Schizophrenia

Question 1

Classification of Schizophrenia

Answer 1

ICD-10 - negative symptoms
DSM-5 - positive symptoms

Question 2

Positive Symptoms

Answer 2

Hallucinations
Dleusions

Question 3

Negative Symptoms

Answer 3

Avolition
Speech Poverty

Question 4

Weakness of classification of Schizophrenia symptoms

Answer 4

Co-Morbidity - When two disorders or conditions are coexistent in a sufferer. Where two conditions are frequently diagnosed together it calls into question the validity of classifying the two disorders separately.
Symptoms overlap - Occurs when two or more conditions share symptoms. This calls into question the validity of classifying two disorders separately.

Question 5

Biological explanations - Family studies

Answer 5

Schizophrenia runs in families.
This is quite weak evidence in itself for a genetic link as family members tend to share aspects of their environment as well as many of their genes.
However, there is a strong relationship between the degree of genetic similarity and shared risk of schizophrenia.

Question 6

Biological explanation - Candidate genes

Answer 6

Individuals are believed to be associated with risk of inheritance.
Genes associated with increased risk included those coding for the functioning of a number of neurotransmitters including dopamine.

Question 7

Biological explanation - The role of mutation

Answer 7

2

Question 8

The Dopamine Hypothesis - Hyperdopaminegia

Answer 8

Too much dopamine in the sub cortex i.e. the central areas of the brain such as Broca’s area.
It is said that Broca’s area may be associated with poverty of speech as well as the experience of auditory hallucinations.

Question 9

The Dopamine Hypothesis - Hypordopaminegia

Answer 9

Too little dopamine in the cortex.

Question 10

Neural correlates - Positive symptoms

Answer 10

Reduced area in the superior temporal gyrus and anterior cingulate gyrus is a neural correlate of auditory hallucination.

Question 11

Neural correlates - Negative symptoms

Answer 11

Activity in the ventral striatum is a neural correlate of negative symptoms of SZ.

Question 12

Psychological - Family dysfunction - The Schizophrenogenic mother

Answer 12

Reichmann (1948) proposed a psychodynamic explanation for SZ based on the accounts she heard from her clients about their childhoods.
The mother is cold, rejecting and controlling, and tends to create a family based on tension and secrecy.
This leads to distrust that later develops into paranoid delusions, and ultimately schizophrenia.

Question 13

Psychological - Family dysfunction - Double Bind theory

Answer 13

Bateson et al. (1972) emphasized the role of communication style within a family.
The child is often going to receive mixed messages about what they ay do wrong and feel unable to comment on the unfairness of this situation or seek clarity.
Bateson made it clear that this was neither the main type of communication in the family of a person with schizophrenia nor the only factor, just a risk factor.

Question 14

Psychological - Family dysfunction - Expressed Emotion

Answer 14

Expressed Emotion (or EE) is the level of emotion, in particular negative emotion, expressed towards a person with schizophrenia by their carers.
EE contains several elements:
- Verbal criticism of the person, occasionally with violence.
- Hostility towards the person, including anger and rejection.
- Emotional over-involvement in the life of the person, including needless self-sacrifice.

Question 15

Cognitive explanation - Dysfunctional thinking

Answer 15

A general term meaning information processing that is not functioning normally and produces undesirable consequences.

Question 16

Cognitive explanation - Meta-representation

Answer 16

The cognitive ability to reflect on thoughts and behaviour. This allows us insight into our own intentions and goals.
Dysfunction in metarepresentation would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else.
This would explain hallucinations of voices and delusions like thought insertion.

Question 17

Cognitive explanation - Central Control

Answer 17

The ability to suppress automatic responses while we perform deliberate actions instead.
Disorganised speech and thought disorder could result from the inability to suppress automatic thoughts and speech triggered by other thoughts.

Question 18

Biological therapy - Typical anti-psychotics

Answer 18

Chlorpromazine
Typical anti-psychotics act as antagonists to the dopamine system as they reduce the action of dopamine.
Effective against positive symptoms of schizophrenia but not negative symptoms.
Have more but less drastic side effects.

Question 19

Biological therapy - Atypical anti-psychotics

Answer 19

Clozapine
A treatment for schizophrenia when typical anti-psychotics fail.
Attacks both positive and negative symptoms of schizophrenia.
Acts on serotonin.
Has less but more drastic side effects such as tardive dyskinesia.

Question 20

Psychological therapy - Cognitive behaviour therapy

Answer 20

Usually takes place between five and twenty sessions, either in groups or an individual basis.
The aim of CBT involves helping people identify irrational thoughts and trying to change them.
This may involve an argument or a discussion of how likely the persons beliefs are to be true, and a consideration of other less threatening possibilities.
This will not get rid of the symptoms but can make it possible for people to cope with them.

Question 21

Psychological therapy - Family therapy

Answer 21

Takes place with the aim of improving quality of communication and interaction between family members.
Pharoah et al. (2010) identified a range of strategies to improve functioning of a family:
- Forming a therapeutic alliance with all family members.
- Reducing the stress of caring for a relative with SZ.
- Reduction of anger and guilt in family members.
- Helping family members achieve a balance between caring for the individual and maintaining their lives.
- Improving families’ belief about and behaviour towards SZ.

Question 22

Management of Schizophrenia - Token economies

Answer 22

Based on operant conditioning, Tokens are secondary reinforcers as they only have value once the patient has learnt that hey can be used to gain rewards.
In the form of social services, rewards may be having a room cleaned or privilege’s such as a walk outside the hospital.

Question 23

Interactionist approach - The diathesis stress model

Answer 23

The diathesis stress model says that both a vulnerability to SZ and a stress-trigger are necessary in order to develop the condition.

Question 24

Treatment according to the interactionist approach

Answer 24

2