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schizophrenia Flashcards

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1
Q

define schizophrenia

A

means “split” or “shattered” mind, split in the sense of being cut off from reality and self knowledge

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2
Q

what are positive symptoms

A

symptoms that schizophrenia adds to your experience of the world

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3
Q

list examples of positive symptoms of schizophrenia

A
  1. hallucinations
  2. delusions
  3. disorganised thinking
  4. thought insertion
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4
Q

explain hallucinations as a positive symptom of schizophrenia

A

refer to seeing or hearing things that are not there

may also involve smells or feelings of being touched by someone

voices in people diagnosed with schizophrenia are harsh and critical, providing a running commentary on what the person is doing.

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5
Q

explain delusions as a positive symptom of schizophrenia

A

refer to a person thinking their movements are being controlled by someone else

and even when proven illogical or false the thoughts still remain. a common one is a paranoid delusion where the sufferer believes that someone is trying to mislead, manipulate or kill them

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6
Q

explain disorganised thinking as a positive symptom of schizophrenia

A

when someone finds it hard to put their thoughts into logical sense, e.g. neologism is when someone makes up words that have no meaning

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7
Q

explain thought insertion as a positive symptom of schizophrenia

A

person believes that their thoughts have been put there by someone else

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8
Q

what are negative symptoms

A

symptoms that schizophrenia takes away from your experience of the world, they commonly occur in the prodromal period (when negative symptoms start before positive symptoms start, years before schizophrenia is diagnosed)

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9
Q

list and explain examples of negative symptoms of schizophrenia

A
  1. speech problems - inability to speak at all
  2. loss of emotion - the feeling of numbness and loss of facial expressions
  3. lack of motivation - inability to feel pleasure, to begin or carry on with tasks
  4. social withdraw - breaking off friendships, quitting jobs, not making eye contact or responding to others
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10
Q

what are cognitive deficits

A

difficulties with following aspects of cognition can make it hard to live a normal life or earn a living

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11
Q

list examples of cognitive deficits of schizophrenia

A
  1. memory loss
  2. attention deficit
  3. planning difficulties
  4. poor decision-making
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12
Q

what are the features of schizophrenia?

A
  • average life expectancy for someone with schizophrenia is 10 years less than average
  • adolescents with psychotic symptoms are nearly 70x more likely to attempt suicide
  • Schizophrenia tends to be diagnosed at 30
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13
Q

what is paranoid schizophrenia

A

characterised by someone being suspicious of others and having delusions of grandeur, there are often hallucinations

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14
Q

what is disorganised schizophrenia

A

characterised by disorganised speech being disorganised and hard-to-follow, as well as having inappropriate moods for a given situation. no hallucinations.

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15
Q

what is catatonic schizophrenia

A

when someone is very withdrawn and isolated, not a lot of physical movement, unusual body positions

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16
Q

what are the symptoms associated with a psychotic episode

A
  • hallucinations
  • delusions
  • confused and disturbed thoughts
  • lack of insight
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17
Q

how is the ICD-10 used to diagnose schizophrenia?

A
  • the clinicians will try to place the client in 1 of the 7 types of schizophrenia
  • if their symptoms do not fit into any, they will be diagnosed with undifferentiated type schizophrenia
  • symptoms must be present for 1 month
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18
Q

how is the DSM-5 used to diagnose schizophrenia

A
  • clinicians will look for delusions, hallucinations, disorganised speech and behaviour and other symptoms that show dysfunctions
  • patient must have 2 of these symptoms for a valid diagnosis
  • symptoms must be present for 6 months
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19
Q

define neurotransmitters

A

neurotransmitters are fast chemical messengers that travel between neurones by crossing the synapse

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20
Q

how does dopamine cause schizophrenic symptoms?

A
  • dopamine systems in the mesolimbic pathway may contribute to the positive symptoms of schizophrenia (such as hallucinations)
  • dopamine systems in the mesocortical pathway may be responsible for the negative symptoms, such as lack of motivation and inability to speak
21
Q

what does Davis suggest about the origins of positive and negative symptoms of schizophrenia?

A
  • positive symptoms of schizophrenia may result from excess dopaminergic activity in the mesolimbic pathway (hyperdopaminergic)
  • negative symptoms arise from a lack of dopaminergic activity in the mesocortical pathway (hypominergia)
22
Q

what might be responsible for hyperdopaminergic activity?

A

D2 dopamine receptor on the postsynaptic cell

23
Q

explain the dopamine differences

A
  • dopamine receptors can be present in the brain in different numbers
  • development of receptors in one area might inhibit their development in another
24
Q

what is the role of serotonin in schizophrenia?

A
  • Due to the fact that the drug clozapine also binds to serotonin receptors and greatly reduces both positive and negative symptoms of schizophrenia
  • It was hypothesised that negative symptoms may be caused by irregularities in serotonergic energy
  • because serotonin regulates dopamine levels in mesolimbic pathway
25
Q

describe the glutamate hypothesis

A
  • animal studies have shown that when animals were treated with NMDA antagonists to glutamate receptors, it lead to a decrease in glutamate but did not always lead to an increase in dopamine
  • if NDMA antagonists are psychostimulants and lead to psychosis-like symptoms and inhibit dopamine release then this does not support the idea that excess dopamine causes schizophrenia
  • there is more to schizophrenia and psychotic behaviour than excess dopamine - glutamate has a role.
26
Q

how are anti-psychotic drugs evidence for the dopamine hypothesis

A
  • in the 1950s 2 antipsychotic drugs called chlorpromazine and reserpine were found to be helpful in alleviating the symptoms of schizophrenia
  • both drugs had side effects of induced tremors and muscle rigidity which is symptomatic of Parkinson’s disease that is caused by low levels of dopamine
  • symptoms of schizophrenia may be linked to high levels of dopamine (hyperdopaminergic)
27
Q

how are recreational drugs evidence for dopamine hypothesis

A
  • amphetamines can cause an excess of dopamine
  • which results in an amphetamine psychosis
  • the symptoms are similar to the positive symptoms of schizophrenia
  • Tenn et al found that rats given 9 amphetamine injections over 3 weeks showed various schizophrenic symptoms
  • this can manifest itself as stereotypical movements or social withdraw
  • suggests that increased dopamine levels may be a cause of schizophrenia in humans
28
Q

how are different types of dopamine receptors evidence against the dopamine hypothesis

A
  • research suggests that the striatum, limbic system and cortex are the three areas of the brain where excess dopamine receptors are present
  • however when looking more closely at the striatum in schizophrenic patients it was not found that there were more dopamine receptors
  • so relying on the D2 receptor may be reductionist
  • Depatie and Lai showed that apomorphine, a dopamine agonist which stimulates the D2 receptors, does not induce psychotic symptoms in non-psychotic patients
  • nor does it exacerbate symptoms in those that have been diagnosed with schizophrenia
29
Q

how are social and environmental factors evidence against the dopamine hypothesis

A
  • social and environmental factors seem to trigger schizophrenia so a biological explanation is not sufficient
  • it can not explain why certain groups in society such as second-generation immigrants, are more likely to be diagnosed with schizophrenia
  • environmental factors such as social stress may interact with internal neurochemistry making some people more prone to psychosis
30
Q

what are the factors that suggest schizophrenia is genetic

A
  • the fact that schizophrenia tends to run in families perhaps suggests that it has a genetic basis
  • the more closely related the family member to the person with schizophrenia is, the greater their chance of developing the disorder
  • identical twins are more likely to both have schizophrenia than non-identical twins
31
Q

explain how schizophrenia is a heritable condition

A
  • a recent study shows that the heritability of schizophrenia is 78%
  • in order to understand the genetic underpinning of schizophrenia is to identify responsible genes that are present in family members who have been diagnosed with the disorder
  • Jessica wright indicated that as many as 700 genes have been linked to schizophrenia
32
Q

explain how schizophrenia can occur from a gene mutation

A
  • schizophrenia can appear in the absence of a family history of the disorder
  • the DNA code in 1 or more genes may spontaneously change (mutate)
  • these changes can result from an environmental factor or error during cell division such as the deletion or duplication of a strand of DNA
  • For example: DiGeorge syndrome is caused by the deletion of around 30-40 genes located in a specific region of chromosome 22
    • as many as 25% of people with this condition go on to develop schizophrenia
33
Q

what are the 2 candidate genes that can cause schizophrenia

A
  1. COMT
  2. DISC 1
34
Q

describe how COMT gene can cause schizophrenia

A
  • link between schizophrenia and DiGeorge syndrome may be due to the deletion of the COMT gene
  • this gene is responsible for breaking down dopamine in the prefrontal cortex
  • the deletion of this gene would cause poor regulated dopamine levels which can cause schizophrenic symptoms
35
Q

describe how the DISC 1 gene can cause schizophrenia

A
  • people with an abnormality in the DISC 1 gene are 1.4 more likely to develop schizophrenia than people without this abnormality
  • the gene is responsible for coding for the creation of GABA which regulated neurotransmitters such as dopamine and glutamate in the limbic system
36
Q

explain the diathesis-stress model

A
  • genes create a vulnerability to schizophrenia rather than causing it
  • may possess ‘schizophrenia’ genes (a diathesis) but the condition is only triggered by other biological or environmental effects.
  • the stress was seen as psychological in nature, e.g. harsh parenting, but today it includes anything that risks triggering schizophrenia
37
Q

what research support is there for the genetic explanation of schizophrenia

A
  • Gottesman analysed the concordance rates for people of different genetic similarities and an increase in two related individuals both having schizophrenia
  • in an early study, they identified a concordance rate of 42% for MZ twins and 9% for DZ twins
  • this shows that schizophrenia is not a purely genetic disorder, but the fact that the concordance rate is greater for the MZ twins than DZ twins shows that biology plays a significant part
38
Q

what research support is there for the DISC1 and COMT genes

A
  • candidate genes as an explanation is a wealth of research evidence
  • in a review of 14 studies, Dahoun concluded that DISC1 is associated with presynaptic dopamine dysregulation which is a key factor in schizophrenia
  • Egan proposed a link between decreased dopamine activity in the prefrontal cortex and one form of the COMT gene
  • the Val allele, they proposed that inheriting two copies of the Val allele increases the risk of schizophrenia by 50%
  • this shows how genetic variations underpin neurochemical differences which can predispose a person toward schizophrenia
39
Q

what is the application of the genetic explanation of schizophrenia?

A
  • it has been used to inform genetic counselling
  • when a family member receives a diagnosis of schizophrenia, the family may want more information about whether the condition is heritable
  • recurrence risk can be calculated and the counsellor will then help the family to interpret this information
  • this service can provide support during difficult times, help allay fears of the inevitability of schizophrenia, while also helping people to make rational choices about family planning
40
Q

what is the social causation view of schizophrenia

A

the human world acts as a major cause of schizophrenia, or at least precipitates in relapse of those who already have a diagnosis

41
Q

what are the social risk factors for schizophrenia

A
  1. social adversity
  2. urbanity
  3. immigration and minority status
42
Q

explain social adversity as a social risk for schizophrenia

A
  • all human beings have basic physical and intellectual needs
  • some children grow up in environments which are less favourable than others and this can make them vulnerable to mental health disorders
  • families affected by unemployment, poverty and a poorer standard of living may be exposed to considerably more stress than other families
  • people from lower socioeconomic groups may not be able to access treatment for schizophrenia, leaving them even more vulnerable and further aggravating their problems
43
Q

explain urbanity as a social risk for schizophrenia

A
  • William Eaton suggested that city life is more stressful than rural life and long-term exposure to such stress may trigger an episode of schizophrenia
  • there are many stressors linked to city life including noise, light, pollution, criminality and collectively these factors may make a person more vulnerable to schizophrenia
  • increased population density makes life more competitive and increases the experience of chronic social defeat - a stressor which may elicit schizophrenia symptoms
44
Q

explain social isolation as a social risk for schizophrenia

A
  • Faris suggested that people with schizophrenia withdraw because they feel that contact with others is stressful
  • self-imposed isolation cuts the individual off from feedback about what behaviours or thoughts are inappropriate and, in the absence of corrective feedback, they begin acting strangely
45
Q

explain immigration and minority status as a social risk for schizophrenia

A
  • first and second generation immigrants are at greater risk of schizophrenia than the general population, this risk decreases as the number of people from the same ethnic background increases
  • minority or out-group status is the key, as opposed to belonging to any particular ethnic group
  • the implication that marginalisation of out-groups may leave people vulnerable to schizophrenia
  • Veiling claimed that schizophrenia may be a reaction toward the chronic experience of prejudice and discrimination
  • second-generation immigrants may be at a greater risk than first-generation immigrants because they have a weaker cultural/ethnic identity
  • second generation immigrants have learned, more than their parents, to fit in with the norms of the indigenous society therefore their identification with their parents and beliefs they hold personally may be at odds with those of their parents and extended family - this creates stress which increases any vulnerability for schizophrenia
46
Q

what is the strength of the social causation hypothesis for schizophrenia

A
  • research shows significant correlation between urban dwelling and schizophrenia
  • Vassos performed a meta-analysis of data from four studies conducted in Sweden, the Netherlands and Denmark, including nearly 24,00 cases of schizophrenia
  • they correlated location (urban to rural) with schizophrenia risk and found a link
  • at the extremes, they found that the risk was 2.37 times higher for people living in the most urban environments compared with the most rural environments
47
Q

explain the weakness of social causation hypothesis for schizophrenia

A
  • it is difficult to know which social factors directly cause schizophrenia
  • in urban regions crowded living conditions can lead to toxins in the environment, for example leaded fuel, and there are other risk factors such as not having social support and instability among communities leading to social isolation and difficulties in communication
  • it might be claimed that there are social factors that can help to explain schizophrenia but it is hard to know which social factors are involved as social factors interact and are hard to isolate for study
48
Q

what is the application of the social causation hypothesis for schizophrenia

A
  • has a real-world application to treating schizophrenia
  • governments can develop housing projects which aim to reduce overcrowding (which therefore reduces stress in the community and creates a less competitive environment) and encourage neighbourhood cohesion (which reduces social isolation) to celebrate cultural diversity
  • this will help communities arm themselves against mental breakdown

psychology (78 decks)

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