schizophrenia Flashcards
What is used to diagnose schizophrenia?
DSM-V
Positive symptoms of SZ
an excess or distortion of normal functions, for example hallucinations, delusions.
What are classified as hallucinations?
Hallucinations are usually auditory or visual perceptions of things that are not present.
What are classified as delusions?
Delusions are false beliefs.
Negative symptoms of SZ
loss of normal functions such as psychomotor disturbances, avolition. Symptoms of these might be ‘word salad’ incoherant sentences or jumbled thoughts etc.
Avolition meaning
Lack of desire, person becomes apathetic, no motivated etc (a negative symptom)
Classification AO3 (EVAL)
Slater & Roth (1969) say that hallucinations are the least important of all the symptoms, as they are not exclusive to schizophrenic people.
Scheff (1966) points out that diagnosis classification labels the individual, and this can have many adverse effects, such as a self-fulfilling prophecy (patients may begin to act how they are expected to act), and lower self-esteem.
Reliabilty in SZ
They should use the same diagnosing strategies (DSM) Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures;
Reliability in SZ (AO3)
Diagnosis of schizophrenia is difficult as the practitioner has no physical signs but only symptoms
Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females.
Validity in SZ
For the classification system to be valid it should be meaningful and classify a real pattern of symptoms, which result from a real underlying cause.
Validity in SZ (AO3)
Since their are problems with the validity of diagnois classification, unsuitable treatment may be administered.
Cultural bias – African Americans and those of Afro-carribean descent are more likely to be diagnosed than their white counterparts.
Genetics in SZ (studies)
Gottesman (1991) found that monozygotic twins (idential twins) have a 48% risk of getting schizophrenia whereas dizygotic twins (non-idential) have a 17% risk rate. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia.
Genetics EVAL AO3
Very important to note genetics are only partly responsible, otherwise identical twins would have 100% concordance rates.
A second weakness is the problem of nature-v-Nurture. It is very difficult to separate out the influence of nature-v-nurture. The fact that the concordance rates are not 100% means that schizophrenia cannot wholly be explained by genes
Dopamine hypothesis
The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine.
High dopamine activity leads to acute episodes, and positive symptoms which include: delusions, hallucinations, confused thinking.
Dopamine hypothesis AO3 EVAL
One criticism of the dopamine hypothesis is there is a problem with the chicken and egg. Is the raised dopamine levels the cause of the schizophrenia, or is it the raised dopamine level the result of schizophrenia
One of the biggest criticisms of the dopamine hypothesis came when Farde et al found no difference between schizophrenics’ levels of dopamine compared with ‘healthy’ individuals in 1990.
Neural correlates SZ
Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia.
People with schizophrenia have abnormally large ventricles in the brain. This means that the brains of schizophrenics are lighter than normal. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002).
Neural correlates EVAL AO3
A strength is that the research into enlarged ventricles and neurotransmitter levels have high reliability. The reason for this is because the research is carried out in highly controlled environments,
weakness of the neuroanatomical explanations is that it is biologically deterministic. The reason for this is because if the individual does have large ventricles then does it really mean that they will develop schizophrenia?
Family dysfunction sz
abnormal processes within a family such as conflict, communication problems, cold parenting, criticism, control and high levels of expressed emotions. Prolonged exposure to such interactions prevents the development of an internally coherent construction of reality; in the long run, this manifests itself as typically schizophrenic symptoms
Family dysfunction sz EVAL AO3
One strength of the double bind explanation comes from further empirical support provided by Berger (1965). They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics.
A second strength of the research into expressed emotion (EE) is that it has practical applications. For example Hogarty (1991) produced a type of therapy session, which reduced social conflicts between parents and their children which reduced EE and thus relapse rates.
Individual differences – EE is associated with relapse but not all patients who live in high EE families relapse and not all patients in low EE families avoid relapse.
Cognitive explanations
Examine how people think, how they process information. Researchers have focused on two factors which appear to be related to some of the experiences and behaviors of people diagnosed with schizophrenia.
Cognitive Deficits SZ
There is evidence that people diagnosed as schizophrenic have difficulties in processing various types of information, for example visual and auditory information.
Cognitive Biases
Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them – delusions of persecution. Research suggests that these delusions are associated with specific biases in reasoning about and explaining social situations.
Cognitive biases (AO3)
Strength - Yellowless et al. (2002) developed a machine that produced virtual hallucinations, such as hearing the television telling you to kill yourself or one person’s face morphing into another’s. The intention is to show schizophrenics that their hallucinations are not real.
One weakness of the cognitive explanation is that there are problems with cause and effect. Cognitive approaches do not explain the causes of cognitive deficits – where they come from in the first place.
Drug therapies, Typical antipsychotics
Typical antipsychotic drugs are used to reduce the intensity of positive symptoms, blocking dopamine receptors in the synapses of the brain and thus reducing the action of dopamine.
