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1 Know the positive negative symptoms of schizophrenia Positive Symptoms characterized by the presence of unusual perceptions thoughts or Positive refers to the fact that symptoms are salient added experiences behaviors delusions hallucinations disorganized thought or speech disorganized or catatonic behavior Negative Symptoms characterized by losses or deficits in certain domains people are less aware of these Negative refers to the absence of behaviors feelings experiences etc 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 Positive vs Negative negative symptoms are less obvious weird And not exactly bizarre BUT negative symptoms associated more with impairment negative symptoms are less responsive to medication 2 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 vs Normal Self Deception 3 main differences 1 Bizarreness self deceptions are at least possible whereas delusions are not people with self deceptions think about these beliefs occasionally but not to the point of it preoccupying 2 Preoccupation 3 Resistance people holding self deceptions typically aknowledge that their beliefs may be wrong but people holding delusions highly resistant to arguments or compelling their delusions them often are facts that contradict Types of Delusions 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 Thought Insertion Peron or object is inserting thoughts into one s head Thought Withdrawal thoughts are being removed Hallucinations unreal perceptual experiences hallucinations in schizophrenia are more bizarre and are extremely distressing and impairing Types of Hallucinations Auditory Most common hallucination e g hearing voices music etc Visual Tactile Somatic Second most common hallucination Often accompanied by auditory hallucinations Feeling that something is happening outside your body IE bugs crawling up your back Feeling that something is happening inside your body IE worms eating your intestines Disorganized Thought Speech aka Formal Thought Disorder Forms of disorganization Loosening of Associations or Derailment tendency to slip from one topic to a seemingly unrelated topic with little coherent transition Word salad extremely disorganized totally incoherent speech Neologisms made up words Clangs making associations between words based on sounds rather than content Disorganized or Catatonic Behavior Catatonia unresponsiveness to the world Catatonic excitement person becomes agitated for no apparent reason 3 Know the cognitive deficits of schizophrenia deficits in basic cognitive processes attention working memory difficulty focusing and maintaining their attention at will can hold info in their memory and manipulate it as a result it is difficult for them to distinguish the thoughts in their mind that are relevant to the situation at hand and to ignore stimuli in their environment that are not relevant to what they are doing also problems in problem solving and abstract thinking 3 5 What is the criteria for schizophrenia and the phases A Characteristic Symptoms 2 of the following for 1 month 1 Delusions 2 Hallucinations 3 Disorganized speech 4 Grossly disorganized or catatonic behavior 5 Negative symptoms B Social Occupational Dysfunction C Duration continuous signs of the disturbance for 6 months 1 month of this must meet Criterion A acute phase Phases of Schizophrenia Prodromal Phase symptoms present before full criteria is met Acute Progressive Phase active psychosis Residual Phase symptoms present after acute phase negative symptoms occur then everyone goes thru all 3 phases but in different time intervals can go back and forth between phases except prodromal 4 Know the major subtypes of schizophrenia Paranoid Preoccupation with one or more delusions or auditory hallucinations usually persecutory grandiose or both delusions are argument resistant those with it argue and defend themselves hardcore Do NOT show grossly disorganized speech or behavior Prognosis is better than other the other subtypes because symptoms of hallucinations delusions are easier to treat than other symptoms Disorganized Thoughts and behaviors are severely disorganized Disorganized speech Disorganized behavior Flat Inappropriate affect Do NOT have well formed delusions or hallucinations Course Prognosis Early onset continuous course Most disabling subtype Catatonic Two or more of the following are present 1 Motoric immobility catelepsy waxy flexibility or stupor 2 Excessive purposeless motor activity catatonic excitement 3 Extreme negativism or mutism motiveless resistance to all instruction or maintenance of rigid posture 4 Odd voluntary movement posturing stereotyped movements grimacing etc 5 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 not treatable 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 Paranoid disorganized catatonic differentiated by specific symptoms undifferentiated residual differentiated by acute vs attenuated mix of symptoms Schizoaffective disorder symptoms of schizophrenia occur with significant mood symptoms Schizophreniform disorder meet criteria for schizophrenia but for a period of 1 to 6 months Brief psychotic disorder meet criteria for schizophrenia but for a period of less than 1 month and sometimes in response to a major stressor Delusional disorder characterized primarily by the presence of nonbizarre


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FSU CLP 4143 - Notes

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