Essay ones Flashcards
(36 cards)
What are the two classifications of mental disorders?
- ICD-10
- DSM -5
What are the positive symptoms of schizophrenia?
Hallucinations
- unusual sensory beliefs which could be related to the environment and can be experienced in relation to any sense
Delusions
- irrational beliefs that can take a range of forms, for example : being involved in big historical events
What are the negative symptoms of schizophrenia?
Avolition
- finding it difficult to being or keep up with a goal-directed activity
Speech poverty
- reduction in the amount of quality of speech
What is comorbidity?
- two or more conditions are present in a person at once
What is symptom overlap?
two or more conditions share symptoms
- Sz + BPD both share delusion
Genetic basis for schizophrenia
Ripke et al
- Individual genes have been believed to be associated with risk of inheriting schizophrenia
- since each gene is associated with a small risk, it can be said that schizophrenia is polygenic
- Further research has proved that there are many factors in causing schizophrenia including many different candidate genes, making it aetiologically heterogenous
- Ripke et al (2014) looked all the pervious genome-wide studies and found that 108 genes are related in causing schizophrenia
- some genes also included affecting dopamine
The dopamine hypothesis for schizophrenia
- DA is important in the function of the brain systems
- Hyperdopaminergia in subcortex : excess DA receptors in broca’s area which is associated with poverty of speech
- Hypodopmerminergia in the cortex : low levels in DA cause negative symptoms
- More recent research focuses on abnormal levels of DA and says that both high and low levels can have an affect on schizophrenia symptoms
Biological explanations for Sz AO3 (adoption studies?)
P: Supporting evidence from adoption studies
E: Tienari et al (2004) shows that children that are biologically connected to people with Sz are still at high risk even when adopted by non-Sz families. Also, gattsman found that if your aunt had sz you have 2% chance of getting it but if its your identical twin its goes to 48%
A: There is overwhelming evidence for genes making you more vulnerable for being at risk for schizophrenia
Biological explanations AO3
curran et al
Evidence for dopamine Curran et al amphetamines increase dopamine and worsen symptoms in people with schizophrenia DOUBLE not all drugs that increase dopamine lead to worse symptoms for example apomorphine
Biological explanations for Sz AO3 (dopamine hypothesis) support from drug therapy
P: Support from drug therapy
E: DA is involved in Sz as dopamine agonists increase dopamine-receptor activity and make Sz worse, antipsychotic drugs which block DA reduce symptoms of Sz
A: there is a direct link between Sz and dopamine which increases validity of theory as DA plays a role in Sz
Biological explanations AO3 (dopamine hypothesis) other neurotransmitters
P: Other evidences show that other neurotransmitters have a central role such as glutamate
E: Several brain scan studies and post mortem showed that paitents with Sz have high levels of glutanate. Several candidate genes of Sz also are involved in glutamate production
A: evidence for dopamine hypothesis is mixed and equally as strong for other neurotransmitters
Drug therapy AO1 (Chlorpromazine)
Chlorpromazine
- typical antipsychotic, dopamine antagonist (block DA receptors and doesn’t allow message to pass
- this reduces hyperdopaminergia which reduces certain positive symptoms
- Atypical drugs were created to reduce the many side effects that come with this
Drug therapy AO1 (risperidone)
Risperidone
- developed to avoid a certain blood condition that comes from clozapine
- blocks DA, serotonin and glutamate receptors but stronger on DA
- This makes it more effective in smaller doses and has fewer side effects
Drug therapy AO1 (Clozapine)
Clozapine
- Atypical which acts as an antagonist where it blocks DA receptors but also serotonin and glutamate receptors
- effective at improving cognitive functioning and mood
- used when patient doesn’t respond to typical drugs
Risperidone
Drug therapy AO3 ( evidence for effectiveness of antipsychotic drugs/ thornly?)
P: Evidence for effectiveness of antipsychotic drugs
E: Thornly (2003) review studies comparing effects of chlorpromazine to control conditions. 13 trials 1121 ptps overall showed better functioning with the drug. Meltzer (2012) clozapine is more effective than typical antipsychotics and effective in 30-50% of treatment resistant cases where anitpsychotic have failed
A: Shows they’re effective at reducing symptoms, it is better to treat as early as possible
Drug therapy AO3 (serious side effects?)
P: serious side effects
E: Typical AP, long term effects associated with tardive dyskinesia (Involuntary facial movements) caused by DA super sensitivity. Very serious sone is neuroleptic malignant syndrome - drug blocks DA in hypothalamus, resulting in high temp, delerium and coma
A: Typical AP can do harm as well as good so many may avoid them, making them ineffective
Drug therapy AO3 (weakness) unclear mechanism
P: Unclear mechanism due to dependence on dopamine hypothesis
E: DA hypothesis is an incomplete explanations as explained by the updated version. DA levels in other parts of the brain are too low rather than too high - antipsychotics shouldn’t work
A: AP may have be the best treatment to opt for and there may be other factors involved in their success
Psychological explanations : Schizophrenogenic
- Cold, rejecting, controlling mother which creates a family environment characterized by tension and secrecy
- Leads to distrust that later develops into paranoid delusions, ultimately Sz
Issues: - Alpha bias as it maximizes the difference between male and female
- it is socially sensitive that is blaming the parent, in this case, blaming the mother which can create stress for mothers
Psychological explanations : Double bind theory
- Child may be trapped in situation where they fear doing the wrong thing
- get mixed signals from parents as to what is right/wrong
- they get punished by withdrawal of love
- Leads them to learn the world is confusing and dangerous which causes disorganized thinking and delusions
Issues with this: - Socially sensitive, blames parent
- Creates additional stress for parents who already see their children experience Sz
Psychological explanations : Expressed emotion
- Level of mainly negative emotion expressed towards a Sz paitent
- This includes:
- verbal criticism (sometimes paired with violence)
- Hostility towards them (anger and rejection)
- emotional over-involvement in their life
- stress can trigger onset of sz in someone who is vulnerable
- Mostly used to describe how increase stress is more likely to lead to relapse
- attachment type studies suggests that over half of men and women who develop Sz have a history of mental/physical abuse
Psychological explanations : cognitive explanations
Central control errors
- Inability to suppress automatic thoughts while performing deliberate actions
- Leads to derailment of thought and disorganised speech
Misrepresentation errors
- Misinterpreting our own behaviour as being under another’s control due to error in thinking about our own goals or intentions
Psychological explanations A03 (read et al)
P: Evidence showing that difficult family relations may increase risk of Sz
E: Read et al (2005) reviewed 46 studies of child abuse and Sz and found that 69% of adult woman patients had a history of verbal, physical and sexual abuse. For men, it was 59%
A: shows a clear link between family dysfunction and increased risk of sz
H: Most of the evidence shares a weakness, they are all based on information about childhood, reported after all the symptoms have occurred so they may havterm-24e forgotten or Sz may have distorted their recall
Psychological explanations A03 (weakness: schizophrenogenic mother)
P: weak evidence for schizophrenogenic mother
E: Research provided is from clinical observations and early evidence that looked at mothers and gave them “crazy-making” observations.
A: The supporting evidence is weak and may tell us very little about the extent to which childhood and family affect the development of Sz
P: Schizophrenogenic mother leads to parent-blaming
E: After having to see your child descent into Sz and having to bear a life-long responsibility of taking care of them. This theory adds further trauma by “adding salt to the wound”
A: this makes it very hard for a mother to take care of her child and causes her to blame herself for everything
Psychological explanations A03 (research support for cognitive explanation)
P: Research support for cognitive explanation
E: Stirling found, comparing 30 people in a control to 30 people with a Sz, that those with Sz performed poorly on cognitive tasks like the stroop test (took twice as long)
A: Supports ‘central control errors’ hypothesis
H: fails to explain the actual cause and offers only part of the explanation on what is happening
