Abnormal Chapter 8

psychosis

Inability to tell the difference between the real and the unreal
-ex: schizophrenia

perception, thought, emotion, behavior

4 things psychosis interferes with the functioning of

1, 19, 50

Prevalence of schizophrenia: ___% of population, equal distribution across cultural groups
-cost: ___ billion a year
-make up about ___% of hospital beds

males, males, estrogen

gender differences in schizophrenia:
-___ more severe-higher rates of hospitalization and poorer outcomes
-earlier age of onset in ___ in early 20s, may happen because this gender doesn't cope as well as the other gender, other gender more likely to seek

20, chronic, episodic, remit

___% of schizophrenia patients experience just one episode
-law of thirds
-1/3 are ___
-1/3 are ___
-1/3 ___
-estimates of suicide: 10-15%

chronic

type of schizophrenia where medication doesn't help and the disorder doesn't go away

episodic

type of schizophrenia where there are periods of recovery and periods of getting worse, stress brings out worse periods

remit

type of schizophrenia where the symptoms are almost gone or gone without medication

independently

despite stigma, most persons living with schizophrenia live ___

delusions, hallucinations, disorganized thought and speech, disorganized behavior

4 positive symptoms of schizophrenia

persecutory, delusions of reference, grandiose delusions, delusions of thought control

4 types of delusions

delusions

positive symptom of schizophrenia where there are fixed or false beliefs had by the person

persecutory

type of schizophrenic delusion where you think people are out to get you, paranoid, they feel that they're being persecuted

delusions of reference

type of schizophrenic delusion where you see meaning in things, think that these things are arranged to tell you something
-ex: billboard was put somewhere to send you a message, you then act on that message

grandiose delusions

type of schizophrenic delusion where you think you have special powers or are God
-ex: Isaac referred to himself as a rock star

delusions of thought control

type of schizophrenic delusion where you think everyone can see your thoughts

insertion, withdrawal, broadcasting

3 types of delusions of thought control

insertion

type of delusion of thought control where you think thoughts are being put in your head

withdrawal

type of delusion of thought control where you think thoughts are being taken out of your head

broadcasting

type of delusion of thought control where you think everyone can see your thoughts

hallucinations

positive symptom of schizophrenia where there are unreal perceptual experiences
-can have these in all 5 senses but hearing and seeing are most common
-ex: hearing voices

disorganized thought and speech

positive symptom of schizophrenia where people slip from one topic to a seemingly unrelated topic with little coherent transition
-ex: word salad, incoherent to the listener, loose associations

loose associations

speech that connects in a loose way but doesn't make any sense and is very hard to follow
-ex: "The problem is insects. My brother used to collect insects. He's now a man 5 foot 10 inches. You know, 10 is my favorite number. I also like to dance, draw, an

neologisms

where the person may make up words that mean something only to him or her

clangs

where the person may make associations between words that are based on the sounds of the words rather than on the content

catatonia

type of disorganized behavior which is a positive symptom of schizophrenia that reflects unresponsiveness to the world
-happens when person hasn't been treated for schizophrenia
-may happen because of dysfunction in part of brain that filters stimuli and

disorganized behavior

type of positive symptom of schizophrenia where the person has problems in dressing, feeding, and grooming
-characterized by unpredictable agitation and highly inappropriate behavior

stereotyped behavior

type of disorganized behavior in schizophrenics where there is an act of engaging in purposeless behaviors repetitively over long periods of time

disorganization

Breakdown in the ability to think coherently and respond in a meaningful way

flat affect, inappropriate affect, alogia, anhedonia, avolition

5 negative symptoms of schizophrenia

flat affect

negative symptom of schizophrenia where there is a severe reduction or complete absence of affective (emotional) responses to the environment
-ex: somebody setting their house on fire and just sitting down and watching tv

inappropriate affect

negative symptoms of schizophrenia where people say inappropriate things, behavior doesn't match situation
-ex: talking about the death of a loved one and then laughing

alogia

negative symptom of schizophrenia where there is a poverty of speech
-Severe reduction or complete absence of speech

anhedonia

negative symptom of schizophrenia where there is a lack of pleasure in everything

avolition

negative symptom of schizophrenia where there is an Inability to persist at common, goal-oriented tasks
-May withdrawal and become socially isolated

negative, positive, cognitive

in schizophrenia, ___ symptoms occur first before ___ symptoms
-this type of deficit comes before everything

cognitive, attention, executive, working

type of symptoms with schizophrenia that are characterized by deficits in basic cognitive processes, including ___, abstract thinking, ___ functioning, and memory
-deficits in ___ memory

1 month, 6 months

to be diagnosed with schizophrenia, a person must have at least 2 of the positive and/or negative symptoms during a ___ ___ period, have impairment in work, relationships and self-care, and have continued signs of disturbance for at least ___ ___

paranoid, disorganized, catatonic, undifferentiated, residual

5 subtypes of schizophrenia (PRUDC)

paranoid

subtype of schizophrenia where there are prominent delusions and hallucinations; no prominent negative symptoms

disorganized

subtype of schizophrenia where there is disorganized speech, behavior, affect and any hallucinations/delusions are not organized

catatonic

subtype of schizophrenia where there is marked psychomotor disturbance

undifferentiated

subtype of schizophrenia where there are schizophrenic symptoms but does not meet criteria for paranoid, disorganized, or catatonic

residual

subtype of schizophrenia where there are no prominent positive symptoms but continued negative or attenuated positive ones

prodromal symptoms

symptoms of schizophrenia that are present before people go into the acute phase of schizophrenia

residual symptoms

symptoms of schizophrenia that are present after the person emerges from the acute phase of schizophrenia

negative

the ___ symptoms of schizophrenia are especially prominent in the prodromal and residual phases of the disorder

positive

the ___ symptoms of schizophrenia respond better to treatment

stigma

beliefs and attitudes held by a society that are ascribed to groups considered deviant in some manner
-ex: Belief that those with schizophrenia are violent
-reality: Those with schizophrenia are more likely to be victims of crime than perpetrators. They a

labeled, undesirable, discriminated

components of stigma:
-Group is ___
-Label associated with ___ attributes
-Labeled group seen as "not one of us"
-Group is ___ against

NAMI, 1/3, 1/5, 1/3

the ___ survey of 1301 consumers showed that:
-___ of mental patients were turned down for health insurance
-half overheard hurtful comments
-___ turned away when volunteered services
-___ turned down for job because of label
-3/4 avoid disclosing

schizoaffective disorder

a mix of schizophrenia and a mood disorder
-simultaneously experience schizophrenic symptoms and mood symptoms meeting the criteria for a major depressive episode, a manic episode, or a mixed mania/depression
-requires at least 2 weeks of hallucinations o

schizophreniform disorder

disorder that shows the primary critera for schizophrenia but show symptoms lasting only 1 to 6 months

brief psychotic disorder

disorder characterized by the sudden onset of delusions, hallucinations, disorganized speech, and/or disorganized behavior that lasts only between 1 day and 1 month, after which the symptoms vanish completely

delusional disorder

disorder characterized by delusions lasting at least 1 month regarding situations that occur in real life, such as being followed, poisoned, or deceived by a spouse or having a disease; people with this disorder do not show any other symptoms of schizophr

shared psychotic disorder

disorder in which individuals have a delusion that develops from a relationship with another person who already as delusions

antipsychotics

type of medication for schizophrenia that:
-Reduce relapse rates compared to no medications (Shown in 200+ studies)
-Reduce positive symptoms
-About 70% of individuals with schizophrenia have improved symptom control on these

typicals, atypicals

first generation antipsychotics are known as ___ while second generation antipsychotics are known as ___

typicals

type of antipsychotic that acts on dopamine
-Higher risk of EPS symptoms (motor dysfunctions)

atypicals

type of antipsychotic that act on both dopamine and serotonin
-Reduced risk of EPS symptoms and TD but increased risk of weight gain

tardive dyskinesia

type of side effect with antipsychotics that involves:
-Involuntary movements ("tics") such as lip-smacking and facial grimaces, rapid eye-blinking
-Risk increases with continued use of antipsychotic (~ 5% increase in cases per year
-(Mostly) Irreversible

antipsychotics

side effects of ___:
-Drowsiness
-Weight gain
-Blurred vision
-Dry mouth
-Sexual dysfunction

medication+therapy

best treatment for individuals with schizophrenia that has least likely relapse

assertive community treatment, supported employment, family psychoeducation, integrated dual disorders treatment, illness management and recovery

5 evidence based practices psychosocial treatments for SMI (serious mental illness) (ASFII)

assertive community treatment

evidence based practice for treatment of SMI
-TEAM APPROACH to serving the most severely mentally ill
-Ratio of 1:10 staff to consumers
-Team members have specific roles (e.g. nurse, psychiatric, vocational specialist, substance abuse specialist, etc.)
-M

illness management and recovery program

evidence based practice for treatment of SMI
-Recovery Model
-10 modules that teach concept of recovery, coping skills, illness self-management (relapse prevention, medication management, psychoeducation, etc.), and getting needs met.
-Significant improve

remission, improvement, recovery, individual

the illness management and recovery practice for treatment of SMI
-looks for a complete ___ of symptoms
-very few can achieve recovery under this definition
-ignores ___
-___ movement: deeply personal unique process, might still have symptoms but can stil

peer specialist movement

type of therapy where consumer provider=peer support
-Consumers who provide other consumers with mental health services
-VA initiative
-Involvement on ACT teams in Indiana
-pros: people with disorders helping other people with disorders, work is meaningfu