Psychosis and Schizophrenia Flashcards
What are the main features of psychosis?
- loss of awareness of socially perceived reality
- not knowing what’s real, thinking it’s coming from the outside rather than their mind
What are the causes of psychosis?
- schizophrenia
- drug misuse
- severe depression
- neurological injury
What are the main features of schizophrenia?
- delusional beliefs
- hallucinations
- withdrawal states
Definition of delusional beliefs?
-belief that can be seen as a misinterpretation of reality
Definition of hallucinations?
- hearing voices tat others don’t hear
- may be quite frightening and usually tend to be negative
Definition of withdrawal states?
- avolition
- loss of energy and absence of interest in routine activities
Definition of positive symptoms?
- excess cognition
- something that has been added to the person’s life
What are the positive symptoms of schizophrenia?
- hearing voices
- delusions
- disorganised speech (jumping from topic to topic)
Definition of negative symptoms?
- deficits in behaviours
- something that’s been removed from the person’s life
What are the negative symptoms of schizophrenia?
- avolition (loss of energy)
- alogia (poverty of speech)
- anhedonia (inability to feel pressure)
- flat effect (outward expression)
What are the different forms that symptoms take in schizophrenia?
- disorganised
- catatonic
- paranoid
What are the disorganised symptoms?
- content of speech disordered and bizarre associations
- behaviour disorganised and not congruent with social cues
What are the catatonic symptoms?
- apathy
- withdrawal states
- leading to immobility (though with islands of excitement and agitation)
- may later recall experience
What are the paranoid symptoms?
- delusions prominent, especially persecutory
- hallucinations
What are the biological factors of schizophrenia?
- genetics
- biochemistry
- neurology
What are the genetic causes of schizophrenia?
-may be genetic risk for range of related disorders that share common neuro-chemical underpinnings
Gottesmann & Shields (1972)
twin study for genetic cause
- MZ 42% concordance
- DZ 9% concordance
- negative symptoms more genetically linked
Cardon et al
twin study for genetic cause
- significant genetic correlations between syndromes
- degree of overlap contributing to schizophrenic, schizoaffective, manic syndromes
Heston (1966)
adoptee study for genetic cause
-greater risk of sz in those with diagnosed schizophrenic birth mothers despite being raised in another family/environment
What are the biochemistry causes of schizophrenia?
- chemical imbalances trigger symptoms
- due to genetic risk,injury,drugs or combination
- excess dopamine activity
What are the neurology causes of schizophrenia?
- excess activity in the substantia nigra
- decreased activity in prefrontal cortex
- diminished functional connectivity between above
- higher connectivity between substantia nigra and striatum the higher level of psychosis
What are the psycho-social factors of schizophrenia?
- deprivation
- family issues
- long term sources of stress (e.g. racism)
How might stressful life events induce schizophrenia?
- bereavement
- job loss
- ending relationship/divorce
- significant transitions
How does being in a low socio-economic group increase likelihood of schizophrenia?
- poor housing, low income
- overcrowding or homelessness
- environmental hazards
- stresses, uncertainty
- lack of opportunities
- less control over decisions
How might family issues lead to schizophrenia?
- expression of emotions and how it’s perceived by others, critical comments
- family environment
How might racism lead to schizophrenia?
- higher rates of schizophrenia
- confirmed diagnoses,not just incorrect diagnoses
- long term source of stress for them
Factors of the bio-psycho-social condition that influence development of schizophrenia?
- genetic risk
- risk of viral infection
- risk to development of brain (e.g. drugs)
- risk from social disadvantage
- risk of being in particular family environment
- particular social stresses
How does family therapy treat it?
- aimed at preventing relapses
- educative
- tries to change patterns from conformative to collaborative and constructive
- reduced stress leads to reduced relapses
Falloon et al (1982)
family therapy study
- 18 in each condition
- 2 in family therapy relapsed
- 9 of the control relapsed
Cognitive therapy as a treatment for schizophrenia?
- self-monitoring for use of medication
- investigate content of beliefs and sources of voices
- check evidence for the beliefs
- manage/answer the voices
Romme et al (1993)
continuum of ‘experience’ of symptoms
- 700 responded to TV programme
- 400 had voices, 350 difficult to cope, 100 coped well
- differences between groups (positive voices, less commanding, set more limits and listened selectively (e.g. sit down for a set time to pay attention), communicate about voices with other)
