Psych Schizophrenia spectrum and other psychotic disorders

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Author:
tmlindquist
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303766
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Psych Schizophrenia spectrum and other psychotic disorders
Updated:
2015-06-22 13:53:17
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Schizophrenia Psychology
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Psychology
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Schizophrenia spectrum and other psychotic disorders Does not include medications
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  1. Define psychosis
    • A symptom state that refers to the presence of reality misinterpretations, disorganized thinking and lack of awareness regarding reality.
    • Distinct from delirium or dementia but can co-occur with them.
  2. Schizophrenia spectrum and other psychotic disorders are defined by abnormalities in at least two of these and is present for a significant portion of time during a 1-month period
    • *Delusions
    • *Hallucinations
    • *Disorganized thinking/speach
    • Grossly disorganized (abnormal) motor behavior or catatonia
    • Negative symptoms (loss of function)

    *Must include at least one of these
  3. Define positive symptoms
    • sensory amplification associated with agitation; highly distressing.
    • Includes delusions, hallucinations, disorganized thinknig or grossly disorganized or abnormal motor behavior
  4. Define negative symptoms
    • loss of function
    • accounts for most of the morbidity in schizophrenia
    • less pronounced in other types of psychotic disorders
  5. Define delusions
    • altered thought processes involving beliefs that are not consistent with reality
    • not abile to be reality-tested in light of conflicting evidence (not amenable to change)
  6. Define hallucinations
    altered sensory perceptions that are not consistent with reality and that occur without an external stimulus
  7. Types of hallucinations
    • auditory: most common
    • visual: next most common
    • tactile: may indicate need for neurologic examination as it may indicate withdrawal or a tumor
  8. Schizophrenia is associated with high morbidity and premature mortality of this length
    25-35 years earlier compared to general populations
  9. In addition to the effected psychotic processes, diagnosis of schizophrenia must also include:
    • a marked change in functioning since time of onset
    • continuous signs of disturbance persist for at least 6 months
    • Schizoaffective, depressive, and bipolar disorders have been ruled out
    • not attributable to effects of a substance or another medical condition
  10. Define schizotypal personality disorder
    • eccentricity
    • lack of overt psychotic symptoms
  11. Define delusional disorder
    non-bizarre fixed beliefs not consistent with reality, but functioning is not significantly impaired and no other psychotic symptoms.
  12. Define brief psychotic disorder
    acute onset of psychosis, lasting less than 1 month with full recovery
  13. Define schizophreniform disorder
    • features of schizophrenia of less than 6 months duration
    • may or may not develop into schizophrenia
    • this is normally how people present; gradual pathway
  14. Define schizoaffective disorder
    schizophrenia plus co-occurring affective disorder such as major depression, mania or bipolar disorder
  15. Early pattern schizophrenia
    • peak 18-25 years
    • more often male
    • poor baseline functioning and structural brain abnormalities
    • prominent negative symptoms
    • poor prognosis with earlier onset and decreased level of function
  16. Later onset schizophrenia
    • peak 25-35 years
    • more often in females
    • less structural brain abnormalities
    • better outcome with therapy and medication
  17. Phases of schizophrenia
    • Phase I: acute
    • Phase II: stabilization
    • Phase III: maintenance/recovery
  18. Define Phase I of schizophrenia
    • drastic changes in behavior, unusual preoccupations, social isolations and problems in school or work
    • often initially thought to be a different disorder (depression)
    • person is "not who they used to be"
    • Includes positive and negative symptoms
  19. Define hallucinations
    altered sensory perceptions that are not consistent with reality
  20. Define delusions
    • altered thought processes involving belies that are not consistent with reality
    • Cannot be tested/talked out of
  21. Define illusions
    • misinterpretations of naturally occurring even (crack on wall moving, animal print running). 
    • Can be tested
  22. List negative symptoms
    • flat affect
    • alogia
    • anhedonia
    • avolition
    • ambivalence
    • poverty of speech
  23. Define flat affect
    shows little or no emotion
  24. Define alogia
    brief empty verbal responses (poverty of speech)
  25. Define anhedonia
    lack of pleasure in activities which usually bring pleasure
  26. Define avolition
    Decreased motivation and attention
  27. Define thought blocking
    unable to get thoughts organized - can't get it together such as figuring out how to get out of bed and ready for the day.
  28. Neurocognitive impairment in schizophrenia and other psychotic disorders affects these
    • memory: most pronounced in acute phase
    • vigilance:  hypo- or hyper-arousal, impairment in sustaining attentional focus
    • verbal fluency:  impaired ability to articulate thoughts, feelings
    • executive functioning: multiple types of impairment
  29. Define echolalia
    • "Echo"
    • parroting back words
  30. Define loose associations
    • lack of linkage between individual thoughts/topis
    • not tangentiality, which is "beating around the bush"
  31. Define flight of ideas
    complete lack of linkage of ideas plus rapid expression of unrelated ideas
  32. Define word salad
    expression of multiple unrelated words in absence of clearly-articulated thoughts
  33. Define neologisms
    • imaginary words to refer to objects
    • have special meaning to the person
  34. Define referential thinking
    • ideas of reference (tapping knee means something - a signal)
    • non-relity-based beliefs manifested in vebalizations that actions of others have special individual meaning.
    • often related to paranoia and delusions
    • "you know what I mean"
  35. Define concrete thinking
    literal interpretation of words/questions
  36. Define echopraxia
    • behavioral analog of echolalia
    • mimicking of another's behavior
  37. Define stereotypy
    • repetitive, non-meaningful motor movements
    • preoccupied movements meant to self-soothe or gain control (rocking)
  38. Define waxy flexibility
    • occurs in catatonia
    • remaining in the same bodily position
  39. Define catatonic excitement
    • manifests as either hypo- (catatonia) or hyper-activity (constant motor activity)
    • very urgent medical situation - effects of exhaustion, dehydration, agitation

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