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Clinical Psychology
Psychosis
29
Psychology
Undergraduate 1
10/29/2017

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Term
What is Psychsis?
Definition
A mental health problem in which:
- The person loses touch with demands of reality (lack of reality testing)
- They often suffer from delusions (fixed, incorrect beliefs) – start to think they have ultimate powers
- They usually have little insight of their mental problem (they do not know that they are experiencing a mental health problem) – isn’t an on/off switch, ranges in a continuum
- They experience a marked deterioration in functioning
- Differs from the neuroses like anxiety and depression where there is ‘limited impairment’, the person has insight into their problems and remains largely in touch with reality.
Term
Name six disorders with psychotic features
Definition
• Schizophrenia

• Bi-Polar Disorder

• Depression

• Post partum psychosis (psychotic illness after having a child)
• Dementia/Delirium

• Drug induced psychosis (drug consumption can tip person over the reality and person may stay in that space)
Term
What is the DSM 5 Criteria for Schizophrenia?
Definition
Two (or more) of the following, each present for a significant portion of time during a 1 month period (or less is successfully treated):
- Delusions (lost believes)
- Hallucinations (hearing voices, seeing things and feeing things that are not there i.e. all senses that can experience things which are not there in reality)
- Disorganised speech (e.g. frequent derailment or incoherence)
- Grossly disorganised or catatonic behaviour
(don’t move)
- Negative symptoms (i.e., diminished emotional expression or avolition – flat emotionally)
- Marked impairments in social/occupational functioning; continuous signs of the disturbance persist for at least 6 months (may include periods of prodromal or residual symptoms)
Term
What are the Positive features of Schizophrenia (features absent in others but present in people with schizophrenia)?
Definition
• Delusions – false beliefs of who person is e.g. persecution, grandeur etc. e.g. believe they are an other person, believe people are listening to all your thoughts, CIA is coming to get you, if you believe this 100% then will do anything to avoid it.
• Hallucinations – auditory (hearing voices), visual, tactile, olfactory.
• Thought disorder and confused speech – difficulty maintaining logical thought e.g. knights move, thought blocking, thought insertion, word salad, neologisms.
• Disorganized or catatonic behaviour e.g. agitation or stupor (catatonia)
Term
What are the Negative features of Schizophrenia (A lack of feelings or behaviors that are usually present in a person,
such as)?
Definition
- Losing interest in everyday activities, like bathing, grooming, or getting dressed
- Feeling out of touch with other people, family, or friends
- Lack of feeling or emotion (apathy)
- Having little emotion or inappropriate feelings in certain situations
- Having less ability to experience pleasure
Term
How many schizophrenic patients attempt suicide?
Definition
40-50%
10-15% succeed
Term
Describe Biological approaches to schizophrenia
Definition
- Based on the Overactive dopamine theory (neuro-structural differences)
- Treatment mainly anti-psychotic medication e.g. Risperidone, Olanzapine
- Newer drugs brought in 1990s, claimed that they have less side effects than the old drugs
Term
What are some side effects of the Anti-Psychotic medication?
Definition
Weight gain, akathisia, sedation, dysphoria, insomnia, sexual dysfunction, low blood pressure, high blood pressure, muscle stiffness, muscle pain, tremors, hypersalivation, constipation, photosensitivity, acne, irritability, aggression, sleep problems, eating problems, tardive dyskinesia.
Term
What are some Psychological explanations of Psychosis?
Definition
- Trauma/abuse
- Parental loss
- Poverty psychosis
- Childhood adversisty
Term
Explain link between Trauma/Abuse and Psychosis
Definition
- People who had experienced THREE types of trauma (sexual abuse, physical abuse etc.) were 18 TIMES MORE LIKELY to be psychotic than non-abused people

・ Events in lives are incredibly impactful as to whether person experiences psychosis
- People who had experienced FIVE types of trauma were 193 TIMES MORE LIKELY to be psychotic
Term
Explain link between Parental Loss and Psychosis
Definition
390 people with a first episode of psychosis, compared to a control group
–  2.4 times more likely to have been separated from one or both parents before age 16
–  3.1 times more likely to have had a parent die
–  12.3 times more likely to have had their mother die
Term
Explain link between Poverty and Psychosis
Definition
- Deprived children are EIGHT TIMES MORE LIKELY to develop Schizophrenia as adults
- 30 years ago the relationship between Schizophrenia and poverty was described as ‘one of the most consistent findings in the field of psychiatric epidemiology’ (Eaton, 1980).
- If framed in biological aspect, people avoid having to deal with societal problems
Term
Explain link between Child Adversity and Psychosis
Definition
- Examined relationship between childhood adversity (sexual abuse, physical abuse, emotional/psychological abuse, neglect, parental death, and bullying) and psychosis
- Meta analysis of 41 studies showed that patients with psychosis 2.7 times more likely to have been exposed to childhood adversity than controls
Term
Explain the Vulnerability Stress Model
Definition
[image]
- Could be an hour, a week, a year
- All have a line of wellness (orange line). When above the line, our mood goes up and down e.g. self-esteem, energy, day’s events
- There are moments where life takes you bellow the wellness line
- When below the line person is ‘clinically unwell’
- Parts shaded in green are ‘periods of unwellness’
- As time passes (and sometimes it is only time that is needed) person may go over the line again
- Interested in what event keeps person above the line or takes a person under/above the line

"Vulnerability" refers to our basic susceptibility to mental health disorders. This is determined by our genetic makeup and our early life experiences. It is affected by our use of medications and our likelihood of using alcohol or drugs. "Stress" refers to the challenges faced in our lives. It is affected by our coping skills, social support, and involvement in meaningful activities.
Term
What are three possible vulnerability factors?
Definition
1. Genetic predisposition
2. Brain abnormalities
3. Psycho social factors (e.g. childhood adversity)
Term
What are possible Stressors in life?
Definition
1. Major life events
2. Loss
3. Sexual/physical/emotional abuse
4. Neglect
Term
What are possible Protective Factors?
Definition
1. Intelligence
2. Social support
3. Healthy family communication
4. Social competence
Term
What are the two main new psychosis medications?
Definition
Risperdal and Olanzapine
Term
Name the Old antibiotics side effects
Definition
- Uncontrollable mouth movements
- Uncontrollable tongue movements
- Finger tapping
- Shuffling walking effect
- Because people are on them for a long time, even if person is taken off these medications it does not go away
Term
Explain Chochrane's Review of Risperidone
Definition
- Global effects suggests that there is no clear difference between Risperidone and placebo
- Risperidone causes many adverse effects and these effects are important and common.
- Even if evidence does not show that what they are dong isn’t working, they are still going to hang on to their idea
- Don’t have to deal with the society, and protects us all from looking at our issues in society if we can all remain in denial
- Don’t have actual tests showing evidence that it s a specific hormone imbalance, it is only a hypothesis that gives a feeling of control
Term
What are the Five Psychological Treatments for Psychosis
Definition
1. CBT
2. Counselling
3. Family therapy
4. Psychoeducation
5. Skills Training
Term
Explain CBT Psychological Treatment
Definition
- Combines the goals and techniques of both behaviour and cognitive therapies.
- The two sets of techniques can work together to promote therapeutic change: cognitive techniques change thoughts which then affect feelings and behaviours, behavioural techniques change behaviours, which in turn, lead to new experiences, feelings and ways of relating, which then change how people think about themselves and the world.
- Helps client to establish a sense of control (not to challenge delusional beliefs).
[image]
Standard: Relapse rate without talking therapies, only medication
CBT: Relapse rate is much lower
Term
Explain Counselling psychological treatment
Definition
Working with the client’s understanding of their experience and provide empathy for their distress (Psychotherapy)
Term
Explain Family Therapy psychological treatment
Definition
– A therapy modality in which a family is treated. Works on the premise that an individual’s problem is a family problem.
- Therapy helps recognise these problems and teach new skills on how to deal with them e.g., improving listening and problem solving, support for family.
Term
Explain Psychoeducation psychological treatment
Definition
The process of educating clients about therapy and research findings pertaining to their disorders and problems. This knowledge is then used to help clients develop a more realistic, undistorted view of their problems.
Term
Explain Skills Training psychological treatment
Definition
1. Social skills training is a type of psychotherapy that works to help people improve their social skills so they can become socially competent. SST is predominantly a behavioural therapy but cognitive therapy can also be used in some situations to maximise the success of SST. This psychotherapy can be done one-on-one or in a group situation. e.g. assertiveness, social skills.
Term
Explain the Reality about hearing voices
Definition
- About 10-15% of us hear voices at some point in our lives (Beavan, Read & Cartwright, 2011, Journal of Mental Health)
- About 80% of over 60 year olds who have lost their life partner hear or see their partner within 12 months of their death
- Move towards understanding hearing voices as being on a continuum of ‘normal’ experience
- When people are hearing voices their voice muscles are moving and the speech area of the brain lights up
- Hearing voices is a misperception of thoughts/inner speech
Term
Explain the Treatment for Hearing Voices
Definition
- Find out about the characteristics of the voices and what they say
- Voice content might provide important clues unresolved early experiences or current difficulties
- Use these as an opportunity to talk about the meaning that these things have in the client’s life.
Term
What are the cultural considerations os psychosis?
Definition
• Non-westernized views of schizophrenia are different. Have different names and are treated in different ways. Can sometimes be seen as a positive thing i.e. believe these people are sacred because they are talking to spiritual beings

West Africa:
• Ukuthwasa (symptoms include social withdrawal, irritability, restlessness, and appearing to respond to auditory hallucinations)
• Amafufunyana (described as a hysterical condition characterized by people who speak in a strange muffled voice, cannot be understood, and have unpredictable behaviour)

Guatemala (Colera, marked by violent outbursts, hallucinations, delusions, and temper tantrums)
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