Neuropsychology and Law 3

Question 1

Schizophrenia

Answer 1

Illness typified by the disconnection/splitting of psychic functions. There are positive and negative symptoms as well as cognitive impairments.
Main symptom: (auditory) hallucinations leading to strange beliefs or delusions to make sense of the critical voices.

Question 2

Genetic aspect

Answer 2

Patients likely inherit several risk genes which interact with each other and the environment, leading to cause schizophrenia when a certain threshold is crossed.
Heritability is estimated to be 80%.

Question 3

Environmental aspect

Answer 3

Patients are likely to have experienced obstetric complications (e.g. premature birth), low birth weight and perinatal hypoxia.

Adulthood: social isolation, migrant status and urban life act as environmental stressors.

Question 4

Drug use aspect

Answer 4

Cocaine and amphetamines can lead to paranoid schizophrenia, as well as cannabis use (for a small percentage of people). May reflect genetically determined vulnerability to stressors.

Question 5

Positive symptoms

Answer 5

Manifest the expression of unusual perceptions, thoughts and behaviours such as hallucinations and delusions.

Question 6

Negative symptoms

Answer 6

Involve the loss of certain qualities such as lack of motivation and social withdrawal.

Question 7

Cognitive impairment

Answer 7

Deficits in working memory, executive functions and processing speed.
This occurs due to a lack of efficiency in communication between neurons, leading to a breakdown. Therefore, there is more grey matter than usual.

Question 8

Stress, dopamine and psychosis

Answer 8

Psychosocial stressors sensitise the subcortical dopamine system to increase the response to subsequent triggers, while cortical deficits mean that regulatory control is also impaired –> triggers therefore lead to inappropriate striatal dopamine release –> development of psychotic symptoms.

Question 9

GABA (gamma-aminobutyric acid)

Answer 9

Neurotransmitter responsible for regulating neuronal activity, meaning its impairment affects the ‘calming down’ aspect, leading to excessive neuronal activity. This causes disorganised thinking, hallucinations and cognitive deficits.

Question 10

Aberrant salience

Answer 10

Refers to the attribution of excessive value to certain stimuli, leading to hallucinations and delusions.

Question 11

Subcortical Dopamine Dysregulation

Answer 11

Dopamine signaling within the dorsal striatum has been associated with threat, leading to “reward prediction error signal” –> discrepancy b/w out prediction and the outcome.

Can be caused by bullying or child abuse.

Question 12

Treatments

Answer 12

Pharmacological ones use Dopamine d2 receptors blockers.
Psychological ones address biased cognitive schemes and reappraise psychotic symptoms, breaking the cycle of psychosis causing stress itself.

Question 13

Behaviours

Answer 13

Increased risk for non-violent crime, higher for violent crime and even higher risk to kill.
Persecutory hallucinations such as conspiracy and being spied on lead to higher rates of aggression. Depression may also contribute.

Question 14

Environmental factors

Answer 14

1. Lack of learning non to be aggressive + subsequent motor deficiencies, receptive language deficits, and lower average IQ.
2. Poor recognition of emotions –> e.g. parents’ facial expressions.
3. Non-optimal parenting –> elevated rates of antisocial behaviours of parents.

Question 15

Hostility

Answer 15

Recurring and enduring tendency to feel anger toward and a desire to inflict harm upon a (group of) person.

Question 16

Aggressiveness

Answer 16

Urgency + paranoid delusions, hallucinations and grandiosity + substance disorders + cognitive deficits, e.g. inefficient regulation of negative affective states, reasoning and problem-solving, working memory + social emotion processing deficits (impaired facial expressions).

Question 17

Coccaro’s model

Answer 17

1. reduced prefrontal cortex function;
2. hyperactivity in limbic system, specifically amygdala;
3. serotonin dysregulation;
4. interaction with environmental stressors.