Chapters 1-6 and Handouts
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How common is schizophrenia and how many people does it affect? | show 🗑
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According to the National Institute of Mental Health approx. how many people will develop schizophrenia in their lifetime? | show 🗑
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show | As long as humankind.
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show | Hallucinations (Auditory), delusions, bizzare behavior
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show | A thought disorder...but not all forms of the disorder include long-term cognitive deficits.
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show | A psychotic disorder...yet psychosis may be present only for some period during the course of the disease, not as a chronic condition.
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List the 8 common myths of schizophrenia: | show 🗑
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Does a person with schizophrenia have a split personality? | show 🗑
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Is schizophrenia a product of bad parenting? | show 🗑
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Is schizophrenia caused by drug experimentation? | show 🗑
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Is schizophrenia caused by a lack of motivaion? | show 🗑
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show | NO! Because of out stressful society - people w/schizophrenia may be more seriously diabled by condition.
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show | NO! Schizophrenic individuals do not always live in institutions and are not always profoundly disabled. Most live w/families, in residential care facilities in the the community, or independently. Can be disabling but is highly variable.
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Does a schizophrenic person have low intelligence? | show 🗑
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show | Poor obstruction, judgement, and processing time. These can be misunderstood as low intelligence.
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show | Generally not! More likely to hurt themselves. Major predictions of violent behavior are male gender, younger age, past history of violence, noncompliance with antipsychotic medication & substance abuse.
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Causes of schisophrenia: | show 🗑
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What may play a role in the onset of episodes of schizophrenia and the severity of the disorder? | show 🗑
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show | Lesion in the brain stem, enlargement of the ventricles, brain atrophy, and abnormalities in the limbic structures, cerebellum, and corpus callosum. There is a growing body of evidence that frontal lobe dysfunction, possibly related to basal ganglia.
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show | It is hypotesized that there is an excess of dopamine or an excessive quantity of dopamine receptors in a person w/schizophrenia. Assumed that this is related to positive symptoms.
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show | Viruses may stay inactive for many years and start to grow slowly. Possible that exposure to certain viruses prenatally while involved ares of the brain are being developed. Possible autoimmune reaction triggered by virus.
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Common possible causes of schizophrenia: | show 🗑
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show | usually after adolescence, or early 20's
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show | Tends to be over diagnosed w/people demonstrating bizarre or flagrant behaviors. Some societies more than others appear to tolerate "eccentric" behavior w/out necessarily considering it pathological.
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DSM-IV-TR stands for what? | show 🗑
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2 ways to classify schizophrenia: | show 🗑
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DSM-IV-TR Minimum Criteria: | show 🗑
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DSM-IV-TR Minimum Criteria: A. Characteristic Symptoms - 2 or more of the following, each present for a significant protion of time during a one-month period | show 🗑
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show | For a significant protion of the time since the onset of the disturbance
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show | most common (for sure), most common positive symptoms - delusions, hallucinations, perceptional distortions.
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show | Bizarre speech, echolalia, incoherency, pressured speech, motor responses (pacing, rocking, restlessness & lethargy), disturbance is sleep patterns
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show | - Usually very paranoid - Forms: Thought broadcasting - can transmit thoughts; Thought Control
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show | Most common & Hallmark symptom Auditory are most common presentation
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What creates a greater level of dysfunction? | show 🗑
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show | Affective flattening or blunting, Alogia, Avolition, Anhedonia, Inattention
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What is limited ability to express emotions and feelings? | show 🗑
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show | Alogia
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What is the lack of interest or engergy unaccompanied by depressed affect? | show 🗑
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What is an inability to experience pleasure or sustain interest in activities? | show 🗑
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What is an inability to sustain concentration or attention; person may be totally unaware? | show 🗑
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show | Hypohedonia
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show | Anhedonia
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Why is it essential that the therapist understand the nature of negative symptoms? | show 🗑
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A meaningful treatment plan reflects an awareness of these symptoms and efforts to be made to help the individual cope with, and compensate for, existing deficits. | show 🗑
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show | structured tasks, expressive activities, functional living skills, psychoeducation, social skills training, vocational training
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show | Provide habit training, diversion, coping skills, time management training. Potential for leisure skill development. May also build sef-esteem through successful completion.
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Tx formats: Expressive Activities | show 🗑
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Tx formats: Functional Living Skills | show 🗑
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show | Can be used to teach living skills. Also used for teaching symptom management. Teach health and safety awareness, assertive training.
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Tx formats: Socail Skills Training | show 🗑
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show | Basic skill prep. Time management. Social Skills. Vocational pursuits must be carefully graded and may require ongoing support.
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show | Psychotropic
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What is a significant impairment of reality testing and daily functioning due to presence of positive symptoms? | show 🗑
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The outcome. | show 🗑
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show | but data on its prognosis in unreliable.
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show | Cultural and environmental influences.
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Severity and clinical presentation are also partially determined by... | show 🗑
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show | Women; less severe
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Role dysfunction can be minimized if diagnosed when? | show 🗑
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show | Two to Three decades. So recovery rates may actually be much higher than previously estimated, but only after a prolonged course of illness.
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Interdisciplinary Tx: | show 🗑
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show | Have to be hospitalized. Typical hospitalization stays have shortened considerably over the last decade - usually only occurs if individual is having a severe psychotic episode.
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Interdisciplinary Tx: Goal of Acute Hospitalization | show 🗑
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show | Also help stablize by providing a safe environment w/adequate rest and nutrition.
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Schizophrenia Tx should include: | show 🗑
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show | Should involve individual along w/family and significant others if patient gives consent. Cooperative goal setting can also be hampered by individauls pathology (symptoms)
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Who may be incapable of healthy and realistic goal setting, which will also hamper cooperative goal setting? | show 🗑
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show | The goals of the team may be quite different from those of the person with schizophrenia, whose ideas may also differ from the goals and expectations of the family.
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show | But every effort should be made to seek out and honor his expressed interest/desires even if they conflict w/team.
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show | Target outcome is a vision of the future shared by client and therapist and driven by dream and desire of individual.
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show | Dreams are unique to each individual thus targeted outcome will be also.
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show | Often misunderstood. Does not cure schizophrenia. Typically decreases symptoms.
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Psychotropic Medication: Role of drug therapy | show 🗑
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Psychotropic Medication: Drug Trials and Noncompliance | show 🗑
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How do you minimize non-compliance? | show 🗑
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OT Intervention: Treatment | show 🗑
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show | Hallucinations etc. benefit from activities that benefit from activities that divert attention from their symptoms. Can learn self-help coping strategies to minimize positive symptomology.
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Activities for Negative Symptoms: | show 🗑
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OT Intervention: Evaluation and Assessment Tools | show 🗑
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show | The Homunculus
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show | "little man"
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What is a mapping out of areas of the brain connections to body that tells scientists which parts of the brain control various parts of body? | show 🗑
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show | Model of Human Occupation
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MOHO | show 🗑
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Engagement in activity of occupation in itself will produce and maintain health | show 🗑
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MOHO was developed by... | show 🗑
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show | playful, restful, serious, and productive activities
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Activites in the MOHO model are all carried out by individuals... | show 🗑
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show | which provides input. Input produces a behavior called output. The person sees the results of their actions, these results are calle feedback.
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show | External Environment (ex. Chef)
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show | A lack of objects or too many objects can lead to psychosocial dysfunction. Must find a balance.
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show | Volition, Habituation, Mind-Brain-Body Performance
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Volition: | show 🗑
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Volition: Comprised of 3 Areas - | show 🗑
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show | Personal Causation
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show | Values
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show | Interest
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Volitions: | show 🗑
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show | Subsystem with roles and habits as its components.
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show | Habits Inernalized Roles (teacher, spouse)
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show | Habituation Subsystem
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Habituation: Interests to the OT | show 🗑
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Role dysfunction may not be a consequence of mental illness... | show 🗑
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An ex of role dysfunction: | show 🗑
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Role dysfunction: | show 🗑
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The habit patterns of most people with mental illness often gravitate toward being... | show 🗑
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show | Musculoskeletal Neurological Cardiopulmonary Symbolic Images
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Mind-Brain-Body Performance: | show 🗑
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Performance deficits... | show 🗑
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In example, borderline personality disorder people seem intact cognitively with perceptual motor functioning intact... | show 🗑
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show | Usually we will observe difficulties with motor coordination, sequencing, and tasks completion as well.
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Many deficits lead to a circle of tragedy: | show 🗑
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Usually we as health care professionals, will only focus on one or two traits of dysfunction... | show 🗑
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brittb12
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