Abnormal Psychology Chapter 13 Schizophrenia Spectrum and other Psychotic Disorders – Flashcards

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prodromal phase
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Precedes an active phase-deterioration in role functioning, may be seen by others as a change in personality, peculiar behaviors, unusual perceptual experiences, outbursts of anger, increased tension, restlessness, social withdrawal, indecisiveness, lack of willpower
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positive symptoms
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hallucinations, dellusions
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negative symptoms
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lack of initiative, social withdrawal, emotional deficits
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disorganization
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verbal communication problems, bizarre behavior
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hallucinations
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sensory experiences not caused by actual external stimuli
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delusions
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idiosyncratic beliefs that are rigidly held in spite of their preposterous nature
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diminished emotional expression
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fail to express emotion, neither happy nor sad, indifferent, apathetic, expressionless, no normal fluctuations in pitch and intonation in voice, lack of concern,
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anhedonia
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inability to experience pleasure
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avolition
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lack of willpower, indecisiveness, ambivalence, apathy
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alogia
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impoverished thinking -poverty of speech -thought blocking: train of thought interrupted before complete
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poverty of speech
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reductions in the amount of speech
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loose associations/derailment
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changing topics too abruptly
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preservation
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persistently repeating a word or phrase
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tangentiality
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irrelevant responses to questions
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catatonic behavior
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obvious reduction in reactivity to external stimuli immobility marked muscle rigidity reduced/awkward spontaneous movements OR excitement and overactivity (pacing, repetitive motions)
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criteria for schizophrenia
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Criteria A: must exhibit 2+ active symptoms for at least one month (at least one being 1,2, or 3) 1 Delusions 2 Hallucinations 3 Disorganized Speech 4 Grossly disorganized or catatonic behavior 5 Negative Symptoms (diminished emotional expression or avolition) Criteria B: Lower level of functioning for significant time since onset Criteria C: Continuous for 6+ months (at least one month of active-phase but may include prodromal and residual periods--negative symptoms or lesser form of active symptoms) Criteria D: No MDD or Manic episodes with active phase and any mood disorders occur for only a minority of the active and residual phases Criteria E: no other attributable medical cause Criteria F: if already diagnosed with autism spectrum disorder or childhood onset communication disorder then there must be prominent hallucinations or delusions for at least one month in addition to other symptoms to make a diagnosis of schizophrenia
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stuporous state
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associated with catatonic posturing =generally reduced responsiveness
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inappropriate affect
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incongruity and lack of adaptability in emotional expression -responses are inconsistent with the persons situation (ex. feel one thing in result of situation but respond in unrelated way)
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schizophreniform disorder
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shows symptoms more than one month but less than 6 months
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DSM-5 changes
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eliminated subtyping based on symptoms (paranoid, disorganized, catatonic, undifferentiated)
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delusional disorder
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do not meet full criteria at least one month realistic delusions (followed, poisoned...could occur but are not) Only impaired in regards to delusions, not other aspects of life NO -hallucinations -negative symptoms -disorganized speech -catatonic behavior
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Brief psychotic disorder
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psychotic symptoms for 1+ days but <1 month -often follows a stressful event -return to normal functioning after
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schizoaffective disorder
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- Schizophrenic symptoms overlap with Major Depressive or Manic episode ----so psychotic symptoms must be present in the absence of mood disturbance for at least two weeks otherwise it is just MD/Manic episode with psychotic features
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Schizophrenia lifetime prevalence
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1% of US and Europe
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Schizophrenia gender differences?
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Men -30-40% more likely - onset 4-5 years earlier (18-25 v. 25-30W) -poor social functioning, more schizotypal traits -more negative symptoms -more chronic course, more resistant to treatment Woment -more hallucinations and paranoia, more emotional and impulsive
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Schizophrenia- Cross Cultural Differences
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Seen in all cultures More in Urban areas IPSS and DOS studies ---> outcomes better in developing countries, possibly because of greater tolerance and acceptance of pt
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Brian areas with reduced size in pts
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hippocampus thalamus amygdala Ventricles enlarged
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Brain areas with reduced activity
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dorsolateral prefrontal cortex
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dopamine hypothesis
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possibly more dopamine receptors--> more sensitive to dopamine (D2 receptor targeted with antipsychotics)
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Expressed Emotion (EE)
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High EE :negative or hostile attitudes toward pt overprotective, overinvolved --> pt with High EE family member more likely to relapse
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vulnerability marker criteria
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distinguish between those that have it and not stable characteristic over time be able to predict future development of disorder
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possible vulnerability markers for Schizophrenia
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1) working memory impairment 2) eye-tracking dysfunction
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central executive component of working memory
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responsible for the manipulation and transformation of data in storage buffers ---> impaired in pts
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eye-tracking dysfunction
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trouble following swinging pendulum pt have trouble with smooth-pursuit eyemovement
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antipsychotic drugs
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First and Second generation -first had slightly more side effects -block dopamine receptors
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Extrapyramidal symptoms (EPS)
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pathway that connects brain to motor neurons in spinal cord --> motor disturbances
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Tardive Dyskinesia (TD)
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abnormal uncontrollable movements of face and mouth and spastic movements of limbs --> from long term use of antipsychotics
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atypical antipsychotic
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less side effects used in europe clozapine
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family-oriented aftercare
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educational component moderate expectations
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social skills training
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structured modeling, role playing, social reinforcement
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assertive community treatment
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team of clinicians that provide many types of treatment during crisis periods(whenever they are) to keep disordered pts in the community
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3 phases of Schizophrenia
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prodromal, active, residual
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Difference between psychotic, schizophreniform, schizophrenia
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psychotic - 1 day schizophreniform - 6months
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