NR 547 Week 3
1. psychosis neurobiological factors: Environmental Triggers: RegularCannabis Use
Exposure to Early Life Trauma
-Sexual Abuse
-Emotional Abuse
-Emotional Neglect
-Bullying
2. psychosis neurobiological factors: Neuroanatomy
Several areas of the brain are associated with the symptoms of schizophrenia. When brain
circuitry in the prefrontal cortex malfunctions, patients mayexperience symptoms.
Match the brain area with malfunctioning circuitry with the symptoms produced:
Area of brain:
Mesocortical and ventromedial prefrontal cortex
Dorsolateral
Orbitofrontal and connections to the amygdala
Symptoms:
aggressive, impulsive symptomsnegative and affective symptoms
cognitive symptoms: Mesocortical and ventromedial prefrontal cortex: negativeand affective
symptoms
Dorsolateral: cognitive symptoms
Orbitofrontal and connections to the amygdala: aggressive, impulsive symptoms
3. psychosis neurobiological factors: Neural networks: Dopamine pathwaysexplain the
positive and negative symptoms seen in schizophrenia and psychosis
-as well as the side effects associated with antipsychotic medications
4. psychosis neurobiological factors: Neural signaling: Dopamine Role in Psy-chosis
-leading hypothesis is that psychosis and schizophrenia are associated with adysfunction of
,the neurotransmitter dopamine (DA)
• Traditionally, schizophrenia and psychosis symptoms have been associated with a surplus of
dopamine, since medications that block dopamine, specifically D2, have been found to reduce
the positive symptoms of schizophrenia
-schizophrenia symptoms are related to "out of tune" dopamine
-Dopamine dysfunctions are also involved in other conditions that cause psychosis,such as
severe depression, certain medical disorders, and substance abuse
5. Esme is a 22-year-old client who presents to the clinic with her mother.Esme appears
quiet and withdrawn with very little emotional expression. Her mother reports that for the last
couple of years, Esme has gradually disengaged from all her friends. After graduating from
high school, she left
for college but started hearing voices telling her that she was ugly and stupid.She stopped
attending class or completing her work. When asked directly about her symptoms, Esme
provides very short, one-to-two-word responsesin a monotone voice.
Which of the following symptoms is Esme exhibiting? Select all that apply.
anosognosia alogia avolition asociality blunted affect
depersonalizationcatatonia anhedonia hallucinations delusions: alogia avolition
asociality blunted affecthallucinations
Rationale:
Esme is experiencing the following symptoms of psychosis: alogia: short answers, using few
words to communicate avolition: lack of initiative, withdrawal from work/school asocialtiy:
lack of relationships, reduced social interactions blunted affect: decreased facial expressions
and voice inflections
hallucinations: perceptual experiences in the absence of external stimuli
Esme has not provided enough information to support the following symptoms atthis time:
anhedonia: inability to experience pleasure anosognosia: functional inability to recognize
illness
depersonalization: a perception that the body is floating, changing, or detachedcatatonia:
lifeless, trance-like state with lack of response or movement delusions: fixed false, irrational
beliefs
6. Types of Psychotic Disorders: -Schizophrenia
-Schizoaffective Disorder
, -Schizophreniform Disorder
-Brief Psychotic Disorder
-Delusional Disorder
-Catatonia
7. Schizophrenia: -affects between 0.25% & 0.75% of the population in the U.S.
-one of the top 15 leading causes of disability worldwide
-at risk of premature mortality due to co-occurring medical conditions that are often
undiagnosed or undertreated
• Common comorbidities include heart and liver disease and diabetes
-increased risk for suicide
-typically symptoms begin to manifest before age 25 and persist throughout thelifespan
-Prodromal Phase: usually develop before the first psychotic episode
8. Schizophrenia Prodromal Phase: -usually develop before the first psychoticepisode
-over a few days to a few months and may persist for a year or more before the onsetof overt
psychotic symptoms
-Symptoms that occur in the prodromal phase of the illness are typically negative and may be
overlooked due to their similarity to other conditions, such as depression
-signs and symptoms:
• interest in abstract ideas, philosophy, and occult or religious questions
• noticeably strange behavior, abnormal affect, unusual speech, bizarre ideas, andodd
perceptual experiences
9. Schizophrenia Course: typically involves exacerbations and remissions
-after the first psychotic episode, clients may recover and function somewhat nor-mally for a
long time before relapsing
-pattern of illness during the first five years after the diagnosis generally indicatesthe client's
course
-Each relapse leads to further decline in client functioning
-Over time, positive symptoms tend to become less severe while negative symptomsmay
increase in severity
10. Psychosis Screening tools: -Brief Psychiatric Rating Scale (BPRS)
-Positive and Negative Syndrome Scale (PANSS)
-Clinician-Rated Dimensions of Psychosis Symptom Severity Scale
1. psychosis neurobiological factors: Environmental Triggers: RegularCannabis Use
Exposure to Early Life Trauma
-Sexual Abuse
-Emotional Abuse
-Emotional Neglect
-Bullying
2. psychosis neurobiological factors: Neuroanatomy
Several areas of the brain are associated with the symptoms of schizophrenia. When brain
circuitry in the prefrontal cortex malfunctions, patients mayexperience symptoms.
Match the brain area with malfunctioning circuitry with the symptoms produced:
Area of brain:
Mesocortical and ventromedial prefrontal cortex
Dorsolateral
Orbitofrontal and connections to the amygdala
Symptoms:
aggressive, impulsive symptomsnegative and affective symptoms
cognitive symptoms: Mesocortical and ventromedial prefrontal cortex: negativeand affective
symptoms
Dorsolateral: cognitive symptoms
Orbitofrontal and connections to the amygdala: aggressive, impulsive symptoms
3. psychosis neurobiological factors: Neural networks: Dopamine pathwaysexplain the
positive and negative symptoms seen in schizophrenia and psychosis
-as well as the side effects associated with antipsychotic medications
4. psychosis neurobiological factors: Neural signaling: Dopamine Role in Psy-chosis
-leading hypothesis is that psychosis and schizophrenia are associated with adysfunction of
,the neurotransmitter dopamine (DA)
• Traditionally, schizophrenia and psychosis symptoms have been associated with a surplus of
dopamine, since medications that block dopamine, specifically D2, have been found to reduce
the positive symptoms of schizophrenia
-schizophrenia symptoms are related to "out of tune" dopamine
-Dopamine dysfunctions are also involved in other conditions that cause psychosis,such as
severe depression, certain medical disorders, and substance abuse
5. Esme is a 22-year-old client who presents to the clinic with her mother.Esme appears
quiet and withdrawn with very little emotional expression. Her mother reports that for the last
couple of years, Esme has gradually disengaged from all her friends. After graduating from
high school, she left
for college but started hearing voices telling her that she was ugly and stupid.She stopped
attending class or completing her work. When asked directly about her symptoms, Esme
provides very short, one-to-two-word responsesin a monotone voice.
Which of the following symptoms is Esme exhibiting? Select all that apply.
anosognosia alogia avolition asociality blunted affect
depersonalizationcatatonia anhedonia hallucinations delusions: alogia avolition
asociality blunted affecthallucinations
Rationale:
Esme is experiencing the following symptoms of psychosis: alogia: short answers, using few
words to communicate avolition: lack of initiative, withdrawal from work/school asocialtiy:
lack of relationships, reduced social interactions blunted affect: decreased facial expressions
and voice inflections
hallucinations: perceptual experiences in the absence of external stimuli
Esme has not provided enough information to support the following symptoms atthis time:
anhedonia: inability to experience pleasure anosognosia: functional inability to recognize
illness
depersonalization: a perception that the body is floating, changing, or detachedcatatonia:
lifeless, trance-like state with lack of response or movement delusions: fixed false, irrational
beliefs
6. Types of Psychotic Disorders: -Schizophrenia
-Schizoaffective Disorder
, -Schizophreniform Disorder
-Brief Psychotic Disorder
-Delusional Disorder
-Catatonia
7. Schizophrenia: -affects between 0.25% & 0.75% of the population in the U.S.
-one of the top 15 leading causes of disability worldwide
-at risk of premature mortality due to co-occurring medical conditions that are often
undiagnosed or undertreated
• Common comorbidities include heart and liver disease and diabetes
-increased risk for suicide
-typically symptoms begin to manifest before age 25 and persist throughout thelifespan
-Prodromal Phase: usually develop before the first psychotic episode
8. Schizophrenia Prodromal Phase: -usually develop before the first psychoticepisode
-over a few days to a few months and may persist for a year or more before the onsetof overt
psychotic symptoms
-Symptoms that occur in the prodromal phase of the illness are typically negative and may be
overlooked due to their similarity to other conditions, such as depression
-signs and symptoms:
• interest in abstract ideas, philosophy, and occult or religious questions
• noticeably strange behavior, abnormal affect, unusual speech, bizarre ideas, andodd
perceptual experiences
9. Schizophrenia Course: typically involves exacerbations and remissions
-after the first psychotic episode, clients may recover and function somewhat nor-mally for a
long time before relapsing
-pattern of illness during the first five years after the diagnosis generally indicatesthe client's
course
-Each relapse leads to further decline in client functioning
-Over time, positive symptoms tend to become less severe while negative symptomsmay
increase in severity
10. Psychosis Screening tools: -Brief Psychiatric Rating Scale (BPRS)
-Positive and Negative Syndrome Scale (PANSS)
-Clinician-Rated Dimensions of Psychosis Symptom Severity Scale
