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Abnormality > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

psychotic disorders

A

Psychotic disorders involve a major break from reality in
which the individual perceives their world in a way that is
very diff erent from how others perceive it

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2
Q

Dsm 5 defines psychotic spectrum as

A

Delusions
Hallucinations
Disorganised thoughts
Catatonic behaviour
Negative symptoms

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3
Q

affect

A

a person’s feelings or emotions. A ‘flat’ affect can refer
to a lack of visible response such as a frown or smile

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4
Q

schizotypal

A

great difficulty in developing emotionally meaningful relationships with
others and showing extreme ‘coldness’ and flat affect

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5
Q

schizophrenia

A

-at least one positive symptom
-and may include negative symptoms or catatonic
-must show a reduction in normal functioning
-these symptoms need to be present for at least 6 months and cannot be attributed to use of illegal substances or medication

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6
Q

Case study

A

Conrad, m, 23

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7
Q

Delusional disorder diagnosis

A

-persistent delusions, otherwise normal
-must have the symptoms for at least 1 month
-mustn’t be linked to substance, medication, or other disorders

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8
Q

Types of delusions

A

erotomanic
grandiose
jealous
persecutory

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9
Q

Symptom assessment using vr (Freeman)

A

-Normal diagnosis of schizophrenia presents problems: interpretation of individual’s experiences in the social world, misinterpretation of others’ behaviour, distrust paranoia and withdrawal, relies on truthful answers
-Using vr the assessment can be novel and standardised while assessing actual behaviour
-it can also ensure that paranoid behaviour is genuine as the social environment is artificial

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10
Q

Evaluation (freeman)

A

+fairly large sample
-did not represent a clinical population
+standardised assessment -> +reliability of measurement
-ecological validity (artificial environment)
-uses self report which can lead to response bias

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11
Q

Explanations of schizophrenia and delusional disorders

A

II

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12
Q

II Genetic

A

-Gottesman & Shields, genetic inheritance of schizophrenia
- genes or particular combinations of genes are passed on to offspring which may cause the disorder to develop
-symptoms may include psychosis
-known as endophenotypes
-schizophrenic symptoms are believed to have identifiable genetic markers which can be inherited

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13
Q

Psychosis

A

consists of a series of abnormalities of function; such as sensory dysfunction and working memory impairment

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14
Q

Gottesman and Shield 1972 (GENETIC)

A

-467 twins
-Maudsley hospital london
-1948-1964
-24 MZ
-33 DZ
-interviewed them (some had schizophrenia), also took cognitive tests

-50% of mz shared a schizophrenic status (9% in dz)
-in mz if one was severely schizo, the other was much more likely

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15
Q

II Biochemical (dopamine)

A

-The dopamine hypothesis essentially states that the
brains of those with schizophrenia produce more
dopamine than those without the disorder
-links excessive amounts of dopamine with positive symptoms of schizophrenia
-evidence comes from drug trial on those with and without schizo
-(if patients with parkinsons are given too much L-dopa they have the same positive effects as those with schizo
- autopsies have found that the brains of deceased individuals with
schizophrenia have a larger number of dopamine receptors
than those without the disorder
-Wise et al -> low levels of enzyme which breaks down dopamine
-PET scans show that excessive dopamine in striatum, limbic system, and cortex leads to positive symptoms
-Nestler argues that decreased dopamine in the prefrontal cortex may lead to negative symptoms such as flattened affect

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16
Q

II Cognitive

A

-Frith
-recognises that biological factors contribute in some way to the positive symptoms of schizophrenia
-describes schizo as ‘abnormality of self-monitoring’
-patients fail to recognize their own internal voice as theirs
-delusional thinking may arise from a misinterpretation of perception
-those experiencing negative symptoms such as lack of action have difficulty generating spontaneous actions; this may arise due to impaired theory of mind
-flattening of affect, lack of speech and social withdrawal result from difficulties in monitoring their own mental states and the states of others

17
Q

Gottesman and shields evaluation

A

+large sample
-not generalisable to non-twins
-sample drawn from only one hospital
+independent judges reducing researcher bias
qualitative data +in depth data about participants -subjective

18
Q

Treatment and management

A

III

19
Q

III Biochemical

A

antipsychotics and atypical antipsychotics reduce the severity of symptoms
-chloropromazyne and others block dopamine and serotonin receptors in cortical and limbic areas
-others affect serotonin and norepinephrine
-after one week less hostile and agitated, after 3 weeks diminished positive symptoms

20
Q

Research on biochemical

A

-randomized control trial (rct)
-double blind placebo controlled
-50% show significant improvement after 4-6 weeks
-30-40% show partial improvement
-rest show no improvement
-relapse rates are high
-side effects such as weight gain, drowsiness, extrapyramidal symptoms, tardive dyskenesia (last two affect motor control)

21
Q

III Electro convulsive therapy

A

ECT involves passing electricity through the
brain with the intention of inducing a seizure; the
seizure is the ‘treatment’ rather than the electricity
-usually undergo a course of ECT of 6-12 sessions
-usually twice a week
-it is now applied unilaterally to the non-dominant hemisphere to reduce memory loss
-The procedure affects the central nervous system and cardiovascular system
-Memory loss is still a common side effect
-extremely rarely: death

22
Q

Research on ECT

A

-no generally accepted explanation
-One theory is that it affects post-synaptic responses to central nervous
system transmitters
-evidence suggests it is can be effective during acute episodes where fast short term improvement is needed
-lack of evidence to suggest it is more effective than other treatments

23
Q

III Token economy

A

-Paul & Lentz
-The behavioural approach to schizophrenia considers that
symptoms of the disorder occur as a learned response
-not focused on internal experiences (auditory hallucination) as with the effect on their behaviour (acting as they hear voices)
-therapies focus on ‘unlearning’ individual symptoms

24
Q

Paul & Lentz 1977 (TOKEN ECONOMY)

A
  • operant conditioning to reinforce appropriate behaviour in schizo patients through use of rewards (in this case)
    -84 individuals with chronic admissions to psychiatric institutions
    -3 different forms of treatment: millieu therapy, traditional, token economy
    -once 4 and 1/2 years they used an independent measures design to compare the outcomes
    -behavior such as self-care, attending therapy and engaging socially
    -tokens could be exchanged for luxury items
    -the behaviour was monitored through time-sampled observations, standardised
    questionnaire scales and individual interviews

-some overall reduction in positive and negative symptoms was observed
-most effective at reducing catatonic behaviour and social withdrawal but less successful in reducing hallucinations and delusional thinking
-97% of the token economy were able to live independently in the community for 1.5 years, 71% millieu, 45% hospital group

25
Q

III Cognitive behaviour therapy

A

-Sensky et al
- CBT is a talking therapy designed to help people change through recognising thoughts
which underlie their behaviours

26
Q

Sensky et al 2000 (CBT)

A

-randomised control trial
-compare cbt with control group engaging in ‘befriending’
-befriending sessions included one-to-one sessions of talking about hobbies, sports, etc
-90 patients
-16-60 years
-diagnosed with treatment-resistant schizophrenia from 5 different clinics
-mean of 19 sessions of befriending or cbt
-randomly allocated, independent groups design
-cbt included talking with patients about emergence of disorders before tackling symptoms
-assessed by blind raters before treatment, at treatment competition and 9 month follow up
-they used CPRS and SANS scales
-both groups showed significant reduction in positive and negative symptoms
-at follow up, cbt continued to improve while the other did not

27
Q

Paul and Lentz evaluation

A

+intensive staff training –> improved reliability
+standardised
-low ecological validity
-ethical issues with patients who are denied privileges by not behaving

28
Q

Sensky et al evaluation

A

+RCT –> improved validity
+double blind –> reduces bias
+sample from different clinics across UK –> representative
+nurses carefully trained –> standardised

Abnormality (5 decks)

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