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Chapters 1-6 and Handouts

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Question
Answer
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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