Schizophrenia Flashcards

Question

How do drugs that block dopamine receptors effect schizophrenia

Answer 1

They reduce symptoms (not cure)

Answer 2

Block dopamine receptors and reduce schizophrenia symptoms

Answer 3

Parkinsons treatment Increases dopamine in the brain and can bring out schizophrenia symptoms

Answer 4

Increase dopamine levels and cause the development of schizophrenia symptoms in users

Answer 5

Led to drug development such as Phenothiazine Tauscher found antipsychotics that reduce the role of dopamine will alleviate schizophrenia symptoms and reduce the occurrence of **positive symptoms** Very reductionist - evidence that other biological factors play a role e.g. genetics and also psychological factors such as family. A more holistic approach may be more favourable Drugs don't work for all users - this is an issue as if schizophrenia is caused by dopamine levels, drugs should work for everyone

Answer 6

Relating brain structure or function to schizo

Answer 7

The ventral striatum

Answer 8

Measured activity levels in the ventral striatum in schizophrenic people Lower level of activity than the controls The less activity, the worse the negative symptoms

Answer 9

Scanned brains of those with auditory hallucinations Compared to controls Played pre-recorded speech to participants They had to identify speech as their own or others Sufferers experienced lower level of activation in their superior temporal gyrus and anterior cingulate gyrus

Answer 10

The research is all correlational - there is a relationship between brain region and certain symptoms of schizo however we are still lacking cause and effect Application - way to diagnose sufferers as if there is a change in brain structure, this could be used to identify the disorder Buchsbaum used PET scans to find reduced cerebral blood flow in schizophrenic patients compared to controls. This can explain the arise of catatonic symptoms. Current research only explains a few schizophrenia symptoms such as alogia and auditory hallucinations. Doesn't explain other symptoms suggesting another approach may be better. Opposing argument ...

Answer 11

Schizophrenogenic mother High EE (expressed emotion) Double bind

Answer 12

**A psychodynamic explanation** Cold and rejecting mothers Atmosphere of tension and secrecy Child is therefore distrusting and paranoid Develops delusions and eventually schizophrenia

Answer 13

No matter what a child does, they can't win as parents give mixed messages and inconsistent standards are imposed on them The child wants to do the right thing but fears being wrong. A child caught in a double-bind may develop schizophrenic symptoms such as paranoia and disorganised thoughts e.g. Am I doing the right thing? When they make an error, they are punished through withdrawal of love The world is confusing, unpredictable and dangerous

Answer 14

How a family member communicates their **thoughts and feelings** towards a person in the family Negative emotions directed towards child - "can't you do anything right?" Hostility, anger and rejection of child Parents too emotionally involved in kids social lives

Answer 15

High EE because high stress triggers a schizophrenic episode. These families have secret alliances between them which encourages paranoid symptoms

Answer 16

The schizophrenogenic mother creates a dangerous stereotype and produces a blame culture which has no scientific basis The schizophrenogenic mother theory clearly shows acute gender bias as it suggests that women play a key, destructive role in the onset of schizophrenia in a child (alpha bias as it assumes key differences based on gender). Biology cannot fully explain the development of schizophrenia. Family dysfunction helps to fill in gaps. C.A - Research in this area is often retrospective, meaning that patients with the disorder are asked to think back to their childhood and explain what it was like. Such recollections are unlikely to be completely trustworthy, therefore reducing the validity of the evidence and therefore the explanation. Led to family intervention therapies

Answer 17

Cognitive Family dysfunction

Answer 18

Disfunctional thought processes Negative schemas

Answer 19

It happens in 2 forms Conscious - we deal with info in full awareness Pre-conscious - We do this without thinking

Answer 20

Having a faulty filter between conscious and pre-conscious processing Our preconscious thoughts arrive in the conscious mind giving it more importance than necessary This would bombard stimuli leading to hallucinations

Answer 21

The ability to suppress information like what's in our peripheral vision whilst we are performing a deliberate action instead. This could lead to disorganised speech alogia

Answer 22

The ability to reflect on thoughts or behaviour It would disrupt our ability to recognise our actions - could lead to hallucinations or delusions

Answer 23

Issues with the validity of cognitive explanations, for example a person’s thought processing is highly subjective, regardless of whether they have schizophrenia or not, so it is difficult to know how to judge and asses what is ‘dysfunctional’ or ‘biased’ Doesn't explain why people experience these faulty thought processes - Abnormal cognitions may be one of the effects/consequences of schizophrenia, rather that actually causing the development of it in the first place. Research support for the idea that people with schizophrenia process information differently. **Stirling** et al. (2006) compared 30 people with schizophrenia to controls on a range of cognitive tasks such as the Stroop test. They found that schizophrenics took over twice as long as controls to complete these tasks. Stroop test can be used to diagnose schizophrenia - if peoples cognitive functioning is very different to a healthy adult, may indicate schizophrenia

Answer 24

Anti-psychotics

Answer 25

Typical = older Atypical = 2nd gen drugs

Answer 26

The dopamine hypothesis

Answer 27

Patient begins treatment Drug builds up in nervous system over a few weeks Drug blocks dopamine receptors on synapses (acts as a dopamine antagonist) Initial increase in dopamine as dopamine is stuck in the synapse Overtime, dopamine production reduces Symptoms reduce

Answer 28

Compared treatment of chlorpromazine to controls 13 trials 1121 people Increased function and reduced symptom severity

Answer 29

Sedative - schizophrenics can benefit from calming effects It is not fully understood why this is the case Chemical straight jacket

Answer 30

They maintain the effectiveness of typical drugs but reduce side effects

Answer 31

Tested clozapine, an atypical drug Also works on serotonin receptors Effective in 30-50% of cases where previous treatment hadn't worked

Answer 32

Clozapine works in the same way as chlorpromazine but also works on serotonin and glutamate receptors Clozapine users need regular blood tests to insure they don't develop a fatal blood condition

Answer 33

Diziness Tardive dyskinesia NMS

Answer 34

The result of dopamine super sensitivity - leads to grimacing and lip smacking

Answer 35

Neuroleptic malignant syndrome - hypothalamus isn't getting enough dopamine which can cause comas and can be fatal

Answer 36

Positive effect on treating people helping schizophrenics to lead happy lives Still don't fully understand the drugs Socially sensitive (chemical straight jacket) They are effective - counter side effects

Answer 37

CBT Family intervention therapy

Answer 38

To help patients identify irrational thoughts and try to challenge them

Answer 39

Mainly positive symptoms

Answer 40

Short term solution (12-16 weeks) It doesn't cure it but helps develop coping mechanisms

Answer 41

Normalisation Reality testing Coping mechanisms

Answer 42

A therapist convinces the schizophrenic that the voices they hear are an extension of their own thoughts

Answer 43

The therapist and patient question how likely the persons delusions are to be true

Answer 44

The patients can be given methods to help with their depression and anxiety

Answer 45

Opposed by drugs which are easy and effective R.S. from Jahuar Just challenging the dysfunctional thoughts through disputing may not be enough to change them if the thoughts have a biological basis. CBT is rarely used without drug therapy, suggesting it is not enough on its own to treat schizophrenia. CBT may involve challenging the validity of beliefs, which may interfere with freedom of thought. For example, trying to persuade an individual that the government is not watching or monitoring them in any way may interfere with their (possibly justifiable) fear of an over-controlling government. Therefore, CBT has potential ethical issues

Answer 46

34 studies of CBT on schizophrenia Jauhar et al (2014) found in a meta-analysis that CBT had an effect on positive and negative symptoms. This effect was significant, but quite small. This is therefore moderate support for the effectiveness of CBT in treating schizophrenia.

Answer 47

Whole families take part including the patient

Answer 48

Forming a therapeutic alliance with family members Reduces tree of caring for a relative with schizophrenia Improves families ability to anticipate and solve problem Reduction go anger/guilt in family members Helps family members for a balance between caring for patient and maintaining their own lives Improves families beliefs around schizophrenia

Answer 49

Very cost effective as it helps **reduce relapse rate by 50-60% (McFarlane)** Family therapy may actually worsen someone’s symptoms if they feel that they are being forced to interact with or depend on people who are emotionally destructive Not a cure - Family therapies may improve the quality of life for schizophrenia patients and their families, but do not provide a cure for schizophrenia, rather a management of the effects. This means it cannot be used to treat schizophrenia by itself - which questions its validity Family therapy should result in a schizophrenia patient feeling less alone and isolated which should ultimately benefit the economy as it means less reliance on external mental health providers plus the patient may be able to work which means fewer days absence lost to sickness

Answer 50

A **management technique** (not a cure)

Answer 51

Positive behaviours are rewarded and negative behaviours discouraged Incentivise schizophrenia patients to behave in a more socially acceptable way

Answer 52

Operant conditioning

Answer 53

Patients given coloured disks for doing a good thing that can later be cashed in

Answer 54

Valueless secondary reinforcers

Answer 55

They have no intrinsic value but can be exchanged for things with value

Answer 56

Negative symptoms

Answer 57

Personal care Condition related behaviour e.g. apathy Social behaviour

Answer 58

Sultana - meta-analysis of 110 studies, that only 3 had used random allocation (where a true comparison was available with an experimental and control group). Of these, only 1 study showed improvement in symptoms and behavioural change in patients. Therefore, the evidence supporting token economies is very weak. Doesn't work outside institutional setting as they will no longer get rewarded Token economies raise ethical issues. The patients with the most severe symptoms are unable to access the tokens, as they are unable to perform the desirable behaviours. They are effectively discriminated against (in this case, denied rewards) for being more severely ill. The legality of this has been challenged, and the use of token economies has declined as a result. Very socially sensitive - the hospitals have the power to reward good behaviour. Who decides what behaviours need correcting?

Answer 59

A **holistic** approach that combines biology and psychology into 1 theory and realises its cause is likely a combination of both

Answer 60

You must be genetically vulnerable to it but also have a stressor

Answer 61

People had a "schizo" gene which created a schizotypic personality and therefore makes you vulnerable to developing the disorder Some form of psychological stress must accompany it which activates the gene

Answer 62

Cannabis can be a trigger of the diathesis stress. It can increase the risk of it 7X

Answer 63

46 studies of childhood abuse and schizophrenia 69% of women with schizophrenia experienced physical/sexual abuse 59% of men Severe enough trauma can affect the brains development

Answer 64

Anti-psychotics and CBT

Answer 65

Treatment causation fallacy - just because schizophrenia is treated successfully via interactionist treatments, doesn't mean that it must be caused by a combination of factors (biological theories underpin majority of theory) We don't know how the diathesis and the stress interact with each other - there is some vagueness Accepts both nature and nurture - therefore drug and CBT treatment Ignores other biological factors such as dopamine levels

Answer 66

19000 adopted from parents with schizophrenia Compared to controls High EE was linked to schizophrenia but only to people who were already genetically vulnerable The stress was needed as a trigger