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A-level Psychology > Sc - Classification of schizophrenia > Flashcards

Sc - Classification of schizophrenia Flashcards

1
Q

Avolition

A

The reduction, difficulty, or inability to initiate and persist in goal-directed behaviour, often mistaken for apparent disinterest.

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2
Q

Delusions

A

Firmly held erroneous beliefs that are caused by distortions of reasoning or misinterpretations of perceptions or experiences.

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3
Q

Hallucinations

A

Distortions or exaggerations of perception in any of the senses, most notably auditory hallucinations.

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4
Q

Negative symptoms

A

Appear to reflect a diminution or loss of normal functioning.

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5
Q

Positive symptoms

A

Appear to reflect an excess or distortion of normal functioning.

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6
Q

Schizophrenia

A

A type of psychosis characterised by a profound disruption of cognition and emotion.

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7
Q

Speech poverty

A

The lessening of speech fluency and productivity, which reflects slowing or blocked thoughts.

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8
Q

How many people does schizophrenia affect?

A

4/1000 (Saha et al., 2005).

1% of the population at some point in their lifetime.

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9
Q

At what age is schizophrenia most often diagnosed?

A

15-35

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10
Q

Who is more affected by schizophrenia?

A

Men and women equally.

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11
Q

How is schizophrenia diagnosed?

A

Using the DSM-V or ICD (in Europe).

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12
Q

What has to be present for schizophrenia to be diagnosed (DSM-V)?

A
  1. ) 2 or more of; delusions, hallucinations, disorganised speech, disorganised/catatonic behaviour, negative symptoms, for at least 1 month. (one of which must be in the first 3).
  2. ) Level of functioning in one or more major areas must be disturbed for a significant proportion of time.
  3. ) Continuous signs of disturbance for 6 months (with at least 1 month of symptoms.
  4. ) Schizoaffective disorder and depressive or bipolar disorder with psychotic features have been ruled out.
  5. ) Disturbance isn’t attributable to the physiological effects of a substance or other medical condition.
  6. ) If there is a history of autism spectrum disorder or similar, the additional diagnosis of schizophrenia is only made if prominent hallucinations, in addition to other required symptoms are also present for at least 1 month (or less if successfully treated).
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13
Q

What does DSM stand for?

A

The Diagnostic and Statistical Manual of Psychiatric Disorders.

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14
Q

What is DSM?

A

A classification and description of over 200 mental disorders, grouped in terms of their common features.

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15
Q

What does ICD stand for?

A

International classification of Diseases.

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16
Q

What are the symptoms of schizophrenia typically divided into?

A

Positive and negative symptoms.

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17
Q

What are the positive symptoms of schizophrenia?

A
  • Hallucinations.
  • Delusions.
  • Disorganised speech.
  • Grossly disorganised or catatonic behaviour.
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18
Q

Describe hallucinations

A
  • Bizarre, unreal perceptions of the environment.
  • Usually auditory (hearing voices), may be visual (seeing lights, objects, people), olfactory (smelling things) or tactile (feeling things, e.g. bugs crawling on body).
  • Many schizophrenics hear a voice (or several voices), telling them to do something (such as harm themselves or someone else) or commenting on their behaviour.
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19
Q

What are the different hallucinations?

A

Usually auditory (hearing voices).

May be:

  • Visual (seeing lights, objects, people).
  • Olfactory (smelling things).
  • Tactile (feeling things, e.g. bugs crawling on body/under skin).
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20
Q

Describe delusions

A
  • Bizarre beliefs that seem real.
  • Can be paranoid (i.e. persecutory) in nature (often involves a belief that the person is being followed or spied on by someone).
  • May involve inflated beliefs about the person’s power and importance (delusions of grandeur) (may believe they are famous or have special powers or abilities).
  • Delusions of reference where events in the environment appear to be directly related to them.
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21
Q

What are the different types of delusions?

A

Paranoid (i.e. persecutory) in nature (often involves a belief that the person is being followed or spied on by someone).

Delusions of grandeur (inflated beliefs about the person’s power and importance) (may believe they are famous or have special powers or abilities).

Delusions of reference where events in the environment appear to be directly related to them - e.g. special personal messages are being communicated through the TV or radio.

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22
Q

What are auditory hallucinations?

A

Hearing things others can’t hear.

23
Q

What are visual hallucinations?

A

Seeing lights, objects, people that other can’t see.

24
Q

What are olfactory hallucinations?

A

Smelling things others can’t smell.

25
Q

What are tactile hallucinations?

A

Feeling things, e.g. bugs crawling on body/under skin.

26
Q

What are delusions or paranoia?

A

Paranoid (i.e. persecutory) in nature (often involves a belief that the person is being followed or spied on by someone).

27
Q

What are delusions of grandeur?

A

Delusions of grandeur (inflated beliefs about the person’s power and importance) (may believe they are famous or have special powers or abilities).

28
Q

What are delusions of reference?

A

Delusions of reference where events in the environment appear to be directly related to them - e.g. special personal messages are being communicated through the TV or radio.

29
Q

Describe disorganised speech

A
  • The result of abnormal thought processes, where individual has problems organising their thoughts and this shows up in their speech.
  • May slip from one topic to another (derailment), even in mid-sentence, and in extreme cases their speech may be so incoherent that it sounds like complete gibberish - ‘word salad’.
30
Q

Describe grossly disorganised or catatonic behaviour

A
  • Includes the inability or motivation to initiate a task, or to complete it once it is started, which leads to difficulties in daily living and can result in decreased interest in personal hygiene.
  • They may dress or act in ways that appear bizarre to others, such as wearing heavy clothes on a hot summer’s day.
  • Catatonic behaviours are characterised by a reduced reaction to the immediate environment, rigid postures or aimless motor activity.
31
Q

What are catatonic behaviours characterised by?

A

A reduced reaction to the immediate environment, rigid postures or aimless motor activity.

32
Q

What do negative symptoms often persist?

A

During periods of low (or absent) positive symptoms.

33
Q

How many people with SZ suffer from significant negative symptoms?

A

About 1 in 3 (Makinen et al., 2008).

34
Q

What do negative symptoms do to people?

A

Weaken the person’s ability to cope with everyday activities, affecting their quality of life and their ability to manage without significant outside help.

35
Q

What are people with SZ often unaware of in terms of negative symptoms?

A

Often unaware of the extent of their negative symptoms, and are typically less concerned about them than their relatives may be.

36
Q

What enduring negative symptoms sometimes referred to as?

A

The ‘deficit syndrome’.

37
Q

What is the ‘deficit syndrome’ characterised by?

A

The presence of at least two negative symptoms for 12 months or longer.

38
Q

What has been found about people who have ‘deficit syndrome’?

A

Have more pronounced cognitive deficits and poorer outcomes than patients who do not have this syndrome.

39
Q

What have studies reported about people with more prominent negative symptoms?

A

E.g. Milev et al., 2005

Worse functional outcomes.

40
Q

What do negative symptoms respond poorly to?

A

Antipsychotic treatment.

41
Q

What treatment is better for negative symptoms?

A

The newer atypical antipsychotics compared to typical antipsychotics.

42
Q

What are examples of negative symptoms?

A

Speech poverty (alogia)
Avolition
Affective flattening
Anhedonia

43
Q

What is the term of speech poverty?

A

Alogia

44
Q

What is speech poverty (alogia) characterised by?

A

The lessening of speech fluency and productivity.

45
Q

What is the lessening of speech fluency and productivity though to reflect?

A

Slowing or blocked thoughts.

46
Q

What characteristic signs do people with speech poverty display?

A
  • Produce fewer words in a given time on a task of verbal fluency (e.g. name as many animals as you can in one minute).
  • Less complex syntax (e.g. fewer clauses, shorter utterances, etc.).
47
Q

What part of SZ does less complex syntax appear to be associated with?

A

Long illness and earlier onset of the illness.

48
Q

Describe avolition

A

Reduction of interests and desires as well as an inability to initiate and persist in goal-directed behaviour (e.g. sitting in the house for hours every day and doing nothing).

Distinct from poor social functioning or disinterest, which can be the result of other circumstances.

49
Q

Describe affective flattening

A

Reduction in the range and intensity of emotional expression, including facial expression, voice tone, eye contact and body language.

Compared to controls without this symptoms, individuals show fewer body and facial movements and smiles, and less co-verbal behaviour, i.e. those movements of the hands, head and face that usually accompany speech.

When speaking, patients may also show a deficit in prosody, i.e. paralinguistic features (such as intonation, tempo, loudness and pausing) that provide extra information that is not explicitly contained in a sentence, and which gives cues to the listener as to emotional or attitudinal content and turn-taking.

50
Q

Describe anhedonia

A

Loss of interest or pleasure in all or almost all activities, or a lack of reactivity to normally pleasurable stimuli.

It may be persuasive (i.e. all-embracing) or it may be confined to a certain aspect of experience.

Physical anhedonia is the inability to experience physical pleasures such as pleasure from food, bodily contact and so on.

Social anhedonia is the inability to experience pleasure from interpersonal situations such as interacting with other people.

Because social anhedonia overlaps with other disorders (such as depression), whereas physical anhedonia doesn’t, the latter is considered a more reliable symptom of SZ (Sarkar et al., 2010).

51
Q

What is avolition distinct from?

A

Distinct from poor social functioning or disinterest, which can be the result of other circumstances.

52
Q

What is physical anhedonia?

A

Physical anhedonia is the inability to experience physical pleasures such as pleasure from food, bodily contact and so on.

53
Q

What is social anhedonia?

A

Social anhedonia is the inability to experience pleasure from interpersonal situations such as interacting with other people.

54
Q

Which is a more reliable symptom of SZ, physical anhedonia or social anhedonia, and why?

A

Physical anhedonia.

Because social anhedonia overlaps with other disorders (such as depression), whereas physical anhedonia doesn’t, the latter is considered a more reliable symptom of SZ (Sarkar et al., 2010).

A-level Psychology (55 decks)

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