Psychology Chapter on Schizophrenia

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Questions and Answers

What distinguishes delusions from self-deceptions regarding the acknowledgment of beliefs?

  • Individuals with delusions often view opposing arguments as conspiratorial. (correct)
  • Individuals with self-deceptions are more likely to ignore opposing facts.
  • Individuals with delusions acknowledge that their beliefs may be wrong.
  • Individuals with self-deceptions tend to resist arguments against their beliefs.

Which of the following is an example of a nihilistic delusion?

  • Believing that one is being monitored by technology.
  • Believing that a global catastrophe is imminent.
  • Believing that one has died. (correct)
  • Believing that one is in a romantic relationship with a celebrity.

How do delusions typically manifest differently across cultures?

  • They adapt based on modern technology and current events. (correct)
  • They only occur in developed nations.
  • They are fundamentally the same regardless of cultural context.
  • They exclusively reflect ancient cultural myths.

What is a key characteristic of hallucinations in individuals with schizophrenia compared to normal hallucinations?

<p>They are more frequent, persistent, and complex. (C)</p> Signup and view all the answers

What best describes the treatment or management of hallucinations in normal individuals?

<p>They can often be managed through lifestyle changes and self-care. (C)</p> Signup and view all the answers

In what scenario would a belief not be classified as a delusion?

<p>When the belief is part of a culture's shared belief system. (B)</p> Signup and view all the answers

What is a component of the behavior exhibited by individuals with delusions?

<p>They actively seek evidence to support their beliefs. (A)</p> Signup and view all the answers

What outcome criteria did patients rate MCT superior to in the initial study involving schizophrenics?

<p>Boredom and enjoyment (A)</p> Signup and view all the answers

In the second study comparing MCT with an active control, what improvement was significantly higher in the MCT group?

<p>Decrease in positive symptoms and JTC (A)</p> Signup and view all the answers

What does MCT+ specifically combine in its approach?

<p>Cognitive biases with a CBT-oriented approach (C)</p> Signup and view all the answers

What finding contributed to the critical view of the hypofrontality model in schizophrenia?

<p>Not all studies found evidence of hypofrontality (D)</p> Signup and view all the answers

What task does the Wisconsin Card Sorting Test (WCST) measure, relevant to frontal lobe function?

<p>Concept formation and cognitive flexibility (A)</p> Signup and view all the answers

Which treatment is reported to have the highest effectiveness at reducing relapse rates for schizophrenia?

<p>Family therapy (D)</p> Signup and view all the answers

What is the primary aim of assertive outreach in mental health services?

<p>To build relationships with clients in their own environments (A)</p> Signup and view all the answers

What role do family therapies play in medication adherence for patients with schizophrenia?

<p>They increase adherence to antipsychotic medications (C)</p> Signup and view all the answers

Which model do traditional healers use that focuses on the integration of different levels of experience?

<p>Structural model (C)</p> Signup and view all the answers

What is the primary reason clozapine is often used after other atypical antipsychotics?

<p>It has a high potential for inducing agranulocytosis. (A)</p> Signup and view all the answers

Which atypical antipsychotic showed the highest 6-month remission rate?

<p>Olanzapine (Zyprexa) (B)</p> Signup and view all the answers

What is a key challenge faced by community care programs for individuals with schizophrenia?

<p>Very few individuals receive such services. (B)</p> Signup and view all the answers

Which aspect is NOT typically included in the comprehensive services of assertive community treatment programs?

<p>Crisis intervention (C)</p> Signup and view all the answers

What type of symptoms do many individuals with schizophrenia continue to experience despite medication?

<p>Negative symptoms primarily. (B)</p> Signup and view all the answers

Which of the following is NOT a common side effect associated with atypical antipsychotics?

<p>Agranulocytosis (A)</p> Signup and view all the answers

The social support model used by traditional healers emphasizes which of the following approaches?

<p>Mobilizing kin to support the patient (D)</p> Signup and view all the answers

In the context of family therapy, what behavioral technique is aimed at discouraging inappropriate behavior?

<p>Reinforcement of positive behavior (C)</p> Signup and view all the answers

Which psychological intervention can help reduce isolation and apathy in schizophrenia patients?

<p>Social skills training (D)</p> Signup and view all the answers

What percentage of patients experienced remission during the study's 18-month period when using the atypical antipsychotics?

<p>44.5% (A)</p> Signup and view all the answers

Which treatment method for schizophrenia is characterized by reliance on folk beliefs and community practices?

<p>Folk/religious healing (A)</p> Signup and view all the answers

What is the primary focus of assertive community treatment?

<p>24-hour support for a variety of patient needs (C)</p> Signup and view all the answers

In addition to medication, what type of personalized treatments are mentioned for schizophrenia?

<p>Behavioral, cognitive, and social deficit treatments (A)</p> Signup and view all the answers

Which of the following is NOT a side effect of atypical antipsychotics mentioned in the content?

<p>Hyperactivity (D)</p> Signup and view all the answers

What factor complicates determining the safest and most effective atypical antipsychotic?

<p>The variability in patient responses and side effects. (C)</p> Signup and view all the answers

What is one of the key benefits of psychological interventions for individuals with schizophrenia?

<p>They enhance social skills and reduce conflict. (D)</p> Signup and view all the answers

What is the primary benefit of interventions aimed at reducing family expressed emotion for individuals with schizophrenia?

<p>They lead to a significant decrease in the relapse rate. (A)</p> Signup and view all the answers

Which cognitive bias may contribute to delusions in schizophrenia according to cognitive perspectives?

<p>Jumping to conclusions based on limited evidence. (D)</p> Signup and view all the answers

How do negative symptoms in schizophrenia typically manifest according to expectations of social interactions?

<p>By withdrawing to conserve cognitive resources. (D)</p> Signup and view all the answers

What does the orienting response indicate in healthy individuals when exposed to a novel stimulus?

<p>Active processing of the stimulus. (B)</p> Signup and view all the answers

What impact does high distractibility have on the cognitive performance of individuals with schizophrenia?

<p>They function better with distractions in non-relevant tasks. (A)</p> Signup and view all the answers

What common result of deficits in the orienting response correlates with symptoms in schizophrenia?

<p>Association with both positive and negative symptoms. (C)</p> Signup and view all the answers

What may cause hallucinations in individuals with schizophrenia according to cognitive perspectives?

<p>Hypersensitivity to external perceptual input. (B)</p> Signup and view all the answers

Which thought pattern is indicative of a failure in making relevant associations during conversations in schizophrenia?

<p>Clanging associations. (D)</p> Signup and view all the answers

How does the negative priming effect manifest in non-clinical participants?

<p>Increased reaction times for targets previously mentioned. (D)</p> Signup and view all the answers

Flashcards

Nihilistic delusion

A belief that you are dead, or that the world is no longer real.

Erotomanic delusions

A belief that someone is in love with you, even though there is no evidence.

Delusions

Strong false beliefs that are resistant to change, even in the face of evidence to the contrary.

Cultural and Temporal Delusions

Delusions can vary across cultures and time periods.

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Cultural Beliefs vs. Delusions

Shared beliefs in a culture are not considered delusions, unless they are extreme.

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Hallucinations

Unreal sensory experiences that can include seeing, hearing, feeling, smelling, or tasting things that aren't actually there.

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Hallucinations in Schizophrenia

Hallucinations in people with schizophrenia are more frequent, persistent, complex, and bizarre.

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Cognitive Bias in Schizophrenia

A style of thinking that can lead to the formation of delusions in people with schizophrenia. It involves drawing conclusions based on limited evidence and attributing strange experiences to external sources.

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Hyper-reactivity to Stimuli

The tendency to overreact to irrelevant stimuli, which can lead to difficulty focusing on important information.

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Orienting response

The process of diverting attention from irrelevant information, which is a crucial skill for healthy individuals.

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Abnormal Orienting Response in Schizophrenia

An abnormal reaction to stimuli in people with schizophrenia. It indicates they are not fully attending to or processing important information.

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Negative Priming Effect

A cognitive bias where people take longer to respond to a word they were previously asked to ignore.

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Attention Deficits in Schizophrenia

A difficulty in making relevant associations between events, leading to issues in communication and social interaction.

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Clanging

A specific cognitive bias in which a person makes associations based on unrelated sounds, often seen in schizophrenia.

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Reward Sensitivity Bias

A form of cognitive bias that involves a tendency to prioritize immediate sensations over long-term goals, leading to impulsivity.

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Negativity Bias

The tendency to overestimate the likelihood of negative events, which can lead to avoidance behavior and social withdrawal in schizophrenia.

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Metacognitive Training (MCT)

A type of therapy that focuses on helping people become aware of their own thinking patterns and how those patterns can influence their emotions and behavior. This involves training people to identify and challenge negative thoughts, and develop more adaptive thinking habits.

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Hypofrontality

A common symptom of schizophrenia characterized by reduced blood flow to the frontal lobe, potentially affecting cognitive function.

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Wisconsin Card Sorting Test (WCST)

A neuropsychological test that measures executive function, cognitive flexibility, and working memory, often used to assess frontal lobe function and identify potential damage.

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Cognitive Activation Paradigm

A type of research where participants are asked to perform a specific mental task while their brain activity is monitored, allowing scientists to understand brain regions involved in cognitive processes.

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MCT+

A personalized form of Metacognitive Training (MCT) that combines the principles of MCT with Cognitive Behavioral Therapy (CBT) to address cognitive biases and improve overall mental well-being.

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Agranulocytosis

A serious side effect of clozapine that can be fatal, requiring close monitoring of patients taking the drug.

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Atypical Antipsychotics

Atypical antipsychotics are a newer class of drugs used to treat schizophrenia. They are generally more effective than older traditional antipsychotics, but have potential side effects.

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Common Side Effects of Atypical Antipsychotics

Risperidone, olanzapine, quetiapine, and ziprasidone are examples of atypical antipsychotics. These medications can cause weight gain, diabetes, sexual dysfunction, sedation, low blood pressure, seizures, gastrointestinal problems, vision problems, and concentration problems.

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Schizophrenia

Schizophrenia is a complex mental illness that affects how a person thinks, feels, and behaves. It's characterized by positive symptoms like hallucinations and delusions, and negative symptoms like a lack of motivation and social withdrawal.

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Psychological Interventions for Schizophrenia

Psychological treatments like social skills training can help individuals with schizophrenia improve their social skills, reduce isolation and apathy, and manage the stress and conflict associated with the disorder.

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Personalized Schizophrenia Treatment

Personalized treatments for schizophrenia address behavioral, cognitive, and social deficits tailored to each individual. These treatments are used in conjunction with medication to improve functioning and reduce relapse risk.

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Negative Symptoms of Schizophrenia

Negative symptoms of schizophrenia include a lack of motivation, social withdrawal, apathy, and emotional flattening. These symptoms make it difficult for individuals to engage with their environment and build relationships.

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Positive Symptoms of Schizophrenia

Positive symptoms of schizophrenia involve distorted perceptions of reality. They include hallucinations (seeing or hearing things that aren't there) and delusions (false beliefs that are strongly held despite evidence to the contrary).

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Medication for Schizophrenia

Medication plays a crucial role in managing schizophrenia. However, it's not a cure and ongoing treatment is often needed. Medications aim to reduce symptoms and improve overall functioning, but they may have side effects.

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Treatment Variability in Schizophrenia

Although atypical antipsychotics are generally more effective than older medications, the best treatment for schizophrenia is not clear-cut. Finding the safest and most effective drug, and the right dose, varies by patient.

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Family therapy for schizophrenia

A type of therapy that involves educating family members about schizophrenia, teaching them coping mechanisms for dealing with stress (e.g., lack of money), and improving communication within the family.

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Assertive community treatment programs

Programs that offer comprehensive support to people living with schizophrenia, providing a range of services like psychotherapy, daily life assistance, decision-making guidance, residential supervision, and vocational training.

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Assertive outreach

A proactive approach to working with individuals with severe mental health issues who are not actively engaging with mental health services. It involves reaching out to them in their own environments and building long-term relationships to encourage participation in treatment.

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Community care programs

Programs aimed at helping people with schizophrenia integrate into their communities, adhere to medication regimens, and reduce hospital stays. These services often involve coordination with various professionals.

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Folk/religious healing for schizophrenia

Traditional healers often use cultural beliefs and practices to address the symptoms of schizophrenia. These approaches often involve restoring balance and support systems within an individual's life.

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Structural model of traditional healing

A model used by traditional healers where symptoms are seen as arising from a lack of integration between different aspects of a person's experience (body, emotions, cognition, etc.). Healing involves restoring this balance.

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Social support model of traditional healing

A model used by traditional healers where symptoms are attributed to conflictual relationships. Healing involves strengthening the patient's support network and rebuilding positive connections.

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Persuasive model of traditional healing

A model used by traditional healers where rituals are believed to change the meaning of symptoms for the patient, reducing their distress. Rituals might involve symbolic actions or storytelling.

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Integrated approaches to schizophrenia

Family therapy, assertive community treatment, and assertive outreach are all examples of approaches that focus on active support, community integration, and reducing relapse rates for people with schizophrenia.

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Individualized treatment for schizophrenia

Approaches to schizophrenia treatment, including both therapeutic and medical interventions, often need to be tailored to individual needs and cultural contexts. The best treatment approach may vary based on the individual's situation and preferences.

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Study Notes

Introductory Chapters

  • Psychosis is the inability to differentiate between reality and unreality. Examples include hearing voices or believing thoughts are broadcast.
  • Schizophrenia is a type of psychotic disorder, characterized by disorganized thinking and impaired reality perception during active phases.
  • Lifetime prevalence of schizophrenia is 0.5-2% worldwide. Typical onset is during late adolescence or early adulthood.
  • Schizophrenia is a chronic condition often requiring ongoing support like residential care, rehabilitation, and financial aid.
  • Significant healthcare costs are associated with treating psychotic disorders, and substantial productivity losses occur. Countries spend up to 3% of their healthcare budgets addressing these issues.

Symptoms, Diagnosis, and Course of Schizophrenia

  • The DSM-5 classifies symptoms on a schizophrenia spectrum. The number, severity, and duration of these distinguishes different psychotic disorders.
  • Positive symptoms: These are excesses or distortions of normal function, including delusions, hallucinations, disorganized thinking (speech), and unusual motor behavior.
  • Delusions: False beliefs considered true, even in the face of evidence, differing from other self-deceptions in several crucial ways. For example, delusions are considered impossible, whereas self-deceptions are not always impossible.
  • Hallucinations: Unreal sensory experiences that often involve multiple senses, and are more frequent and persistent in schizophrenia than in healthy individuals.
  • Negative symptoms: Reduced or lost normal functions, including diminished emotional expression and avolition (lack of motivation). These symptoms are often more resistant to treatment.

Positive Symptoms (Detailed)

  • Delusions: false, fixed beliefs that defy reality.
  • Auditory, visual, tactile, somatic, olfactory, and gustatory hallucinations (unreal sensory experiences).
  • Disorganized thoughts/speech: Disordered and illogical connections between ideas.
  • Disorganized/abnormal motor behavior: Includes bizarre and agitated movements (catatonia).

Types of Delusions (Table 1)

  • Detailed descriptions of different types of delusions (e.g., persecutory, grandiose, referential, being controlled). Specific examples of the delusion are provided with each type.

Nihilistic and Erotomanic Delusions

  • Nihilistic: belief that parts of the self or world has ceased to exist.
  • Erotomanic: belief that another person desires/loves the individual.

Cultural Variations in Delusions

  • Delusions differ across cultures and even evolve with time within cultures.

Diagnostic Criteria (DSM)

  • Details of the specific DSM-5 criteria for Schizophrenia, Schizophreniform Disorder, Schizoaffective Disorder, and Brief Psychotic Disorder.

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