non advance eval

Question 1

Schizophrenia diagnosis + and -

Answer 1

+Regier et al (0.46), Sartorius et al (0.86)
+only 3.8% of clinicians said they lacked confidence diagnosing sz using the ICD-10
——-> - however difficult to diagnose Sz as it shares symptoms with other disorders e.g. catatonic behaviour and mdd
-Cultural diff- rastafarians use neologisms, clinicians unaware of these conventions see that as a sign of mental distress

Question 2

neurotransmitters as an expl + and -

Answer 2

+Tenn et al- rats given amphetamine injection showed SZ symptoms over 3 weeks, dopamine antagonists reduced effects
——> Depatie and lal- showed dopamine antagonist doesnt induce psychoticism in non-Sz or exacerbate in sz clients. This challenges hyperdopaminergia.
+Snyder-D2. Found that chlorpromazine acts as an antagonist at D2 receptors
+App to drugs- D2- haloperidol reduces pos symptoms, clozapine (blocked serotonin receptors) reduces p and n symptoms
-Cultural diff (2nd gen imm)- Veling et al found moroccan imm more likely to be diagnosed w sz than turkish

Question 3

Difference between agonist and antagonist

Answer 3

Agonist- binds to receptor, producing similar response to intended chemical receptor
Antagonist- binds to receptor which all together stops receptor from producing response

Question 4

Heritability of Sz

Answer 4

79% (hilker et al)

Wright- indicated 700 genes linked to Sz, likely 1000s niw

Question 5

Digeorge syndrome and sz

Answer 5

Caused by deletion of 30-40 genes in chromosome 22. 35% of people with syndrome develop Sz

Question 6

COMT gene

Answer 6

Gene provides instruction for enzyme which breaks down neurotransmitters such as dopamine in pfc. Deletion of COMT=poorly regulated dopamine=sz symptoms

Question 7

DISC1 gene

Answer 7

Abnormality to DISC1 gene 1.4x more likely to develop Sz (Kim et al). regulates neurotransmitters, involved in creation of GABA

Question 8

Genetic expl +

Answer 8

• Gottesman- 42% concordance Mz twins, 9% Dz. High genetic similarity and Sz conc rates
• Dahoun- DISC1 associated with presynaptic dopamine dysfunction
• Egon proposed link between low dop in PFC and one form of COMT gene (which increases Sz risk by 50%)

Question 9

Genetic expl -

Answer 9

• Gottesman counter- Mz twins more likely to be treated similary than dz (environ factors)
• Concordance rate not 100% even for Mz twins. Pedersen and Mortensen found the longer a person has been exposed to city life (and the denser the pop), the higher the risk of Sz

Question 10

Urbanicity

Answer 10

Eaton (1974) suggested city life is more stressful than rural life, lt exposure to such stress may trigger sz episode. Increased pop density also. (Pedersen and mortensen)

Question 11

social isolation

Answer 11

Faris (1934)- suggested people with Sz withdraw because they feel contact with others is stressful. They behave strangely because they cut themselves off from feedback about their weird behaviour.

Question 12

What happens to sz when number of people from same ethnic background are in the same community?

Answer 12

Boydell- Risk of Sz decreases as amount of people from same ethnic background increases

Question 13

Veling

Answer 13

Suggests Sz may be a reaction to chronic experience of prejudice and discrimination

Question 14

Why are second gen immigrants at greater risk than first

Answer 14

Weaker sense of cultural identity. Learned indigenous culture from parents, societal norms from peers. Stress increases vulnerability to Sz

Question 15

Social causation hypothesis strengths

Answer 15

• Vassos correlated location with Sz risk in SE, ND and DE. 2.37x higher Sz risk in urban areas
• Veling- people classed as marginalised and assimilated at higher Sz risk than integrated or separated people.
• App to treatemnt- collective social responsibility in communities to reduce Sz risk

Question 16

Social causation hypothesis weaknesses

Answer 16

• Vassos counter- correlational, not causal. Social drift hypothesis- Sz leads to urbanicity, rather than vice versa
• Gottesman (biological causation)- high concordance rates between genetic similarity (MZ twins) and Sz risk

Question 17

Drugs as treatment for Sz quick sum

Answer 17

FGAs- chlorpromazine, dopamine antagonist. Effective FGAs bind to D2s. 40% of people have no relief of symps, negative symps still exp. Unpleasant side effects
SGAs- Clozapine acts on dop AND serotonin and glutamate receptors. Reduces pos and neg symptoms. Bad side effects- fatal blood cond. Risperidone most pref, smaller dosage
Protocol- important to start meds early, first 7 days of psychotic episodes. When symps subside, maintenance does prescribed for 12 months to combat relapse.
Additional consideration- Amphetamines, alcohol, caffeine + nicotine disrupts effectiveness if antipsych medications. Drug treatments also fail to bring relief to those who have suffered symptoms for many years.