CLINICAL- Schizophrenia Flashcards
State the positive symptoms of Schizophrenia
- persecutory thoughts
- disordered thinking
- persistent hallucinations
- belief that their emotions are not controlled by them but by someone else.
State the negative symptoms of schizophrenia
- Diminished emotional state
- avolition
- Impaired cognitive factors
- No social skills
- Catatonia
Define persistent hallucinations
sensory experiences that are not there most commonly, auditory hallucinations
Define Avolition
This is a negative symptom whereby the persons motivation levels are lower than would be considered normal/ flattened affect
Define Catatonia
This is an inability to move normally
State and define the 3 types of delusions
Persecutory delusions: Belief that you are in danger and others are looking to harm you
Grandiose delusions: Belief that you inherit strong special abilities/ powers e.g a superhero
Delusion of reference : A belief that events in the environment are about you
In Aneja et al. what were the signs of schizophrenia in the boy
- A decline in academic studies
- Hearing voices
- He muttered to himself
- shouted at people that were not the there
- his level of self care declines
In Aneja et al. what was he diagnosed with and after treatment, which type of symptoms did he still experience
- He was diagnosed with early-onset schizophrenia
- Negative symptoms
In Freeman et al. state the 2 aims
- Investigate whether participants with no previous mental illness experience persecutory thoughts in Virtual reality
- Whether emotional or cognitive factors could predict the likelihood of Persecutory ideation in virtual reality
In Freeman et al. define persecutory ideation
The belief that people want to hurt you despite there being no evidence to back this up.
What is interpersonal sensitivity
A tendency to focus on feelings of personal inadequacy or inferiority
What was the hypothesis in Freeman et al.
'’That fewer people would have thoughts of persecutory nature in Virtual reality and that this would be people with high levels of emotional distress and paranoia’’
Describe the sample in freeman et al.
- 24 in total (12males 12 females)
- All were students/staff from University college London UK
- avg. age of 26 years old
- No history of mental illness
- Volunteer sampling
What were the data collection methods in Freeman
Questionnaires;
- Brief symptom Inventory (BSI)
- Closed questionnaire
Interviews;
- semi structured interview
to avoid the possibility of the questionnaires introducing persecutory thoughts, what did the researchers do
- They split the participants in half, half of them completed the questionnaire both before and after the VR
What are the results found in Freeman et al.
- Higher levels of interpersonal sensitivity and higher levels of anxiety were significantly correlated with higher levels of persecutory thoughts
what did freeman conclude
- People are likely to show persecutory ideation if they show high levels of Interpersonal sensitivity or anxiety
State the biological explanations of schizophrenia
GENETIC :
- Genes or a particular combination of them can be passed down which may cause the disorder to develop
BIOCHEMICAL:
- This describes the dopamine hypothesis.
Describe how family studies, twin studies and adoption studies have helped investigate genes in schizophrenia
Family studies suggest that there’s a general trend in the development of a disorder for individuals who have close family members that have the disorder.
Twin studies have shown the concordance of schizophrenia is higher in MZ twins than DZ twins.
Adoption studies are able to divide the influence of the environment and genetics
State some statistics found in twin and adoption studies
- Gottesmamn found in Twin studies 48% MZ twins have a risk of developing schizophrenia while 17% DZ twins
- Tienari et al. found that 6.7% of adoptees had schizophrenia with mothers who had the disorder compared to the 4% that had a mother who did not have schizo
Describe the Dopamine hypothesis (Biochemical)
- They have identified a link between excessive amounts of dopamine or dopamine receptors and positive symptoms
- Research has suggested that neurone that use dopamine either fire it too often or send too much information
- An excess of dopamine in a particular brain region can be related to a particular function e.g dopamine in the Broca’s region which is known for language, can result to impaired logical speech.
Describe how drug trials, post mortem studies and PET scans can help investigate the dopamine hypothesis
Drug trials: drugs that result to an increase in dopamine such as cocaine, have resulted to more reports of hallucinations and delusions
Post mortem studies: these studies have found that deceased individuals with schizo have a larger number of dopamine receptors than those without the disorder. Wise et al. found that there brain fluid has a lower number of enzymes that break down dopamine
PET scans : These have found that excessive dopamine activity are linked to positive symptoms while others have found decreased dopamine activity is linked to the negative symptoms
What does the cognitive explanation believe
- They believe that in some way, biological factors can contribute to some of the symptoms but are not the only explanations.
- Frith (2015) believes that patients to recognise that their perceived hallucinations are in fact just inner speech
- He tested this out and found that patients with incoherent speech as a symptom performed the worst
- It was also believed that those with delusional thinking are applied logical reasoning to their hallucinations. so thought that are self generated appear to come from an external source/ out of their control
- He also explains that negative symptoms such as avolition are a result of a lack of theory of mind. This is because they find it difficult to make decisions and start a conversation as they believe they need a prompt.
Biological treatments include:
- Atypical antipsychotics
- Typical psychotics
- Electro-convulsive therapy
How do typical antipsychotics work
- They work by reducing the neurotransmitter ; dopamine, by blocking dopamine receptors to reduce its activity
- an example is chlorpromazine
How do atypical antipsychotics work
- They work by rapidly blocking dopamine but do not block the normal amount of dopamine levels that should be present
- They rapidly dissociate and block dopamine for a short time
- They have a lower risk of side effects and work on both positive and negative symptoms
- an exmaple is clozapine
Evaluate drug therapy
+ Evidence has shown that the drugs have been useful with 50% of patients improving their symptoms compared to the placebo group
-Can gain a dependancy on drugs
-Relapse rates could occur after not taking the drugs
-severe side effects; involuntary body movement, drowsiness, weight gain
-Treatment is deterministic
How does Electro convulsive therapy work
It works by passing electricity through the brain with the intention of inducing a seizure
- the treatment ranges from 6-12 sessions and is typically given twice a week.
- it is applies to the non-dominant hemisphere only to reduce memory loss.
Evaluate ECT
+A short -term effective treatment
-This treatment still affects the nervous system, and cardiovascular system dangerous for those with pre-existing medical conditions
-Memory loss is still a common side effect of ECT
-Extreme cases can lead to lasting neurological damage or even death
The Cognitive treatment for schizo include:
- Cognitive behavioural Therapy
What does CBT involve
- This is a talking therapy that is designed to help people challenge their thoughts
- CBT almost always uses antipsychotics during therapy. This is in order to stabilise the patient enough for them to engage with the therapy.
What did Sensky (2000) want to compare CBT to?
Befriending- refers to a one on one informal convo about hobbies, likes and etc
What was the procedure in Sensky (2000)
- There were 19 CBT sessions
- This was a Randomised control trial
- The patient would discuss the emerge of their disorder first before tackling their symptoms
- Those that experienced auditory hallucinations would have a diary where they would write down what they hear.
What were the standardised scales used in Sensky (2000)
- Comprehensive psychiatric Rating scale (CPRS)
- Scale for the assessment of negative symptoms (SANS)
How did the researchers in Sensky carry out a follow up and what were the results
- With the help of the Comprehesive Psychiatric Rating Scale and Scale for the Assessment of Negative Symptoms (SANS)
- At the 9 month follow up, they found that those who took CBT had lasting improvements than those that took befriending.
