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Clinical Psychology > psychosis and schizophrenia REVISE > Flashcards

psychosis and schizophrenia REVISE Flashcards

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1
Q

relationship between psychosis and schizophrenia?

A

schizophrenia is a psychotic disorder as has psychotic symptoms

schizophrenia can cause psychosis (collection of positive symptoms of schizophrenia) but has some other symptoms

psychosis is the name of some of the positive symptoms of schizophreia (hallucinations and dellusions)

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2
Q

how does the media wrongly view psychosis?

A

just because someone with psychosis might behave in an anti-soical way, doesn’t mean they have anti-social personailty disorder (media depicts that they do)

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3
Q

how does the media wrongly view schizophrenia?

A

shows schizophrenia as being split personailty disorder but it’s a split between reality and imagination NOT personalities

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4
Q

what effect does the incorrect depiction of psychosis and schizophrenia in the media have?

A

leads to stigma and social isolation for those with the condition

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5
Q

what is psychosis?

A

collection of symptoms involving loss of “shared” sense of reality involving hallucinations and/or delusions

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6
Q

what is schizophrenia?

A

both positive and negative symptoms involving difficulty in understanding difference between reality and imagination

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7
Q

why is there a high suicide rate for those with psychosis and schizophrenia?

A

unable to trust people and voices constantly negative and persecutory

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8
Q

are you more prone to commit crime if you have psychosis/schizophreniAa?

A

yes but when these disorders are combined with alcohol and drug abuse

also, more likely to kill themselves than other people

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9
Q

what percentage of people with schizophrenia commit suicide?

A

10%

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10
Q

what are some of the causes of psychosis?

A

schizophrenia, drug misuse, severe depression, neurological injury, severe stress, lack of sleep

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11
Q

positive symptoms of schizophrenia?

A

delusions
hallucinations
disorganised speech

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12
Q

what do positive symptoms of schizophrenia involve?

A

excess cognition

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13
Q

what are delusions?

A

beliefs that can be seen as a misinterpretation of reality e.g believing they are being spied on

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14
Q

what are hallucinations?

A

vivid visual or auditory experiences distorted from reality and not experienced by others

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15
Q

what is disorganised speech?

A

thoughts and therefore speech becomes disorganised and fragmented, jumping from topic to topic

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16
Q

what are the negative symptoms of schizophrenia?

A

avoltion
alogia
anhedonia
flat affect

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17
Q

what do negative symptoms of schizophrenia involve?

A

deficits in behaviour

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18
Q

what is avolition?

A

loss of energy and interest in usually fun activities

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19
Q

what is alogia?

A

poverty of speech in both quality and quantity

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20
Q

what is anhedonia?

A

lack of feeling of pleasure

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21
Q

what is the flat affect?

A

no outward expression or emotion but probably not actual experience

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22
Q

what are the 3 forms of schizophrenia diagnosis?

A

disorganised
catatonic
paranoid

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23
Q

what is the prevalence rate of schizophrenia?

A

1-2% in UK US and Caribbean

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24
Q

what is needed for a disorganised diagnosis of schizophrenia?

A

content of speech disordered

behaviour disorganised and not congruent with social cues

25
Q

what is needed for a catatonic diagnosis of schizophrenia?

A

extreme apathy and withdrawal leading to immobility with brief periods of excitement and agitation

26
Q

what is needed for paranoid diagnosis of schizophrenia?

A

delusions prominent (especially persecutory) and hallucinations

27
Q

when is the typical onset of schizophrenia and psychosis?

A

adolescence or early adulthood

28
Q

what are some of the most common positive symptoms of schizophrenia?

A 
lack of insight (97%) due to not trusting people so not trusting diagnosis 
auditory hallucinations (74%)
29
Q

why may schizophrenia be triggered by an excess of dopamine in the brain?

A

when drugs increasing dopamine levels were given to Parkinson’s sufferers, their symptoms lessened (disease associated with reduced dopamine levels) but they began to experience hallucinations

suggesting some symptoms are due to high levels of dopamine

ALSO schizophrenia symtpms themelves reduce once given neuroleptics to reduce dopamine levels

30
Q

difference in brain systems of those with schizophrenia?

A

excess activity in the substantia nigra (produces dopamine)
decreased activity in the prefrontal cortex (decision making and social behaviour)

and diminished connectivity between them (communication out of sync)

31
Q

relationship between level of connectivity between the substantia nigra and the striatum and psychosis levels?

A

the higher the level of disconnectivity, the higher the level of psychosis seen in schizophrenic patients

32
Q

genetic cause of schizophrenia

A

MZ 42% and DZ 9% (Gottesman and Shields) and negative symtpoms more genetically linked than positive BUT COULD BE DUE TO SHARED SOCIAL ENVIRONMENT

however, greater risk of having schizophrenia if genetic mother schizophrenic even when raised in another environment (Heston)

33
Q

what is the lifetime risk of having sz if first degree relative has it?

A

6.5%

34
Q

what is the lifetime risk of having sz if MZ twin has it?

A

40%

35
Q

early cause of schizophrenia being brain injury in pregnancy

A

Helsinki found offspring were more likely to develop schizophrenia if there was a flu epidemic in 2nd trimester
BUT FAILED TO CONFIRM THIS FINDING MORE RECENTLY

36
Q

what are some psychological stress factors triggering the onset of schizophrenia?

A

social factors
stressful life events
family environment

37
Q

social factors as a cause for sz

A

likelihood of schizophrenia highest in low socio-economic groups (due to poor housing and environmental hazards not due to the disorder lowering their social class)

BUT ABLE TO REDUCE LIKELIHOOD THROUGH BUFFERS E.G EDUCATION AND SOCIAL SUPPORT

38
Q

stressful life events as a cause for schizophrenia

A

such as beareavement, job loss and divorce

39
Q

family environment as a cause of schizophrenia

A

high levels of expressed emotion not so much a cause of schizophrenia but may trigger relapse and maintain disorder (58% in high EE group relapsed)

high levels of EE include critical comments and confronting the patient

40
Q

reduction in number of cases of schizophrenia if no one smoked cannabis?

A

8-24% in different countries

issue as USA making steps towards legalising and therefore inrceasing consumption of cannabis

41
Q

social stress as a cause of sz

A

racism
5% prevalence for young black men in south london (Institute of Psychiatry)

deduced racism was the cause as risk not elevated by genetic (2% in carribean), drug use or misdiagnosis

risk greatest in migrants when they form a small proportion of their local community
rates high in children of migrants but not reflected in increased rates from their country (implicating social factors) (Picchioni and Murray)

42
Q

summary of causes for schizophrenia

A

bio-psycho-social condition with one or more factors being influential

family
genetic vulnerabillity
socio-economic status
social stressors
bereavement
43
Q

early ineffective and damaging treatments for schizophrenia?

A

psychosurgery (surgical procedures carried out on brain to remove disorder)
ECT

44
Q

what is the function of neuroleptics/antipsychotics?

A

block dopamine receptors so dopamine unable to bind to receptors
therefore reduces positive symptoms by reducing levels of dopamine in the brain

45
Q

issue with neuroleptics/antipsychotics?

A

negative symptoms still remain as not caused by high but low levels of dopamine

side effects of parkinsons from sexual dysfunction to tardive dyskinesia and NMS so discontinue use

some symptoms are still drug resistant

46
Q

what does family therapy involve?

A

aims to prevent relapse by educating and changing patterns in the family enivronment from confrontative to collaborative and constructive e.g don’t shout or stand over them

reduce stress = reduce relapse

47
Q

effectiveness of family therapy?

A

out of 18 receiving family therapy so EE lowered, only 2 relapsed compared to 9 of control group not receiving changes to EE levels (Falloon et al.)

48
Q

what are the psychological interventions for sz?

A

family therapy
social skills training
psychoeducation

49
Q

what does social skills training consist of?

A

aims to develop social and daily living skills

role playing in groups and real social situations to learn and reacquire unknown social skills

50
Q

what do cognitive therapies involve?

A

investigate content of beliefs and sources of voices and challenge them with evidence and learning to manage and answer voices (CBT)

normalise certain cognitive functions such as memory and attention which are deficient in sufferers (cognitive remediation and cognitive enhancement therapies)

51
Q

what is the ABC model?

A

used in CBT
A - activating event e.g voices
B - beliefs e.g voices control me
C - consequences e.g behaviour

52
Q

effectiveness of CBT in treating schizophrenia?

A

modest efficacy in reducing symptoms and improving subjective quality of life
BUT MINIMAL EFFICACY IN REDUCING RELAPSE (Penn et al.)

53
Q

long term outcome for those with schizophrenia?

A

30% independent and working full time (schizoaffective disorder potentially not full sz)

50% relatively independent but continuing with medication

20% long term structured care

54
Q

when is a better outcome expected for those with schizophrenia?

A

known trauma that triggered the first episode
onset of schizophrenia after 20
onset sudden rather than gradual
good social functioning before onset

55
Q

what percentage of sufferes after their first episode will never have another?

A

less than 20%

Picchioni and Murray

56
Q

what is the relationship between causes of psychosis and the type of the psychosic experience they’ll have?

A

if cause was bi-polar, delusions likely to involve agrandising themselves

if cause schizophrenia or depression, may develop persecutory delusions

57
Q

why are antipsychotics also referred to as neuroleptics?

A

cause side-effects similar to that of a neurological disease

58
Q

what does psychoeducation treatment involve?

A

teaching them about symptoms and biological and psychological triggers for symptoms

Clinical Psychology (15 decks)

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