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Pysch Paper 3 > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

DSM -5 schizophrenia diagnosis

A

at least one positive symptom plus two further symptoms ( could be pos or negative)

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2
Q

positive symptom

A

extra things experienced by somebody with schizophrenia

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3
Q

3 positive symptoms

A

delusion, hallucination, disorganised thinking

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4
Q

negative symptom

A

symptoms that normal people experience but are impaired in people with schizophrenia

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5
Q

3 negative symptoms

A

avolition , speech poverty , flattened effect

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6
Q

4 types of hallucinations

A

Auditory, Visual , Olfactory , Tactile

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7
Q

Auditory hallucinations

A

hearing voices

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8
Q

visual hallucinations

A

seeing things

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9
Q

olfactory hallucinations

A

false sense of taste or smell

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10
Q

tactile hallucinations

A

feeling something

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11
Q

Delusion def

A

irrational beliefs that have no basis of reality

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12
Q

4 types of delusions

A

persecution
grandeur
control
erotomania

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13
Q

delusion of persecution

A

beleif others want to harm you

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14
Q

delusion of grandeur

A

belief they are an important person ( celeb)

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15
Q

delusion of control

A

belief they are under control of an alien force

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16
Q

erotomania delusion

A

belief someone is in love with them with no evidence

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17
Q

speech poverty

A

loss of productive speech , difficulty to speak fluently or make much sense

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18
Q

Avolition

A

massive lack of motivation - poor goal keeping , poor hygeine, lack of energy

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19
Q

Issues with schizophrenia diagnosis- reliability

A

diagnosis is not consistent

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20
Q

Issues with schizophrenia diagnosis- test retest reliability

A

consistency when a single clinician makes the same diagnosis on separate occasions

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21
Q

Issues with schizophrenia diagnosis - inter rater reliability

A

consistency when individual clinicians make the same diagnosis for the same patient

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22
Q

Chiniaux et al Procedure - Schizophrenia inter rater reliability

A

2 psychiatrist independently diagnosed 100 patients using DSM -5 and ICD

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23
Q

Chiniaux et al Results - Schizophrenia inter rater reliability

A

ICD 10
1- 44/100
2-24
DSM-4
1- 26/100
2-13

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24
Q

co morbidity

A

occurence of two conditions together

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25
Q

Issue co morbidity creates

A

confuses diagnoses and confuses validity of classification as could just be one disorder

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26
Q

Common co morbid disorders with schizophrenia

A

OCD , depression, Substance abuse

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27
Q

Buckley et al - co morbidity schizophrenia findings

A

50% also have depression
29% also have PTSD
23% also have OCD

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28
Q

symptom overlap

A

when 2 or more conditions share symptoms

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29
Q

what conditions does schizophrenia symptom overlap with

A

bipolar and cocaine abuse

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30
Q

what’s made it easier to distinguish symptom overlap

A

Brain scans

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31
Q

Serper et al - symptom overlap

A

asses patients with either
schiz and cocaine abuse
cocaine abuse
schiz
and found symptom overlap but diagnosis was able to happen

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32
Q

Gender bias in schizophrenia diagnosis

A

more men diagnosed than women

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33
Q

Loring and Powell- Gender bias in schizophrenia diagnosis

A

290 pyschiatrits asked to diagnose 2 patients with identical symptoms
when told it was male patient - 56% diagnosed
when told it was female patient - 20% diagnosed

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34
Q

cultural bias in schizophrenia diagnosis

A

higher rates of schiz in afro craibeans living in UK

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35
Q

explanations for cultural bias in schizophrenia diagnosis

A

heightened stress as minority
more acceptable to hear voices in their culture

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36
Q

Cohrane - cultural bias in schizophrenia diagnosis

A

Afro Caribbean’s in UK are 7x more likely to be diagnosed

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37
Q

Genetic explanation for schizophrenia

A

evident there is a genetic component to schizophrenia

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38
Q

Gottesman meta analysis Procedure- Genetic explanation for schizophrenia

A

40 family studies on concordance rates using MZ/DZ twins , siblings and cousins

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39
Q

Schizophrenia Concordance rate for twins

A

MZ- 48%
DZ- 17%

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40
Q

Schizophrenia Concordance rates for siblings and cousins

A

siblings - 9%
Cousins - 2%

41
Q

what do the concordance rates show

A

genetics plays a part. Nurture is also important as siblings and DZ twins share same % of DNA however it’s higher in DZ twins

42
Q

Kety et al - support for Gottesman concordance

A

Located 33 adopted twins and found a 33% concordance rate

43
Q

Implications of Genetic explanation for schizophrenia

A

could change how you live in a positive way if you are aware you’re at risk
highly deterministic as lack of control

44
Q

Schizophrenia - dopamine hypothesis

A

schizophrenia is caused by abnormal dopamine levels , a patient could experience both hypo/hyper levels

45
Q

Van Rossum - high levels of dopamine

A

hyperdopaminergia in sub cortex is linked to positive symptoms

46
Q

Davis et al - low levels of dopamine

A

hypodopaminergia in cortex linked to negative symptoms as effects decision making

47
Q

dopamine hypothesis alternative explanations ( Glutamate)

A

Glutamate regulates dopamine and people with schiz have raised levels in several brain regions

48
Q

dopamine hypothesis alternative explanations ( Seratonin)

A

people with schiz have excess seratonin in parts of the brain

49
Q

Strength of dopamine hypothesis - drugs that increase dopamine

A

found medication that increases dopamine makes schiz symptoms worse or can give someone symptoms who doesn’t have it

50
Q

Strength of dopamine hypothesis - antiphyscotic drugs

A

drugs that reduce dopamine , reduce schizophrenia shwoing dopamine has a role to play

51
Q

weakness of dopamine hypothesis - individual differences

A

not present in all schizophrenics and especially those who only suffer negative symptoms

52
Q

abnormal brain structures in schizophrenia

A

80% of schizophrenics have enlarged ventricles which indicates brain damage and degenerative

53
Q

strength of abnormal brain structures in schizophrenia

A

MRI and fMRI support this

54
Q

weakness of abnormal brain structures in schizophrenia

A

not present in all
evidence of it in non schitz people
could be caused by medication

55
Q

biological schizophrenia therapies in pre 1950s

A

euthanise , hydrotherapy

56
Q

biological schizophrenia therapies in 1970s

A

development of atypical antiphyscotics

57
Q

biological schizophrenia therapies in 1950s

A

development of typical antiphysoctic drugs

58
Q

biological schizophrenia therapies in 1990s

A

better antiphyscotic drugs with fewer side effects

59
Q

3 methods of administering drugs

A

tablets
syrup
injection

60
Q

tablets

A

gradually increase dosage

61
Q

syrup

A

absorbed faster than tablets so good for someone in a psychotic episode who needs help quickly

62
Q

injection

A

taken every 2-4 weeks for people who don’t take their meds

63
Q

how schizophrenia treatment works

A

block the receptor on post synaptic neuron so less dopamine is absorbed and positive symptoms are reduced

64
Q

pyschological explanation for schizophrenia - family disfunction

A

a family who aren’t operating leading to a dysfunctional environment

65
Q

psychological explanation for schizophrenia- Schizophrenogenic mother ( Freida Fromm)

A

a cold and controlling mother, and a passive and ineffectual father creating family tension and secrecy.
Leads to distrust from child and paranoid delusions in child

66
Q

psychological explanation for schizophrenia- A03 Schizophrenogenic mother ( Freida Fromm)

A

retrospective - inaccurate
distorted memory as schizophrenic
correlation is not causation
temporal validty as dad’s were not around enough in 50s to cause schizophrenia

67
Q

psychological explanation for schizophrenia- double bind theory

A

contradictory messages from parents who say and act in different ways as creates a child who doesn’t know how to respond.
leads to disorganised thinking and delsuions which leads to schizophrenia

68
Q

A03 double bind theory

A

retrospective, schizophrenics may have distorted memories, ethical issues

69
Q

Family dysfunction A03- alternative explanations - attachment type

A

adults with schizophrenia are likely to have an insecure attachment - either insecure resistant or disorganised

70
Q

Family dysfunction A03- alternative explanations- abuse

A

65% of females and 59% of males with schizophrenia have a history of physical or sexual abuse.
Morkved et al - most adults with schizophrenia reported at least one childhood trauma

71
Q

Brown et al - expressed emotion

A

when the emotions towards somebody with schizophrenia are negative or overprotective - can lead to relapse of patients who have returned to families.
When secret alliances are formed between family members can lead to delusion of persecution

72
Q

A03 expressed emotion - Kavangh et al study

A

found relapse rate was 48% when schizophrenics returned to families with high EE

73
Q

A03 expressed emotion - Application

A

therapy that focuses on reducing EE will reduce relapse rates

74
Q

Cognitive explanations of schizophrenia - Frith et al Metarepresntation

A

Inability to recognise thoughts as own so believing they are coming from elsewhere.
This leads to delusions as they believe their mind has been overcome

75
Q

Cognitive explanations of schizophrenia - Frith et al central control

A

Inability to suppress automatic responses so saying whatever pops into your head
This leads to disorganised speech and thoughts - derailment of thoughts that can’t be switched off leading to spech poverty

76
Q

Central control A03 - Stroop test

A

stroop test and compared 30 schitz’s with 18 non schiz’s
the schitz took twice as long
this shows they were struggling to supress the world

77
Q

Central control A03 - applications

A

cognitive explanations can lead to CBT which is an effective treatment for schizophrenia

78
Q

Central control A03 - alternative explanations

A

biological and socio cultural explanations not considered

79
Q

Ellis ABCDE model - cognitive restructuring

A

A- identifying activating event
B- exploring beliefs
C- recognising consequences
D- disrupting irrational beliefs
E - restructuring belief

80
Q

Chadwick et al - study of CBT (Nigel)

A

nigel believed he could predict what people were gonna say
Chadwick showed nigel 50 vids and paused them at random points asking Nigel to predict
he didn’t get one correct
this restructered nigels beliefs

81
Q

Nick Tarrier - specific form of CBT

A

specific form of CBT for schizophrenia focused on building a schizophrenia coping strategies for psychotic symptoms and stress they produce

82
Q

Nick Tarrier - specific form of CBT 2 types of coping stratergies

A

cognitive strategies- distraction
behavioural strategies - relaxation techniques

83
Q

Nick Tarrier - specific form of CBT- 2 types

A

develop a report and identify triggers
target specific symptoms and learn to cope with them

84
Q

A03 CBT- positives

A

fewer side effects than drugs
gives patient applicable skills

85
Q

A03 CBT- positives ( Sameer Jahur)

A

reviewed 34 studies of CBT and schizophrenia and found it effective on both positive and negative symptoms

86
Q

A03 CBT- Negatives

A

not suitable for all patients
positive symptoms lack awareness
negative symptoms may lack motivation
doesn’t treat symptoms but just helps cope with them

87
Q

Family therapy

A

therapy including close family and friends of schizophrenia patient
lasts 9-12 months
based on family dysfunction

88
Q

Family therapy Stage 1 - Psychoeducation

A

aim is
to educate family
understand behaviour’s witnessed
educate schizophrenic on effect on family
educate both parties on how therapy can change behaviour

89
Q

Family therapy Stage 2 - develop strategies

A

improve quality of communication
share burden of care between family members
create a balance between caring but maintaining lives

90
Q

Family therapy A03- Mcfarlen meta-analysis

A

concluded a meta analysis about family therapies and found it reduced relapse rates by 50-60%

91
Q

Family therapy A03-implications on economy

A

is expensive due to length however is cost effective due to family members and schizophrenic being able to return to work

92
Q

Family therapy A03- Ethical implications

A

improves QOL of patient and family members

93
Q

token economies

A

‘tokens’ given when a socially acceptable behaviour is presented , the tokens can then be exchanged for rewards

94
Q

what type of technique is a token economy

A

a management technique not a treatment

95
Q

token economies and schizophrenia

A
  • doesn’t cure schizophrenia but can improve QOL
    as often improves negative symptoms
96
Q

A03 - token economies ethical implications

A
  • certain rewards ( cigs and alcohol) can cause withdrawal
  • is the real motivation by staff to make their job easier
97
Q

A03- token economies and individual differences

A
  • not everyone will continue once they leave the institution
  • good as can be tailored to individual
98
Q

A03 - token economies research evidence - Glowacki et al

A
  • identified 7 studies on token economies in hospitals
  • found that all showed a reduction in negative symptoms and decline in frequency of unwanted behaviour

Pysch Paper 3 (4 decks)

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