Learning Objectives for Psychotic Disorders Readings for this topic include all of Chapter 8 in the textbook Remember information in addition to what is on the pages listed will be discussed in class for some of the objectives 1 What does psychosis mean Psychosis inability to tell the difference between what is real and unreal 2 Describe the specific symptoms that fall within the psychotic symptom categories of positive negative and disorganized e g hallucinations are symptoms that fall under positive symptoms Positive Symptoms Characterized by the presence of unusual perceptions thoughts or behaviors Positive refers to the fact that symptoms are salient added experiences Includes o Delusions o Hallucinations Ideas that an individual believes are true but are highly unlikely or simply impossible Unreal perceptual experiences Hallucinations in schizophrenia are bizarre and are extremely distressing impairing Negative Symptoms o Affective Flattening The person s range of emotional expression is clearly diminished poor eye contact reduced body language the inability to speak because of mental defect mental confusion or aphasia It is a speech disturbance that can be seen in people with dementia o Alogia o Avolition a lack of interest or engagement in goal directed behavior Disorganized symptoms Disorganized thought and speech o Loosening of associations or derailment o Word salad so disorganized Jumble of words not a coherent sentence o Neologisms making up words that they understand but no one else does Disorganized or catatonic behavior o Disorganized unpredictable and seemingly untriggered o Shouting swearing pacing o Echolalia repeating someone elses words o Echopraxia repeating someone elses movements Catatonia group of disorganized behaviors that reflect extreme lack of responsiveness No psychomotor activity Passively holding single posture Stereotyped movements Catatonic excitement wild agitation that is difficult to subdue 3 Describe the three phases that make up the course of schizophrenia What kinds of symptoms are 4 Describe the prevalence and prognosis for schizophrenia What factors are associated with better likely to characterize each phase Prodromal Phase before onset of full syndrome o often negative symptoms Acute active phase of syndrome o negative positive disorganized symptoms Residual Phase after acute phase 1 2 lifetime prevalence in the U S prognosis Schizophrenia is more common in men Life expectancy is 10 years shorter than average High relapse rate 85 have residual and or active symptoms Higher rates of infectious circulatory diseases More likely to be victims of crime 10 15 die by suicide Factors predicting better prognosis Better functioning before disease onset Acute onset Later age at onset Taking antipsychotic medications throughout disease Better inter episode functioning No family history of schizophrenia or mood disorders 5 What are the biological psychosocial and biopsychosocial theories of Schizophrenia Genetics o 50 concordance rate MZ twins vs 14 DZ twins o 50 likelihood of having schizophrenia if both parents have the disorder Structural Brain Abnormalities o Enlarged Ventricles o High rates of schizophrenia associated with mom getting the flu in second trimester o Smaller Prefrontal Cortex Birth Complications o Perinatal Hypoxia Prenatal Virus Exposure Neurotransmitters o Overactive dopamine in mesolimbic pathway o Underactive dopamine in prefrontal areas Other Biological Risk factors o Drug use as a teenager or young adult primarily marijuana hallucinogens o Family history of epilepsy Psychosocial life Urban Birth o Schizophrenia more common among folks of low SES o Social Drift Individuals with schizophrenia more likely to fall to lower SES throughout o Moms more likely to be exposed to infectious diseases during pregnancy o Low SES associated with stressors nutrition security that slightly increase risk for psychosis 6 What is the two hit hypothesis o The Two Hit Hypothesis o Something must occur in vitro oxygen depravation or some other event combined with a second hit later in life that combines with the predisposition to create psychosis 7 What are the biological and psychological treatments for Schizophrenia Biological Treatments o Medication Treatments Neuroleptics revolutionized treatment of schizophrenia Dopamine antagonists Reduction of positive symptoms Examples Thorazine chlorpromazine Haldol butyrophenones and o Issues Navene thioxanthenes 25 of people don t respond More effective with positive symptoms than negative symptoms Discontinuation 78 relapse Side Effects depression etc o Grogginess dry mouth blurred vision drooling sexual dysfunction weight gain o Akinesia slowed motor activity monotonous speech lack of facial expression o Parkinson s like symptoms Dopamine connection o Tardive dyskinesia Involuntary repetitive body movements Irreversible long term side effect 20 of individuals Atypical Antipsychotics o Generally bind to dopamine receptors but also influence other neurotransmitters o Fewer neurological side effects but still have side effects that include dizziness nausea sedation weight gain irregular heartbeat Type II diabetes serious diseases o Examples clozapine olanzapine risperidone Psychological Treatments o Cognitive Therapies o Behavioral Therapies Social skills training Problem solving skills Help individuals recognize and change attitudes To increase ability to ask for help To help them understand that the hallucinations are a part of their thoughts Learning Objectives for Personality Disorders Cluster A Readings for this topic include all of Chapter 9 Remember information in addition to what is on the pages listed will be discussed in class for some of the objectives 1 Describe how personality differs from personality disorder o Personality styles of thinking feeling and behaving that make each of us unique o Relatively stable across time and situations Individuals mostly act the same way at all times o Personality disorder o A long standing pattern of problematic attitudes thoughts and feelings o Can affect relationships identity and or behavior o Present in a variety of contexts e g romantic relationships work settings friendships 2 Identify factors which bring people with personality disorders in to seek treatment o Seeking treatment o Most people experience their way of seeing the world as normal o Comorbid psychopathology o Romantic relationship is at a breaking point Vocational problems Arrested or
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