Chapter 13

Question 1

What is psychosis

Answer 1

• Psychosis
  o Hallucinations and delusions experienced in several disorders
• How is psychosis related to schizophrenia spectrum disorders
  o Some degree of psychosis is typically the defining feature of schizophrenia spectrum disorders
  o Compared to the other spectrum disorders, psychosis is much more severe in schizophrenia

Question 2

Schizophrenia

Answer 2

• Severe disorder characterized by a broad spectrum of cognitive and emotional dysfunctions
  o Includes severe disturbances in thought, language, emotion, behavior
  o Positive symptoms: exaggerated or excess of behavior
  o Negative symptoms: absence or insufficiency of normal behavior
  o Disorganized symptoms: erratic behaviors; affect speech, motor behavior, emotional reactions
  o Typically includes psychosis
  o Functioning: markedly below previously achieved level

Question 3

Schizophrenia: “positive” symptoms

Answer 3

-	Delusions 
o	Characterized by gross misrepresentations of reality 
o	Types of delusions:
•	Delusions of grandeur
•	Delusions of persecution 
•	Capgras syndrome 
•	Cotard’s syndrome 
o	Etiological views of delusion s
•	Motivation 
•	Deficit 
-	Hallucinations
o	Sensory experience in absence of environmental stimuli or input 
o	Can involve all senses 
o	Most common: 
•	Metacognition 
•	Own vs. other voice 
•	Broca’s area

Question 4

Schizophrenia “negative”symptoms

Answer 4

• Abolition (or apathy)
  o Inability to initiate and persist in activities
• Alogia
  o Relative absence of speech
• Anhedonia
  o Lack of pleasure, or indifference
• Affective flattening
  o Absence of normally expected emotional responses
• Asociality
  o Severe deficits in social functioning; social impairment

Question 5

Schizophrenia: “disorganized” symptom cluster

Answer 5

• Disorganized speech
  o Cognitive slippage: illogical and incoherent speech
  o Tagentiality: “going off on a tangent” from the topic, but logically related
  o Loose associations or derailment: taking conversation in unrelated directions, frequent unrelated topic changes
• Disorganized affect
  o Inappropriate emotional behavior
• Disorganized behavior
  o Includes a variety of unusual behaviors including catatonia

Question 6

Prevalence and course of schizophrenia

Answer 6

-	Prevalence 
o	Affects ~1 out of 100 persons (0.3-1.5%)
-	Course = chronic 
o	Complete recovery is rare 
•	Moderate to severe lifetime impairment 
o	Life expectancy = less than average 
•	Suicide is common 
-	Onset = late teens to mid 30s 
-	Female : male = ~1:1
-	Female
o	Later age of onset 
o	Better outcomes 
-	Males
o	Higher incidence of negative symptoms 
o	Longer duration