CLP 4143 07 Final Exam Study Guide Psychotic Disorders Schizophrenia o 24 of exam questions o Important Topics to Review Definition of psychosis and how it relates to psychotic disorders Psychosis inability to tell the difference between what is real and unreal Positive Symptoms Defining features i e why referred to as positive o Added experience hallucinations and delusions o Characterized by the presence of unusual perceptions thoughts or behaviors Delusions Ideas that an individual believes are true but are highly unlikely or simply impossible Belief that someone really believes o Persecutory being persecuted watched conspired against o Reference random events are directed at oneself o Grandiose great power knowledge talent or a famous or powerful person terrible event o Guilt Sin committed a terrible act or responsible for a o Somatic appearance or part of body is diseased altered o Being Controlled thoughts feelings behaviors are being imposed controlled by external force o How do you differentiate delusions from normal self deception Delusions are different from thoughts we tell ourselves in at least three ways Bizarreness Preoccupation Resistance o Importance of culture Usually multiple different types of delusions are woven together in a complex belief system Specific content of delusions differs across cultures and cohorts Cultural relativism is important to consider when diagnosing delusions Hallucinations unreal perceptual experiences hallucinations in schizophrenia are bizarre and are extremely distressing and impairing o Auditory can hear most common Ex hearing voices when there is no auditory stimulus o Visual can see second most common Ex someone may see a person standing before them when there is no one there o Tactile on you Ex feels like something is crawling on your skin o Somatic inside of you Ex feeling electricity through one s body o Which are the most common Auditory Negative Symptoms Defining features i e why referred to as negative o Characterized by loses of deficits in certain domains Affective flattening absence of emotional responses Alogia absence of speech Avolition absence of goal oriented activities Compare and contrast positive vs negative symptoms Negative symptoms are less obvious but Negative symptoms are associated with more impairment Negative symptoms are less responsive to medication Disorganized Symptoms Disorganized thought and speech loosening of associations or derailment more common in men o Examples Word salad combination of words that make no sense Neoglism making up of new words Disorganized of catatonic behavior unpredictable and seemingly untriggered o Examples Echolalia making Echopraxia Repeating sounds that other people are Mimicking someone s behavior o What is catatonia group of disorganized behaviors that reflect extreme lack of responsiveness No psychomotor activity Passively holding single posture Stereotyped movements o Catatonic excitement wild agitation that is difficult to Other associated symptoms subdue Cognitive deficits Inappropriate affect told mom died reaction laughing Anhedonia lost of interest Impaired social skills Phases of Schizophrenia Prodromal phase before onset of full syndrome o Often negative symptoms Acute active phase of syndrome o Negative positive and disorganized symptoms o Last at least a month o Episodic Residual after acute phast o Negative symptoms at least 6 months o Chronic Chronic and episodic o Negative symptoms never go away o Psychotropic medications relieve positive symptoms Gender Differences Who is more likely to receive diagnosis o Men are more likely to receive diagnosis Differences pertaining to o Age of onset Women late 20s to early 30s Men around 21 years o Course Women have better prognosis o Cognitive deficits Women show fewer Factors Predicting Good Prognosis 1 Better functioning before disease onset 2 Acute onset 3 Later age at onset 4 Taking antipsychotic meds 5 Better inter episode functioning 6 No family history of schizophrenia or mood disorders Biological Approach Genetics o 50 concordance rate monozygotic twins vs 14 o 50 likelihood of having schizophrenia if both parents dizoygotic twins have the disorder Structural Brain Abnormalities o Enlarged ventricles o Smaller prefrontal cortex Birth Complications o Perinatal Hypoxia oxygen deprivation during birth o Prenatal Virus Exposure higher rates of schizophrenia associated with mom getting the flu in second trimester Neurotransmitters Risk Factors o Overactive dopamine in mesolimbic pathway positive o Underactive dopamine in prefrontal areas negative o Drug use as a teenager or young adult marijuana and hallucinogens o Family history of epilepsy Psychosocial Theories Describe the social drift theory individuals with schizophrenia more likely to fall to lower SES throughout life o Start in high SES low SES Describe the urban birth theory moms more likely to be exposed to infectious diseases during pregnancy o Low SES associated with stressors that slightly increase Two Hit Hypothesis risk for psychosis Something needs to occur when you are developing in the womb preexisting vulnerability Drug use or many stressors second hit Treatments Medications o Neuroleptics revolutionized treatment of schizophrenia Neurotransmitters involved Dopamine antagonists Problems Symptoms alleviated and not o Positive symptoms alleviated o Negative symptoms not alleviated non response rate o 25 relapse rate o 78 side effects o Grogginess dry mouth blurred vision sexual dysfunction o Akinesia slowed motor activity monotonous speech o Parkinsons like symptoms Dopamine connection lower levels o Tardive dyskinesia Involuntary repetitive body movements Irreversible long term 20 of individuals o Atypical Antipsychotics Neurotransmitters involved Side effects Generally bind to dopamine receptors but also influence other neurotransmitters Fewer neurological side effects dizziness nausea sedation weight gain irregular heartbeat type 2 diabetes and serious diseases Psychological o Cognitive approach Help individuals recognize and change attitudes o Behavioral approaches Social skills training Social learning therapy Modeling Problem solving skills Family based therapy Learning teaching Group therapy Increase social support Cluster A Personality Disorders o 20 of exam questions o Important Topics to Review How do we define personality disorders Impairment or distress A long standing pattern of problematic attitudes thoughts and feelings Can affect
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