exam 3 study guide.docx

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Psychological & Brain Sciences
CAS PS 371
David Shim

Study Guide for Exam 3 Schizophrenia Spectrum Psychosis: loss of contact Bleuler’s definition of schizophrenia: break from reality—he created the term schizophrenia Kraepelin & “dementia praecox”- was the name that kraeplin refers to as schizophrenia (was this at that time) -develops earlier in life and in adol or adulthood -lesion theory: brain structure (frontal lobe develops by then) Delusions: fixed beliefs that are not amenable when faced with contradictory info Hallucinations: perceptual experiences without external stimuli -neuro-imaging findings: auditory perceptions are cog errors Disorganized Thinking: thinking is shown through disorganized speech -derailment: loss association (changing topics) -tangentiality: word salad (keep going) -incoherence -example of the guy who kept talking about nothing Prodromal: before the active phase (atleast 6 months apart) -mild break down and mild disorganized speech -neg symptoms Residual: after active, the neg symptoms (magical thinking but not the del and hall) Active- the psychotic break (the active symp -3 top ones)- POS SYMPTOMS ONLY DURING THE ACTIVE PHASE!!! -this one has to be atleast one month -all in combination have to be there for atleast 6 months Grossly disorganized/abnormal behavior: abnormal motor beh, child like, and are not goal directed -catatonic: dec in reactivity to the environment negativism, stupor, catatonic excitements -mutism: stop talking -echopraxia: repeating beh and also echolalia (words) Negative symptoms -diminished emotional expression -avoilition: lack of interest and motivation -alogia: do not speak or say much (but are capable of talking) -anhedonia: impairment in ability to enjoy life -asociality: lack of interest in socializing Schizotypal Personality Disorder: impairment in cog and perceptual capacity, eccentric beh, soc or interpersonal impairments: begins in childhood and adol but not really psychotic bec they are still on the functional side -criteria: 5 of the 9 -ideas of reference -odd beliefs -unusual perceptual experiences -odd thinking and speech -suspicious or paranoid ideation -inaprop or constricted affect -odd eccentric beh -lack of close friends -excessive social anxiety does not occur only during the course of this disorder: also bipolar, depressive, and psychotic features of ASD -as a “premorbid”: if person is later diagnosed with schi (prodromal) Delusional Disorder: in dms4: had to be non bizzare but in dsn5 they can be bizzare but they just cant affect functioning too much (functioning is not markedly impaired) Types & duration - erotmanic (sexual) , grandiose (qualities that others don't know about), jealous (cheating on you when you are cheating), persecutory (someone is out to get you), somatic (health and organs not mixed with ocd and body dismorphic) , mixed (flow through all of them), and unspecified (something is wrong but don't know what) -duration: 1 month atleast (can have one or more—most people have more) Specifiers: -bizzare content -first episode or multiple, acute, partial or full remission, cont, or unspec Types that lead to legal problems: erotmanic and jealous (domestic violence and stalking) Brief Psychotic Disorder: one or more the following (have to have one of the first 3) Criteria & duration -hallucinations -delusions -disorganized speech -gross disorganized, catatonic beh -one day to one month (brief part) Specifiers -marked stressors -catatonia Emotional functioning: labiality of emotions change emotions dramatically for no reason (like babies) Co-morbidity: psychotypical pd, borderline, and trait approaches Schizophreniform: two of the following (and one of the first 3): remember this is briefier than more schiz -hallucinations -delusions -disorganized speech -gross disorganized or catatonic -neg symptoms Criteria & duration -one month to less than 6 months -atleast hal, del, and disorg speech -can also have a history of ASD but sympt last atleast one month Specifiers -have to rule out schizoaffective, bipolar, depressive disorders -prognosis -catatonia: criteria -negativism, stupor, catatonic excitement, echopraxia and echolalia -severity: mild, mod, severe Indicators of good prognosis -quicker onset -abrupt and insidious: good prognosis -lack of negative symtoms is a good prognosis -good premorbid functioning- good prognosis Onset & course -similar to schiz -1/3 of prodromal phase recover in 6 months -2/3 go to develop schiz or schizo attective -after 6 months  schizophrenia -men worse -late teens to mid 30s (teen: lesion –brain structure) -only 20% can fully recover Schizophrenia : affects all 3 areas of functioning Significant areas of change between DSM 4-TR & DSM 5 -gradient (consider the less conditions first) -no more subtypes -dimensional model: consider all the premorbid conditions (schizopypal pd) Criteria & duration (be able to distinguish the time element from Brief to schizophreniform to schizophrenia) -over 6 months and atleast one month of symptoms (prodromal and then there is residual) functioning has to be impaired have to have two ore more for less than a month is being treated (have to have atleast the first 3) -delusions -hallucinations -disorganized speech -gross disorganized catatonic beh -neg symptoms Specifiers -first episode to multiple episodes -acute, partial, or full remission -continuous -cataonia -severity level -rule out schizo affective, dep, bipolar disorders with psychotic features -can have a history of asd and del and hall for atleast a month Theory of “mind”: unaware that they are different from others -similar to the neologism (self focus) Role of aggression: men are more aggressive bec of substance abuse but also aggression effects everyon with this disorder at some point Neuroimaging studies- ventricals are larger and brain vol is smaller Onset & course: teens into mid 30s (20% can fully recover) Risk factors -late winter and early spring, born in urban areas -genetic component: same gene that is linked to bipolar and asd -no real causation -birth complications (hypoxia) Cultural issues & cautionary note -context of culture and religion have to rule out -day of the dead -normal to see people and hear gods voices -beware of linguistic diff Suicide risk (5-6% commit and 20% attempt) -high in m and f (more m substance abuse) -dep -unemployed -discharged from hos have to go back to normal life Co-morbidity -substance abuse- tobacco -anxiety -ocd -panic -schizotypal pd (precursor – dimensional model) -history of paranoid personality Adoption studies -monozygotic twins: higher concordance rates -nature and nurture are equal Family variables: good families act as buffers -role of conflict: allows for them to relate to each other and learn how to argue -“double-bind” communication: parents give vague and confusing unclear responses to kids -ex. He gave in class calls them over for a hug and then becomes cold -“schizophrenigenic” families-…. Below they are emotionally out of control or no emo -expressed emotions: emotions that are out of control or no emotions at all Etiology theories -dopamine theory: high levels of dopamine -lesion theory: brain struc (damage ot the tissue of the frontal lobe last to dev that's why there is onset in adole) -viral theory- retroviruses in the spinal cord may cause this this to form, during preg the inactive virus might become active -extra-pyramidal system: the effects of the medication (tartive dyskinesia) –Parkinson like symptoms (the second genderation has less side effects) Neologism-making up words th
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