Title: Schizophrenia and Other Psychotic Disorders
Course: Question bank check

Q: Alan is having a psychotic episode. Which of the following describes his experience?
- Alan isolates himself, does not appear to enjoy social interaction, and rarely seeks friendship. (Incorrect. Asocial behavior occurs in many of the disorders in the psychotic spectrum and some other conditions as well, but it is not psychosis; psychosis involves hallucinations, delusions, or disorganized thinking.)
- Alan feels a high level of anxiety and stress in his life and frequently does not want to get out of bed. (Incorrect. Persons with schizophrenia may feel anxious, but on its own this is not an example of psychosis, which consists of hallucinations, delusions, or disorganized thinking.)
- Alan doesn’t sleep much but has excessive energy during the day and has trouble concentrating. (Incorrect. This description fits better with the concept of mania; psychosis involves delusions, hallucinations, or disorganized thinking.)
- Alan hears someone speaking to him, but there is no one there or he hears odd sounds like radio static. (Correct! This is an example of auditory hallucinations; Alan is perceiving auditory sounds without external stimuli.)
A: Alan hears someone speaking to him, but there is no one there or he hears odd sounds like radio static.

Q: Elena has been suffering from increased difficulty thinking and speaking logically to others as well as talking to people that others don’t see for the past couple of weeks. Her family takes her in to see a physician. Can the doctor diagnose her with schizophrenia?
- No. She is only showing two symptoms, which is not enough to be given a diagnosis for the disorder. (Incorrect. Two positive symptoms are sufficient for a diagnosis, but the symptoms also have to last for at least one month with other symptoms present for at least six months.)
- Yes. She is experiencing psychotic symptoms and would meet the necessary criteria for the disorder. (Incorrect. Many conditions can result in psychotic symptoms, so this is not enough evidence for diagnosis; the symptoms also have to last for at least one month with other symptoms present for at least six months.)
- Yes. Because Elena is manifesting more than one positive symptom, she is experiencing the disorder. (Incorrect. For diagnosis, she does need to manifest more than one positive symptom, but the symptoms also have to last for at least one month with other symptoms present for at least six months.)
- No. Her psychotic symptoms have only lasted for two weeks, which is not enough time for a diagnosis. (Correct! Because other situations can also produce psychotic symptoms, Elena must show ongoing symptoms for a minimum of six months with one month’s duration of active, positive symptoms.)
A: No. Her psychotic symptoms have only lasted for two weeks, which is not enough time for a diagnosis.

Q: It is now eleven o’clock and Tyrone has not come out of his room nor had breakfast. Slightly concerned, his roommate knocks on the door and peeks into his room to find Tyrone hiding behind his desk. When he asks what is going on, Tyrone says that he knows that the Residential Assistant is monitoring his thoughts and plans to take over his body when he sees him next. What psychotic symptom is Tyrone experiencing?
- a hallucination (Incorrect. Hallucinations are sensory experiences without external stimuli; in this case, he is not having a sensory experience but a thought or belief that doesn’t align with reality.)
- flat affect (Incorrect. Flat affect is a negative symptom that manifests as a lack of expected emotional expression; in this case, Tyrone has a belief that is contradictory to reality and social expectations.)
- disorganized thinking (Incorrect. Disorganized thinking is not the same as a delusion; it manifests as difficulty processing information, thinking logically and coherently, and communicating clearly. In this case, Tyrone is experiencing a delusional belief.)
- a delusion (Correct! Tyrone is experiencing an unusual belief that is contradictory to social and cultural expectations.)
A: a delusion

Q: Kozue has schizophrenia and is showing evidence of positive symptoms. What does this mean?
- Her symptoms result in increased positive emotions, similar to mania but more intense. (Incorrect. Positive symptoms do not refer to happiness or energy, but to additional behaviors that are atypical or unusual.)
- She is showing behaviors that result in the need for immediate action and attention. (Incorrect. Positive symptoms generally do not require an urgent response; they are additional behaviors that are unusual and atypical.)
- Her symptoms trigger additional symptoms in a type of feedback loop that gets worse over time. (Incorrect. Positive does not mean adding more symptoms, but the presence of behaviors that are atypical or unusual.)
- She is demonstrating behaviors and thinking that are uncommon and unusual. (Correct! Positive symptoms are additional behaviors that are unusual or atypical.)
A: She is demonstrating behaviors and thinking that are uncommon and unusual.

Q: During a clinical interview, Elliott displays clear negative symptoms of schizophrenia. What does this refer to?
- symptoms that demonstrate that his schizophrenia is getting worse and more intense (Incorrect. Negative does not refer to a deterioration of Elliott’s situation, but to symptoms that manifest a reduction or absence of common behaviors or reactions.)
- behaviors that tend to generate increased tension or conflict with other persons (Incorrect. Negative in this context does not refer to hostility or conflict with others but to symptoms that manifest a reduction or absence of common behaviors or reactions.)
- the presence of emotional exaggeration or overreaction to minor social situations (Incorrect. Negative in this context does not refer to intensified emotions, but rather the opposite; it refers to symptoms that manifest a reduction or absence of common behaviors or reactions.)
- an absence or reduction of common behaviors, reactions, and emotions (Correct! Negative symptoms are subtractive, reflecting a decrease or absence of common reactions and behaviors such as flat affect.)
A: an absence or reduction of common behaviors, reactions, and emotions

Q: Maritza has schizophrenia. She sometimes goes for days without showering or brushing her teeth and mostly keeps to herself, rarely interacting with family and friends. Some think that she is just getting lazy, but others realize that this is what type of symptom of schizophrenia?
- positive (Incorrect. This is an example of avolition, a negative symptom of schizophrenia.)
- residual (Incorrect. This is an example of avolition, a negative symptom of schizophrenia. Residual refers to a stage of schizophrenia, not a symptom.)
- prodromal (Incorrect. This is an example of avolition, a negative symptom of schizophrenia. Prodromal refers to an early stage of schizophrenia, not a symptom.)
- negative (Correct! This is an example of avolition, a negative symptom of schizophrenia.)
A: negative

Q: Minor symptoms of psychosis, problems at school or work, or a decline in social functioning are all considered ________ of schizophrenia.
- negative symptoms (Neither positive nor negative symptoms are more or less severe than the other. Negative symptoms involve a lack of something that is normally present.)
- positive symptoms (Incorrect. Neither positive nor negative symptoms are more or less severe than the other. Positive symptoms are those that are notable for their presence.)
- postdromal symptoms (Incorrect. These are not a type of symptom associated with schizophrenia. The prefix post- means after, so these would be symptoms that come later and would thus be ineffective predictive tools.)
- prodromal symptoms (Correct. These are minor symptoms that may indicate a worsening in the condition to follow, denoted by the prefix pro-, meaning they come before other, more severe symptoms.)
A: prodromal symptoms

Q: Gustav has been diagnosed with delusional disorder; his brother, Brandt, has been diagnosed with schizophrenia. Which one of the brothers most likely hears someone speaking to him and replies back to them even though no one else is present?
- Gustav (Incorrect. Brandt has schizophrenia and therefore probably experiences auditory hallucinations while Gustav has delusional disorder and while he has delusions, does not experience hallucinations.)
- Both brothers likely have this or a very similar experience (Incorrect. The diagnosis of delusional disorder (Gustav) excludes meeting criteria A of schizophrenia; if he has both delusions and hallucinations he would receive the same diagnosis as Brandt.)
- Neither brother likely has this experience (Incorrect. Brandt has schizophrenia and therefore probably experiences auditory hallucinations while Gustav has delusional disorder and while he has delusions, does not experience hallucinations.)
- Brandt (Correct! Brandt has schizophrenia and therefore probably experiences auditory hallucinations while Gustav has delusional disorder and while he has delusions, does not experience hallucinations.)
A: Brandt

Q: Every day after classes, Fahari goes and sits at a bus stop across the street from a house where a young married man lives that she is convinced is in love with her. She waits for him to send a signal of his love for her and has started putting love notes in his mailbox. The two of them have never met, and the young man does not know who she is. What type of delusion is Fahari experiencing?
- Grandiose (Incorrect. Grandiose delusions involve the strong belief that someone has extraordinary talent, is a person of importance or great value or power (e.g. President, Jesus Christ).)
- Delusional jealousy (Incorrect. Delusional jealousy involves the belief that one’s partner is being unfaithful to the relationship even though there is no history or evidence of this. In this case, Fahari does not have a relationship with the young man.)
- Thought insertion (Incorrect. Thought insertion involves the belief that others, especially government officials, television networks, etc. is inserting thoughts into a person’s mind; their thoughts are not their own.)
- Erotomanic (Correct! Erotomanic delusions involve the belief that someone else is in love with the person with the delusion.)
A: Erotomanic

Q: Roald is a clinician. A new patient has been admitted to the hospital for evaluation when he threatened his girlfriend and repeatedly telling her that he knew she was cheating on him. Roald has determined that in order to diagnose the patient, he needs to differentiate between delusional disorder and schizophrenia. Which one of the following situations would contribute to Roald diagnosing delusional disorder?
- The patient tells the nurse to turn off the radio because it bothers him, but the radio was not on. (Incorrect. This is an auditory hallucination; persons with delusional disorder do not typically have hallucinations, and a hallucination plus a delusion would meet Criteria A for schizophrenia.)
- When he speaks or answers questions, the patient usually only answers with one or two words. (Incorrect. This is a negative symptom of schizophrenia and would push diagnosis towards that disorder. Persons with delusional disorder do not show negative symptoms.)
- While interviewing the girlfriend, Roald learns that the patient has been using cocaine frequently. (Incorrect. If the delusional jealousy was connected to frequent use of illegal drugs, then further evaluation is needed, and a diagnosis of delusional disorder is unlikely.)
- On the unit, the patient functions well, gets along, and does not show any unusual behaviors. (Correct! With delusional disorder, apart from behaviors related to the specific content of the delusion(s), the person can function relatively well at home or at work.)
A: On the unit, the patient functions well, gets along, and does not show any unusual behaviors.

Q: Julio just lost his wife yesterday to suicide; although she had experienced periods of depression over the years, he had not expected her to attempt suicide. He now has to care for his three children alone. Which of the following situations would most likely qualify Julio to be diagnosable with brief psychotic disorder?
- He shows a slow but gradually intensifying pattern of psychotic symptoms lasting for six weeks (Incorrect. In this description, the symptoms last longer than one month and show an escalating, rather than sudden onset, pattern.)
- He shows an intense depressive episode and begins to experience delusions for three weeks (Incorrect. Brief psychotic disorder cannot be better accounted for by mood disorder with psychotic features or schizoaffective disorder.)
- He shows a recurrence of intense social anxiety and isolates himself from others, including family (Incorrect. The described symptoms do not include hallucinations, delusions, disorganized speech or disorganized behavior.)
- He shows psychotic symptoms within a couple of weeks that last for 10 days and then stop (Correct! Psychotic symptoms must last at least one day but less than one month followed by complete remission.)
A: He shows psychotic symptoms within a couple of weeks that last for 10 days and then stop

Q: Which of the following persons is most likely to be diagnosed with brief psychotic disorder?
- Lorenzo lives in New York City and abuses alcohol and recently divorced. (Incorrect. Lorenzo lives in a developed nation and does not show other significant markers thought to be related to brief psychotic disorder.)
- Kaarina lives in Sweden, has two children, and is a high school teacher. (Incorrect. While Kaarina is female and thought to be at higher risk than a male for this disorder, she is from a developed nation and is lower risk than Taisha.)
- Itsuki lives in Tokyo; he is single, and works as a web designer in a tech company. (Incorrect. Itsuki is from a developed nation, is male, and does not have significant factors that are thought to be associated with the disorder.)
- Taisha is a woman from Kenya who recently gave birth to her second child. (Correct! Taisha is from a developing country which greatly increases her odds of developing the disorder, and she is also postpartum.)
A: Taisha is a woman from Kenya who recently gave birth to her second child.

Q: Steve has brought his son in for evaluation because his son has begun to say very strange things about being persecuted and at times when he speaks, his sentences do not make any logical sense. This has been going for about a week, and the family has no history of schizophrenia spectrum disorders. After assessment, assuming that Steve’s son may be suffering from brief psychotic disorder, what treatment approach would you suggest be considered first?
- Intensive family education and individual psychotherapy together with stress-management training. (Incorrect. Family education may be helpful as might therapy, but the first priority would be to reduce psychotic symptoms with antipsychotic medications.)
- Three weeks of ECT followed by first-generation antipsychotic treatment for at least two weeks. (Incorrect. ECT is primarily used in treatment of mood disorders, and the treatment window (two weeks) is too short to ensure remission occurs.)
- Combined treatment with antipsychotics and antidepressant medications for at least one month. (Incorrect. This treatment approach suggests schizoaffective disorder. Atypical antipsychotics should be tried first to reduce psychotic symptoms and for longer than one month.)
- Use of second-generation antipsychotic medication with follow-up for several months. (Correct! The first line of treatment is use of newer antipsychotics to relieve positive symptoms with follow-up to make sure remission occurs.)
A: Use of second-generation antipsychotic medication with follow-up for several months.

Q: Thomas has been experiencing the sensation that spiders are crawling underneath his skin. He also usually lacks emotional expressiveness in his face or voice when he interacts with others, and he can be difficult to understand sometimes due to jumping around in his sentences or using words that do not exist. What would differentiate Thomas’s diagnosis between schizophrenia and schizophreniform disorder?
- The intensity of his symptoms (how significant an impact they have on his functioning). (Incorrect. The intensity of symptoms in both disorders can be the same; the only difference is how long the symptoms have lasted (duration).)
- The number of his symptoms (more symptoms indicating schizophrenia). (Incorrect. Both disorders require at least two symptoms, at least one of which must be hallucinations, delusions, or disorganized speech/thought disorder; the only difference is duration of symptoms.)
- The reaction of his symptoms to antipsychotic treatment (faster with schizophreniform) (Incorrect. Antipsychotics do not work better for persons with schizophreniform disorder; the only difference between the disorders is duration of symptoms.)
- The duration of his symptoms (how long he has been experiencing them). (Correct! Symptoms experienced by persons with both disorders are the same, but persons with schizophreniform disorder have symptoms lasting more than one month and less than six months.)
A: The duration of his symptoms (how long he has been experiencing them).

Q: Leila and John are from the same country and generally have similar life histories in terms of their development, education, and life stressors. Which one of them has a greater risk of receiving a diagnosis of schizophreniform disorder?
- It depends on their country; in developing nations, women are more likely to be diagnosed. (Incorrect. While developing nations have higher rates of diagnosis of schizophreniform disorder, the rates between men and women are comparable.)
- Leila (Incorrect. Prevalence rates for this disorder are about the same for men and women.)
- John (Incorrect. Prevalence rates for this disorder are about the same for men and women.)
- Neither; unlike some other disorders, men and women have equal rates of this disorder. (Correct! Prevalence rates for schizophreniform disorder are roughly the same between women and men.)
A: Neither; unlike some other disorders, men and women have equal rates of this disorder.

Q: Stefon is being treated in a partial hospitalization setting for schizophreniform disorder. He was placed on an atypical antipsychotic medication, but it does not seem to be working very well. Which of the following is a strategy that is likely to be attempted next by the psychiatrist?
- Transfer Stefon to an inpatient setting for a two-week trial of ECT. (Incorrect. ECT is used primarily with mood disorders; the psychiatrist is more likely to switch Stefon to another atypical antipsychotic.)
- Add an antidepressant medication to Stefon’s current antipsychotic. (Incorrect. A psychiatrist might add an anticonvulsant (anti-seizure) medication or a mood stabilizing medication to the current drug, but not an antidepressant.)
- Blend Stefon’s current medication with a first-generation antipsychotic. (Incorrect. As with schizophrenia, antipsychotic medications can have significant side effects, so a psychiatrist would not use two of them together.)
- Switch Stefon to another second-generation antipsychotic medication. (Correct! This is a common strategy when the first medication is not working.)
A: Switch Stefon to another second-generation antipsychotic medication.

Q: For several years now Terri has struggled with intense depressive episodes. During some of these episodes, she has told her family and others that she is actually dead; even when doctors have pointed out that she has a heartbeat and temperature, she insists that she has already died. During some of these episodes, she also describes feeling her bones cracking as they decay and can hear ghosts speaking to her. When treatment reduces her depression, the psychotic symptoms are no longer evident. Which of the following is the most likely diagnosis for her given this information?
- Schizoaffective disorder, depressive type (Incorrect. In schizoaffective disorders she must experience two weeks of psychotic symptoms without mood disorder symptoms; Terri’s psychosis only occurs when she is depressed.)
- Schizophreniform disorder (Incorrect. Terri’s symptoms have continued for longer than 6 months, and her primary symptoms are related to depression.)
- Organic psychotic disorder not otherwise specified (Incorrect. The term “organic” disorders is no longer part of the DSM5; her mood symptoms are most prominent and the psychosis only occurs when she is depressed.)
- Major depression with psychotic symptoms (Correct! Terri’s mood disorder is the prominent feature of her situation; she does experience psychosis, but only during mood disruptions.)
A: Major depression with psychotic symptoms

Q: Roland is anxious and upset. The psychologist he went to see just explained the assessment results and told him that he has schizoaffective disorder. Roland says, “What caused this? How could this happen?” What is the most accurate answer the psychologist could give?
- I’m sorry, but this appears to be a condition that is primarily influenced by genetic factors that you have inherited from your parents. (Incorrect. Neither schizophrenia or schizoaffective disorder is caused only by genetics; the biopsychosocial model is relevant to both.)
- The early childhood trauma you experienced, combined with your history of drug use while you were in high school is the best explanation. (Incorrect. Schizoaffective disorder is not caused primarily by psychological factors; the biopsychosocial model is relevant to both.)
- Your episodes of hearing voices and having trouble relating to others seems to have triggered your manic and depressive episodes. (Incorrect. There have not been enough studies to determine a specific etiology for schizoaffective disorder yet.)
- Right now, we don’t have a specific answer; it is probably due to a combination of genetic, biological, psychological, and social factors. (Correct! There have not been enough studies to determine a specific etiology for schizoaffective disorder yet.)
A: Right now, we don’t have a specific answer; it is probably due to a combination of genetic, biological, psychological, and social factors.

Q: In addition to the use of antipsychotics to treat psychotic symptoms, treatment for schizoaffective disorder is more likely to include which forms of treatment compared with schizophrenia?
- Brain stimulation therapies and antidepressants (Incorrect. While antidepressants may be useful in treating schizoaffective disorders, brain stimulation therapies are not usually used; ECT is a “last resort” treatment for schizoaffective disorder.)
- c/ Group therapy and insight-oriented psychotherapy (Incorrect. Neither of these forms of psychotherapy are generally helpful for persons with psychotic disorders due to social isolation and thought disorder.)
- Nutritional therapy and second-tier antipsychotic medications (Incorrect. Nutritional therapy is not usually described in treatment for these disorders, and due to side-effects, multiple antipsychotics are not usually used in combination.)
- Mood stabilizing medication and psychotherapy (Correct! Mood stabilizers may help reduce the severity of manic or depressive episodes and psychotherapy can assist with preventing rehospitalization.)
A: Mood stabilizing medication and psychotherapy

Q: William has a history of drug use and past episodes of psychosis, but he has now been diagnosed with schizophrenia. Which of the following substances was he most likely using?
- Nicotine (cigarettes) (Incorrect. Although nicotine is a stimulant, it is not listed as one of the drugs that frequently contributes to psychosis.)
- Sedative (benzodiazepine) (Incorrect. Although sedatives can produce psychosis and transition to schizophrenia, the rate is much lower than for cannabis.)
- Stimulant (caffeine) (Incorrect. While some stimulants (such as amphetamines) have a much stronger effect on psychosis and transition to schizophrenia, caffeine is not listed as being a major contributor.)
- Cannabis (marijuana) (Correct! Studies of persons who transition from drug-induced psychosis to schizophrenia is highest for cannabis users.)
A: Cannabis (marijuana)

Q: In the emergency room, a physician is examining Dayo who was brought in after she began flinching and screaming that she was seeing flashing lights and thought a truck was going to run her over. She has been in an agitated state but has no history of mental disorders. After some prodding, a friend admits that they were at a party where they were taking PCP. Which question would be the most useful for the doctor to ask that might indicate if Dayo is experiencing a substance-induced psychotic episode?
- Does Dayo have a history of ever being hit by or almost run over by a truck in the recent past? (Incorrect. A history of trauma does not necessarily trigger psychosis and would not be linked to substance use.)
- Has Dayo been severely depressed and untreated for this over the past six weeks? (Incorrect. If this situation had been the case, then Dayo would be more likely to be diagnosed with potential MDD with psychotic features rather than substance-induced psychosis.)
- Has Dayo suffered any type of head injury or been in any kind of a motor vehicle accident? (Incorrect. If her symptoms were related to a recent head injury, she could be experiencing delirium, and would not likely be diagnosed with substance-induced psychosis.)
- Does Dayo have family members diagnosed with schizophrenia or schizoaffective disorder? (Correct! Individuals with a likely genetic diathesis for psychosis are more likely to have a psychotic reaction to some drugs.)
A: Does Dayo have family members diagnosed with schizophrenia or schizoaffective disorder?

Q: Toby was brought into the Emergency Room with psychotic symptoms after a prolonged binge. After some investigation, the doctor diagnoses him with Alcohol-Induced Psychosis. This is apparently Toby’s second episode. After prescribing the use of a second generation antipsychotic drug and evaluating suicidal risk, what would probably be the next best treatment decision for Toby?
- Combination therapy with a mood stabilizer medication and Antabuse to prevent use of alcohol (Incorrect. There is no evidence of need for mood stabilizer; Antabuse may be helpful at some point, but he is not yet committed to treatment.)
- Referral to a recovery support group where he can participate in a 12-step program (Incorrect. Recovery support may be very useful later on and may be incorporated into residential treatment, but he needs more intensive immediate treatment.)
- CBT primarily focused on reducing anxiety and depression that is triggering thet psychosis (Incorrect. CBT may be helpful for learning what triggers the psychosis and how to prevent it, but he needs sustained treatment now to reduce the alcohol use as well.)
- Detox followed by residential treatment in a program that deals with dual diagnosis patients (Correct! Detox will help him get ready for treatment, and residential care will be important since he is at risk of further psychotic episodes.)
A: Detox followed by residential treatment in a program that deals with dual diagnosis patients

Q: Olivia is interested in research into schizophrenia. In particular, she wants to understand the role of genetics versus environmental influences in the development of the disorder. Which of the following is the best explanation of why she should avoid using the twin study design?
- The complexity of following up both sets of twins over time results in too much missing information. (Incorrect. These studies can be difficult to carry out, but the real problem is that twins share similar physical and social environments more than other people.)
- Twins are fairly uncommon and the results are not likely to be generalizable to the overall disorder. (Incorrect. Twins provide unique opportunities to study various situations, but the problem is that they share both physical and social environments more than most.)
- Because twins grow up together, they affect each other’s behavior, increasing environmental influence. (Incorrect. The biggest problem is separating genetic from environmental influences when the twins largely share physical and social environments. There is no data regarding twins increasing environmental influence by how they act together.)
- Twins share physical and social environments so this could interfere with separating the two influences. (Correct! This is a major problem with twin studies, although limited success can be obtained comparing identical twins with fraternal twins.)
A: Twins share physical and social environments so this could interfere with separating the two influences.

Q: Santiago is talking to a friend about the module on schizophrenia in his psychopathology course. The friend says, “That’s the one they always show in the movies, right? It’s the one that’s like a disease and you just inherit it and can’t do anything about it, right?” What is the most accurate reply Santiago can make to inform his friend?
- Yes, it is a genetic disease that involves a lot of genes, and if you inherit the wrong ones, then it affects your brain. (Incorrect. Mental disorders are not diseases in the usual medical sense; schizophrenia is also not a genetic disease; genetics and biological influences are important part of the etiology, but other influences are also involved including psychological and social factors.)
- Not really; genetics play only a small role in schizophrenia. How parents treat their kids is even more important. (Incorrect. Of all the mental disorders, schizophrenia has one of the highest degrees of genetic influence, but many other biological, psychological, and social factors are involved.)
- Yes, it is a brain disease that is related to dementia and causes damage to their ability to speak and understand the world. (Incorrect. Mental disorders are not diseases in the usual medical sense; schizophrenia is not a brain disease although there are effects on the brain. Despite its original name, schizophrenia is not classified as a form of dementia, and psychological and social factors play important roles in etiology.)
- Well, genetics are involved, but it’s complicated and psychological and other influences are also important. (Correct! Genetics play an important role in the etiology of schizophrenia, but the biopsychosocial model and research data shows multiple influences are involved.)
A: Well, genetics are involved, but it’s complicated and psychological and other influences are also important.

Q: Adhita is writing a paper on schizophrenia for her class. In discussing the differing hypotheses about the cause of schizophrenia, which sentence below would be the most accurate to include in her paper?
- Imaging studies have indicated that schizophrenia involves compression of the ventricles of the brain. (Incorrect. Individuals with schizophrenia show expanded, or enlarged ventricles, not smaller ventricles than other individuals.)
- Post-mortem brain analyses showed too much grey matter development compared to white matter. (Incorrect. Studies have shown persons with schizophrenia have reduced grey matter in the brain, especially in the frontal lobes.)
- Multiple studies have demonstrated that drug dependence can create atrophy in the occipital cortex. (Incorrect. Studies have shown that drug use can trigger or exacerbate psychosis, but the areas of concern for schizophrenia do not include the occipital cortex.)
- Early studies suggested that an excess of dopamine in the brain produced psychotic symptoms. (Correct! Early studies suggested too much dopamine might be generating psychotic symptoms; more recent studies have shown other neurotransmitters such as serotonin and glutamate may also be involved.)
A: Early studies suggested that an excess of dopamine in the brain produced psychotic symptoms.

Q: Damion thinks that impairments he sees in his patients with schizophrenia like difficulty with explaining moments in their own lives and slow response time in trying to figure things out are actually part of the risk factors for developing the disorder rather than just the effects of the illness. In reaching this conclusion, Damion is making use of which perspective on schizophrenia?
- Neural pathways perspective (Incorrect. This is not a specific perspective described in the module.)
- Psychodynamic perspective (Incorrect. The psychodynamic perspective emphasizes the intrusion of the unconscious on conscious experience and the patterns of relationships and how they shaped development.)
- Sociocultural perspective (Incorrect. The description focuses on issues such as memory, attention, abstract thinking and problem-solving which are related to cognition and the cognitive perspective.)
- Cognitive perspective (Correct! This perspective takes into account how the brain functions and is linked to research showing that some of these impairments actually begin before psychotic symptoms occur.)
A: Cognitive perspective

Q: Aiko has been studying persons with schizophrenia who seem to have more negative symptoms than others with the illness. They also struggle to understand what other people are feeling during interactions or to understand why people make decisions and choices. Aiko’s study participants appear to be impaired in what major area?
- Intrapersonal conceptualization (Incorrect. This phrase is not found in the module. Intrapersonal = within the person. The people Aiko works with are struggling to understand social and emotional situations or social cognition.)
- Emotional regulation (Incorrect. While schizophrenia does involve negative symptoms like flattened affect, the description fits with a cognitive understanding of social situations and emotion or social cognition.)
- Social alienation (Incorrect. While schizophrenia does involve negative symptoms like social isolation, the description fits with a cognitive understanding of social situations and emotion or social cognition.)
- Social cognition (Correct! Schizophrenia can affect not only one’s own ability to think and reason, but it can affect the ability to understand others and social situations.)
A: Social cognition

Q: Anay has schizophrenia, hears voices, sometimes has difficulty in trying to express himself to others, and shows unusual behaviors at times. He lives in a place where his behaviors are seen as a channel or connection to the spiritual side of life, and he is physically and emotionally supported by his community and even sought out for input and insights to help others. This reduces his stress significantly, and he functions reasonably well in his community. Seeking to understand his situation in its own context is an example of what perspective?
- Interactivity perspective (Incorrect. No specific perspective by this name is mentioned in the module. The description best fits the sociocultural perspective.)
- Developmental Socialization perspective (Incorrect. While both development and socialization are important aspects of understanding etiology, the description best fits the sociocultural perspective.)
- Social Cognitive perspective (Incorrect. Social cognition is focused on understanding social interactions, interpersonal communication, and how people understand each other’s behaviors. The description fits best with the sociocultural perspective.)
- Sociocultural perspective (Correct! The sociocultural perspective seeks to understand the impact of social and cultural forces on symptoms and treatments.)
A: Sociocultural perspective

Q: Felipe was diagnosed with schizophrenia when he was younger and was prescribed a first-generation antipsychotic medication to reduce the intensity of his psychotic symptoms. These drugs were initially developed based on what major idea at the time?
- The Reserpine Cascade hypothesis (Incorrect. There is no such hypothesis, but reserpine was the first drug that led to the development of the dopamine hypothesis of schizophrenia.)
- The Neuroleptic Pathway Theory (Incorrect. There is no such theory; but antipsychotic drugs are often called neuroleptics; the major idea was the dopamine hypothesis of schizophrenia.)
- The Cortico-Limbic Suppression Hypothesis (Incorrect. There is no such hypothesis; the major concept was the dopamine hypothesis of schizophrenia.)
- The Dopamine Hypothesis of schizophrenia (Correct! Schizophrenia was thought to result from excessive dopamine in the brain.)
A: The Dopamine Hypothesis of schizophrenia

Q: Sophia is taking a typical antipsychotic for her schizophrenia while Madison was prescribed an atypical antipsychotic for her schizoaffective disorder. What is the major difference between these two drugs?
- Sophia’s medication increases dopamine levels while Madison’s medication decreases them. (Incorrect. All antipsychotics reduce levels of dopamine by blockading D2 receptors, especially typical antipsychotics.)
- Sophia’s drug reduces positive and negative symptoms while Madison’s includes a mood stabilizer. (Incorrect. Typical antipsychotics usually do not help negative symptoms very much, and atypical antipsychotics do not include mood stabilizers.)
- Sophia’s drug targets the D1-like family while Madison’s drug targets the D2-like family. (Incorrect. All antipsychotic drugs, at this time, primarily target the D2-like family.)
- Sophia’s medication is a strong antagonist for D2 receptors while Madison’s is a weaker antagonist. (Correct! Typical antipsychotic drugs produce a strong D2 blockade while atypical antipsychotics are a much weaker D2 antagonist.)
A: Sophia’s medication is a strong antagonist for D2 receptors while Madison’s is a weaker antagonist.

Q: Keyon has been experiencing extrapyramidal side effects from his antipsychotic medication that concern him greatly. What types of side effects is Keyon most likely experiencing?
- Persistent blurred vision, weight gain, and dry mouth that affects his ability to talk. (Incorrect. These are not hallmark EPS symptoms. He is showing akathisia and dystonia.)
- Increased mood swings that have led to outbursts against his boss at work and family. (Incorrect. Mood swings are not characteristic of EPS; he is showing akathisia and dystonia.)
- Decreased energy, difficulty getting out of bed, and persistent fatigue throughout the day. (Incorrect. These symptoms are not characteristic of EPS; he is showing akathisia and dystonia.)
- Pain in his muscles, restlessness, and repetitive shrugging that he can’t control. (Correct! These are EPS symptoms related to akathisia and dystonia.)
A: Pain in his muscles, restlessness, and repetitive shrugging that he can’t control.

Q: Michael was diagnosed with schizophrenia when he was 19 years old. He was hospitalized, and he and his psychiatrist have struggled for many months to find the right antipsychotic medication to help him with the least side effects. He is now ready to be discharged to a residential living facility. A major goal of his time there will be to practice and rehearse interpersonal and communication skills, money management, stress management, and some other behaviors to help him integrate into the community on his own. But Michael is an adult, so why is such a program necessary?
- Because antipsychotic medications often disrupt memory functioning and create a loss of skills. (Incorrect. Antipsychotic medications can have many side effects but the deterioration of memory is not usually one of them. Schizophrenia can disrupt normal life development in young adults.)
- Because many persons with schizophrenia have delusions that they cannot function on their own. (Incorrect. Delusions are common with schizophrenia, but this is not a typical version. Schizophrenia can disrupt normal life development in young adults.)
- Because being hospitalized is a traumatic event that causes regression to childlike skill levels. (Incorrect. Hospitalization can sometimes be traumatic, but it is the illness itself, not the trauma, that disrupts normal life development in young adults.)
- Because schizophrenia disrupted the normal process of learning the life skills to be on his own. (Correct! Psychosis and thought disorder frequently disrupt a person’s normal process of development and interfere with important life skills the person was developing.)
A: Because schizophrenia disrupted the normal process of learning the life skills to be on his own.

Q: After some time in the hospital and in residential treatment, Breyonna has begun to participate in a treatment where she participates in structured group activities to practice interacting with others, being able to understand them, and resolve conflicts; she also spends time on the computer participating in exercises and therapeutic games that are designed to strengthen her ability to concentrate, process information, and problem-solve. What type of treatment program is she in?
- Metacognitive Training (Incorrect. Metacognitive training is focused on reducing positive symptoms, especially delusions. Breyonna is participating in CET focusing on cognitive skills and social cognition.)
- Cognitive Behavioral Therapy (Incorrect. CBT tends to focus on reality testing of delusional beliefs, enhancing stress management skills, and relapse prevention. Breyonna is participating in CET focusing on cognitive skills and social cognition.)
- Acceptance and Commitment Therapy (Incorrect. ACT teaches clients skills in how to approach and evaluate their thinking and behavior as well as acceptance of their illness. Breyonna is participating in CET focusing on cognitive skills and social cognition.)
- Cognitive Enhancement Therapy (Correct! CET is focused on enhancing cognitive skills, preventing loss of grey matter in the brain, and fostering social cognition.)
A: Cognitive Enhancement Therapy

Q: For several weeks now Diego has been living on his own, although he receives support from a visiting social worker and participates in a day treatment program where he is part of a group focused on Social Skills Training. What kinds of activities does Diego engage in with this group?
- He discusses examples and group discussions about cognitive biases and how to evaluate them. (Incorrect. This is an example of Metacognitive Training; SST focuses on role-plays and feedback as well as application.)
- He practices noticing his own sensations and thoughts and reducing shame and self-criticism. (Incorrect. This is an example of Compassion Focused Therapy (CFT); SST focuses on role-plays and feedback as well as application.)
- He explores with others how to balance questioning his own thinking with acceptance of symptoms. (Incorrect. This is an example of Acceptance and Commitment Therapy (ACT; SST focuses on role-plays and feedback as well as application.)
- He participates in role-plays and receives feedback and discusses how to use the skills in his life. (Correct! This describes the essence of Social Skills Training (SST).)
A: He participates in role-plays and receives feedback and discusses how to use the skills in his life.

Q: Devin was convinced that people were following him. He started hearing voices, and would stare out the window for hours without moving. He eventually dropped out of school and lost his job because of the paranoia. Devin most likely has
- bipolar disorder. (Incorrect. Devin’s symptoms seem to disconnect him from reality and impair his ability to function in the world; he does not display any signs of manic behavior with grandiose moods, nor is there evidence of a low extreme (depression) in his mood.)
- panic disorder. (Incorrect: Devin is not displaying any symptoms of panic attacks, acute episodes of intense anxiety that make him feel like he might die; instead, he seems generally disconnected from and suspicious of the world around him.)
- dissociative identity disorder. (Incorrect. Dissociative identity disorder involves the integration of more than one separate personality or identity within the same individual. Devin is experiencing paranoia and delusions, but not multiple personalities.)
- schizophrenia. (Correct. Devin seems to be displaying the positive symptoms of delusions and audible hallucinations, and the negative symptom of catatonia, that make it difficult for him to function, consistent with schizophrenia.)
A: schizophrenia.

Q: Cooper smoked marijuana at a party over the weekend, and on Monday, he was still experiencing hallucinations and was panicked about going to school. He acted paranoid and mistrustful of everyone, so the point where his family recommended him to a counselor. Which diagnosis best aligns with his symptoms?
- Schizophreniform disorder
- Schizophrenia
- Schizoaffective disorder
- Stimulant-induced psychosis
A: Stimulant-induced psychosis

Q: 29-year old Mary was admitted to the hospital after threatening suicide. In meeting with the psychiatrist, Mary revealed that she suffered from depression for as long as she could remember, but for the past few months, she had been hearing voices telling her to do certain things. What diagnosis will Mary likely receive?
- schizophrenia (Incorrect. In order for a diagnosis of schizophrenia to be made, an individual would need to have been experiencing symptoms for at least six months and not also show signs of severe emotional affect just as depression or mania.)
- substance-induced psychosis (Incorrect. This individual was experiencing psychotic symptoms and severe emotions before treatment with pharmacological drugs. Therefore, this diagnosis can be ruled out.)
- bipolar II disorder (Incorrect. Although the individual reports depression, they would not meet the criteria for bipolar II disorder, as they have no history of hypomania, and they are additionally experiencing psychotic symptoms. This would lead to a diagnosis of schizoaffective disorder.)
- schizoaffective disorder (Correct! This is the correct diagnosis, as the patient presents both mood symptoms and those of psychosis. More specifically, this individual would also be noted for having schizoaffective disorder with depression and catatonia.)
A: schizoaffective disorder

Q: If Stevie is showing evidence of positive signs of schizophrenia, what might that look like?
- She demonstrates increased positive emotions, similar to mania but more intense. (Incorrect. Positive symptoms do not refer to happiness or energy, but to additional behaviors that are atypical or unusual.)
- She demonstrates a need for immediate action and attention. (Incorrect. Positive symptoms generally do not require an urgent response; they are additional behaviors that are unusual and atypical.)
- Her symptoms trigger additional symptoms in a type of feedback loop that gets worse over time. (Incorrect. “Positive” does not mean adding more symptoms, but the presence of behaviors that are atypical or unusual.)
- She demonstrates uncommon or unusual thoughts and behaviors. (Correct! Positive symptoms are additional behaviors that are unusual or atypical.)
A: She demonstrates uncommon or unusual thoughts and behaviors.

Q: Which of the following persons is most likely to be diagnosed with brief psychotic disorder?
- Jamal, who lives in Boston, is recently divorced, and a regular alcohol drinker. (Incorrect. Jamal lives in a developed nation and does not show other significant markers thought to be related to brief psychotic disorder.)
- Conny lives in Sweden, has two children, and is an artist. (Incorrect. While Conny is female and thought to be at higher risk than a male for this disorder, she is from a developed nation and is lower risk than Layla.)
- Takeshi lives in Tokyo; he is single, and works as a web designer in a tech company. (Incorrect. Takeshi is from a developed nation, is male, and does not have significant factors that are thought to be associated with the disorder.)
- Layla is a woman from Vietnam who recently moved to America and recently gave birth to her first child. (Correct! Layla is from a developing country which greatly increases her odds of developing the disorder, and she is also postpartum.)
A: Layla is a woman from Vietnam who recently moved to America and recently gave birth to her first child.