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a levels - history, psychology, literature > 🧠psychology - schizophrenia > Flashcards

🧠psychology - schizophrenia Flashcards

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1
Q

What is schizophrenia?

A

A chronic, severe mental disorder characterised by disturbances in thought, perception, and behavior

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2
Q

List the positive symptoms of schizophrenia

A
  • Hallucinations
  • Delusions
  • Disorganised thought
  • Experiences of influence, passivity, and control
  • Grossly disorganised behavior
  • Psychomotor disturbances
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3
Q

List the negative symptoms of schizophrenia

A
  • Avolition
  • Flattened effect
  • Impaired cognitive function
  • Alogia
  • Anhedonia
  • Asociality
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4
Q

According to the ICD 11, what are the core symptoms of schizophrenia?

A
  • Persistent delusions
  • Persistent hallucinations
  • Thought disorder
  • Experiences of influence, passivity, and control
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5
Q

According to the ICD 11, what conditions are needed for a diagnosis of schizophrenia to be made?

A
  • Persisted for at least one month
  • Not a manifestation of another health condition
  • Not a result of a substance on the CNS, or withdrawal
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6
Q

What is a delusion?

A

A fixed belief that is not amendable to change in light of conflicting evidence

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7
Q

What are the types of delusions?

A
  1. Persecutory
  2. Grandiose
  3. Referential
  4. Somatic
  5. Nihilistic
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8
Q

What is a persecutory delusion?

A

A belief that one is going to be harmed or harassed by an individual, organisation, or other group

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9
Q

What is a grandiose delusion?

A

When an individual believes that they have exceptional abilities, wealth, or fame

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10
Q

What is a referential delusion?

A

A belief that certain gestures, comments, or environmental cues are directed at oneself

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11
Q

What is a somatic delusion?

A

Somatic preoccupations regarding health and organ functions

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12
Q

What is a nihilistic delusion?

A

A belief that involves the conviction that a major catastrophe will occur

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13
Q

What is bizarre delusion?

A

A delusion that is clearly implausable and not understandable to same culture peers and do not derive from ordinary life experiences

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14
Q

What is a hallucination?

A

A perception-like experience that occurs without an external stimulus - vivid and clear, with the full force and impact of normal perceptions, not under voluntary control

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15
Q

What are the types of hallucinations?

A
  1. Auditory
  2. Visual
  3. Tactile
  4. Olfactory
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16
Q

What are the types of disorganised thinking/speech?

A
  1. Derailment / loose associations
  2. Word salad / incoherence
  3. Neologism
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17
Q

What is derailment / loose associations?

A

When an individual swithces from one topic to another

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18
Q

What is word salad / incoherence?

A

When speech is so severely disorganised that it is nearly incomprehensible and resembles repetitive aphasia

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19
Q

What is neologism, as a symptom of schizophrenia?

A

A neologism is a new word that is coined by a person affected with schizophrenia that is meaningless to everyone except the coineer - usually a combination of two existing words or a distortion of an existing word.

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20
Q

What is the most common type of grossly disorganised behavior?

A

Catatonia

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21
Q

What are the types of catatonic behavior?

A
  1. Negativism
  2. Mutism
  3. Catatonic stupor
  4. Catalepsy
  5. Wavy flexibility
  6. Catatonic excitement
  7. Echolalia
  8. Echopraxia
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22
Q

Define

Negativism

A

Little or no response to instructions or external stimuli

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23
Q

Define

Mutism

A

Complete lack of verbal responses

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24
Q

Define

Catatonic stupor

A

Maintaining a rigid, inappropriate, or bizarre posture

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25
Q

Define

Wavy flexibility

A

If a clinician places the patient’s arm in one position, they maintain it in that position until it is moved again

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26
Q

Define

Catatonic excitement

A

Purposeless and excessive motor activity without obvious cause

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27
Q

Define

Echolalia

A

Repeating someone’s speech

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28
Q

Define

Echopraxia

A

Mimicking someone’s actions

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29
Q

What is flattened effect?

A

Reduction of the expression of emotions in the face, eye contact, intonation of speech and movements in the hand, head and face which normally give an emotional emphasis on speech

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30
Q

What is avolition?

A

Decrease in motivated self-initiated purposeful activities

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31
Q

What is alogia?

A

Diminished speech output

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32
Q

What is anhedonia?

A

The decreased ability to experience pleasure from positive stimuli or a degradation in the recollection of pleasure previously experienced

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33
Q

What is asociality?

A

Lack of interest in social interactions and may be associated with avolition

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34
Q

What was the aim of Freeman et al?

A
  • To investigate whether participants without a history of mental illness have thoughts of persecutory nature in virtual reality
  • To investigate if there are cognitive or emotional factors predicting the likelihood of persecutory ideation in VR
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35
Q

What was the hypothesis of Freeman et al?

A

A small number of participants would have thoughts of a persecutory nature in VR and these individuals will have higher levels of emotional distress and paranoia

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36
Q

Freeman et al

What was the split of type of person in the sample?

A

21 students
3 administrative staff

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37
Q

Freeman et al

What was the split of gender in the sample?

A

12 males
12 females

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38
Q

Freeman et al

How, and from where, were participants sampled?

A

Advertising within university college London.

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39
Q

Freeman et al

What was the average participant age?

A

26 years

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40
Q

Freeman et al

What was the criteria of participant selection?

A

No history of mental illness

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41
Q

Freeman et al

What was the research method?

A

Lab experiment

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42
Q

Freeman et al

Was consent obtained?

A

Yes, but aim of the study withheld

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43
Q

Freeman et al

How long were participants in the VR environment?

A

5 minutes

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44
Q

Freeman et al

Describe the distribution of the avatars

A

5 avatars; 3 at one desk, 2 at another desk on the other side of the room

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45
Q

Freeman et al

What sort of behavior did the avatars show?

A

Ambiguous behavior

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46
Q

Freeman et al

How was the study counterbalanced?

A

Half the participants completed questionnaires after, the other half did so before

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47
Q

Freeman et al

What characteristic was keptt equal in both conditions?

A

Gender

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48
Q

Freeman et al

What did all participants complete after the VR environment?

A

Short semi-structured interview

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49
Q

Freeman et al

BSI stands for

A

Brief Symptom Inventory

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50
Q

Freeman et al

What is the BSI a short form of?

A

SCL-90-R

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51
Q

Freeman et al

How many items, and how many measures, did the BSI have?

A

53 items
9 symptom dimensions

52
Q

Freeman et al

What did the BSI measure?

A

The following dimensions over the past 7 days:
- Somatization
- Obsessive-Compulsive
- Interpersonal Sensitivity
- Depression
- Anxiety
- Hostility
- Phobic Anxiety
- Paranoid Ideation
- Psychoticism

53
Q

Freeman et al

How many items was the Paranoia Scale?

A

20 items

54
Q

Freeman et al

What was the Paranoia Scale developed for?

A

To measure paranoia in college students

55
Q

Freeman et al

What two ideas did the paranoia scale asess?

A

Persecution and Reference

56
Q

Freeman et al

What scale was used for the Paranoia Scale?

A

5 point scale

57
Q

Freeman et al

How much could paranoia scale scores vary?

A

20 to 100

58
Q

Freeman et al

What did a higher paranoia scale score show?

A

Greater paranoid ideation

59
Q

Freeman et al

How many items was the Spielberger State Anxiety Questionnaire?

A

20 item

60
Q

Freeman et al

What did the Spielberger State Anxiety Questionnaire measure?

A

State Anxiety

61
Q

Freeman et al

What was the scale used in the Spielberger State Anxiety Questionnaire?

A

1-4 scale

62
Q

Freeman et al

What was the range of scores in the Spielberger State Anxiety Questionnaire?

A

20-80

63
Q

Freeman et al

What did higher scores in the Spielbergfer State Anxiety Questionnaire show?

A

Higher levels of Anxiety

64
Q

Freeman et al

How many items was the VR Paranoia questionnaire?

A

15 items

65
Q

Freeman et al

What was the VR Paranoia questionnaire used for?

A

To assess the participants’ views of the avatars

66
Q

Freeman et al

What areas were assessed in the VR Paranoia questionnaire?

A
  • Sense of “being there” in the environment on the computer displays
  • Sense of having visited a place rather than just having seen images
  • The extent to which the virtual world dominated behavior relative to the virtual world rather than the real world
67
Q

Freeman et al

How many questions in the sense of presence questionnaire?

A

6

68
Q

Freeman et al

What rating scale was used in the VR presence questionnaire, and what did the total score show?

A

Scale of 1-7
Higher numbers: greater reported presence

69
Q

Freeman et al

How was the VR presence scale scored?

A

Score of 6 or 7: coded as 1
Else, coded as 0

70
Q

Freeman et al

VR presence questionnaire: range of scores

A

0 to 6

71
Q

Freeman et al

What was the purpose of the semi-structured interview?

A
  • To hear spontaneous impressions of VR environment
  • To give opportunity for participants to report distress
72
Q

Freeman et al

How was content analysis done on the semi-structured interview?

A
  • Videotaped
  • Rated for persecutory content on a 6 point scale by the first author, a clinical psychogist experienced in assessing persecutory delusions
73
Q

Freeman et al

What was the mean BSI score?

A

56.2

74
Q

Freeman et al

What did the BSI score correlate with?

A

Tendency for higher VR persecution score to associate with higher BSI paranoia scores
- BSI - interpersonal sensitivity and BSI - anxiety were associated with higher levels of persecutory ideation in VR

75
Q

Freeman et al

What was the mean Paranoia scale score?

A

31.8

76
Q

Freeman et al

What was the difference between males and females in the Paranoia scale results?

A

No significant difference

77
Q

Freeman et al

Pretest anxiety mean score vs Posttest anxiety mean score

A

Pre-test: 34.79.
Post-test: 31.82.

No evidence of increase by VR environment

78
Q

Freeman et al

Correlation of VR Persecution with VR Reference scores

A

Significant, r=0.48

79
Q

Freeman et al

Correlation of persecutory ideation from recorded interviews with VR persecution scores

A

Significant, r=0.591

80
Q

Freeman et al

Difference in VR persecution scores between males and females, and before and after task

A

None

81
Q

Freeman et al

Sense of presence: minimum and maximum score

A

0-6

82
Q

Freeman et al

Sense of presence questionnaire: mean

A

2.3

83
Q

Freeman et al

Conclusions

A
  • People attribute mental states to VR characters
  • Vulnerability partly arises from anxiety and interpersonal sensitivity
84
Q

Genetic model for schizophrenia states…

A

It is as a result of genetic phenomena such as inheritance.

85
Q

What was the family study in the genetic explanation for schizophrenia?

A

Gottesman (1991)

86
Q

Findings of Gottesman

General

A
  • Closer the genetic relationship between two, the higher the chance that if one is diagnosed with a psychosis such as schizophrenia, the higher the other is also diagnosed
  • Concordance rates not 100% so environment must also play role
87
Q

Results of Gottesman

Quantitative

A

Likelihood of developing SZ: 1% in general population but 48% with identical twins; one with SZ

88
Q

What have we not found it the genetic explanation for SZ?

A

Specific chromosome

89
Q

What was the adoption study in the genetic SZ explanation?

A

Kety et al (1962)
Tienari et al (2000)

90
Q

Findings of Kety et al

A

Strong link between genes and SZ because adopted children who’s mother was schizophrenic had higher change of developing SZ

91
Q

Qualitative results of Tienari et al

A

Schizophrenia in 6.7% of adoptees with biological mother with SZ, compared to 4% in control

92
Q

What is the twin study for the genetic explanation for schizophrenia?

A

Cardno et al (1999)
Hilker et al (2017)

93
Q

Findings of Cardno et al, quanti

A

Using the Maudsley Twin Register, London…
- 40% concordance in MZ twins
- 5.3% in DZ twins

94
Q

Hilker et al - sample

A

30,000 twin pairs in Denmark using Danish Twin Register and Danish Psychiatric Central Research Centre

95
Q

Hilker et al - quantitative result

A

79% heritability of SZ

96
Q

Study for Drug Treatment of SZ

A

Barlow & Durand (1995)

97
Q

Result of Barlow and Durand

A

Chloropromazine reduces SZ symptoms in 60% of cases

98
Q

Postmortem study for SZ

A

Wise et al (1974)

99
Q

Findings of Wise et al

A

Brain fluid from deceased patients had abnormally low amounts of enzyme breaking down dopamine

100
Q

Study for cognitive explanation of SZ

A

Frith (1992)

study seperately

101
Q

Examples of tratditional antipsychotics

A

Chloroproazine and Haloperidol

102
Q

Examples of atypical antipsychotics

A

Risperdal and Seroquel

103
Q

What did Rzewuska (2002) find?

A

Symptoms of SZ often reappear when patients terminate drug therapy

104
Q

Study for CBT as SZ treatment

A

Sensky et al (2000)

105
Q

Sensky et al

Sample

A

90 patients

Various UK clinics

106
Q

Sensky et al

Age range

A

16-60

107
Q

Sensky et al

Mean treatment sessions

A

19

108
Q

Sensky et al

Duration

A

9 months

109
Q

Sensky et al

Design

A

Independent measures, random allocation

110
Q

Sensky et al

Who delivered intervention?

A

Two experienced nurses

111
Q

Sensky et al

What were the two groups?

A

Befriending group
CBT group

112
Q
A
113
Q

What was the schizophrenia case study?

A

Aneja et al

114
Q

Aneja et al

Case study 1: participant

A
  • 14 y/o boy
  • Educated till class 6
  • Middle socioeconomic status family
  • Urban area
115
Q

Aneja et al

Case study 1: complaints

A
  • Academic decline since 3 years
  • Hearing voices for 2 years
116
Q

Aneja et al

Case study 1: Family background

A
  • Nonconsanguineous marriage
  • Aggressive behavior of father, abusive
  • Divorce at age 10
117
Q

Aneja et al

Case study 1: when did academic decline start?

A

When moving to maternal grandmas’ home, changing school

118
Q

Aneja et al

Case study 1: complaints from school

A
  • Child was in fist fights, undesirable behavior
  • Preference of solitary activity
  • Resentment to eat with family
  • Decline in performance of daily routine
119
Q

Aneja et al

Case study 1: Initial treatment

A

Sodiu Valproate, 400 mg/ day

120
Q

Aneja et al

Case study 1: after initial medications stop

A
  • Hearing voices in next year
  • Voices fulfil dimensions of commanding type of auditory hallucinations
  • Suspecting that family members including mother collude with unknown persons
  • Dropping out of school
  • Awake at night muttering to self
121
Q

Aneja et al

Case study 1: second treatment

A

Treated inpatient for 2 weeks with risperidone 3 mg, olanzapine 2.5mg, oxcarbazepine 300 mg/day

122
Q

Aneja et al

Case study 1: why relapse?

A

Weight gain, relapse in 3 months

123
Q

Aneja et al

Case study 1: participants’ physical features

A
  • Elongated face
  • Large ears
124
Q

Aneja et al

Case study 1: final treatment

A
  • 8 sessions of bilateral modified ECT
  • Aripiprazole 30 mg/day
  • Chloropromazine 600 mg/day
  • Divalproex 1000 mg/day
  • Trihexyphenidyl 4 mg/day
  • Activity Schedule
  • Occupational therapy
125
Q
A

a levels - history, psychology, literature (27 decks)

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