
Chapter 16: Schizophrenia
Key Terms:
-Abnormal Involuntary Movement Scale
(AIMS): tool used to screen for symptoms
of movement disorders (side effects of
neuroleptic medications
-Akathisia: intense need to move about;
characterized by restless movement,
pacing, inability to remain still, and the
client’s report of inner restlessness
-Alogia: a lack of any real meaning or
substance in what the client says; tendency
to speak very little or to convey little
substance of meaning (poverty of content)
-Anhedonia: having no pleasure or joy in
life; losing any sense of pleasure from
activities formerly enjoyed
-Blunted Affect: showing little or a
slow-to-respond facial expression; few
observable facial expressions
-Catatonia: psychomotor disturbance, either
motionless or extensive motor
-Command Hallucinations: disturbed
auditory sensory perceptions demanding
that the client take action, often to harm
self or others, and are considered
dangerous; often referred to as “voices”
-Delusions: a fixed, false belief not based in
reality
-Depersonalization: feelings of being
disconnected from sled; the client feels
detached from their behavior
-Echolalia: repetition or imitation of what
someone else says; echoing what is heard
-Echopraxia: imitation of the movements
and gestures of someone an individual is
observing
-Extrapyramidal Side Effects (EPS):
neurologic side effects of antipsychotic
medications that are drug and dose related;
treated with anticholinergic medication;
includes dystonia, pseudoparkinsonism,
and akathisia
-Flat Affect: showing no facial expressions
-Hallucinations: false sensory perceptions
or perceptual experiences that do not really
exist
-Ideas of Reference: client’s inaccurate
interpretation that general events are
personally directed to him or her, such as
hearing a speech on the news and believing
the message has personal meaning
-Latency of Response: refers to hesitation
before the client response to questions
-Neuroleptic Malignant Syndrome (NMS):
a potentially fatal, idiosyncratic reaction to
an antipsychotic (or neuroleptic) drug
-Neuroleptics: antipsychotic medications
-Polydipsia: excessive water intake
-Pseudoparkinsonism: a type of
extrapyramidal side effect of antipsychotic
medications; drug-included parkinsonism;
includes shuffling gait, mask like facies,
muscle stiffness (continuous) or
cogwheeling rigidity (ratchet-like
movements of joints), drooling, and
akinesia (slowness and difficulty initiating
movement)
-Psychomotor Retardation: overall slowed
movements; a general slowing of all
movements; slow cognitive processing and
slow verbal interaction
-Psychosis: cluster of symptoms including
delusions, hallucinations, and grossly
disordered thinking and behavior
-Tardive Dyskinesia: a late-onset,
irreversible neurologic side effect of
antipsychotic medications; characterized by
abnormal, involuntary movements such as
lip smacking, tongue protrusion, chewing,
blinking, grimacing, and choreiform
movements of the limbs and feet
-Thought Blocking: stopping abruptly in
the middle of a sentence or train of thought;
sometimes client is unable to continue the
idea
-Thought Broadcasting: a delusional belief
that others can hear or know what the client
is thinking
-Thought Insertion: a delusional belief that
others are putting ideas or thoughts into the
client’s head; that is, the ideas are not those
of the client
-Thought Withdrawal: a delusional belief
that others are taking the client’s thoughts
away and the client is powerless to stop it
-Waxy Flexibility: maintenance of posture
or position over time even when it is
awkward or uncomfortable
- Word salad: flow of unconnected words
that convey no meaning to the listener.
Objectives:
Discuss various theories of the etiology of
schizophrenia
-Biological Theories: focus on genetic
factors, neuroanatomic and neurochemical
factors, and immunology
-Genetic Factors: partial inheritance
➢Identical twins 50% chance if one
twin has diagnosis schizophrenia
➢Fraternal twins only 15% chance
➢Children who have one biological
parent with schizophrenia they
have a 15% chance; if both
parents have schizophrenia child
has a 35% chance
- Neuroanatomic and Neurochemical
Factors:
➢Less brain tissue and
cerebrospinal fluid than those who
don’t have schizophrenia
➢Enlarged ventricles in the brain
and cortical atrophy
➢Glucose metabolism and oxygen
is diminished in frontal cortical
structures of brain
➢Decreased brain volume and
abnormal brain function in the
frontal and temporal area of
persons with schizophrenia
➢Intrauterine influences such as
poor nutrition, tobacco, alcohol,
and other drugs, and stress also
are being studied as possible
AMDG