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PSYC 3230 TEST 3 EXAM with complete solutions 2024_2025.
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PSYC 3230 TEST 3 EXAM with complete solutions 2024_2025.
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PSYC 3230 TEST 3 EXAM with completesolutions 2024/2025
NATURE OF SCHIZOPHRENIA AND PSYCHOSIS: AN OVERVIEW - ANSWER-·
Schizophrenia is a form of Psychosis
-Psychosis - broad term (e.g. hallucinations, delusions)
-Schizophrenia - a type of psychosis, but there are many other symptoms besides
Schizophrenia
-Psychosis and Schizophrenia are heterogeneous (diverse) - many symptom
presentations
-Lots of ways and reasons for psychosis
-Diff types of schizophrenia
-Disturbed thought, emotion, behavior
· Historical background and current thinking
-EMIL KRAEPELIN - used the term dementia praecox (premature dementia)
-Focused on subtypes of schizophrenia (paranoid, catatonic). Recently, we've
moved away from these in the DSM.
-Recognized it as a disease of the brain
-Recognized that distinct symptoms appeared to be part of a broader symptom
(symptom clusters)
-Differentiated "dementia praecox" from manic-depressive illness. Now, we're
realizing we may have pulled them apart too far; they're not fully independent,
either. Genes seem to be shared.
-"Positive symptoms" - psychosis, delusions, etc. "Negative symptoms" - lack of
normal beliefs, disorganized systems (ex. talking less, less thought, less interest
in social interactions, less ability to display happiness)
,-EUGEN BLEULER - introduced the term "schizophrenia"
-"Splitting of the mind;" inability to keep a consistent train of thought
-Described "positive" and "negative" symptoms. Negative ones tend to be harder
to treat with medication.
DSM-5 CRITERIA: SCHIZOPHRENIA: MUST HAVE: - ANSWER-A.
CHARACTERISTIC SYMPTOMS: 2 (or more) of the following, each present for a
significant portion of time during a 1-month period (or less if successfully
treated).
-Delusions
-Hallucinations
-Disorganized speech (frequent derailment or incoherence)
-Grossly disorganized or catatonic behavior
-Negative symptoms (Affective flattening - flattened face, can't show emotion-,
alogia (less speech), avolition (difficulty doing motivated behavior like showering,
brushing teeth)
B. SOCIAL/OCCUPATIONAL DYSFUNCTION
C. CONTINUOUS SIGNS OF DISTURBANCE FOR AT LEAST 6 MONTHS
D. NOT SCHIZOAFFECTIVE (blending of Schizophrenia and mood disorder) OR
MOOD DISORDER
E. NOT DUE TO SUBSTANCE ABUSE.
SCHIZOPHRENIA: THE "POSITIVE" SYMPTOM CLUSTER: well treated by almost
any antipsychotic medication - ANSWER-· Active and obvious manifestations of
abnormal behavior
· Excess or distortion of normal behavior
· DELUSIONS - Distortion in thought content
-Erroneous beliefs that usually involve a misinterpretation of perception or
experiences. Beliefs are typically held very strongly.
-Gross misrepresentations of reality. Types:
-Persecutory (most common): "The FBI is after me."
-Referential: "When Madonna waved to the audience, she was really signaling to
me."
-Erotomanic: "Madonna is in love with me."
-SOMATIC: "My liver is dead and rotting inside me."
,-Nihilistic: "The world is ending."
-Jealous - spouse or partner is unfaithful
-Grandiose: "I am President of the entire world."
-"Bizarre" delusions: thought insertion (others are putting thoughts in your
mind); thought withdrawal (others are taking thoughts away), outside forces are
controlling one's body or actions
HALLUCINATIONS: - ANSWER--experience of sensory events without
environmental input
-Can experience in any sensory mode (auditory, visual, olfactory, gustatory,
tactile)
-Auditory are the most common; usually in forms of voices, familiar or not, that
are heard as being distinct from own thoughts
-Scary form - "command" hallucinations
-2 or more voices conversing or one voice keeping a running commentary are
considered highly characteristic of SZ
-Delusions and hallucinations may often have congruent them
-Findings from imaging studies
-Subtle structural damage in parts of brain associated with auditory processing.
Thinner cortex.
-In fMRI studies, activation in auditory regions during auditory hallucinations.
"NEGATIVE" SYMPTOM CLUSTER: not well-treated by any medications -
ANSWER-· Absence or insufficiency of normal behavior
· Spectrum of negative symptoms: AVOLITION/Apathy - lack of initiation and
persistence (ex. lack of hygiene).
· ALOGIA - relative absence of speech - may be due to a decrease in thought
production
· ANHEDONIA - lack of pleasure, or indifference
· ASOCIALITY - limited interest in social interactions
· AFFECTIVE FLATTENING - little expressed emotion
-Face immobile and unresponsive
-May not be indicative of experienced emotion
-Flat affect may appear before other symptoms
, "DISORGANIZED" Symptom Cluster - ANSWER-· DISORGANIZED SYMPTOMS
-Include severe and excess disruptions
-Speech, behavior, and emotion
· "Nature of Disorganized Speech"
-Tangentiality - "going off on a tangent"
-Cognitive slippage/ Loose associations - conversation in unrelated directions
-Word salad; neologisms (making up new words)
· Nature of disorganized affect
-Inappropriate emotional behavior - behavior not consistent with context (ex.
smiling when talking about death)
· Nature of disorganized behavior
-Includes a variety of unusual behaviors (disheveled: odd appearance;
inappropriate or unpredictable behavior)
-Catatonia - spectrum
-Wild agitation (sitting for hours without moving), waxy flexibility (like a doll)
immobility
OTHER DISORDERS WITH PSYCHOTIC FEATURES - ANSWER-·
SCHIZOPHRENIFORM DISORDER
-Schizophrenic symptoms for a few months (less than 6; more than 1)
-Impaired functioning not required
-Some never progress on to schizophrenia but more do (or schizoaffective
disorder)
· SCHIZOAFFECTIVE DISORDER
-Symptoms of Schizophrenia and a mood disorder (unlike a mood disorder with
psychotic features)
-Both disorders are independent of one another. (Ex. must have delusions when
symptoms of depression are not active).
-Prognosis is similar for people with schizophrenia.
-Such persons do not tend to get better on their own.
-Need to have delusions and/or hallucinations that are present for at least 2
weeks in the absence of the mood disorder.
-BIPOLAR TYPE: If mania is part of the presentation.
-DEPRESSIVE TYPE: if only major depressive episodes are part of the
presentation.
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