Chapter 13 Part 2: Neurobiological, Psychological, and Social Influences, and Treatments for Schizophrenia Flashcards
given what we know about schizophrenia and dopamine, what would be the predicted results of giving amphetamines to a person which schizophrenia
amphetamines are dopamine agonists which can worsen positive symptoms
what kind of negative side effects are elicited by neuroleptics
neuroleptics are DA antagonists and can thus produce parkinsonian like symptoms
what group of symptoms do DA antagonists help with
positive symptoms like hallucinations. this only works after days to weeks of treatment.
there is very minimal effect on negative symptoms.
striatal ___ receptors are overactive in people with schizophrenia, and prefrontal cortex ____ receptors are underactive, resulting in negative symptoms like flat affect
striatal D2 receptors are overactive in people with schizophrenia, and prefrontal cortex D1 receptors are underactive, resulting in negative symptoms like flat affect
in addition to DA, what other neurotransmitter may be implicated in schizo?
blocking of glutaminergic NMDA receptors may be implicated.
effect of schizophrenia on ventricle size
abnormally large lateral and third ventricle in people with schizophrenia
effect of schizophrenia on frontal lobe
there is HYPOFRONTALITY (less active frontal lobe), specifically in the DORSOLATERAL PREFRONTAL CORTEX. MAY RESULT IN THE ONSET OF NEGATIVE SYMPTOMS ( bad at planning, reduced attentiveness, flat affect)
how might twins be predisposed to schizophrenia
brain damage may arise due to lack of oxygen. there is a higher risk of O2 cut off to one of the twins, could result in brain cell death.
T/F there is a higher prevalence of schizophrenia in people living in urban areas
true. this suggests that there is merit to the idea that infection can cause schizo
viral infections such as ____ in utero is linked to schizophrenia
Type A2 influenza
Explain how finger tip ridges may be able to play a role in assessing prenatal brain damage
in twins, they should have the same finger print. But if a twin has shcizophrenia, they have markedly different fingerprints than their twin, suggesting that prenatal brain damage can be assessed by FINGERPRINT RIDGE COUNT
2 main psychological and social influences about the onset of schizophrenia
1) stress.
- extreme stress can produce psychotic-like symptoms in otherwise normal people. There is a tendnecy for people with schizophrenia to be found in lower social classes (negative correlation)
2) families and relapse
- if family has HIGH expressed emotion communication style; ie, if emotional expression is characterized by being overly critical, disapproving, or showing animosity or intrusiveness, there is a significant predictor of relapse.
sociogenic hypothesis
the theory that life in lower social classes is stressful, predisposing those in lower social classes to schizophrenia
social selection hypothesis
those experiencing schizophrenia have trouble holding jobs, which may lead to down ward social drift (contents with sociiogenic hypothesis)
schizophrenogenic
used to describe a mother whose cold, dominant and rejecting– this nature was thought to play a role in inducing schizophrenia
T/F amount of social support from friends and non-families correlates to lower rates of relapse
True. higher levels of social support is correlated to better outcomes five year later
double bind
used to portray a type of communication style that produced conflicting messages, which in turn could cause schizophrenia.
ex/ a mother responds coldly to a child hugging her, but when the child lets go, she says “do you love me anymore?”
if family has _____ expressed emotion communication style; ie, if emotional expression is characterized by being overly critical, disapproving, or showing animosity or intrusiveness, there is a significant predictor of relapse.
if family has HIGH expressed emotion communication style; ie, if emotional expression is characterized by being overly critical, disapproving, or showing animosity or intrusiveness, there is a significant predictor of relapse.
how might expressed emotion numbers (EE) explain the cultural relapse differences in people with schizophrenia?
cultures that have higher EE result in higher rates of relapse. Americans have high EE (overinvolvement), resulting in higher rates of relapse
indian cultures have lower EE, resulting in lower rates of relapse.
newer antipsychotics on the market can reduce the servity of this one side effect of most neuroleptics.
tardive dyskineisia.
psychosocial interventions are usually used to increase:
medication-taking compliance
in addition to neuroleptics (dopamine antagonists), what is another biological intervention?
transcranial magnetic stimulation (TMS): used for hallucination treatment, but the effect is brief.
- treats auditory hallucinations
T/F: the psychoanalytic approach is helpful in treating schizophrenia
false. it is not beneficial
how can behaviour modification help in treating schizophrenia? How is this implemented?
usually used to increase social and socialization skills, and self care skills. Social skills training and skills training in stress management is also helpful.
- usually involves positive reinforcement using TOKEN ECONOMIES (cost is a punishment), taking away “tokens”, being given tokens.
How does behavioural family therapy help?
teaches families to be more supportive, teaches families active listening and communication skills. Must be ongoing if patients and families are to benefit from it.
____ treatments involving a combination of medicaton, social skills training, family intervention, vocational rehabilitation reduces chances of relapses
multilevel treatments
what is vocational rehabilitation
giving people with schizophrenia a job that gives them strucutre, but it is SUPPORTIVE EMPLOYMENT that is understanding about the lower workload and accommodations that must be in place.
requirement for family behavioural therpay if it is to be beneficial
Must be ongoing if patients and families are to benefit from it.
a general trend in the treatment of schizophrenia today is toward ___ ___.
early intervention. getting help in the early stages is critical. Get the pt onto right medications and into effective psychotherapy as soon as possible.
5 key elements to early intervention
1) reducing the duration of untreated psychosis
2) assessment and the context of care– building a good therapeutic alliance
3) getting family engagement and support
4) individualized treatment
5) prolonged engagement to sustain gains. Clients may need multiple services/treatments over a period of time
when paired with ___ ___ training, drugs therapy had the lowest chances of major relapses
when paired with drugs and social skills training.
CBT has promising evidence in treating both positive and negative symptoms of schizophrenia. There is also a branch of CBT called ___ and ____ which may also be effective
acceptance and commitment therapy may be effective in treating the symptoms of schizophrenia. It’s a values-based variation on cognitive behavioural therapy similar ot DBT
CBT is good in teaching the pt how to counter their strange thoughts/ reason their way out of paranoia/modify their reactions
which symptom group is affect most by CBT
negative symptoms were lessened in groups with CBT (emotional control, reason their way out of paranoia, modify their reactions)
treatments across cultures
May include herbal medicines, acupuncture, oral treatments, imprisonment, ancestor worship, et
treatment of schizotypal personality disorder
there is growing interest in treatment because it may be a precursor to schizophrenia.
people suggest a combination of antipsychotic medication, community treatment, and social skills training. Some evidence says that this package may reduce symptoms/or postpone onset of later schizophrenia.
How do people with schizotypcal disorder present to the clinic?
Often those seeking treatment who meet criteria for schizotypal personality disorder are seeking assistance due to anxiety and/or depression.
•CBT and/or medication for depression are common
2 main ways to “prevent” schizophrenia
1) identify and treat children who may be at risk for developing schizophrenia by identifing instability in early family-rearing environment.
2) immediately treat people who show signs of early schizophrenia (ex they have a hallucination but they are AWARE of it), may reduce relapse in the future or may slow down the progression.
