Schizophrenia

What are the negative symptoms of Schizophrenia related Affect?

• Inappropriate affect
• Bland/Flat affect
• Apathy

Schizophrenia

What are the negative symptoms of Schizophrenia related Volition?

• Inability to initiate goal-directed activity
• Emotional Ambivalence
• Deteriorated appearance

Schizophrenia

What are the negative symptoms of Schizophrenia related to Integrated Functioning/Relationship to External World?

• Impaired social interaction
• Social isolation

Schizophrenia

What are the negative symptoms of Schizophrenia related too Psychomotor Behavior?

• Anergia
• Wavy Flexibility
• Posturing
• Pacing and rocking

Schizophrenia

What are the negative symptoms of Schizophrenia related to Associated Features?

• Anhedonia
• Regression

Schizophrenia

What are delusions and what are the (6) different types?

False personal beliefs that are inconsistent with person's intelligence or cultural background.

• Delusions of Persecution - feels threatened & thinks others are out to harm them.
• Delusions of grandeur - Exaggerated feeling of importance, power or knowledge.
• Delusions of Reference - All events in the environment are referred by the psychotic person to themselves i.e. someone is trying to send me a message through the TV.
• Delusion of Control Influence - Believes certain objects and persons have control over their behavior (I can only sleep when the TV is off).
• Somatic Delusions - False idea about the functioning of their body i.e. 80 year old thinks their pregnant when their not.
• Nihilistic Delusions - false idea that self, part of self or others in the world are nonexistent i.e. the world no longer exists.

What is Religiosity and Paranoia?

Are they positive or negative symptoms? What category are they?

• Religiosity - excessive demonstration or obsession w/religious ideas & behavior. Schizophrenic patients may use religious ideas to provide rational meaning/structure to their behavior. i.e. - individual believes the voice they hear is God talking to them..
• Paranoia - Extreme suspiciousness of others and actions/perceived intentions.
• Both religiosity and paranoia are positive symptoms and fall under the content of thought category.

What is Magical Thinking and Associative Looseness?

Are they positive or negative symptoms? What category are they?

• Magical Thinking - believes his or her thoughts or behaviors have control over specific situations or people, is common in children. i.e. father thinks if he scolds his child, their child will disappear.
• Associative Looseness - Speech of ideas which shift from one unrelated subject to the other - individual is unaware that topics are unconnected. i.e. we wanted to drive the car but the airport took all the traffic.
• Both Magical thinking is a positive symptom and is under the category of content of thinking. Whereas Associative looseness is positive falls under form of thought.

What is Neologisms and Concrete Thinking?

Are they positive or negative symptoms? What category are they?

• Neologisms - patient invents new words that are meaningless to others but have symbolic meaning to the person i.e. I found his new frumperum cute.
• Concrete thinking - A regression to an earlier level of cognitive development (Piaget's Concrete Operations - age 7-11) , abstract thinking is difficult. Has difficulty explaining "It's raining cats and dogs"
• Both neologism and concrete thinking are positive symptoms and are under the category of form thought.

What is Clang Association and World Salad?

Are they positive or negative symptoms? What category are they?

• Clang Association - Words are chosen based on sound/rhyming i.e. it's very cold, I am cold and bold, the gold has been sold.
• World Salad - group of words that are put together randomly- w/out any logical connection. i.e. Most forward action grows life double plays circle uniform.
• Both clan association and world salad are positive symptoms and fall under the category of form of thought.

What is Circumstantiality and Tangentiality?

Are they positive or negative symptoms? What category are they?

• Circumstantiality - person delays in reaching the point of communication due to unnecessary/tedious details. Point is usually reached when the interviewer to keep person on track.
• Tangentiality - person never really gets to the point of communication - unrelated topics are introduced and focus of discussion is lost.
• Circumstantiality and Tangentiality are both positive symptoms and fall under form of thought.

What is Mutism and Perseveration?

Are they positive or negative symptoms? What category are they?

• Mutism - individual's inability or refusal to speak
• Perseveration - persistently repeats the same word or idea in response to different questions.
• Both mutism and perseveration are positive symptoms and fall under the category of form of thought.

What is Hallucinations and Illusions?

Are they positive or negative symptoms? What category are they?

• Hallucinations - false sensory perceptions not associated with real external stimuli - may involve 5 sense (Auditory, Visual, Tactile, Gustatory & Olfactory)
• Illusions - are misperceptions or misinterpretations of real external stimuli
• Both hallucinations and illusions are positive symptoms and fall under the category of perception.

What is Echolalia and Echoprazia?

Are they positive or negative symptoms? What category are they?

• Echolalia - the repetition of words that the schizophrenic hears - this an attempt to identify w/person speaking.
• Echopraxia - individual purposelessly imitate movements made by others.
• Both echolalia and echopraxia are positive symptoms and fall under the category of sense of self.

What is Identification and Imitation?

Are they positive or negative symptoms? What category are they?

• Identification and imitation - identification occurs on an unconscious level.
• Imitation occurs on a conscious level (used as an ego mechanism) and reflects individuals confusion regarding self-identity. Due to difficulty in knowing their own boundaries their behavior takes on the form of what they see in another person.
• Both are positive symptoms and fall under the category of sense of self.

What is Depersonalization?

Are they positive or negative symptoms? What category are they?

• Unstable self-identity of an individual that leads to feelings of unreality i.e. client may feel extremities have changed in size, or see oneself from a distance.
• Depersonalization is a positive symptom and falls under sense of self.

What is Inappropriate Affect and Bland and Flat Affect?

Are they positive or negative symptoms? What category are they?

• Inappropriate affect - when individual's emotional tone is incongruent w/circumstances i.e. woman laughs when told of the death of a parent.
• Bland/Flat Affect - Described as such when emotional tone is very weak - individual may appear void of emotional tone or overt expression of feelings.
• Both inappropriate affect and bland affect are negative symptoms and fall under the category of affect.

What is Apathy and Emotional Ambivalence?

Are they positive or negative symptoms? What category are they?

• Apathy - An indifference or disinterest in the environment. Bland or flat affect is a manifestation of the emotional apathy.
• Emotional Ambivalence - coexistence of opposite emotions toward the same object, person, or situation. These may interfere w/ person's ability to make even a very simple decision (i.e. whether to drink juice or milk) or in fulfilling a relationship.
• Both apathy and emotional ambivalence are negative symptoms. Apathy falls under the category of sense of self, and Emotional Ambivalence falls under the category Volition.

What is Deteriorated Appearance and Impaired social interaction?

Are they positive or negative symptoms? What category are they?

• Deteriorated Appearance - Personal grooming and self-care activities may be neglected. Client may appear disheveled and untidy and may need to be reminded of the need for personal hygiene.
• Impaired Social Interaction - Clinging and intruding on the personal space of others, exhibiting behaviors that are not socially or culturally acceptable.
• Both Deteriorated Appearance and Impaired Social Interaction are negative symptoms. DA falls under the category of Volition, while Impaired Social Interaction falls under the category of interpersonal functioning/relationship to external world.

What is Social Isolation and Anergia?

Are they positive or negative symptoms? What category are they?

• Social Isolation - Focus inward on themselves to the exclusion of the external environment.
• Anergia - Deficiency of energy to carry out activities of daily living or to interact with others.
• Both Social Isolation and Anergia are negative symptoms and social isolation falls under Interpersonal functioning and relationship to external world.

What is Waxy Flexibility and Posturing?

Are they positive or negative symptoms? What category are they?

• Waxy Flexibility - Allows body parts to be placed in bizarre or uncomfortable positions. One placed in positiong, the arm, leg, or head remains in that position for long periods regardless of how uncomfortable it is for client. I.e. nurse positions arm in outward position to take BP, when cuff is removed client maintains arm in same position.
• Posturing - Manifested by voluntary assumption of inappropriate or bizarre postures.
• Both Waxy Flexibility and Posturing are negative symptoms and fall under the category of Psychomotor Behavior.

What is Pacing and Rocking and Anhedonia?

Are they positive or negative symptoms? What category are they?

• Pacing and Rocking - slow, rhythmic, backward and forward swaying of trunk from hips usually while sitting.
• Anhedonia - inability to experience pleasure - compels client to commit suicide.
• Both Pacing and Rocking are negative symptom. P & R falls under psychomotor behaviors while anhedonia falls under associated features.

What is Regression?

Are they positive or negative symptoms? What category are they?

• Regression - retreating to earlier level of development. Is a primary defense mechanism and a dysfunctional attempt to reduce anxiety.
• Regression is negative symptom and falls under the category of Associated Features.

5 types of Hallucinations

• Auditory
• Visual
• Tactile
• Gustatory
• Olfactory

Auditory Hallucination

• False perceptions of sound and commonly come in the form of voices. Other sounds include clicks, rushing noises, music and other noises.
• Command hallucinations may place individuals or others in a dangerous situation - voices that command individual to self-harm or others.
• Most common type of hallucination

Visual Hallucination

• False visual perceptions and consist of formed images i.e. people, unformed images or flashes of light

Tactile Hallucination

• Are false perceptions of sense of touch - often feeling something on skin or under skin, crawling under skin.

Olfactory Hallucination

• False perceptions of sense of smell.

Gustatory Hallucination

• False perception of taste - unpleasant tastes.