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W&M / Engineering / PSYC 318 / What is the meaning of aqua highlight?

What is the meaning of aqua highlight?

What is the meaning of aqua highlight?

Description

School: The College of William & Mary
Department: Engineering
Course: Abnormal Psychology
Professor: Fredrick frieden
Term: Spring 2019
Tags:
Cost: 50
Name: Abnormal Psychology Final Study Guide
Description: This study guide covers material from chapters 10-12, including material from class, the powerpoint, and the textbook. Highlighting indicates topics that seem to relate to the professor's test question hints.
Uploaded: 04/27/2019
20 Pages 47 Views 6 Unlocks
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Abnormal Psychology


What is the meaning of aqua highlight?



Final Study Guide

Material Covered:  

Multiple Choice- Chapters 10-11

Essay Questions- Cumulative

Aqua highlight means that those notes seem to connect to one of the Professor’s test question hints. Chapter 10: Substance-Related Addictive and Impulse-Control Disorders 

∙ Terms  

o Substance Use  

 Moderate amounts, doesn’t interfere with functioning  

o Substance Intoxication  

 Physical reaction to substance  

o Substance Abuse  

 Use that is dangerous or causes impairment in functioning  

o Substance Dependence  

 Maladaptive pattern of use, including  


What is the meaning of substance use?



∙ Physiological dependence:

o Tolerance

 Need more substance to get same amount  

∙ AND

o Withdrawal

 Physical symptoms when drug removed

∙ Failed attempt at controlling use

∙ Maladaptive behaviors to obtain drug (ex: spend too much money)  

∙ Substance Use Disorders

o Can be mild (2-3 symptoms), moderate (4-5 symptoms), or severe (6+ symptoms)  o Lasting more than 12 months usually  

o Include: substance use disorder, intoxication, and withdrawal  

o Often comorbid with another disorder, often mood or anxiety  

o Criteria for disorder basically all whether or not interferes with functioning (maladaptive behavioral  changes) or causes distress  


What is the meaning of substance intoxication?



If you want to learn more check out What is the meaning of the word “im full”?

o Comorbid substance use disorder- multiple substances (example of Danny in book) 1

o 5 Types of Substances  

 Depressants  

∙ In general: behavioral sedation  Don't forget about the age old question of What are the zones of the respiratory system?

∙ Associated Disorders:  

Disorder

Types

Criteria

Extra Information

Alcohol

Related  

Disorders

(Effects of  

Chronic Use  of Alcohol)

Fetal Alcohol  

Syndrome

 developmental  

problems of child  

because mother  

consumed alcohol  

while pregnant

Video: man with Korsakoff’s Syndrome  

Video: Alcohol  

Alcohol Info: 

-depresses CNS

-targets GABA (increase inhibitory effects)   -makes it harder for neurons to fire  

 -reduces anxiety  

-affects glutamate system  

 -learning and memory: blackouts

-affects serotonin  

 -mood, sleep, eating behavior (including  cravings)  

-ingestion  stomach  small intestine  heart  liver

Withdrawal Symptoms: 

-alcohol withdrawal delirium (AKA DT, delirium  tremens): hallucinations and body tremors  -nausea / vomiting  

-anxiety  

Statistics:  

-heaviest use in US among Caucasian men

-males have twice the rate of alcohol abuse because  they are self-medicating [may be related to the fact  that females have twice the rate of depression]  -use varies widely by country  

-Peak of alcohol use in late teens/ early adolescence:  -one study, 36% college students had binge drank in

Dementia

General loss of  

intellectual abilities -overall deficit

Wernicke-Korsakoff  Syndrome

Confusion, loss of  

muscle coordination,  unintelligible speech  (deficit of thiamine)  -targeted to memory

Alcohol Use Disorder

-different criteria,  

basically saying  

dependent / alcohol  interferes with  

functioning

If you want to learn more check out What is the meaning of anthropogenic?

2

preceding 2 weeks  

 -binge-drinking, drunk driving, & alcohol-related  deaths increase in college 

Sedative,  

Hypnotic, or  Anxiolytic

Related  

Disorders

Sedative- calming  

(barbiturates)

Muscle relaxing

Mechanism for all:  

-GABA

-if combined with alcohol, can have dangerous effects  

-can be prescribed, but carefully because can cause  dependency and be abused

Hypnotic- sleep  

inducing

Anxiolytic- anxiety  reducing  

(benzodiazepines)

Muscle relaxing,  

Similar effects to  

effects of alcohol

If you want to learn more check out What is the meaning of the cerebellum?

 Stimulants  

∙ In general: increase alertness and elevate mood 

∙ Most widely consumed  

∙ Stimulant intoxication = recent stimulant use that leads to significant impairment in  

functioning or psychological changes, AND physical changes

∙ Blocked neurotransmitter reuptake = “prolonged pleasure message”  

∙ Associated Disorders:  

Disorder

Types

Criteria

 Extra Information

Amphetamine Related  

Disorder

 Amphetamines:  

-stimulate CNS (increase release and block reuptake of norepinephrine and dopamine) to produce elation and  reduce fatigue, but usually followed by fatigue and  depression  

Some ADHD drugs are mild stimulants  

 -Washout – person reaches end of medication day  and has ‘coming down’ process where more irritable  &/or emotional

Compare to ecstasy and crystal meth: same effects  without the crash, high dependence risk

We also discuss several other topics like What is the meaning of biota?

3

Cocaine

Related  

Disorder

-cocaine-induced  paranoia common -makes heart beat  rapidly

Video: Cocaine

Cocaine:  

-blocks reuptake of dopamine to produce short-lived  elation, vigor, and reduced fatigue  

Highly addictive (but develops slowly) 

Withdrawal Symptoms: 

-lack of motivation and boredom  more use to feel  alive again

-anxiety, sleep changes  

Statistics:  

-young adult males most likely

Nicotine

Related  

Disorder

Tobacco Use  

Disorder

distress or danger but  keep using

Nicotine:

-stimulates receptors in CNS to produce sense of  relaxation, wellness, pleasure

-highly addictive 

 -rats press bar for drug then drug removed  will press bar longer after removal of drug for nicotine  then morphine  

-relapse rates similar to alcohol and heroin -Relationship with negative affect:  

 -improves mood in short term  

 -dependence linked to depression

Withdrawal Symptoms: 

-insomnia, increased appetite, restlessness, trouble  concentrating, anxiety and depression, irritability

Caffeine

Related  

Disorder

Caffeine Intoxication

Consume >250 mL of  caffeine (regular cup of coffee has 50) 

mimics anxiety, has

 Caffeine:  

-blocks reuptake of neurotransmitter adenosine  -small doses elevate mood and reduce fatigue  -can develop tolerance and dependence

Don't forget about the age old question of How does evolution overtime accounts for the unity and diversity of organisms?

4

physical symptoms

 Opioids

∙ In general: analgesia (painkiller) and euphoria  

∙ Terms:  

o Opiate- natural chemical with narcotic effects found in opium poppy

o Opioids- natural and synthetic substances with narcotic effects  

o Analgesic- term used to describe this class of drugs because it means painkiller  

Disorder

Types

Criteria

 Extra Information

Opioid-Related  Disorders

Opioid Use Disorder

Opioids:

-activate body’s endorphins and enkephalins to induce euphoria, drowsiness, and slow breathing (low doses;  high can result in death)

-high death rates (also HIV risk from shared needles)  

Withdrawal Symptoms: 

-long, severe

 Cannabis, Other hallucinogens, and other drugs  

∙ Hallucinogens in general: alter sensory perception (also hallucinations, delusions,  

paranoia)  

Disorder

Types

Criteria

 Extra Information

Cannabis

Related  

Disorders

Marijuana:  

-active chemical tetrahydrocannabinol (THC) -mood swings, paranoia, hallucinations, reduced  motivation not uncommon  

-impairs memory and concentration  

Withdrawal Symptoms: 

-withdrawal and dependence are rare

5

-irritability, nervousness, appetite change, sleep  disturbance

Hallucinogen Related  

Disorders

LSD:

-more intense than marijuana  

-psychotic delusions and hallucinations  

Withdrawal Symptoms:

-tolerance rapid, withdrawal rare

-no severe physical withdrawal

Other Drugs of  Abuse

Inhalants

Substances found in  volatile solvents (Ex:  spray paint, gasoline,  etc.)

-breathed directly into lungs and rapidly absorbed -effects similar to alcohol  

Withdrawal Symptoms: 

-tolerance and long-lasting withdrawal common

Anabolic  

-Androgenic  

Steroids

Substance derived  from hormone  

testosterone

-used to increase body mass, do not produce high -can cause long-term mood disturbances and physical  problems  

-some people cycle or stack

Designer Drugs

Created by  

pharmaceutical  

companies for  

diseases, then adopted for recreational use (ex: Ecstasy, Special K, etc.)

-cause drowsiness, pain-relief, and dissociations, often heighten senses

-produce tolerance and dependence

∙ Causes  

o Genetic  

 Multiple genes involved

 Can inherit predisposition  

 Much of research has been on alcohol (inherit metabolism)

o Neurobiological  

 Drugs affect dopamine (‘pleasure pathway’) that GABA turns of

 Drugs inhibit neurotransmitters that cause anxiety  

o Psychological Dimensions  

6

 Positive and negative reinforcement  

o Positive- get high, pleasure pathway activated

o Negative- avoid withdrawal or crash, relieve anxiety, tension, negative affect (self medication)  

∙ Opponent-Process Theory

o Positive feelings followed by negative and vice versa, so high followed by crash,  

become tolerant to high and sensitive to crash [positive reinforcement early on,  

then negative reinforcement]  

o Drugs are easiest way to alleviate crash after using

 Explains why the crash doesn’t make people less likely to use again  

 Cognitive Factors  

∙ Expectancy effects- more likely to use if have expectation that effects will be positive  ∙ Cues trigger cravings

o mood, environment, etc.  

 Social  

∙ Exposure to drugs is prerequisite  

∙ Societal views about drug use affect  

o 2 models:  

o moral weakness model of chemical dependence- failure of self-control  

 psychosocial perspective  

o disease model of physiological dependence – caused by underlying physiological  

process  

 biological perspective  

 Cultural  

∙ Some events expect heavy drinking  

∙ Culture affects expectations of the effects of alcohol  

 Integrative Model

∙ Exposure necessary but not sufficient; need combo of above factors  

∙ Treatment  

o Often unsuccessful, but works best when person is highly motivated, need comprehensive treatment o Biological  

 Agonist vs. Antagonist vs. Aversive

7

∙ Agonist substitution- replace dangerous drug with safer drug with similar chemical  compound  

o Ex: nicotine patch for nicotine  

o Ex: methadone for heroin  

∙ Antagonist treatment- block / counter positive effects of substances  

o Ex: Naltrexone for opioids, removes euphoric effect of drug  

∙ Aversive treatment- drugs that make using extremely unpleasant  

o Ex: antabuse- no effects unless ingest alcohol within 24-48 hours of taking, then  

get violently ill

 Cuts down on impulsive drinking

∙ Can be used to deal with effects of withdrawal and make withdrawal safer  

 Efficacy  

∙ Ineffective alone in general  

o Need to be combined with some sort of therapy  

o Psychosocial

 Inpatient and outpatient care equally effective  

 Community support can be helpful at times  

∙ AA, 12 Step- mixed empirical evidence, but may be helpful due to social support; better  for complete abstinence  

 Controlled Use vs. Complete Abstinence  

∙ What is treatment goal?  

∙ Controlled use considered questionable in US, but standard in UK

 Component Treatment  

∙ Incorporate several treatment methods (ex: psychotherapy and contingency  

management)  

 Comprehensive Treatment and Prevention Programs:  

∙ Individual and group therapy  

∙ Aversion therapy and covert sensitization  

∙ Contingency management  

o Agree on behaviors to change and rewards for doing so

∙ Community reform  

o Identify and correct aspects of life that hinder recovery; work on relationships  

∙ Motivational enhancement therapy  

8

∙ Relapse prevention  

o CBT

∙ Prevention  

o DARE doesn’t work; more thoughtful education can, but moving away from that  

and towards more comprehensive community interventions which do have some  

evidence of being effective

∙ Gambling Disorder & Impulse-Control Disorders  

o Gambling Disorder parallels with substance use disorders 

 Increasing amounts of money (tolerance)  

 Withdrawal symptoms when trying to stop  

 Biological contributors may be similar  

o Impulse-control disorders in general:  

 Impaired social / occupational functioning  

 Tension prior to act  

 Relief after act

o Not much research  

Class

Disorder

Criteria

Treatment

Addictive  

Disorders

Gambling Disorder

-Repeated gambling  that causes distress or  impairment  

-4 or more symptoms /  year

-may borrow / find  

ways to get money to  gamble  

-behavior is self

defeating

-similar to substance abuse  

-often does not work

-motivation is crucial and quitting recovery program  frequent  

-limited research, maybe CBT with multiple parts Methods:  

-motivational interviewing, intervention, etc.

Impulse

Control  

Disorders

Intermittent  

Explosive Disorder

Aggressive Outbursts  -rare

Impulse

Control  

Disorders

Kleptomania

Steal Unnecessary  

Items

-often comorbid with

9

mood disorders and  substance-related  

problems

Impulse

Control  

Disorders

Pyromania

Set Fires

-identify urges and practice behaviors that are  incompatible with giving in to urges to set fires -only small percent of arsonists

Chapter 11: Personality Disorders 

∙ Personality Disorders  

o Video: Personality Disorders  

o Characteristics:  

 Enduring predispositions that are maladaptive and cause impairment or distress  

 Poorer prognosis

 Ego-syntonic  

∙ Makes it hard to treat 

o Also little research for most  

 “Kind” vs. “Degree”  

∙ DSM 5 kept categorical model of classifying into labeled personality disorders, but also  

mentions a dimensional aspect where patients are rated by the degree of certain  

personality traits in a section for future models  

 Begin in childhood but not diagnosed until adulthood; chronic course if not treated

∙ Can transition into different personality disorder  

o Statistics  

 ~1% of population  

 Comorbidity Expected  

 Gender:  

∙ Tend to display symptoms along with societal expectations (men aggressive; women  

emotional / insecure)  

10

∙ Study in which clinicians sent descriptions of antisocial pd and histrionic pd, some  

labeled male some labeled female—when correct diagnosis did not align with expected  

gender, more clinicians diagnosed incorrectly as the other  

o Criteria or assessment can be biased separately; this case seems to be assessment

o Just because there is a gender difference does not mean there is bias, but this  

seems to show bias  

o 10 Disorders In 3 Clusters:  

 Cluster A

∙ odd or eccentric  

Personality  Disorder

Characteristics

Causes

Treatment

Paranoid

-pervasive, unjustified  mistrust and suspicious -ideas of reference  

(belief that meaningless events relate to them  alone)

-biological and psychological unclear,  but probably includes early learning  that people and world are dangerous

-develop trust, cognitive to counter  negative thinking  

-few seek treatment on own

Schizoid

-pervasive pattern of  detachment from social  relationships; seem  indifferent to others

-limited range of  

emotions in  

interpersonal situations

-unclear  

-childhood shyness?

-focus on value of interpersonal  relationships, empathy and social  skills

-few seek help on own

Schizotypal

-socially isolated and  exhibit odd behavior,  suspicion, magical  

thinking, ideas of  

reference (though can  test reality), illusions  -many meet criteria for  major depression

 -phenotype of schizophrenia  

genotype?  

-more generalized brain deficits

-develop social skills, address  

depression

-medical treatment similar to  

schizophrenia  

-prognosis poor

 Cluster B

11

∙ Dramatic, emotional, erratic  

Personality  

Disorder

Characteristics

Causes

Treatment

Antisocial

-does not comply with social norms

-violates others’ rights

-irresponsible, impulsive,  deceitful  

-no remorse, empathy,  ‘conscience’  

-can be charming /  

manipulative  

-‘sociopath’ / ‘psychopath’  typically refer to people with this disorder  

-substance abuse common  

-higher IQ may help stay out of trouble with the law

-antisocial conduct disorder -families with inconsistent  

discipline or criminal history  

-under arousal hypothesis  

(connecting to arousal theory  which is why they do what they  do)

-cortical immaturity hypothesis -fearlessness hypothesis  

-Gray’s model-reward signals  outweigh inhibition signals

-genetic influences, high-conflict  childhood  

-less likely to give up  

unattainable goal

-integrated model

-prevention and rehabilitation,  maybe focus on practical / selfish  consequences of actions, but  prognosis poor, so can incarcerate

-there is a checklist of 20 items to  score as assessment  

-rarely seek treatment

Borderline

-unstable mood and  

relationships  

-impulsivity, fear of  

abandonment, poor self image

-self-mutilation and suicidal  gestures  

-comorbidity high,  

particularly mood disorders -extreme black and white  thinking (had a bad day =  bad life); can split

-runs in families  

-high emotional reactivity  

-maybe impaired limbic system] -memory bias (remember things  related to symptoms better)  -early trauma / abuse  

-Triple Vulnerability Model:

 -generalized biological  

vulnerability  

 -reactivity  

 -generalized psychological  vulnerability

 -antidepressants in short-term -dialectical behavior therapy most  promising  

 -help people cope with  stressors / triggers

 -1) accept difficulties and  need for change (address threat to  self), 2) interpersonal effectiveness  (address barriers to therapy), 3)  distress tolerance (address  

hinderances to quality of life)   -taught self-regulation skills,

12

characterization of self and  others as well, leading to 1)  unstable sense of self 2)  intense & unstable  

relationships with others 3)  people react to their  

behaviors

-often comorbid with  

depression  

-gets better as people age

 -lash out when  

threatened  

 -specific psychological  

vulnerability

 -stressors bring out  symptoms  

 Rejection

 Abandonment  

 Indifference

 Neglect

can be done in group with  

worksheets, teach that need wise  mind = emotional mind + logic  mind  

-prognosis pretty good  

-Gunderson research-based scale,  compared to schizophrenics and  neurotic depressors:  

 -higher manipulative suicide  (goal is to bring someone back, not  end life)  

 -higher maintaining past  

relationships with therapists   -past therapy regressions  (things get worse after starting  therapy)

 -reactive to parent / child  relations

Histrionic

-overly dramatic,  

exaggerates but lacks  

detail, sensational, and  sexually provocative  

-impulsive, want to be  

center of attention

-thinking & emotions seem  shallow

-more global in thinking  than OCPD

-shallow & attention-seeking

-more commonly diagnosed in  females  

-failure to learn empathy as a  child (sociologically- “me”  

generation)

-focus on grandiosity, lack of  empathy, unrealistic thinking  -treatment may not be effective  (little evidence)  

-therapist should make them feel  understood and help them label  experiences (show them empathy)

Narcissistic

-exaggerated /  

unreasonable sense of self importance

-failure to learn empathy as a  child (sociologically- “me”  

generation)

 -focus on grandiosity, lack of  empathy, unrealistic thinking  (replace fantasies with realistic

13

-preoccupation with  

receiving attention

-lack sensitivity &  

compassion for others  

-sensitive to criticism,  

envious, arrogant  

-often ego-syntonic  

-often depressed when don’t live up to own expectations

expectations for daily life); coping  strategies  

-can treat depression  

-treatment may not be effective  (little evidence)

 Cluster C

∙ Fearful or anxious  

Personality  

Disorder

Characteristics

Causes

Treatment:

Avoidant

-extreme sensitivity to opinions  of others

-avoids most interpersonal  relationships  

-interpersonally anxious / fear  rejection

-low self-esteem

-many proposed  

-difficult temperament and  early rejection

 -similar to social phobia, target  social skills and anxiety

Dependent

-relies on others for big and  small life decisions

-unreasonable fear of  

abandonment  

-clingy and submissive in  

interpersonal relationships

-largely unclear  

-early disruptions in learning  independence

 -therapy progresses gradually  (don’t want patient to become  overly dependent on therapist),  foster independence

Obsessive

Compulsive

-excessive and rigid fixation on  doing things the right way -perfectionist, orderly,  

emotionally shallow

-obsessions and compulsions  are rare

NOT OCD: driven by rigidity (do

-largely unclear

-weak genetic link?

 -address fears linked to need for  order, rumination, procrastination, and feelings of inadequacy

14

things in a certain way) not  anxiety (do compulsion to  alleviate anxiety of obsession)

Chapter 12: Schizophrenia Spectrum and Other Psychotic Disorders  

∙ Video: Schizophrenia  

∙ History: Kraepelin called dementia praecox (including catatonia, hebephrenia [silly/immature emotionality], and paranoia) but Bleuler called it schizophrenia, which means ‘splitting of the mind’

o Psychotic behavior can refer only to the hallucinations / delusions or to unusual behavior as well ∙ Key Terms:  

o Psychosis- gross departure from reality, which can include hallucinations and delusions  

 Hallucinations- sensory experiences with no sensory input

 Delusions- strong beliefs that are wrong but continue to be held despite contradictory  

evidence; gross misrepresentations of reality  

o Schizophrenia- pervasive psychosis characterized by disturbed thought, emotion, and behavior (DSM includes dimensional rating scale for severity as well)  

o Symptoms- 3 Clusters  

 Positive- present in addition to normal functioning  

∙ Delusions  

o Most common: delusions of grandeur (mistaken belief that person is famous or  

powerful) and delusions of persecution  

o Aka disorder of thought content  

o Why?

 Motivational view- they are ways to avoid anxiety about uncontrollability of  

the world  

 Deficit view- brain dysfunction  disordered cognition or perception  

∙ Hallucinations  

o Most common: auditory  

o SPECT studies- Broca’s Area is what is active, area related to production, involved  

in speech production  

o Why?

 Poor emotional prosody comprehension – non-word aspects of language that  

communicates meaning (ex: raise pitch of voice for question)

15

∙ This can contribute to not differentiating between own thoughts and  

others’ words

 Negative- missing normal behaviors  

∙ 5 A’s:

o Avolition / Apathy – lack of initiation and purpose

 Ex: may not even do daily hygiene  

o Alogia- relative absence of speech

 May respond slowly, have trouble finding right words

o Anhedonia- lack of pleasure or indifference  

o Asociality- lack of interest in social relations  

o Affective flattening- little expressed emotion

 Does not mean they do not experience appropriate emotion, it simply is not  

expressed

 Disorganized- odd  

∙ Disorganized Speech

o Associative Splitting / Cognitive Slippage- illogical and incoherent speech  

o Tangentiality- going off on a tangent

o Loose associations- conversation in unrelated direction  

∙ Disorganized / Inappropriate Affect

o Inappropriate emotional behavior  

∙ Disorganized Behavior  

o Variety of unusual behavior  

o Catatonia  

 Can range from wild agitation to catatonic immobility (can have waxy  

flexibility)

o Other terms / notes from class

 Religiosity- distorted religious beliefs (different from normal religious conviction), common in  schizophrenics

 Chronic vs. Acute  

∙ Chronic- something missing and doesn’t look like they will gain it (ongoing disorder)  ∙ Acute- sudden detachment, medication may help a lot  

 Not uncommon for person to go on a trip  

 Sense of parody- know their behavior is odd and can laugh at themselves  

16

 Prodromal period- period where symptoms are beginning, year or two (ex: felt depressed  before)

∙ Ideas of reference, magical thinking (believing they have special abilities, ex: telepathic), and illusions  

∙ Attenuated psychosis syndrome  

o Subtypes  

 No longer used in DSM 5 because low reliability and validity and course and treatment of  subtypes was similar  

 Historic categories:  

∙ Paranoid, disorganized, and catatonic  

∙ Also residual and undifferentiated  

∙ Other Schizophrenia Spectrum Disorders  

o Difference is time  

 For reference: need to have psychotic symptoms for greater than 6 months to be diagnosed  with schizophrenia  

 Schizophreniform Disorder = psychotic symptoms lasting 1-6 months

∙ Can prove to be schizophrenia over time  

 Brief Psychotic Disorder = psychotic symptoms for less than 1 month  

o Other Disorders: 

Disorder

Characteristics

Extra Info

Schizoaffective  

Disorder

Symptoms of schizophrenia and a major mood  disorder, with psychotic symptoms also  appearing outside mood disorder

-prognosis similar for people with  

schizophrenia

Delusional Disorder

Delusions without other negative or positive  symptoms  

Types:

-erotomania- another person is in love with them  -grandiose- inflated self-worth  

-jealous- spouse / lover cheating on them -persecutory type- individual is being conspired  against / harmed in some way  

-somatic- involve bodily functions / sensations

-extremely rare, better prognosis than  schizophrenia

17

-mixed type- no theme predominates  

-unspecified type- can’t be clearly determined

Shared Psychotic  Disorder

-develop delusions because of close relationships with delusional individual

Catatonia

-unusual motor responses (often immobility or  agitation)

-severe and rare

-can be present in psychotic disorders or  stand-alone diagnosis

Substance-induced  psychotic disorder

-address underlying cause

Psychotic Disorder  Associated with  

another medical  condition

-address underlying cause

∙ Statistics  

o Typically develops early adulthood, thought at any time (but childhood rare)  

o Chronic in general

o Life expectancy slightly lower than average  

o Genders equal  

o Similar rates in all cultures  

∙ Causes

o Culture

 Tend to diagnose minority groups, or at least detain against their will, more

o Genetics 

 Multiple gene variances combine to make some people vulnerable  

∙ Risk for schizophrenia higher the closer the relative with it is (risk greater if identical than fraternal twins, which is higher than if uncle had it)

o Do not inherit predisposition for particular subtype  

∙ Monozygotic twin risk just above having two parents with schizophrenia  

∙ Risk still higher if biological parent had schizophrenia even if adopted, but healthy  

environment of adopted home does have some protective factors  

∙ Monozygotic neurotypical twin can be ‘carrier’ of schizophrenia if twin has it, as shown  

by child having same risk as child of affected twin (does not hold for dizygotic twins)  

18

∙ Endophenotype evidence- behaviors such as poor smooth-pursuit eye movement may be linked

o Neurobiological Influences  

 Overactive dopamine  

∙ Dopamine increasing drugs (agonists) produce schizophrenia-like symptoms and dominie reducing drugs (antagonists) help reduce such behavior  

o Probably more complex; may affect different types of dopamine receptors  

differently and even other neurotransmitters involved  

 Structural

∙ Sometimes do worse on functional tests  

∙ Enlarged ventricles, showing less developed brain around  

o Gets worse as get older (had disease longer)  

 Prenatal  

∙ Viral infections before birth may connect

∙ maternal marijuana use, but connections unclear

o Psychological and Social Influences  

 Stress  

∙ May trigger vulnerability  

∙ May make symptoms worse (vulnerability-stress model)  

∙ May increase risk of relapse  

 Family 

∙ Theories that are NOT supported

o Schizophrenogenic mother- cold, dominant, rejecting nature of mother caused  

schizophrenia  

o Double bind communication- communication style that included messages that  

conflicted  

∙ Living with family with high expressed emotion (criticism/disapproval, hostility/animosity, overinvolvement/intrusiveness) toward person with psychological disorder) related to  relapse  

o Levels of expressed emotion different in different cultures, yet rate of  

schizophrenia is the same, showing that it is not a cause  

o High expressed emotion makes it seem like the family thinks the person does not  want to get better from the disorder, making the person more likely to relapse  

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∙ Treatment  

o Neuroleptic Medications  

 Historical Treatments-insulin therapy, psychosurgery, ECT- not effective  

 Takes away positive symptoms (may help a bit with negative or disorganized)  

 Antipsychotics  

 Work on dopamine system, as well as others  

 side effects can be very uncomfortable, so some people refuse to take medication  ∙ Parkinson’s-like motor difficulties  

o Akinesia- expressionless face, slow motor activity, monotonous speech  

o Tardive dyskinesia- involuntary movements of the face

 Often irreversible  

o Psychological Interventions

 Historical precursors: psychodynamic therapy to find roots of psychosis- did not work and  made some people worse

 Token economies rewarding adaptive behavior in inpatient settings  

 Community care programs  

 Social and living skills training  

 Behavioral family therapy  

 Vocational rehabilitation  

 Illness management and recovery  

 Must take culture into account and adapt intervention accordingly  

 Prevention: for at-risk kids especially, supportive home environment, social skills training, etc.   “Successful treatment rarely includes complete recovery”  

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