Chapter 13 Part 2: Neurobiological, Psychological, and Social Influences, and Treatments for Schizophrenia

Question 1

given what we know about schizophrenia and dopamine, what would be the predicted results of giving amphetamines to a person which schizophrenia

Answer 1

amphetamines are dopamine agonists which can worsen positive symptoms

Question 2

what kind of negative side effects are elicited by neuroleptics

Answer 2

neuroleptics are DA antagonists and can thus produce parkinsonian like symptoms

Question 3

what group of symptoms do DA antagonists help with

Answer 3

positive symptoms like hallucinations. this only works after days to weeks of treatment.

there is very minimal effect on negative symptoms.

Question 4

striatal ___ receptors are overactive in people with schizophrenia, and prefrontal cortex ____ receptors are underactive, resulting in negative symptoms like flat affect

Answer 4

striatal D2 receptors are overactive in people with schizophrenia, and prefrontal cortex D1 receptors are underactive, resulting in negative symptoms like flat affect

Question 5

in addition to DA, what other neurotransmitter may be implicated in schizo?

Answer 5

blocking of glutaminergic NMDA receptors may be implicated.

Question 6

effect of schizophrenia on ventricle size

Answer 6

abnormally large lateral and third ventricle in people with schizophrenia

Question 7

effect of schizophrenia on frontal lobe

Answer 7

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)

Question 8

how might twins be predisposed to schizophrenia

Answer 8

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.

Question 9

T/F there is a higher prevalence of schizophrenia in people living in urban areas

Answer 9

true. this suggests that there is merit to the idea that infection can cause schizo

Question 10

viral infections such as ____ in utero is linked to schizophrenia

Answer 10

Type A2 influenza

Question 11

Explain how finger tip ridges may be able to play a role in assessing prenatal brain damage

Answer 11

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

Question 12

2 main psychological and social influences about the onset of schizophrenia

Answer 12

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.

Question 13

sociogenic hypothesis

Answer 13

the theory that life in lower social classes is stressful, predisposing those in lower social classes to schizophrenia

Question 14

social selection hypothesis

Answer 14

those experiencing schizophrenia have trouble holding jobs, which may lead to down ward social drift (contents with sociiogenic hypothesis)

Question 15

schizophrenogenic

Answer 15

used to describe a mother whose cold, dominant and rejecting– this nature was thought to play a role in inducing schizophrenia

Question 16

T/F amount of social support from friends and non-families correlates to lower rates of relapse

Answer 16

True. higher levels of social support is correlated to better outcomes five year later

Question 17

double bind

Answer 17

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?”

Question 18

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.

Answer 18

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.

Question 19

how might expressed emotion numbers (EE) explain the cultural relapse differences in people with schizophrenia?

Answer 19

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.

Question 20

newer antipsychotics on the market can reduce the servity of this one side effect of most neuroleptics.

Answer 20

tardive dyskineisia.

Question 21

psychosocial interventions are usually used to increase:

Answer 21

medication-taking compliance

Question 22

in addition to neuroleptics (dopamine antagonists), what is another biological intervention?

Answer 22

transcranial magnetic stimulation (TMS): used for hallucination treatment, but the effect is brief.
- treats auditory hallucinations

Question 23

T/F: the psychoanalytic approach is helpful in treating schizophrenia

Answer 23

false. it is not beneficial

Question 24

how can behaviour modification help in treating schizophrenia? How is this implemented?

Answer 24

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.

Question 25

How does behavioural family therapy help?

Answer 25

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.

Question 26

____ treatments involving a combination of medicaton, social skills training, family intervention, vocational rehabilitation reduces chances of relapses

Answer 26

multilevel treatments

Question 27

what is vocational rehabilitation

Answer 27

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.

Question 28

requirement for family behavioural therpay if it is to be beneficial

Answer 28

Must be ongoing if patients and families are to benefit from it.

Question 29

a general trend in the treatment of schizophrenia today is toward ___ ___.

Answer 29

early intervention. getting help in the early stages is critical. Get the pt onto right medications and into effective psychotherapy as soon as possible.

Question 30

5 key elements to early intervention

Answer 30

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

Question 31

when paired with ___ ___ training, drugs therapy had the lowest chances of major relapses

Answer 31

when paired with drugs and social skills training.

Question 32

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

Answer 32

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

Question 33

which symptom group is affect most by CBT

Answer 33

negative symptoms were lessened in groups with CBT (emotional control, reason their way out of paranoia, modify their reactions)

Question 34

treatments across cultures

Answer 34

May include herbal medicines, acupuncture, oral treatments, imprisonment, ancestor worship, et

Question 35

treatment of schizotypal personality disorder

Answer 35

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.

Question 36

How do people with schizotypcal disorder present to the clinic?

Answer 36

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

Question 37

2 main ways to “prevent” schizophrenia

Answer 37

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.