9. Schizophrenia Flashcards
Emil Kraepelin (1856-1926) classified severe mental health problems into c____. One category was ‘d____ p____’ meaning senility of the y____. Sufferers exhibited:
1. I____ impairment
2. Problems of a____ and m____
3. H____ and d____
He said it started young, people were unable to r____ and if you r____ then you didn’t have it in the first place!
categories
‘dementia praecox’
young
1. Intellectual
2. attention, memory
3. Hallucinations, delusions
recover, recovered
E____ B____ (1857-1939) coined the term schizophrenia, meaning s____ m____
Eugen Bleuer, split mind
To receive a DSM-V diagnosis of schizophrenia, people must be experiencing 2 or more of the following:
1. D____
2. H____
3. D____ s____
4. Grossly d____ or c____ behaviour
5. N____ symptoms e.g. emotional f____ and a____
- Delusions
- Hallucinations
- Disorganised speech
- disorganised, catatonic
- negative, flattening, apathy
To receive a schizophrenia diagnosis from the DSM-V, symptoms must be experiencing d____ of work, relationships or self-care and symptoms must have been c____ for at least __ months
deterioration, continuous, 6
Distressing voices (a____ h____) are common among not just people with schizophrenia:
1. Schizophrenia approx __%
2. Bipolar disorder __%
3. PTSD __%
4. Dissociative Identity Disorder __-__%
5. Borderline Personality Disorder __%
auditory hallucinations
1. 70
2. 7
3. 50
4. 70-90
5. 32
General population rates of schizophrenia are __:__
One parent with schizophrenia __:__
Both parent with schizophrenia __:__
1:100
10:100
45:100
__% of cases of schizophrenia will have one or more parents with the same diagnosis, whilst __% of all cases of schizophrenia will have neither a first or a second degree relative with the same diagnosis
11%, 37%
If one identical twin has schizophrenia, the other has a __% chance of being diagnosed, suggesting there are influences beyond the g____ p____
50%, gene pool
The o____ of schizophrenia is usually earlier in men (peak onset = late ____ to early ____) than in women (peak onset = mid to late ____). This is possibly due to a historical combination of men needing to seek i____ at an earlier age but lacking the m____ to do so and becoming o____ by that transition. Females are less understood but may relate to g____ r____, so may change as those change
onset, teens, 20s
20s
independence, maturity, overwhelmed
gender roles
‘Treatments’ of schizophrenia in the past have involved:
1. Long b____
2. S____
3. I____ c____
4. E____ c____ therapy
5. A____ medication
- baths
- sedation
- insulin coma
- electro convulsive
- antipsychotic
Myth 1a - Delusions are meaningless symptoms of schizophrenia
Delusions are actually:
1. R____ of p____ t____ in peoples l____
2. P____ of low s____ e____
3. Maintained by n____ b____ in i____ p____
- reflective, prominent themes, lives
- protective, self esteem
- normal biases, information processing
Myth 1b - Voices are meaningless symptoms of schizophrenia
The experience of hearing voices is actually:
1. C____ amongst people who have experienced t____
2. R____ of the o____ that people have about t____
3. S____ to i____ e____ in the ‘r____’ world
- common, trauma
- reflective, opimions, themselves
- similar, interpersonal encounters, ‘real’
Myth 2 - If you hear voices or hold delusional beliefs you have schizophrenia
Posey and Losch (1983) asked 375 students:
1. __% = heard someone call name
2. __% heard whilst falling asleep
3. __% conversation with dead relative
Tien (1991) found __% of the general population experience hallucinations
- 71%
- 30%
- 5%
11%
Myth 3 - Schizophrenia makes people violent
1. Violent events can be prevented with e____ with t____ s____ with a focus on s____ a____
2. People with schizophrenia are more likely to be v____ of violence
3. Much more likely to be harmful to s____ than o____ - about __% commit suicide
- engagement, treatment services, substance abuse
- victim (up to 14 times the rate of being victimised compared with being arrested as a perpetrator)
- self, others, 5%
There are a huge amount of side effects to antipsychotics. C____ tends to be effective in people other drugs haven’t worked for, however it can k____ y____. It reduces w____ b____ c____ c____ so requires patients give regular blood samples.
clozapine, kill you, white blood cell count
Cognitive behavioural therapy for schizophrenia involves:
1. L____, being c____ and m____ s____
2. Playing d____ and working with e____
3. Assessing the a____ of v____ and b____
4. Enhancing s____ e____
- Listening curious, making sense
- detective, evidence
- accuracy, views, beliefs
- self-esteem
Challenges with delivering CBT:
1. Resource i____ therapy - minimum of __ sessions, likely to be over __ months or more
2. Only a q____ of patients with diagnosis offered CBT in England
3. E____ based treatment (arguably more effective) only offered to m____ of patients
- intensive, 16, 6
- quater
- evidence, minority
Three solutions of increasing access to CBT:
1. G____ w____
2. B____ t____
3. B____ t____ t____
- Group work
- Brief therapy
- Briefly trained therapists
Myth 5 - People don’t recover from schizophrenia
Data from longitudinal studies shows recovery possible from as many as h____ of patients. This ‘recovery’ is very high bar… people being in p____ e____, having f____ g____, living i____.
half, paid employment, friendship group, independently
Recovery can be meaningful even if not over high bar set by studies. Recovery can mean the development of new m____ and p____ in one’s life as one grows beyond the c____ effects of mental illness. Quality of life is defined by the individual. Some recovery is possible for all patients if they get s____ and t____.
meaning, purpose, catastrophic
support, treatment
There is no single cause of schizophrenia. Some causes, often in combination, include:
1. G____ p____
2. B____ c____
3. C____ n____
4. D____ f____
5. B____
6. H____, e____ c____ use
- Genetic predisposition
- birth complications
- child neglect
- dysfunctional families
- bullying
- heavy, early cannabis use
Studying twins is difficult because…
1. they share the same g____
2. but are also the same s____
3. And usually p____ i____ so are likely to be t____ more alike than non-identical twins
- genes
- sex
- physically identical, treated
If there is a g____ element in psychosis, then this should also show up in the c____ of twins, even if one of the twins does not develop p____ s____
genetic, children, psychotic symptoms
Identical twin with diagnosis = 16.8% of children diagnosed
Identical twin with no diagnosis = 17.4% of children diagnosed
Obstetric complications can d____ or t____ the risk of the child developing schizophrenia in later life
double, treble
Women with a diagnosis of schizophrenia are more likely to experience birth complications possibly due to:
1. Poor p____ c____
2. Higher rates of s____, a____ and s____ use
3. P____
- Prenatal care
- smoking, alcohol, substance
- poverty
Family problems do not c____ schizophrenia. However, the way parents t____ about and b____ towards the person diagnosed with schizophrenia (e____ e____) can influence future r____
cause, talk, behave, expressed emotion, relapse
Higher c____, h____ or over-i____ from families can lead to increased risk of future r____. In contrast, lower e____ e____ can lead to lower risk of r____.
criticism, hostility, involvement, relapse
expressed emotion, relapse
We can attribute d____ between our i____ self and a____ self to i____, external s____ or external p____ factors.
discrepancy, ideal, actual, internal, situational, personal
The beads test is used to assess people on how q____ and with how l____ e____ they jump to c____
quickly, little evidence, conclusions
Safety behaviours are used in __% of patients to e____ feelings of safety. They are n____ r____ by threat being a____ but they prevent the processing of any d____ evidence that may be available
96%, enhance, negatively reinforced, averted, disconfirmatory
There is a link between e____ rates and rates of recovery. Higher e____ leads to higher recovery
employment, employment
Principles of individual placement and support:
1. Focus upon the g____ of c____ e____
2. Attention to patient’s p____
3. Rapid j____ s____
4. I____ of employment services and mental health t____
5. I____ l___-t____ support
- goal, competitive employment
- preferences
- job search
- Integration, treatment
- Individualised long-term
Outcomes of individual placement and support:
1. Gained e____ f____
2. M____ employment f____ time longer
3. Earned t____ times the amount
4. T____ times as likely to work __ hours or more
- employment faster
- maintained four
- three
- three, 20
Stigma is a mark or sign of d____ or d____
disgrace, discredit
Public-stigma is the r____ to service-users by the ‘c____’
reaction, community
Self-stigma is the r____ by service-users to t____ in light of their experience of mental illness and/or p____ stigma
reaction, themselves, public
Brohan et al. (2010) found that __% of sample reported moderate to high levels of s____-s____. This is associated with increased symptom s____ and d____ symptoms and reduced s____ functioning. Higher levels of s____-e____ and s____ c____ were associated with reduced s____-s____
42%, self-stigma
severity, depressive, social
self-esteem, social contact, self-stigma
The insight paradox states that higher i____, higher s____-s____ and lower q____ of l____ are all linked
insight, self-stigma, quality, life
The 5 Ps of CBT formulation:
1. What are the problems (p____)?
2. What triggers the problems (p____)?
3. What keeps the problem going (p____)?
4. What led to the problem starting (p____)?
5. What are the person’s strengths (p____)?
- presenting
- precipitating
- perpetuating
- predisposing
- protective
CBT can treat patients that have the mindset of s____ o____ or i____
sealing over, integration
