Chapter 15: Schizophrenia Acute dystonia- acute, often painful, sustained contraction of muscles, usually of the head and

neck, which typically occurs from 2 to 5 days after the introduction of antipsychotic medications. Affect- the external expression of emotion attached to ideas or mental representations of objects. Affective symptoms- symptoms involving emotions and their expression Akathisia- a condition marked by motor restlessness, ranging from anxiety to inability to lie or sit quietly or to sleep, a common extrapyramidal side effect of neuroleptic drugs Ambivalence- simultaneous existence of conflicting attitudes, emotions, ideas, or wishes toward the same object Anosognosia- a patients inability to realize that he or she is ill; caused by the illness itself. Associative looseness- a disturbance of thinking in which ideas shift from on subject to another in an oblique or unrelated manner Atypical antipsychotics- a classification of antipsychotic medications, also known as second-generation antipsychotics, which commonly interact with serotonin as well as dopamine receptors. They are considered the first line of treatment for psychosis and have a low profile for extrapyramidal side effects. Autism- a complex developmental disorder distinguished by difficulties with social interaction, verbal and nonverbal communication, and behavioral problems, including repetitive behaviors and narrow focus of interest Clang association- Psychic associations resulting from sounds, often observed in the manic phase of manic-depressive psychosis Cognitive symptoms- abnormalities in how a person thinks; difficulty with attention, memory, information processing, cognitive flexibility, and executive functions. Command hallucinations- a condition in which individuals hear and sometimes obey voices that command them to perform certain acts. The hallucinations may influence them to engage in behavior that is dangerous to themselves or to others Concrete thinking- a stage in the development of the cognitive thought processes in the child. During this phase thought becomes increasingly logical and coherent so that the child is able to classify, sort, order, and organize facts while still being incapable of generalizing or dealing in abstractions. Problem solving is accomplished in a concrete, systematic fashion based on what is perceived, keeping to the literal meaning of words, as in applying the word horse to a particular animal and not to horses in general. In Piaget's classification this stage occurs between 7 and 11 years of age, is preceded by syncretic thinking, and is followed by abstract thinking

Conventional antipsychotics- the original classification of antipsychotic medications, also known as typical antipsychotics and first-generation antipsychotics, which works by D2 receptor antagonism. They are accompanied by a variety of side effects, including extrapyramidal symptoms. Effective in the treatment of positive symptoms (e.g., delusions, hallucinations, disorganized thought) but not negative symptoms (e.g., depression, avolition, anhedonia). Delusions- an unshakable belief in something untrue. These irrational beliefs defy normal reasoning, and remain firm even when overwhelming proof is presented to dispute them. Delusions are often accompanied by hallucinations and/or feelings of paranoia, which act to strengthen confidence in the delusion. Delusions are distinct from culturally or religiously based beliefs that may be seen as untrue by outsiders Depersonalization- alteration in the perception of self so that the usual sense of one's own reality is temporarily lost or changed; it may be a manifestation of a neurosis or another mental disorder or can occur in mild form in normal persons. Derealization- The feeling that things in one's surroundings are strange, unreal, or somehow altered, as seen in schizophrenia Echolalia- stereotyped repetition of another person's words and phrases Echopraxia- stereotyped imitation of the movements of others Extrapyramidal side effects (EPSs)- side effects that mimic extrapyramidal disease and are caused by drugs that block dopamine receptor sites in the extrapyramidal system tract Hallucinations- false or distorted sensory experiences that appear to be real perceptions. These sensory impressions are generated by the mind rather than by any external stimuli, and may be seen, heard, felt, and even smelled or tasted. Ideas of reference- Incorrect interpretation of casual incidents and external events as having direct reference to oneself, which may be sufficiently intense as to constitute delusions Illusions- a mental impression derived from misinterpretation of an actual experience Metabolic syndrome- a combination including at least three of the following: abdominal obesity, hypertriglyceridemia, low level of high-density lipoproteins, hypertension, and high fasting glucose level Negative symptoms- Symptoms of schizophrenia characterized by the absence or elimination of certain behaviors. DSM-IV specifies three negative symptoms: affective flattening, poverty of speech, and loss of will or initiative Neologisms- a newly coined word; in psychiatry, a new word whose meaning may be known only to the patient using it.

Neuroleptic malignant syndrome (NMS)- Hyperthermia in reaction to the use of neuroleptic drugs, accompanied by extrapyramidal and autonomic disturbances that may be fatal Paranoia- an unfounded or exaggerated distrust of others, sometimes reaching delusional proportions. Paranoid individuals constantly suspect the motives of those around them, and believe that certain individuals, or people in general, are "out to get them." Positive symptoms- Symptoms of schizophrenia that are characterized by the production or presence of behaviors that are grossly abnormal or excessive, including hallucinations and thought-process disorder. DSM-IV subdivides positive symptoms into psychotic and disorganized Pseudoparkinsonism- Adverse effect of drugs that causes symptoms resembling parkinsonism such as tremor, masklike faces, drooling, rigidity, and stiff gait Reality testing- In psychoanalytic theory, the ego function by which the objective or real world and one's relationship to it are evaluated and appreciated by the self Recovery model- an approach to mental disorder or substance dependence (and/or from being labeled in those terms) that emphasizes and supports each individual's potential for recovery. Recovery is seen within the model as a personal journey, that may involve developing hope, a secure base and sense of self, supportive relationships, empowerment, social inclusion, coping skills, and meaning. Originating from the 12-Step Program of Alcoholics Anonymous and the Civil Rights Movement, the use of the concept in mental health emerged as deinstitutionalization resulted in more individuals living in the community. It gained impetus due to a perceived failure by services or wider society to adequately support social inclusion, and by studies demonstrating that many can recover. The Recovery Model has now been explicitly adopted as the guiding principle of the mental health systems of a number of countries and states. In many cases practical steps are being taken to base services on the recovery model, although there are a variety of obstacles and concerns raised. A number of standardized measures have been developed to assess aspects of recovery, although there is some variation between professionalized models and those originating in the Consumer/Survivor/Ex-Patient Movement. Stereotyped behaviors- a motor pattern that originally had meaning to the person (e.g., sweeping the floor or washing windows) but has become mechanical and lacks purpose. Tardive dyskinesia (TD or TDK)- a mostly irreversible neurological disorder of involuntary movements caused by long-term use of antipsychotic or neuroleptic drugs Word salad- a meaningless mixture of words and phrases characteristic of advanced schizophrenia.