Psychology Chapter on Schizophrenia
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Questions and Answers

Which Greek words form the basis of the term 'schizophrenia'?

  • skhizo and philo.
  • phren and philo.
  • skhizo and phren. (correct)
  • phren and skizo.

    • Which of the following is NOT a typical area of disturbance associated with schizophrenia?

  • Thought processes.
  • Motor skills. (correct)
  • Perception.
  • Affect.

    • What is the approximate lifetime prevalence of schizophrenia in the United States?

  • 20%.
  • 5%.
  • 1%. (correct)
  • 10%.

    • Which of the following is most characteristic of the prodromal phase of schizophrenia?

    <p>Sudden onset of obsessive-compulsive behavior, social withdrawal and functional impairment. (D)</p> Signup and view all the answers

    What is a primary characteristic of the residual phase of schizophrenia?

    <p>Symptoms similar to the prodromal phase, including flat affect and impaired role functioning. (D)</p> Signup and view all the answers

    Which type of delusional disorder is characterized by the belief that one has a great talent or has made an important discovery?

    <p>Grandiose type (B)</p> Signup and view all the answers

    What is the typical duration of symptoms for brief psychotic disorder?

    <p>Lasts less than 1 month (D)</p> Signup and view all the answers

    Which of the following is a key feature of substance-induced psychotic disorder?

    <p>Hallucinations and delusions are directly attributable to substance use (D)</p> Signup and view all the answers

    What is the main difference between psychotic disorder due to another medical condition and substance-induced psychotic disorder?

    <p>In psychotic disorder, symptoms are attributable to a medical condition, not substance use (B)</p> Signup and view all the answers

    Which of the following is a defining feature of catatonic disorder due to another medical condition?

    <p>The catatonic symptoms are directly attributable to a general medical condition (A)</p> Signup and view all the answers

    Which intervention primarily uses role-play to teach appropriate social behaviors?

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

    What is the primary focus of family therapy in the context of mental illness?

    <p>Addressing the long-term effects of mental illness on the family (D)</p> Signup and view all the answers

    Which program employs a team approach to deliver comprehensive psychiatric care in the community?

    <p>Program of Assertive Community Treatment (B)</p> Signup and view all the answers

    What is a key concept of the recovery model in mental health?

    <p>Living a meaningful and fulfilling life, despite mental illness (A)</p> Signup and view all the answers

    Which program shares similarities with PACT in providing community-based support?

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

    Which of the following is considered a factor associated with a positive prognosis for schizophrenia?

    <p>Abrupt onset precipitated by a stressful event (C)</p> Signup and view all the answers

    According to the information provided, which biological factor is suggested to contribute to the development of schizophrenia?

    <p>Excess of dopamine activity within the brain (A)</p> Signup and view all the answers

    Which of the following is NOT identified as a predisposing physiological factor for schizophrenia?

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

    The 'downward drift hypothesis' suggests that poor social conditions are:

    <p>A consequence of schizophrenia (C)</p> Signup and view all the answers

    Which of the following is associated with a less favorable prognosis for an individual experiencing schizophrenia?

    <p>Family history of schizophrenia (A)</p> Signup and view all the answers

    What percentage of individuals with schizophrenia are thought to have a genetic predisposition, according to the provided information?

    <p>5-10% (A)</p> Signup and view all the answers

    What is the likely relationship between psychological theories and schizophrenia, according to the information?

    <p>They developed due to a lack of understanding of the biological factors (C)</p> Signup and view all the answers

    According to the theoretical integration, what is considered the primary basis for schizophrenia?

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

    What is the primary difference between schizophrenia and schizophreniform disorder?

    <p>The duration of the disorder (D)</p> Signup and view all the answers

    Which of the following is a 'positive' symptom related to the form of thought, often characterized by a shift of ideas from one unrelated topic to another?

    <p>Associative looseness (B)</p> Signup and view all the answers

    A patient is experiencing a false sensory perception that is not related to an external stimulus. Which symptom is the patient most likely exhibiting?

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

    What is the term for a deficiency of energy that is considered a negative symptom of schizophrenia?

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

    Which of the following best describes the 'negative' symptom of avolition?

    <p>An inability to initiate goal-directed activity (C)</p> Signup and view all the answers

    Which symptom best describes the situation where a patient's emotions are incongruent with the circumstances?

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

    What is a common feature of 'waxy flexibility'?

    <p>Passive yielding of the body to be placed in certain positions (D)</p> Signup and view all the answers

    A nursing diagnosis of 'Disturbed Sensory Perception' would most likely be related to which of the following?

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

    A patient is pacing back and forth and rocking their body. Which associated feature of schizophrenia is being described?

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

    Which of these is NOT a typical trigger for the exacerbation of schizophrenia symptoms?

    <p>Changes in diet (A)</p> Signup and view all the answers

    Which of these is a nursing diagnosis directly related to a patient's inability to trust?

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

    What is a primary reason why individual psychotherapy may not be successful for all clients with schizophrenia?

    <p>Impairment in the client's interpersonal functioning (D)</p> Signup and view all the answers

    What is the main drawback of behavior therapy that limits its long-term effectiveness in treating people with schizophrenia?

    <p>Its inability to generalize improvements to a community setting (C)</p> Signup and view all the answers

    A client demonstrates a delay in reaching the point of communication due to unnecessary and tedious details. What positive formal thought symptom is being displayed?

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

    Which of the following is a 'negative' symptom of schizophrenia that involves a disinterest in the environment?

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

    Study Notes

    Schizophrenia Spectrum and Other Psychotic Disorders

    • The word schizophrenia is derived from the Greek words skhizo (split) and phren (mind).
    • Schizophrenia requires comprehensive, multidisciplinary treatment.
    • It is one of the most costly mental illnesses, causing lengthy hospitalizations, family distress, and significant financial burden for individuals and governments.
    • Schizophrenia causes disturbances in thought processes, perception, and affect.
    • The lifetime prevalence of schizophrenia in the United States is about 1%.

    Phases of Schizophrenia

    • Phase 1 (Personality/Premorbid phase): Characterized by shy, withdrawn behavior, poor peer relationships, difficulties in school, and sometimes antisocial behavior.
    • Phase 2 (Prodromal phase): Lasts from weeks to years, marked by deterioration in role functioning and social withdrawal; substantial functional impairment also occurs. Symptoms include depressed mood, poor concentration, fatigue, and sudden onset of obsessive-compulsive behaviors.
    • Phase 3 (Acute schizophrenic episode): Psychotic symptoms are prominent, including delusions and hallucinations, and impairment in work, social relations, and self-care.
    • Phase 4 (Residual phase): Similar to the prodromal phase, with symptoms like flat affect and impairment in role functioning.

    Prognosis

    • Positive prognosis factors include good premorbid functioning, later age of onset, female gender, abrupt onset precipitated by a stressful event, associated mood disturbance, and brief duration of active-phase symptoms.
    • Continued positive prognosis factors include minimal residual symptoms, absence of structural brain abnormalities, normal neurological functioning, and no family history of schizophrenia.

    Predisposing Factors

    • Biological: Genetics (5-10%)
    • Biochemical: One theory suggests schizophrenia may be caused by an excess of dopamine activity in the brain. Abnormalities in other neurotransmitters are also possible.

    Physiological Factors

    • Viral infection
    • Anatomical abnormalities
    • Electrophysiology
    • Epilepsy
    • Huntington's disease
    • Birth trauma
    • Head injury in adulthood
    • Alcohol abuse
    • Cerebral tumor
    • Cerebrovascular accident
    • Systemic lupus erythematosus

    Psychological Factors

    • Psychosocial theories lack biological credibility.
    • Sociocultural factors like poverty may influence schizophrenia development. The idea of 'downward drift' is controversial, suggesting poor socioeconomic conditions as a consequence, rather than a cause, of the disorder.
    • Schizophrenia is most likely a combination of biological and environmental factors.

    Types of Schizophrenia and Other Psychotic Disorders

    • Delusional disorder: Characterized by prominent, non-bizarre delusions (e.g., erotomanic, grandiose, jealous, persecutory, somatic, mixed).
    • Brief psychotic disorder: Sudden onset of symptoms, lasting less than a month, often triggered by a psychosocial stressor. Patient returns to baseline functioning after the event.
    • Substance/medication-induced psychotic disorder: Hallucinations or delusions directly caused by substance intoxication or withdrawal.
    • Psychotic disorder due to another medical condition: Hallucinations and delusions associated with a general medical condition.
    • Catatonic disorder due to another medical condition: Catatonic symptoms due to the physiological consequences of a general medical condition.
    • Schizophreniform disorder: Shares symptoms with schizophrenia but lasts for at least one month but less than six months.
    • Schizoaffective disorder: Schizophrenic symptoms accompanied by mood episodes (mania or depression).

    Positive Symptoms

    • Content of thought: Delusions (fixed, false personal beliefs), persecutory, grandiose, somatic, erotomanic, and jealous delusions.
    • Form of thought:
      • Associative looseness
      • Neologisms
      • Concrete thinking
      • Clang associations
      • Word salad
      • Circumstantiality
      • Tangentiality
      • Mutism
      • Perseveration
    • Perception: Hallucinations (false sensory perceptions), auditory, visual, tactile, gustatory, olfactory, and illusions (misperceptions).
      • Echopraxia (repeating movements seen in others)

    Negative Symptoms

    • Affect: Inappropriate affect (emotions incongruent with circumstances), blunt/flat affect (weak emotional tone); apathy (lack of interest).
    • Avolition: Inability to initiate goal-directed activity.
    • Emotional ambivalence: Coexistence of conflicting emotions.
    • Deterioration in personal appearance (poor personal hygiene)
    • Impaired interpersonal functioning: Difficulty with social relationships, clinging, intruding on personal space. Social isolation: Focusing inward
    • Lack of insight, Anergia (lack of energy): Deficiency of energy. Anhedonia: Inability to experience pleasure. Lack of abstract thinking:
    • Associated features:
      • Waxy flexibility
      • Posturing
      • Pacing and rocking
      • Regression
      • Eye movement abnormalities

    Nursing Diagnoses

    • Related to schizophrenia:* Disturbed sensory perception, disturbed thought processes, social isolation, risk for violence (self-directed or other-directed), impaired verbal communication, and self-care deficit. Also consider possible family coping issues.

    Management of Illness

    • Connection of exacerbation of symptoms to stress periods
    • Appropriate medication management
    • Side effects of medication
    • Importance of not stopping medications
    • When to contact healthcare provider
    • Relaxation techniques
    • Social skills training
    • Daily living skills training

    Support Services

    • Financial assistance
    • Legal assistance
    • Caregiver support groups
    • Respite care
    • Home healthcare

    Treatment Modalities (Psychological)

    • Individual psychotherapy (long-term, difficult due to interpersonal impairment)
    • Group therapy (some success in long-term)
    • Behavior therapy (challenging to generalize outside treatment setting)

    Social Treatments

    • Social skills training (role-playing for appropriate social behaviors, eye contact, communication)
    • Family therapy (help family members cope with long-term illness)

    Program of Assertive Community Treatment (ACT)

    • Team approach for comprehensive community-based psychiatric care, rehabilitation, and support, focused on serious, persistent mental illness.

    Recovery Model

    • A concept of healing and transformation, enabling persons with mental illness to live a meaningful life in the community while striving to achieve his or her full potential.
    • Supported by recovery research as an obtainable objective for individuals with schizophrenia.

    Recovery After an Initial Schizophrenia Episode (RAISE)

    • Case management program. A team approach to providing comprehensive, community-based psychiatric treatment, rehabilitation, and support.

    Psychopharmacology

    • Refer to Chapter 4 and pages 367-370 (in the text).

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    Chapter 15: Schizophrenia Spectrum PDF

    Description

    Test your knowledge on schizophrenia with this quiz that covers its terminology, symptoms, and treatment interventions. Explore key concepts including the prevalence, phases, and types of disturbances associated with this mental health condition. Great for psychology students and professionals alike.

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