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Schizophrenia | devastating psychotic disorder involving characteristic disturbances in thinking, delusions, perception, hallucinations, speech, emotions, Bhav |
3 categories of schizophrenia Emil Kraepelin 1899 | 1) Catatonia - immobility/ excited agitation 2) hebephrenia - silly/ immature emotion 3) paranoia - delusions of grandeur and persecution |
dementia praecox Kraepelin | latin - premature loss of mind, frequent appearance in adolescences, early term for schizo. |
Kraepelin's second contribution to understanding schizo. | defining the difference b/w manic depression/ bi-polar and schizo. |
Eugen Blauler 1908 associated splitting | - came up w/ term schizo. - separation among basic human functioning of personality that is seen by some as defining characteristic |
psychotic | unusual Bhav including: delusions, hallucinations |
positive symptoms | obvious signs of psychosis, delusions, hallucinations |
delusions 50-70% of ppl experience w/ schizo. | misrepresentation of reality, disorder of thought content |
3 different types of delusion | 1) delusions of grandeur 2) delusions of persecution 3) Cotard's syndrome 4)Capgras syndrome |
Cotard's Syndrome Capgras Syndrome | - person believes his/ her body has changed in some way - believes someone he or she knows has been replaced by double |
Hallucination | experience of sensory events w/out any input from surrounding environment |
auditory hallucinations fMRI results | higher metabolic activity in left primary auditory cortex, right middle temporal gyrus, mistake of higher persons own inner voice as outside or not themselves |
negative symptoms 25% of schizo.s experience | absence or insufficiency of normal Bhav: emotional w/drawal, apathy, poverty of thought, or speech |
Avolition/ Apathy | inability to initiate & persist in activities: little interest in daily life function, personal hygiene |
Avolition Stats | -28% of schizo.s experience - only related to emotional w/drawal and poor outcome |
Alogia | relative absence of speech, reflects negative thought disorder, trouble finding words to formulate right sentences |
Anhedonia | lack of pleasurable experiences or wish to partake: eating, social interactions, sexual relations |
Anhedonia stats | - linked to depression, relates to delay of seeking treatment - correlated to negative symptoms |
Affective flattening 2/3 of schizo experience | similar to ppl wearing a mask because, do not show emotions normally, stare vacantly, speak in flat tone, unaffected by what is going on around |
Asociality | severe deficits in social relationships, having few friends, little social interest, poor social skills |
Disorganized Symptoms | erratic Bhav affecting speech, motor Bhav, emotional reactions. |
disorganized speech | style of talking involving incoherence and a lack of typical logic patterns |
tangentiality | going off on tangents instead of answering a specific question |
inappropriate affect | laughing or crying at improper times, exhibit odd Bhav, holding postures, fidgeting, |
catatonic immobility | holding unusual postures, fearful something terrible may occur, waxy flexibility, keep bodies in positions that others put them in |
paranoid type of schizophrenia | delusions & hallucinations, generally do not have disorganized speech or flat affect, problems w/ social info processing & recognizing facial expression |
disorganized type of schizophrenia/ hebephrenic | disruption in speech & Bhav, flat affect, inappropriate affect, spend lots of time looking in mirrors, fragmented delusions, lacks remission |
catatonic type of schizophrenia | unusual motor responses, remaining in fixed positions, excessive activity, odd body & facial mannerisms, repeat of echo words & movements |
ecopraxia echolalia | - copy body movements of others -copying words of others |
4 types of catatonic stype | 1) negative w/drawal - lack of movement 2) Automatic - routine obedience 3) Repetitive/ echo 4) agitated/resistive |
undifferentiated type of schizo. | -individual does not fit into anyone category, major symptoms from more then one |
residual type of schizophrenia | one episode but no longer manifest major symptoms left w/ negative self image, asociality making it residual |
2 Crow's Model of Schizo | 1)type I - positive symptoms and treatment base 2) Type II - negative symptoms and treatment |
schizophreniform disorder | involves symptoms of schizophrenia for less then 6 months |
schizoaffective disorder | schizophrenia and mood disorder, individuals tend not to get better, it is a life long condition |
delusional disorder 20-34/100 000 ppl in pop. | persistent belief that is contrary to reality, subtypes: grandiose, jealous, persecutory, somatic, erotomanic |
brief psychotic disorder | psychotic disturbances including delusions, hallucinations, disorganized speech, Bhav, lasts only month after stress |
shared psychotic disorder/ folie a deux | condition in w/h an individual develops delusions simply as result of close rela. w/ delusional person |
3 Development and schizo | 1) more negative emotional reactions 2)brain damage in early years, progressive deterioration 3) tend to be remissions and degeneration throughout life |
2 Schizo Genetic | 1) Genes are responsible for causing some individuals to be vulnerable 2) multiple genes are responsible |
5 family studies | 1) severity of parents disorder influenced childs schizo. 2) all forms of schizo seen in families 3) may inherit any form of schizo not just one from parents 4) family risk for spectrum of psychotic disorders 5) more genes in common, more likely to get schizo |
3 Twin studies | 1) ID twins share 100% likelihood when raised together 2) faternal twins 50%3) genain quadruplets: all have schizo. w/ varying times of onset & severity |
3 Adoption Studies | 1) biological mother has schizo, adopted child has 5% of getting 2) mother has schizo & related psychotic disorder -child increases to 22% 3) protective factor if brought up in healthy home |
2 facts: offspring of twins | 1) 1.7% of children w/ schizo. have no parents w/ schizo 2) 17% chance of inheritance from mono, mono-co & di twin as parents, 2% chance from di-co twin |
2 genes increase likelihood of getting schizo after smoking weed | 1)COMT - catechol-O-methyltransferase VAL - valine = 158 alleles 2) compared to two copies of MET - methionine |
smooth-pursuit eye movement/ eye tracking | a marker for schizophrenia when individual cannot hold eye contact w/ pendulum swinging |
3 Dopamine T. supports | 1) Dopamine - too active, D2 2) L-Dopa produces schizo-like symptoms 3) Amphetamines increase schizo- symptoms |
3 Dopamine T. contradictions | 1) dopamine antagonists dont always work 2) neuroleptics block reception of dopamine symptoms subside for days/ weeks 3) drugs only slightly reduce negative symptoms |
3 theories involved in Neurotransmitters | 1) lack of D2 receptors striatum of basal ganglia 2) lack of prefrontal D1 receptors 3) blocking glutamate, NMDA receptor create psychotic like symptoms |
2 reasons forEnlarged Ventricles | 1) deficits in ability to attend reaction & exercises 2) increased size of ventricles - atrophy of brain or adjacent parts are not fully developed |
2 reasons for hypofrontality | 1) less activity in frontal lobe & dorsolateral prefrontal cortex due to Wisconsin card sorting task and eye tracking 2)thalmus, subcortical circuits, stratum |
3 viral influences on schizo. | 1) A2 influenza introduced in second trimester 2) second trimester problems w/ cell migration 3) ridge count may be an indicator |
5 stresses and schizo. | 1) high correlation w/ schizo. following extremely stressful events 2) 55% of a study had relapse w/out stressful event 3) lower class society increased schizo. = sociogenic hypothesis 4) social selection hypothesis - inability to hold job w/ schizo. 5) lack of social support |
schizophrenogenic | term for children w/ schizo as result of cold, unloving, dominant, rejecting mother |
double blind | communication style produced by conflicting messages of cold to love causing confusion in child, unsupported theory |
expressed emotion EE | higher levels of criticism, hostility, emotional overinvolvement creates higher relapse |
3 timeline Treatments | 1) 1930s lobotomy, ECT, insulin coma 2) 1950s neuroleptics (60% effective), chlorpromazine 3) 1990 clozapine, risperidone, olanzapine - 3/4 of patients, fewer side effects |
extrapyramidal symptoms | motor difficulties, Parkinsons like symptoms |
akinesia | expressionless face, slow motor activity, monotone speeach |
Tardive Dyskinesia | involuntary movement of tongue, mouth, jaw, face, protrusions of tongue, puffing of cheeks, puckering of mouth, chewing movements |
4 other side effects | 1) think/ concentration- 18% 2) salivation - 16% 3) blurred vision - 16% 4) negative view towards medication - 25% |
transcranical magnetic stimulation | used to stimulation area where auditory hallucinations are seen, improvement occurs, only decreased loudness |
4 psychosocial influences in treatment | 1) mainly not effective for actual schizo. 2) used to ensure compliance, use of drugs 3) self control through work & religion 4) group sessions encouraging self reliance, appropriate socialization |
token economy | residents could earn access to meals and small luxuries by behaving appropriately, daily activities |
7 Treatments for social skills | 1) role play 2) teaching social skills 3) independent living skills program 4) stress management intervention 5) community support over institutionalization 6) Bhav family therapy 7) vocational rehabilitation |
CBT and schizo | can be used to challenge delusions or hallucinations, to learn from trial and error that delusions in the mind |
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