PSYC3102 Lecture 3 with correct answers

What are some points in history of Schizophrenia? 1. Emil Kraeplim categorized it as Dementia Praecox. 2. Eugene Bleuler (1911) called it Schizophrenia with four core disturbances: Affect, Ambivalence, Associations, Preference for Fantasy over reality. What are two myths about people with Schizophrenia? 1. They're dangerous. 2. The have split personalities. What are the prognostic and prevalence factors of Schizophrenia? 1. Approximately 1% prevalence in population. 2. Peak age onset is: Male: 15-25 Female: 25-35 Onset before 10 or after 50 is rare. Men are 30-40% more likely to develop it. Approximately 50% of all patients attempt suicide and 10% will be successful. Why are people with Schizophrenia found more frequently in the low SES category? Because: 1. It is the most expensive disorder. 2. There is more socioeconomic disadvantage to people with mental illness e.g. inability to keep jobs (conditional)... Who is Dr Frese? 1. He had severe classic symptoms including psychosis and paranoia. 2. Managed to get qualified as a clinical psychologist. Who is John Nash? 1. Mathematical Genius diagnosed with paranoid schizophrenia. 2. Was awarded Nobel Prize in economics. What are the characteristic symptoms (according to the DSM-5 criteria) of Schizophrenia? 1. Delusions 2. Hallucinations 3. Disorganised speech 4. Grossly disorganised or catatonic behaviour 5. Negative symptoms including: Affect flattening Alogia: loss of speech processes that are normally there but now aren't. Avolition: loss of motivation. First four are positive symptoms: meaning adding something, something that wouldn't normally be there. What are the B, C, D, E and F criteria? B. Social/Occupational functioning. C. Duration: continuous signs for 6 months. D. Symptoms aren't better explained by another Schizoaffective or Mood disorder. E. Symptoms are caused by Substance/general medical condition. F. No relation to autism spectrum disorder or a communication disorder. What are some disturbances in content of thought (delusions)? 1. Persecution (people coming to get you) 2. Reference (things only happen to you) 3. Grandeur (you're the best) Some others: Delusions of sin, Hypochondriacal, Nihilistic, Somatic Passivity, Thought insertion, Thought broadcasting, "Made" feelings and impulses, Capgras Syndrome, Cotards Syndrome. What are some disturbances in form of thought (delusions)? Disturbances in production and organisation of thought revealed by peculiarities in verbal expression. 1. Loosening of associations (Cannot talk in a cohesive way, cannot associate). 2. Neologism (made up words) 3. Perseveration (Repetition and difficulty engaging in cognitive set) 4. Word salad (jumbled language) 5. Circumstantiality (no flow of conversation) 6. Tangentiality (never getting back to the point) What are some disturbances of perception (hallucinations)? Hallucinations make people percept like experience occurring in the absence if appropriate stimulus and not under voluntary control. 1. Auditory 2. Visual 3. Olfactory 4. Gustatory 5. Tactile What are some disturbances in affect? 1. Can't show outward expressivity. 2. Restricted affect 3. Blunted affect 4. Flat affect What are some disturbances in Psychomotor Behaviour? CATATONIA 1. Catatonic stupor: extreme psychomotor slowing. Showing negativism, don't want to do anything. 2. Catatonic rigidity: rigid in an unusual position. Can't move from the position unless having waxiflexibility: you can move the position you're in and stay rigid in the new position. What are the 9 Schizophrenia specifiers used after one year? 1. Three first episode specifiers: in acute, partial or full remission. 2. Three multiple episode specifiers: in acute, partial or full remission. 3. Continuous. 4. Unspecified: people diagnosed but don't full into one category. 5. With catatonia: marked psychomotor disturbance which may involve stupor, rigidity, excitement or posturing. Rated on a 5 point scale for the past seven days, on the 5 core characteristics of delusions, hallucinations, disorganised speech, disorganised or catatonic behaviour, negative symptoms e.g. affect, avolition, alogia. What is the different between type one and type two Schizophrenia? Type 1: Sudden onset, Normal intellect, No brain damage, No negative symptoms, Good drug response. Type 2: Slower onset, intellectual deterioration, brain abnormality, prominent negative symptoms, poor drug response. Doesn't help to use these in clinical setting as people normally show signs of both. What are the three episode in a course of Schizophrenia? 1. Prodromal phase: precedes the diagnosis, normally see a slower onset, diagnosis is given when behaviours can't be seen as normal anymore. 2. Active phase: operating in a way that doesn't aline with reality. 3. Residual phase: able to function again but still with odd behaviors. What is the prognosis of Schizophrenia? 1. 20-30% are able to lead "normal lives" 2. 20-30% experience moderate symptoms 3. 40-60% remain significantly impaired. What some characteristics of good and bad longterm prognosis'? Good: Good premorbid adjustment, no family history, sudden onset, precipitating stress, good response to medication, positive symptoms, later age of onset, female. Bad: poor premorbid adjustment, family history, slow onset, no precipitating stress, poor response to medication, negative symptoms, early age on onset, male. What are four other psychotic disorders? 1. Schizophreniform disorder: duration at least one month but less than 6, impaired social function not required. Other than that same as schizophrenia just shorter. 2. Schizoaffective disorder: symptoms fall on the boundary between schizophrenia and mood disorders. Prominent episode of mood disturbance concurrent with criterion A schizophrenia symptoms. Delusions and hallucinations for at least 2 weeks in absence of prominent mood disturbance. 3. Delusional disorder: one or more delusions and never met criterion A schizophrenia. 4. Brief psychotic disorder: Sudden onset of at least one; delusions, hallucinations, disorganised speech, disorganised catatonic behaviour. Lasts at least one day but less than a month and full return to premorbid functioning. According to genes, what is a characteristic of schizophrenia? Most likely polygenetic: no one single gene linked. MZ twins have a 48% concordance. Offspring have 46% concordance with parents. What is the dopamine hypothesis? What is the course of fixing this? Too much dopamine causes psychotic activity. Schizophrenia, Disordered thoughts and behaviour, given a neuroleptic drug which decreases dopamine, and calms thoughts and behaviours. BUT CAUSES STIFFNESS AND TREMORS (LIKE PARKINSONS) BECAUSE NOT ENOUGH DOPAMINE, GIVEN L-DOPA? BUT THIS CAUSES PSYCHOSIS. What are some structural brain changes in schizophrenia? 1. Enlarged brain ventricles. (suggests it not a purely genetic disease). 2. Decreased frontal, temporal, and whole brain volume. 3. Volumetric differences in twins discordant for schizophrenia. Bare et al. 4. Reduced action in frontal regions. What are three complications in foetal neurodevelopment that can cause schizophrenia? 1. Obstetrical complications: labour and delivery problems. 2. Maternal infection: 'season of birth' effect. Born in flue season? Flu can cause schizo. 3. Maternal stress: Maternal stress hormones can interfere with foetal development. What is one things that can cause schizophrenia postnatally? 1. Head injuries before the age of 10. What are four limitations of the biological view? 1. A biological abnormality is at most a correlation. 2. Difficult to determine whether the abnormality is related to the disease process or to treatment. 3. Pathology identified in one area of the brain does not mean that the primary area of pathology has been defined. 4. A single pathological process in the brain can cause a wide range of phenomena in different individuals. What is the behavioural view on the development of schizophrenia (psychoanalytic theory)? 1. Failure to attend to relevant social cues results in bizarre responses to environments 2. Acquisition of bizarre behaviours through operant conditioning 3. Unable to fully account for the origins of the various symptoms of schizophrenia.