Problem 6

Question 1

What are the positive symptoms of schizophrenia?

Answer 1

• positive symptoms: everything that includes excesses and distortions
• delusions:
  
  • thought insertion: may believe their thoughts are not their
  • thought broadcasting: believe thoughts are being broadcasted/transmitted
  • believe thoughts are controlled by an external force
  • grandiose delusion: an exaggerated sense of his or her own importance, power, knowledge, or identity
  • ideas of reference: reading personal significance into the trivial activities of others
• hallucinations:
  
  • some hear their voice spoken by someone else
  • greater activity in the Broca’s area and the Wernicke’s area for people who hear voices
  • there is a problem in the connections between the frontal lobe areas that enable the production of speech and the temporal lobe areas that enable the understanding of speech

Question 2

What are the negative symptoms of schizophrenia (avolition, asociality, anhedonia, blunted effect and alogia)?

Answer 2

• Avolition:
  
  • lack of motivation and an absence of interest usually routine activities
• Asociality:
  
  • severe impairments in social relationships
• Anhedonia:
  
  • loss of interest or less experience of pleasure
  • consummatory pleasure: the amount of pleasure experienced in the moment or in the presence of something pleasurable
  • anticipatory pleasure: the amount of expected pleasure from future events
  • people with schizophrenia have a deficit in anticipatory pleasure not in consummatory pleasure
• Blunted affect:
  
  • lack of outwards expression of emotion
• Alogia:
  
  • significant reduction in the amount of speech

Question 3

What are the disorganised symptoms of schizophrenia?

Answer 3

• Disorganised speech:
  
  • problems in organising ideas and in speaking
  • loose associations/derailment: person better at communicating but has difficulties sticking to one topic
• Disorganised behaviour:
  
  • loss of ability to organise their behaviour and make it conform to community standards
  • catatonia: gesturing repeatedly, often seems purposeful, increase in activity for some or immobility for others

Question 4

What are prodromal and residual symptoms of depression?

Answer 4

• prodromal symptoms: observable symptoms that occur before a episode
• residual symptoms: symptoms that occur after an episode

Question 5

What are the genetic causes of schizophrenia?

Answer 5

• strong genetic link, high heritability
• more negative symptoms when inherited
• monozygotic twins have a higher chance of getting schizophrenia than dizygotic twins
• DRD2 and COMT are both important genes
  
  • DRD2: gene that encodes a specific type of dopamine receptor (D2)
  • COMT: associated with cognitive control processes that rely on the prefrontal cortex
• no one gene, a collection of genes linked to schizophrenia
• children who have biological mothers with schizophrenia but don’t grow up with them tend to not develop schizophrenia

Question 6

What is the role of neurotransmitters in schizophrenia?

Answer 6

• dopamine theory:
  
  • idea that excess dopamine activity causes schizophrenia
  • negative symptoms may be more clearly accounted for by other neurotransmitters
• ## glutamate defiencies may also explain the symptoms of schizophrenia

Question 7

What are the effects of schizophrenia on the brain?

Answer 7

• brain ages faster
• Enlarged ventricles:
  
  • large ventricles = loss of brain cells
• Prefrontal cortex:
  
  • reductions in grey matter and overall volume size
  • caused by having less dendritic spines (they receive impulses of other neurons)
  • causes a disruption in communication between neurons
  • less activation in the prefrontal cortex is related to more severe negative symptoms
• Temporal cortex:
  
  • structural and functional abnormalities in temporal cortex
  • reduced grey matter in temporal and frontal brain regions
  • reduced hippocampus in first degree relatives of people with schizophrenia as well
  • disruptions in HPA- axis, reduces hippocampus

Question 8

What are the environmental factors that influence the brain?

Answer 8

• those who are genetically exposed to schizophrenia, risk can be increased at birth due to delivery complications
• maternal infections during birth = greater risk
• even though issues in the brain may arise early in life, schizophrenia will only manifest itself in adolescence or early adulthood as that is when the brain will have developed
• dopamine activity is at a peak in adolescence
• cannabis worsens the symptoms of schizophrenia and increases risk of getting it

Question 9

What are the psychological factors of schizophrenia?

Answer 9

• people with schizophrenia do not experience more stress but are more reactive to the stressors

Question 10

What are the sociocultural factors that influence schizophrenia?

Answer 10

• Poverty (socioeconomic status)
  
  • people in poverty show the highest levels of schizophrenia
• Urbanicity (living in cities)
  
  • people living in urban areas have a higher chance of developing schizophrenia
• Migration (moving from one city to another)
  
  • greater risk of developing
• Family related factors:
  
  • returning to families who make a lot of critical and hostile comments increase the risk of relapse

Question 11

what are some developmental factors of schizophrenia?

Answer 11

• Retrospective studies:
  
  • lower IQ, signs of cognitive deficits
  • boys may show disagreeable behaviour
  • girls show more passive behaviour
• Clinical high risk studies: Identifies people who could have early schizophrenia
• Higher likelihood of schizophrenia:
  
  • having relative with schizophrenia
  • less developed motor skills
  • hallucinations
  • asocial behaviours from young age

Question 12

What are the uses of first and second generation antipsychotic drugs for schizophrenia?

Answer 12

• First generation antipsychotic drugs:
  
  • they can reduce the positive and disorganisation symptoms of schizophrenia but little to no effect on the negative symptoms
• Second generation antipsychotic drugs:
  
  • second-generation drugs are not more effective than the older, first-generation drugs
  • second-generation drugs did not produce fewer unpleasant side effects, they can cause weight gain
  • African Americans were more likely to be prescribed first generation antipsychotic drugs

Question 13

What is the evaluation of drug treatments?

Answer 13

• they work better than a placebo but not well for a lot of people
• mixed success has motivated people to find new therapies

Question 14

What psychological treatments can be used for schizophrenia (social skills training, family therapies, CBT, cognitive remediation therapies, psychoeducation and residential treatments)?

Answer 14

• Social skills trainig?