Paper 3 : Schizophrenia Flashcards
Schizophrenia diagnosis
ICD 11 : 2 negative symptoms
DSM-5 : 1 positive symptom
Hallucinations
Extra sensory experience eg voices
Delusions
Beliefs with no basis in reality
Avoiltion
Severe loss of motivation
Speech poverty
Reduced amount, speed and quality of speech
Symptom overlap
Same symptom in different conditions
Co morbidity
Occurrence of two conditions at the same time
Hyperdopaminergia
High activity of dopamine in sub cortex linked to hallucinations
Hypodopaminergia
Low activity in prefrontal cortex linked to disordered thinking
Neural correlates
Brain scans show structural abnormality and abnormal functioning in different areas of the brain linked with symptoms of SZ
Enlarged ventricles
Low activity in ventral striatum (linked to a avoilition)
Low activity in superior temporal gyrus (hallucinations)
Typical antipsychotic
Older
Chlorpromazine
400-800mg
Risk of agranulocytosis
Atypical
Newer
Risperidone
4-8mg
Also affects serotonin transmission
Family dysfunction
Due to family experiences of conflict, communication problems, criticism and control
Schizophrenogenic mother
Mother is cold and controlling and rejecting. Father is passive and not involved. Stress triggers psychotic thinking
Double bind communication
Bateson
Child receives mixed messages. Makes lots of mistakes, cannot do right thing. Punishment is withdrawal of love. Results in disorganised thinking and paranoia
High expressed emotion
Family show’s exaggerated involvement, control and criticism.
Dysfunctional thought processing
Lower levels of information processing in some areas of the brain.
Dysfunction of meta representation
Cannot recognise one’s thoughts as their own
Leads to sensations of hearing voices (hallucinations)
Dysfunction of central control
Cognitive ability to suppress automatic responses. Derailment of thoughts as each word triggers automatic associations they can’t suppress. Speech poverty
Egocentric bias
Individual perceives themselves as central component in events and jumps to conclusions (delusions)
CBT
Form of talking therapy. Aims to identify and change irrational thoughts. Helps patients to understand their symptoms. Learn hearing voices is okay, reduces anxiety helping them cope
Family therapy
Aims to reduce expressed emotion and improve communication. Helps them solve and anticipate problems, reduces anger, guilt
Token economies
Based on operant conditioning
Tokes given to reinforce target behaviours
Meehls
Gene + stress = schizophrenia
Schizogene makes you vulnerable to the effects of chronic stress
