virus Exposure High rates of schizophrenia associated with flu Second
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