Peds Psych Exam 2 (part 2)

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A belief that one is in danger of being harmed or harassed by someone else. (most common)

Persecutory

A belief that comments, gestures, environmental cues are directed at oneself and have a personal meaning.

Ideas of reference

A belief that the individual possesses special abilities, powers, control, wealth, or fame.

Grandiose

A false belief that someone else is in love with the individual.

Erotomanic

A false belief that a spouse or lover is unfaithful

Jealous

A conviction that a disaster will occur.

Nihilistic

A false belief related to health or body function.

Somatic

A belief that someone or something is removing thoughts from their mind.

Thought withdrawl

A belief that someone or something is putting ideas in their mind.

Thought insertion

A belief that others know their thoughts and ideas without the individual sharing their thoughts.

Thought broadcasting

A belief that one’s body or actions are being manipulated by an outside force.

Delusions of control

Perceptions of something that is not present or occurring without external stimuli.

Hallucinations

Tactile hallucinations that are sensation of bugs crawling under the skin

Formication

Occurring when falling asleep

Hypnagogic hallucinations

Occurring when waking

Hypnopompic hallucinations

Switching from one topic to another

Derailment/Loose associations

Indirect/unrelated answers

Tangential

“word salad”

Incoherent

immobile, stuporous, decreased reaction to the environment, abnormal/bizarre movements, lack of speech (mutism), repeated movements (staring, grimacing, echolalia)

Cataonia

does not follow instructions

Negativism

excessive motor activity, purposeless movements

Catatonic excitement

Key Features of Psychotic Disorders

Disorganized/Abnormal Motor Behavior -Childlike -Unpredictable agitation -Problems with goal directed behavior -Inability to complete ADLs

False beliefs

Delusions

hearing, seeing, feeling, smelling, or tasting something that does not exist

Hallucinations

moving from one topic to another without making sense, making up words or sounds, repeating phrases

Disorganized thinking and speech

unable to perform ADLs, uninhibited/bizarre actions, impulsivity, unprovoked outbursts, agitation

Disorganized behavior

decreased expression of emotions in facial expressions, eye contact, intonation, and other movements associated with emotional emphasis.

Diminished emotional expression

decreased motivation and self-directed activities

Avolition

decreased speech

Alogia

decreased ability to experience or loss of pleasure

Anhedonia

a lack of interest in socializing or social activities

Asocial

Childhood-onset schizophrenia (COS)

Diagnosed prior to age 13

Early-onset schizophrenia (EOS)

Diagnosed prior to age 18

In order to diagnose COS and EOS what must be met?

1 of the following “positive” symptoms is required: delusions, hallucinations, or disorganized speech

What are the 4 phases of Schizophrenia in children?

Prodromal, Acute, Recovery, and Residual

overall decline in function (social, cognitive, emotional, developmental, and behavioral)

Prodromal

positive symptoms appear (hallucinations, delusions, disorganized/dangerous behaviors)

Acute

may take 6 months or longer and often incomplete

Recovery

chronic impairment in function (social and academic)

Residual

What is the rule out test for Schizophrenia that tests for protein associated with serum copper?

Ceruloplasmin

Children with Schizophrenia may re-experience trauma by?

Hallucinations and restrictive and repetitive play.

Children with Schizophrenia may show OCD behaviors like?

Ruminating thoughts and compulsive behaviors may appear as impaired reality

Clinical tool used to interview caretakers and the child/adolescent patient. Includes family psychiatric history, developmental history, academic history, patient’s psychiatric history, chief complaint, past treatments, history of substance use, medical history, past hospitalizations, medication history, and an assessment of overall functioning. Language can be modified for use with children.

Structured Clinical Interview (SCID-5)

Clinical tool used to interview to interview parents and patient. Determines manifestation of symptoms of schizophrenia or other psychotic disorders. Assesses hostility, suspiciousness, hallucinations, and grandiosity

Brief Psychiatric Rating Scale (BPRS)

Allows for an assessment of the presence and severity of positive and negative symptoms. 30 items are rated from 1 to 7 with a total score ranging from 30 to 210. The higher the score the more severe the symptoms. A score > or = to 70 is considered symptomatic

Positive and Negative Symptom Scale (Kiddie - PANSS)

Assesses for the presence of positive symptoms and negative symptoms

Scale for Assessment of Positive Symptoms (SAPS) and Scale for Assessment of Negative Symptoms (SANS)

Addresses deficits in thought processes, helps the child/adolescent and caregiver recognize delusional thinking, early signs of relapse, exacerbating factors, and teaches problem solving strategies.

Cognitive behavioral therapy (CBT)

To improve functioning and self-efficacy

Skills training (social and behavioral)

To help improve verbal memory and executive function.

Cognitive remediation

An integrated approach for first-episode psychosis. Offers supportive education and employment and improves length of treatment time, quality of life, and participation in work and school

NIMH RAISE Project

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