Paper 3- Topic 3 Schizophrenia Flashcards

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1
Q

State the two psychological explanations for Sz

A
  • family dysfunction

* cognitive explanations

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2
Q

Define family dysfunction as a psychological explanation for Sz

A

the processes in family environments that may be risk factors for the development and maintenance of Sz
(e.g. cold parenting, poor communication within family and level of expressed emotion

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3
Q

3 explanations related to family processes for Sz

A
  • schizophrenogenic mother
  • double binds
  • expressed emotion
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4
Q

Describe the schizophrenogenic mother and how it leads to development of Sz

A
  • mother is cold, rejecting and controlling
  • creates family tension and secrecy
  • leads to distrust, leads to paranoid delusions and eventually develops Sz
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5
Q

Who coined the schizophrenogenic mother

A

• Fromm-Reichmann

-found patients with symptoms of Sz often had schizophrenogenic mothers

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6
Q

Describe the double bind theory to explain Sz

A
  • emphasis on communication style in the family
  • children feel trapped in situations and fear they are doing the wrong thing, but receive mixed messages
  • therefore they feel unable to comment or ask for clarity on situation
  • child is punished by withdrawal of love
  • leads to disorganised thinking and paranoid delusions
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7
Q

Who coined the double binds theory

what did he suggest

A

Bateson

  • he said it doesn’t have to be the main type of communication in the family and can still be a risk factor
  • he said communication contradictions means the person struggles to create a coherent clear idea of the world’s reality
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8
Q

Define the the two key types of double bind communication between parents that could influence a child developing schizophrenia

who coined them

A

Lidz

• marital schism
- parents are emotionally distant and compete for child’s affection

• marital skew
-one parent more dominant than the other

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9
Q

Describe expressed emotion to explain Sz

A

the level of emotion showed to a patient by carers (often family members)

  • high levels of negative expressed emotion acts as source of stress and may trigger relapse of Sz (or could be vulnerability in a diathesis stress model)
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10
Q

State the key aspects of expressed emotion that trigger relapse of Sz

A
  • verbal criticism (can be violent)
  • hostility towards person (includes anger and rejection)
  • emotional over involvement (includes needless self-sacrifice)
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11
Q

Define needless self sacrifice

A

giving up something for a reason and then blaming it on the patient

(e.g. I’ve stopped book club as all my time is taken up washing your clothes)

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12
Q

Describe the cognitive explanation for Sz

and how is it shown

A

focuses on role of mental processes, particularly dysfunctional thought professing

•shown in symptoms

  • reduced thought processing in ventral striatum associated with negative symptoms
  • reduced processing of information in the temporal and cingulate gyri associated with hallucinations (positive symptoms)
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13
Q

Define dysfunctional thought processing

A

disrupted information processing that doesn’t represent reality accurately, causing undesirable consequences

• disrupted thought processing in ventral striatum (- symptoms) and temporal/ cingulate gyri (+ symptoms)

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14
Q

Who identified the two types of dysfunctional thought processes

state what they are

A

Frith

  • metarepresentation
  • central control
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15
Q

define metapresentation and describe the effect of dysfunction to it

A

• our cognitive ability to reflect on thoughts and behaviours
- allows insight into own intentions and to interpret actions of others

-Dysfunction disrupts the ability to recognise our actions and thoughts as being carried out by ourselves rather than someone else
—> explains hallucinations and delusions (like insertion- thoughts being projected in mind by others)

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16
Q

define central control and the effect of dysfunction to it

A

• cognitive ability to suppress automatic responses while deliberate actions are performed

-dysfunction explains speech poverty and derailment
—> as patients are unable to suppress automatic thoughts or speech

17
Q

how is the ability of the central control measured

A

stroop test

18
Q

Define derailment of thoughts

A

when each word triggers associations and a person cannot suppress automatic central responses to these, as a result of faulty filter

  • may result in topics changing mid sentence
19
Q

Define speech poverty

A

deficits in fluency of spoken language
- fewer words, less grammar, reflect automatic, blocked thoughts

aka alogia

20
Q

State the name of drug most commonly used to treat Sz symptoms

What do they affect

A

anti-psychotics

  • work by reducing dopamine receptors in brain
  • link to dopamine hypothesis (both too little and too much) as an explanation of Sz
21
Q

Define antipsychotics

Two types of anti-psychotics

A
  • drugs used to reduce the intensity of symptoms of Sz, particularly positive symptoms
  • atypical
  • typical
22
Q

define psychosis

A

a symptom of Sz, when a person loses contact with reality

  • through hallucinations or delusions
23
Q

Describe typical antipsychotics

And how they affect neurotransmitters

A

focus solely on dopamine receptors

act as antagonists in the dopamine system
- reduce the amount of dopamine by blocking their receptors in synapses in the brain

e.g. chlorpromazine

24
Q

Describe the dosage and usage of chlorpromazine

when was it used since

A
  • taken orally as tablets syrup or injection
  • gradually increase small to dose to a maximum of 400-800mg (usually)
  • maximum dosage is 1000mg

used since 1950s

25
Q

how does chlorpromazine affect dopamine levels

A
  • block dopamine receptors so reduced dopamine

- when patients starts taking drug dopamine levels build up but then production is reduced

26
Q

symptoms treated and other beneficial effects of chlorpromazine

A

•treats positive symptoms
- manages hallucinations and delusions

•sedative effects
- blocks histamine receptors so helps calm patients down (used when patients are first admitted to hospital and nervous)

27
Q

side effects of chlorpromazine

initial and long term

A

• initial effects
- dizziness, agitation, itchy, sleepiness

• long term

  • neural malignant syndrome (characterised by delirium and a possible coma)
  • tardive dyskinesia (involuntary movement disorder - lip smacking)
28
Q

describe atypical antipsychotics

A
  • target a range of to neurotransmitters like dopamine and serotonin (are dopamine antagonists)
  • developed after typical anti-psychotics
  • aim to improve effectiveness of the drugs and minimise side effects
29
Q

examples of atypical antipsychotics

A

clozapine

risperidone

30
Q

Describe the dosage of clozapine

when was it used since

A
  • lower than chlorpromazine, daily dosage of 300-450 mg a day
  • no injections

since 1970s

31
Q

how does clozapine affect dopamine levels

A

• binds to dopamine receptors like chlorpromazine
-reduces dopamine

• also binds to serotonin and glutamate receptors

32
Q

symptoms treated and other beneficial effects of clozapine

A

• binding to serotonin and glutamate helps:

  • improve mood regulation
  • reduce depression and anxiety
    —> useful for high risk of suicide patients (30-50% of Sz patients try suicide)
  • also improved cognitive functioning
33
Q

side effects of clozapine

A

•risk of agranulocytosis

  • potentially fatal blood condition
  • those taking clozapine need regular blood tests
  • (was withdrawn in 1970 as some patients died of agranulocytosis)
34
Q

describe dosage of risperidone

when was it used since

A
  • gradually increase from a small dose to 4-8 mg up to 12mg
  • taken orally as tablets, syrup and injections

since 1990’s

35
Q

how does risperidone affect dopamine levels

A

-binds to dopamine and serotonin, more strongly than clozapine
—> so more effective in much smaller doses

36
Q

symptoms treated and other beneficial effects of risperidone

any side effects?

A

• more effective than clozapine in in much smaller doses
—> in regulating mood and reducing depression

• lower risk of side effects
—> especially extrapyramidal side effects (movement related effects)

37
Q

Two psychological therapies for Sz

A
  • cognitive behaviour therapy

- family therapy

38
Q

Briefly describe cognitive behaviour therapy (CBT)

unfinished (making notes instead)

A

aim is to identify and challenge irrational thoughts