CLINICAL- Schizophrenia

Question 1

State the positive symptoms of Schizophrenia

Answer 1

• persecutory thoughts
• disordered thinking
• persistent hallucinations
• belief that their emotions are not controlled by them but by someone else.

Question 2

State the negative symptoms of schizophrenia

Answer 2

• Diminished emotional state
• avolition
• Impaired cognitive factors
• No social skills
• Catatonia

Question 3

Define persistent hallucinations

Answer 3

sensory experiences that are not there most commonly, auditory hallucinations

Question 4

Define Avolition

Answer 4

This is a negative symptom whereby the persons motivation levels are lower than would be considered normal/ flattened affect

Question 5

Define Catatonia

Answer 5

This is an inability to move normally

Question 6

State and define the 3 types of delusions

Answer 6

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

Question 7

In Aneja et al. what were the signs of schizophrenia in the boy

Answer 7

• 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

Question 8

In Aneja et al. what was he diagnosed with and after treatment, which type of symptoms did he still experience

Answer 8

• He was diagnosed with early-onset schizophrenia
• Negative symptoms

Question 9

In Freeman et al. state the 2 aims

Answer 9

• 1. Investigate whether participants with no previous mental illness experience persecutory thoughts in Virtual reality
• 2. Whether emotional or cognitive factors could predict the likelihood of Persecutory ideation in virtual reality

Question 10

In Freeman et al. define persecutory ideation

Answer 10

The belief that people want to hurt you despite there being no evidence to back this up.

Question 11

What is interpersonal sensitivity

Answer 11

A tendency to focus on feelings of personal inadequacy or inferiority

Question 12

What was the hypothesis in Freeman et al.

Answer 12

'’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’’

Question 13

Describe the sample in freeman et al.

Answer 13

• 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

Question 14

What were the data collection methods in Freeman

Answer 14

Questionnaires;
- Brief symptom Inventory (BSI)
- Closed questionnaire
Interviews;
- semi structured interview

Question 15

to avoid the possibility of the questionnaires introducing persecutory thoughts, what did the researchers do

Answer 15

• They split the participants in half, half of them completed the questionnaire both before and after the VR

Question 16

What are the results found in Freeman et al.

Answer 16

• Higher levels of interpersonal sensitivity and higher levels if anxiety were significantly correlated with higher levels of persecutory thoughts

Question 17

what did freeman conclude

Answer 17

• People are likely to show persecutory ideation if they show high levels of Interpersonal sensitivity or anxiety

Question 18

State the biological explanations of schizophrenia

Answer 18

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.

Question 19

Describe how family studies, twin studies and adoption studies have helped investigate genes in schizophrenia

Answer 19

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

Question 20

State some statistics found in twin and adoption studies

Answer 20

• 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

Question 21

Describe the Dopamine hypothesis (Biochemical)

Answer 21

• 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.

Question 22

Describe how drug trials, post mortem studies and PET scans can help investigate the dopamine hypothesis

Answer 22

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

Question 23

What does the cognitive explanation believe

Answer 23

• 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 saw that schizophrenia is viewed as involving faulty mental processes]
• 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

Question 24

Biological treatments include:

Answer 24

• Atypical antipsychotics
• Typical psychotics
• Electro-convulsive therapy

Question 25

How do typical antipsychotics work

Answer 25

• They work by reducing the neurotransmitter ; dopamine, by blocking dopamine receptors to reduce its activity
• an example is chlorprozamine

Question 26

How do atypical antipsychotics work

Answer 26

• 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

Question 27

Evaluate drug therapy

Answer 27

+ 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

Question 28

How does Electro convulsive therapy work

Answer 28

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.

Question 29

Evaluate ECT

Answer 29

-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

Question 30

The Cognitive treatment for schizo include:

Answer 30

• Cognitive behavioural Therapy

Question 31

What does CBT involve

Answer 31

• 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.

Question 32

What did Sensky (2000) want to compare CBT to?

Answer 32

Befriending- refers to a one on one informal convo about hobbies, likes and etc

Question 33

What was the procedure in Sensky (2000)

Answer 33

• 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.

Question 34

What were the standardised scales used in Sensky (2000)

Answer 34

• Comprehensive psychiatric Rating scale (CPRS)
• Scale for the assessment of negative symptoms (SANS)

Question 35

How did the researchers in Sensky carry out a follow up and what were the results

Answer 35

• 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.