Psychosis Flashcards

Question

Delusional disorder

Answer 1

Previously termed paranoia Just having delusions instead of anything else - Mostly crystallised - very well thought out, elaborate theories Lifetime prevalence is around 0.2% Persecutory/paranoia type delusions are most common

Answer 2

Two people share the same delusion Very rare and potentially not real

Answer 3

Classified as a mood disorder in DSM-5 Evidence increasingly supports the concept of a spectrum of bipolar disorder (Akiskal et al., 2000)

Answer 4

Presence of high and low symptoms at the same time May be the most dangerous as there can be suicidal thoughts (low symptoms) and impulsivity (high symptoms) which can lead to suicide

Answer 5

Elation Irritability/anger Decreased speech Increased goal-directed activity Risk-taking behaviour Impulsivity Pressure of speech Energy and drive Flight of ideas Distractibility Grandiosity Psychotic symptoms (hallucinations, paranoid, delusions)

Answer 6

Aetiological models - Causes of experience and prevalence rates (genetic, life experience) Relapse models - Factors that predict relapse/reoccurrence of previous condition Phenomenological models - Accounts and explanations of individual experiences and behaviours

Answer 7

Psychotic symptoms occur on a continuum and more people than are diagnosed specifically may have psychotic experiences There is no clear boundary between normal and psychotic Different symptoms show cultural diversity of experience and meaning

Answer 8

- Hallucinations = 10-15% (Tein, 1991) - Delusions = 12% (van Os et al., 2000) - Paranoia = 12.6% (Poulton et al., 2000) - Bipolar spectrum = 6.4% (Judd & Akiskal, 2003)

Answer 9

Weak expressions of positive psychotic symptoms (psychotic experiences) can be measured in the general population 80% of these are transitory (brief) and only 7% go on to develop a psychotic disorder Argument for the continuum model as these experiences are clearly experienced on a spectrum

Answer 10

Zubin et al. (1992) People have an underlying biological or psychological vulnerability to certain disorders When presented with environmental stress, this vulnerability can be triggered and result in a mental health disorder

Answer 11

Voices occur as a result of traumatic experiences and their purpose is to draw attention to the trauma in order to promote recovery In third person as a defence mechanism against the emotional upset caused by memories of the trauma (Romme & Escher, 1989) Bereavement, sexual abuse, assault and bullying have been associated with hallucinations (Varese et al., 2012)

Answer 12

If you have one parent with schizophrenia you have an approximately 17% chance of developing the disorder If you have two parents with the disease you have an approximately 46% chance of inheriting the condition If you have an identical twin with the disorder you have about a 48% chance of developing the disorder Grottesman (1991)

Answer 13

Child with a schizophrenic parent is brought up by non-affected adopted parents still demonstrated a higher risk factor for schizophrenia Tienari et al. (2000) Shows genetic element is important, not just due to the social environment or learned behaviour passed on to the child from the schizophrenic parent

Answer 14

MRI studies show that on average the ventricles of patients with schizophrenia were 26% larger than those without the condition Wright et al. (2000)

Answer 15

Frontal and temporal areas in schizophrenic patients have been shown to be smaller Lawrie et al. (2008) Temporal lobes are responsible for aspect of language and emotion and therefore might account for difficulties displayed in these domains Frontal areas are associated with drive and motivation and so some of the negative symptoms may be a result of this brain abnormality (Galderisi et al., 2008)

Answer 16

PET study showed that adolescents with schizophrenia show a loss of grey matter in these areas over 6 years, indicating that the volume of these areas and total brain volume is decreasing (Thompson et al., 2001)

Answer 17

Drug used to reduce positive symptoms of schizophrenia reduces dopamine within the brain Stahl (1996) L-DOPA - used to reduce Parkinson's symptoms works by increasing the amount of dopamine and too much can lead to schizophrenic-like symptoms and vice versa Jaskiw & Popli (2004)

Answer 18

Dopamine has been thought to tag certain thoughts, experiences and behaviours as important to us If dopamine system is overactive then many seemingly irrelevant events may be identified as being special This may explain delusions and hallucinations experienced in schizophrenia Kapur et al. (2005)

Answer 19

Suggested that an increase in dopamine is associated with positive symptoms and a decrease in dopamine is associated with negative symptoms Lieberman et al. (1990)

Answer 20

Up to 30% of patients do not respond to treatment with antipsychotic medication suggesting that dopamine is not the only factor in schizophrenia as they still exhibit symptoms despite the reduction of their dopamine levels Conley & Buchanan (1997)

Answer 21

Theory of mind (Frith, 1992) explains the ability that we develop where we are able to understand the self-generated nature of our own thoughts If this process is deficient, we cannot tell which thoughts are self-generated and therefore might think that our inner monologue has been implanted into our heads

Answer 22

Stirling et al. (2001) Found that patients with schizophrenia were not able to recognise geometric drawings that they had made themselves Marjoram et al. (2005) Found that schizophrenics were poorer that controls in understanding cartoon jokes of which a key element was seeing the situation from a particular character's perspective They could not see the situation from another person's POV

Answer 23

Hemsley (1996) Auditory hallucinations may be a result of problems focusing attention properly Usual mechanisms which filter out irrelevant or unwanted material are not working properly Results in the individual being bombarded with information and consequent difficulty focusing on and interacting with the relevant environmental cues appropriately Hallucinations result from attention paid to irrelevant sensory information Delusions result from the individual trying to derive meaning from a plethora of confusing information stemming from both internal and external sources Negative symptoms occur due to a natural response to cope with sensory overload

Answer 24

Bentall et al. (2001) Delusions operate as a self defence mechanism when there is discrepancy between the actual self and the ideal self If someone is unemployed, with few prospects or little money, then it would be a psychological defence to attribute the failings to conspiracy between employers and the government rather than their own inadequacy