Sophomore 2 Test 4 > Thought Disorders > Flashcards

Thought Disorders Flashcards

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1
Q

Schizophrenia

A

A group of psychotic disorders that affect the perception of thought, the way language is spoken as well as how it is perceived, emotions, social behavior, and the ability to perceive reality

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2
Q

How does schizophrenia progress?

A

It is a chronic illness that worsens with time and with an eventual halt in the progression of the symptoms
** Only for elderly patients with schizophrenia has it been suggested that improvement might occur

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3
Q

Is there a standard treatment for schizophrenia?

A

No, treatment is so customized and unique that it can vary from one person to the next, as well as one episode of an individual to the next

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4
Q

Early Age Onset of Schizophrenia is usually associated with what?

A

18-25 years old

  1. More often male
  2. Poorer premorbid adjustment
  3. More structural brain abnormalities
  4. More prominent negative symptoms
    * * The younger the patient is at the onset of schizophrenia, the more discouraging the prognosis
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5
Q

Later Age Onset of Schizophrenia is usually associated with what?

A

25-35 years old

  1. More female cases
  2. Less structural brain abnormalities
  3. Better outcomes
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6
Q

Which has a more favorable prognosis, an abrupt onset or a slow onset?

A

An abrupt onset

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7
Q

Characteristics of Schizophrenia

A
  1. Dependency
  2. Depressive symptoms
  3. Anxiety disorders
  4. Psychosis-Induced Polydipsia
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8
Q

Characteristics of Schizophrenia: Dependency

A

Very common characteristic, 75-85% schizophrenic client’s smoke. They tend to smoke 2-3 times more than the average smoker

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9
Q

Characteristics of Schizophrenia: Depressive Symptoms

A

Suicide is the leading cause of premature death and 20 times higher with schizophrenics than those of the general population

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10
Q

Characteristics of Schizophrenia: Anxiety Disorders

A

Significantly higher in those with schizophrenia than those in the general population

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11
Q

Characteristics of Schizophrenia: Psychosis Induced Polydipsia

A

Compulsive drinking of water (up to 4-10 L/day) seen in those with schizophrenia and severe mental illness. May result in severe hyponatremia, cerebral edema, and death

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12
Q

Diagnostic Criteria for Schizophrenia

A

The criteria for the diagnosis of schizophrenia includes a mixture of core (positive and/or negative) symptoms for a significant portion of a one month period but with continuous signs of disturbance persisting for at least 6 months

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13
Q

Types of Schizophrenia

A
  1. Disorganized
  2. Catatonic
  3. Paranoid
  4. Undifferentiated
  5. Residual
    * * Recent research indicates that subtyping schizophrenia is not useful for predicting course of disease and subtypes may no longer be recognized by DSM
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14
Q

Disorganized Schizophrenia Onset

A

Before the age of 25, usually early to mid-teens

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15
Q

Characteristics of Disorganized Schizophrenia

A
  1. Chronic
  2. Behavior is aggressive and primitive
  3. Poor reality orientation
  4. Flat or incongruent affect
  5. POOR prognosis, usually institutionalized
  6. Hebephrenic
  7. Word salad, thought blocking, clang association
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16
Q

How would get a Disorganized Schizophrenic to communicate with you?

A

Parallel play

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17
Q

Catatonic Schizophrenia

A

Its essential feature is extreme abnormal motor behavior. They exhibit either extreme motor agitation or extreme psychomotor retardation

  • Echolalia
  • Echopraxia
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18
Q

Two Types of Catatonic Schizophrenia

A
  1. Catatonic stupor

2. Catatonic excitement

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19
Q

Catatonic Stupor

A

Characterized by extreme psychomotor retardation such as a pronounced decrease in spontaneous movements and activity

  • May have mutism
  • May have negativism (an apparent senseless resistance to all instructions or attempts to be moved)
  • May have waxy flexibility
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20
Q

Catatonic Excitement

A
  • Extreme psychomotor retardation

- Frenzied and purposeless movements accompanied by incoherent verbalizations and shouting

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21
Q

Why does a patient in catatonic excitement require urgent medical attention?

A

They require physical and medical control due to destructive and violent behavior to others. Excitement may cause them to injure themselves or collapse from exhaustion

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22
Q

Paranoid Schizophrenia Onset

A

Mid to late 20s-30s

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23
Q

Characteristics of Paranoid Schizophrenia

A
  1. Delusion of persecution or grandeur
  2. Hallucinations (usually auditory - most common)
  3. Usually centered on a single theme (hurt themselves, degrade themselves)
  4. Often have good social/occupational function with help
  5. Unable to trust
  6. They are guarded, apprehensive, and reserved
  7. Projection is the most common defense mechanism used
    * * TRUST is very important with these patients
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24
Q

Undifferentiated Schizophrenia Onset

A

Begins early and has insidious onset (early to middle teens)

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25
Characteristics of Undifferentiated Schizophrenia
1. Psychosis with a mixture of positive and negative behaviors 2. Active signs of disorder, but does not meet the criteria for a specific sub-schizophrenia 3. Premorbid state is less predictable, and disability remains fairly stable, although persistent over time
26
Residual Schizophrenia
1. Active phase symptoms (delusions, hallucinations, or disorganized speech) no longer exist, but at least 2 residual symptoms are present 2. Residual symptoms include lack of initiative, social withdrawal, inability to work or study, vague or lack of content in speech, and magical thinking or odd beliefs
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Phases of Schizophrenia
1. Prodromal Phase 2. Acute Phase 3. Maintenance Phase 4. Recovery Phase (Stabilization)
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Prodromal Phase
- May appear in a month or a year before the first psychotic break - Occurs in up to 80-90% of people before the acute phase - Has early and late symptoms
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Early Symptoms of Prodromal Phase
1. More withdrawn, and have odd behavior (neglect personal hygiene/grooming) 2. There is a lack of initiative, interests, or energy 3. Blunted or inappropriate affect 4. Speech may be characterized by unclear symbolism
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Late Symptoms of Prodromal Phase
- Words and phrases may become indecipherable
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Three Kinds of Symptoms in the Acute Phase
1. Positive symptoms 2. Negative symptoms 3. Cognitive symptoms
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Positive Symptoms of the Acute Phase
1. Hallucinations 2. Delusions 3. Disorganized behavior 4. Bizarre behavior
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Negative Symptoms of the Acute Phase
1. Blunted affect 2. Alogia 3. Avolation 4. Anhedonia
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Alogia
"Poverty of thought" - Alogia is the inability to speak because of mental defect, mental confusion, or aphasia. It is a speech disturbance that can be seen in people with dementia. However, it is often associated with the negative symptoms of schizophrenia.
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Avolation
Loss of motivation
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Anhedonia
Inability to experience pleasure
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Cognitive Symptoms of the Acute Phase
1. Inattention 2. Impaired memory 3. Illogical thinking 4. Impaired judgement
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Maintenance Phase of Schizophrenia
Acute symptoms decrease in severity - particularly positive symptoms
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Recovery Phase (Stabilization) of Schizophrenia
1. Symptoms go into remission | 2. Milder persistent symptoms may be present (withdrawn, lack of interest, lack of energy)
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Delusion
Personal beliefs not consistent with a person's intelligence or cultural background
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Hallucination
False sensory perception not associated with real external stimuli. May involve any of the 5 senses
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Illusion
Misperception of a real external stimuli
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Neologisms
New words that a person develops that are meaningless to others, but have a symbolic meaning to the psychotic person
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Concrete Thinking
Literal interpretations of the environment
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Clang Association
Choice of words governed by sounds
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Word Salad
Group of words that are put together randomly, without logical connection
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Depersonalization
Alteration in the perception or experience of the self so that the feeling of one's own reality is temporarily lost
48
Circumstantiality
The delay of a person to reach the point of communication, owing to unnecessary and tedious details when speaking
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Echolalia
Parrot-like repetition by an individual with loose ego boundaries of the words spoken by another
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Echopraxia
Mimicking a movement or gesture made by others
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Magical Thinking
A belief that one's thoughts have control over a specific situation, object, or people
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Religiosity
Excessive demonstration of or obsession with religious ideas and behavior
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Paranoia
Extreme suspiciousness of others and of their actions of perceived intentions
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Associative Looseness
Thinking characterized by speech in which ideas shift from one unrelated topic to the next
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Waxy Flexibility
When placed in an awkward position by someone else, the position is held for an uncomfortable length of time
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"A man believing that wiring and gas lines make him ill and chooses not to go into buildings unless all the windows are open"
Paranoia
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"9 am meds, 9 am meds, 9 am meds"
Echolalia
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"Oh, I love to watch So You Think Can Dance, but the car does not eat bananas"
Associative Looseness
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"Doing an Indian Rain Dance will cause precipitation to fall from the sky"
Magical Thinking
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"I am the President of the United States"
Delusion
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"GET UP!!! ... Don't sit there! ... Can't you see that Molly is sitting there!"
Hallucination
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"Imagine the worst systematic, sympathetic, quite pathetic, apologetic, paramedic as your heart is prosthetic"
Clang Association
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"I am involved with the CIA"
Delusion
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A woman runs out of her room upset and states, "I hear my baby crying!!" when actually it is two cats howling outside her window
Illusion
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"As soon as I get out of school, the first thing that I am going to do is buy me a sproggle"
Neologisms
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"Market blue dog asphalt jeans"
Word Salad
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A client in group therapy overheard a visitor say "What a storm! It's raining cats and dogs out there" The patient asked the group leader to go outside to pick out a pet for group therapy"
Concrete Thinking
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Define positive symptoms
These are often called florid symptoms because they are so dramatic in nature. These are associated with an acute onset, normal CT findings, and normal neuropsychological test findings.
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Examples of positive symptoms
1. Hallucinations 2. Delusions 3. Disorganized speech 4. Bizarre behavior, such as walking backwards constantly
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Do positive symptoms respond well to treatment?
Yes (hospitalization, medication, reduced stimuli, and interactive therapy)
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Define negative symptoms
These tend to reflect a decrease or loss of normal functioning. Negative symptoms are associated with an insidious onset. - These symptoms are more debilitating in the long run - Much harder to recognize than positive symptoms
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Examples of Negative Symptoms
1. Unchanged facial expression 2. Poor eye contact 3. Reduced body language 4. Anergia 5. Avolution
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Schizophrenia and Older Typical Antipsychotics
There is a poor response to the older typical antipsychotics, and may worsen when these drugs are used to treat the positive symptoms, making medication compliance an issue for client and family. Newer atypical antipsychotics drugs have promised better results for negative symptoms
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Pharmacologic Interventions for Schizophrenics
1. Lorazepam 2. Haloperidol 3. Quetiapine
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Activity and Exercise Interventions for Schizophrenic Patients
The encouragement of activity and exercise is essential, not only to maintain a healthy lifestyle but also to counteract the side effects of psychiatric medications that cause weight gain. ** Exercise increases Serotonin
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Communication Guidelines for Schizophrenics
1. Lower the patient's anxiety 2. Decrease defensive patterns 3. Encouraging participation in therapeutic and social events 4. Raising feelings of self-worth 5. Increasing medication compliance
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Schizophreniform Disorder
Exact essential features of those with schizophrenia except: - Duration of illness is al least one month but less than 6 months - Impaired social or occupational functioning may not be noticeable
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Brief Psychotic Disorder
Characterized by a sudden onset of psychotic symptoms (delusions, hallucinations, disorganized speech) or grossly disorganized or catatonic behavior - Episode lasts at least one day, but less than one month, returning to the patient's premorbid level of functioning - Seems to suddenly follow after an extremely stressful life event
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Schizoaffective Disorder
"Schizophrenia with a mood disorder" | - Must not be the result of any substance use or abuse or to a general medical condition
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Delusional Disorder
Involves non-bizarre delusions (situations that occur in real life, such as being followed, infected, loved at a distance, deceived by a spouse, or having a disease) of at least one month's duration. The person's ability to function is not markedly impaired, nor is the person's behavior obviously odd or bizarre
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Types of Delusional Disorders
1. Erotomatic 2. Grandiose 3. Jealous 4. Persecutory 5. Somatic
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Erotomatic Type
Believes that someone, usually of a higher status is in love with him or her.
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Grandiose Type
Has irrational ideas about their own worth, talent, or power
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Jealous Type
Centers on the idea that the person's sexual partner is unfaithful. It is irrational and without cause
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Persecutory Type
Most common - individuals believe that they are being maliciously treated in some way
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Somatic Type
Believe that they have some form of physical defect, disorder, or disease
Sophomore 2 Test 4
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