schizophrenia Flashcards
what is schizophrenia
a serious mental disorder, 1% of population more common in men and low social economic groups, symptoms can interfere with everyday tasks, meaning schizophenics can often become hospitalized
how do you diagnose schizophrenia
need to distinguish 1 disorder from another, so, identidy clusters of symptoms that occur together and classying this as a disorder. Diagnosis is possible by identifying symptoms and deciding what disorder person has
what are the 2 major systems for classification of mental disorder
ICD-10 and DSM-5
how do ICD-10 adn DSM-5 differ in classification for schizophrenia
DSM-5, a positive symptom (add to normal function) must be present for diagnosis but 2 or more negative symptoms (taken away from normal function) are sufficient in ICD-10
what are positive symptoms of schizophrenia
additonal experiences beyond those of ordinary existence like hallucinations and delusions
what are hallucinations
unusual sensory experiences, some are related to events in environment but others have no relationship to this (eg. voices heardeither talking to or commenting on a person), can be experienced in relation to any sense, e.g. person may see distored facial expression or animals which aren’t there
what are delusions
aka paranoia, they are irrational beliefs. (e.g. thinking your an important historical figure or thinking government is aliens). Delusions make people believe their acting normally but other will think it’s bizzare
what are negative symptoms of schizophrenia
loss of usual abilities and experiences like speech poverty and avolition
what is speech poverty
reduction in amount and quality of speech and often accompaied by delay in persons verbal response in conversation. Also speech disorganisation where speaker chances topic mid sentence (but this is classified as a positive symptom by DSM-5)
what is avolition
apathy, finding it difficult to begin or keep up with goal directed activity (actions performed to achieve a result), schizophrenics have reduced motivation to do a range of activities. 3 signs of avolition are poor hygiene and grooming, lack of persistence and lack of energy
what is family dysfunction
psychologists have attempted to link schizophrenia to childhood and adult experiences of living in dysfunctional family
what is the schizophrenogenic mother
Fromm-Reichmann proposed psychodynamic explanation for schizophrenia based on accounts from her paitents childhood. She noted many paitents refered to one parent (who she called the schizophrenogenic mother-schizophrenia-causing)
according to Fromm-Reichmann how does the schizophrenogenic mother cause schizophrenia
they are cold, rejecting and controlling and creates family tension and secrecy which leads to distrust that later develops into paranoid delusions and ultimately schizophrenia
what is double-bind theory
Baterson et al agreed family climate is important in schizopohrenia but emphasised role of communication style in family. Child often finds themselves trapped in situation where they fear wrong-doingbut receive mixed messages about what it is and feel unable to comment on unfairness of situation or seek clarification and when child is wrong punished by withdrawal of love.
what happens in double-bind when condiitonal love occurs
understanding of the world is confusing and dangerous and reflected in symptoms like disorganised thinking and paranoid delusions. Baseson said this was neither main type of communication in family of someone with schizophrenia or only factor in developing schizophrenia, just a risk factor
what is expressed emotion in family dysfunction
EE is level of emotion, especially negative, towards person with schizophrenia by their carers
whar are the elements of expressed emotions
verbal critism, occasionally with violence, hostility towards person, including anger and rejection and emotional overinvolvement in life of person, including needless self-sacrifice
how does expressed emotion cause schizophrenia
high levels of expressed emotions directed towards individual is source of stress and explains relaapses in schizophrenia but it can also be a source in someone who is already genetically vulnerable (diathesis-stress model)
what is dysfunctional thinking in cognitive explanations
schizophrenia categorised as disruption to normal thought processing which we can see in many of its symptoms. Reduced thought processing in ventral striatum associated with negative symptoms but reduced processing of information in temporal and cingulate gyri associated with hallucinations, this is lower than usual level of info processing so cognition is likely to be impaired
what is congitive explantion for schizophrenia
focuses on role of mental processes, schizophrenia associated with a few types of dysfunctional thought processing
what is meta representation dysfunction in cognitive explanations
Frith et al idenfied 2 dysfunctional thought processes, first is metarepresentation, cognitive ability to reflect on thoughts and behaviour allowing insight into our intentions and goals and interpret others actions. Dysfunctional metarepresentation impacts our ability to recognise are own actions and thoughts as being carried out by ourselves not someone else, explaining hallucinations of hearing voices and delusions
what is central control dysfunction
Frith et al identified issues with cognitive ability to suppress automatic responses while we perform deliberate actions. Speech poverty and thought disorder could result from inability to suppress automatic thoughts and speech triggered by other thoughts (e.g. people with schizophrenia tend to experience derailment of thoughts as each word triggers association and can’t suppress automatic response to these
what is a strength of family dysfubnction
evidencing linking it to schizophrenia. Indicators of family dysfunction include insecure attachment and exposure to childhood trauma, esp abuse. Read et al found adults with schizophrania are disproportionally likely to have insecure attachment, type C or D and also reported 69% or women and 59% men have history of physical and/or sexual abuse. Morkved et al found most adults with schizophrenia reported 1 childhood trauma, mostly abuse. This suggests family dysfunction makes people more vulnerable to schizophrenia
what is a limitation of family dysfubnction
poor evidence for this explanation. Almost no evidence supporting importance of traditional family based theory like the schizophrogenic mother and double bind. Both these theories based on clinical observations of shcizophrenics and informal assessment of mothers personalities but not systematic evidence. This means family explanations have not been able to account for link between childhood trauma and schizophrenia
what is a strength of cognitive explanations
evidence for dysfunctional throught processing. Stirling et al compared performance on range of cognitive tasks in 30 people with schizophrenia and a control group of 30 people without schizophrenia, including Stroop tasks. Found firth et al central control theory was accurate, people with shcizophrenia tooklonger. This means cognitive process of people with schizophrenia is impaired.
what is a limitation of cognitive explanations
they only explain the proximal origins of symptoms because they explain what is happening now to produce symptoms (instead of distal explanations which focus on what initially causes the condition). Possible distal explanations are genetic and family dysfunction. What is unclear atm is how genetic variation or childhood trauma might cause problems with metarepresentation or central control. This means cognitive theorieson their own only provide partial explanations for schizophrenia.
what does most common schizophrenia treatment involve
use of antipsychotics
what does antipsychotic refer to
psychosis, person with psychosis experiences some loss of contact with reality through hallucinations or delusions
How long are antipsychotics taken for
can be short or long term, antipsychotics can also be divided into typical (traditional) and atypical (second generation drugs)
what are typical antipsychotics
have been around since 1905 including chlorpromazine taken as tablets, syrup or injection. Dosages are gradually increased the longer the drug has to be taken but the use of typical drugs for schizophrenia has decreaased in last 50 years
what is dopamine anatagnosists in typical antipsychotics
strong association between use of typical antipsychotics (chlorpromazine) and dopamine hypothesis. Typical antipsychotics work by acting as antagonists in dopamine system, anatgonists are chemicals that reduce action of a neurotransmitter. Dopamine anatgonists work by blocking dopamine receptorsin synapses, reducing dompaime action. Initially when you strat on the drug dopamine levels build up but then they reduce. According to dopamine hypothesis of schizophrenia this dopamine-anatgonist effect normalises neurotransmittion in key areas of brain and reduces symptoms like hallucinations
what is sedation effect
as well as antipsychotic proterties typical drugs (chlorpromazine) is an effective sedative. This is related to the histamine receptors but not fully understood how it causes sedation. Typical drug oftyen used to calm individuals not only with schizophrenia but with other conditions, has been done when paitents first admitted to hospital and are very anxious
