Treatment for Schizophrenia

Treatment for Schizophrenia

One reliable correlate of schizophrenia is the presence of enlarged ventricles, which indicates that schizophrenia is associated with


·         neural degeneration


What is bipolar disorder?


·         A mood disorder characterized by alternating periods of mania and depression


Of the following, who is demonstrating mania?


·         Dakota, who feels so cheerful that he talks extensively and rapidly with strangers on the subway and on the street


Mania, unlike many other disorders, actually


·         increases productive, goal-directed behavior.


Which of the following is true regarding the prevalence of major depressive disorder?


·         People over 60 are about one third as likely as people between 18 and 29 to be diagnosed with depression


Frank and Marie have been married for over 40 years. The marriage started out with very little conflict, and Frank was happy to please Marie. However, as the years have passed, no matter what Frank does, Marie criticizes him: his appearance, his opinions, his cooking, the gifts he buys for her, and all of his other actions. At this point Frank is feeling more and more discouraged despite his best efforts to make her happy. This is likely a case of


·         learned helplessness.


Four students in sociology class received a D on their final project and are required to rewrite and resubmit it. In their responses to this situation, who exemplifies the attribution style that is most prone to depression?


·         Gina, who feels that she is not smart, she is not good at sociology, and she is never going to have success on written tests


According to the diathesis-stress model, a psychological disorder such as depression might be caused by stress interacting with which of the following?


·         An individual's biological vulnerabilities


What is the definition of a specific phobia?


·         The unrealistic fear of an object or situation other than those associated with agoraphobia or social anxiety


Which of the following exemplifies specific phobia?


·         A fear of flying or heights


The experience of intense fear and autonomic arousal in the absence of real threat is called a(n)


·         panic attack


What is one of the primary characteristics of panic disorder?


·         Fear of future attacks


Edvard has become so fearful of going outside of his home alone, and of being in open spaces such as parking lots, that he has difficulty holding a job. This is best described as


·         agoraphobia.


Generalized anxiety disorder is a condition characterized by excessive anxiety and worry that


·         is not correlated with particular objects or situations.


What kind of obsessions are involved in obsessive-compulsive disorder?


·         Distressing, intrusive thoughts


Compulsions appear to be


·         efforts to ward off the anxiety produced by obsessions or some other feared event.


Schizophrenia is a disorder characterized by hallucinations, delusions, disorganized thought and speech, disorders of movement, avolition/asociality, and


·         restricted affect


A delusion is a(n)


·         false, illogical belief


Libby has hallucinations and delusions. Which of the following is a hallucination, as opposed to a delusion?


·         Libby hears critical voices commenting on her every action.

-Person experiences 2+ weeks of
-depressed moods
-feelings of worthlessness
-sleep difficulties
-loss of interest in pleasure and activities


·         depression


common cold of mental illness


·         depression


-17% of people will be affected
-Most depressive episodes last a few weeks
-But 50-60% of those who suffer one episode will
eventually have a more severe recurrence


·         depression


________ are almost twice as likely to be diagnosed with depression


·         women


Causes of Depression


·         -Biological factors
-Genetics: If identical twin has had it, 50% chance
you'll get it
- serotonin level are lower in depressed brains
-Social factors
-Disruptions in social relations often lead to
episodes of depression
-Cognitive factors
-Learned helplessness: the belief that you can't
control important things in life
-Negative explanatory style: tendency to blame
negative events on factors that are
-Internal ("It's my fault")
-Stable ("It won't change")
-Global ("It affects every part of my life")
-Rumination: brooding, repetitive thinking about
negative events


Treatment for Depression

·         -Cognitive Techniques
-identifying negative thought patterns, replacing
them with more adaptive thoughts
-Selective serotonin reuptake inhibitors (SSRI's)
-Prozac, Paxil, Zoloft, Luvox, Celexa...
-In extreme cases, electroconvulsive ("shock") therapy


-Marked by uncontrollable cycles between
-Episodes of depression
-Mania, a state of hyperactivity and wild


·         Bipolar Disorder


Learned helplessness


·         the belief that you can't control important things in life


negative attributional style


·         -occurs when a person explains his or her partner's behaviors in negative ways
-Internal ("It's my fault")
-Stable ("It won't change")
-Global ("It affects every part of my life")




·         brooding, repetitive thinking about negative events


Treatment for Bipolar Disorder

·         -Lithium is a mood stabilizer


-Will affect about 1-3% of population
-More common in females
-Person experiences sudden episodes of intense
dread and anxiety, including:
-Heart palpitations, hyperventilation, occasional
-Often, feelings of unreality and detachment from
-Person often fears going crazy, losing control, or


·         Panic Disorder

-After the first attack, person often develops:
-Fear of fear - fear of having another panic attack
-Agoraphobia - fear of going outside


·         Panic Disorder


Causes of Panic Disorder


·         Unclear, but first panic attack often happens after a stressful life event, such as an illness, or miscarriage.


-Can often successfully treat w/o use of drugs
-Therapy often includes some combination of:
-Relaxation training
-Exposure therapy


·         Treatment for Panic Disorder


-Will affect about 4% of population
-Person feels continually aroused, but often doesn't
know why
-Person worries constantly and excessively about
things like:
Money, work, family matters, illness
-Person is highly sensitive to criticism
-Person has difficulty making decisions


·         General Anxiety Disorder


-Frequent and unpredictable traumatic experiences in
childhood can predispose a person to GAD
-Often, it first appears following a stressful experience


·         Causes of General Anxiety Disorder


-Typically tranquilizers, such as
-Xanax, Valium, Libruim
-Dangerous when combined with alcohol


·         Treatment for GAD


-Will affect about 10% of population
-Phobias: Persistent, irrational fear and avoidance of specific object or situation


·         Specific Phobic Disorder



·         fear of snakes




·         fear of heights




·         fear of flying




·         fear of enclosed or narrow spaces




·         fear of spiders




·         fear of thunderstorms




·         fear of being alone


-Some phobias may be based on actual experiences
-A bad experience flying
-Witnessing a plane crash
-Observing another person's fear of flying
-Some phobias may be based in evolution
-Fear of darkness, heights, and snakes may be
genetically programmed


·         Causes of Specific Phobia Disorder


-Phobias can often be successfully treated w/o drugs
-Therapy usually includes behavioral techniques such
-Systematic desensitization

-Virtual reality systematic desensitization


Treatment for Specific Phobia Disorder


-Will affect about 3% of population
-Obsessions: Person has unwanted repetitive thoughts
-Compulsions: Behavior rituals performed in response
to the obsessions
-To qualify for obsessions and compulsions must:
-Consume more than 1hr per day
-Interfere with work or social relationships


·         Symptoms of OCD


-Biological causes
-People will have increased activity in the
caudate nucleus, a part of the brain involved in
initiating habitual behaviors
-Strep throat infections may cause early-onset in
-Learning through operant conditioning
-Compulsions are rewarding because they help
reduce a person's anxiety surrounding obsessive


·         Causes of OCD


-Usually includes a combination of
-Behavioral techniques:
-Exposure and response prevention
-Cognitive techniques:
-Relabeling obsessions/compulsions as symptoms of
a medical disorder
-Refocusing attention to a constructive behavior
(such as hobbies or exercise) whenever an
obsession appears


·         Treatments for OCD


-Contamination germs
-Need for Symmetry


·         Common Manifestations of OCD


-Person has two or more identities ("alters") that
alternately control the person's behavior
-Often, the original personality denies
any awareness of the others
-May be caused by physical or sexual
abuse as a child


·         Dissociative Identity Disorder


-A very controversial disorder
-Symptoms often emerge and are most dramatic after
beginning therapy.
-"Alters" often appear during hypnosis by a therapist
who tries to probe for multiple personalities
-Most reported cases come from a small group
of therapists...


·         Dissociative Identity Disorder


-"split mind" - mind is split from reality
-It is a disorder that affects how people think,
perceive, feel, and act.
-It is a disorder that affects how people think,
perceive, feel, and act.


·         Schizophrenia


-Approximately 10-15% of homeless people have
-Rates of drug and alcohol addiction are very high
-Approximately 10% of people with schizophrenia
commit suicide.


·         Schizophrenia


-Irrational beliefs about the world.
-"My landlord is trying to poison me" (delusion of
-"I invented the internet" (delusion of grandeur)
-"The CIA are monitoring my thoughts" (thought
-Perceiving things that aren't there
-"I hear voices" (auditory hallucination)
-"I see demons" (visual hallucination)
-Disordered thinking
-Incoherent speech, odd trains of thought


·         Schizophrenia: Positive Symptoms


-Lack of motivation
-Leads to problems with work, school, even basic
-Flattened or inappropriate emotions
-Poverty of speech
-Reduced talking, reduced verbal fluency.


·         Schizophrenia: Negative Symptoms


-strongly genetic disorder.
-If identical twin has it, odds are about 50% that you'll
get it
-also linked to non-genetic fx:
-Prenatal viral infections
-Oxygen deprivation at birth


·         Schizophrenia: Possible causes


-Enlarged ventricles
-Reduction in gray matter
-Dopamine over-reactivity
-May explain positive symptoms
-Low brain activity in the frontal lobes
-May explain negative symptoms


Schizophrenia: Brain abnormalities


·         -Primarily through medications.
-follows a "rule of quarters"
-¼ will get well and will not get sick again
-¼ will need to take medications but can live
-¼ will need to take medications and live in a group
-¼ will not recover
-15% will not respond to medication, 10% will commit
-Recovery often depends on type of onset
-Acute onset - prognosis is relatively good
-Chronic onset - prognosis is not so good



·         Treatment for Schizophrenia

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