Schizophrenia Flashcards
what is the difference between classification and diagnosis?
- classification is organising symptoms into categories based on which symptoms cluster together in sufferers
- diagnosis - deciding whether someone has a particular mental illness using the classifications
what are positive and negative symptoms?
- positive symptoms are atypical symptoms experienced in addition to normal experience
- negative symptoms are atypical experiences that represent the loss of usual experience
examples of positive symptoms
- hallucinations - disturbances of perception in any of the senses
- delusions - irrational beliefs that have no basis in reality
- speech disorganisation - jumping from topic to topic in conversation
what are the types of delusions?
- delusions of control - the belief that their body is under external control
- delusions of persecution - the belief that others want to harm, threaten or manipulate you
examples of negative symptoms
- Avolition - reduction, difficulty or inability to start and continue with goal - directed behaviour
- speech poverty - reduction in the amount and quality of speech
differences between ICD-10 and DSM-5
ICD-10:
- two or more negative symptoms
- or one positive symptom
DSM-5:
- two positive symptoms for at least 6 months
what is criterion validity?
the extent to which different classification systems produces the same diagnosis in the same patient
What does co-morbidity mean?
the occurrence of two or more disorders or conditions together
Issues with reliability and validity of classification and diagnosis
- symptom overlap
- co-morbidity
- gender/cultural bias
what is the concordance rate for schizophrenia?
58%
how many gene variations did Ripke et al 2014 find?
108 separate variations
what does neural correlates mean?
measurements of the structure/function of the brain that occur in conjunction with the characteristic symptoms of SZ
what is central control dysfunction
the inability to suppress automatic responses while performing deliberate actions
what is meta representation dysfunction?
the inability to identify your thoughts and actions as being your own by paying attention to them
what is double-bind theory?
- a child receives mixed messages from their parent and feels unable to do the right thing
- this leaves the child with an understanding of the world which as confusing
- this could be reflected in symptoms such as disorganised thinking and paranoid delusions
what is expressed emotion?
- the level of emotion, in particular negative emotion, expressed towards a patient by their carer including:
- exaggerated overinvolvement
- criticism and control
- hostility
evaluation of family dysfunction
- research support from Tienari (2004)
- poor communication may not have causality
Evaluation of CBT for schizophrenia
- research support for effectiveness (NICE review 2014) Counter: most studies have been conducted whilst patients are also being treated with antipsychotics - difficult to look at its effectiveness on its own
- Thomas (2015) - different studies have involved different CBT techniques and a range of patient symptoms
what are the features of family therapy
Psychoeducation:
- the family is educated on SZ and the particular diagnosis to understand the difficulties a patient faces
- the patient is asked to discuss their experience with the family - they are the expert
Improve Communication:
- family members learn more constructive ways of communicating with a focus on the positive rather than the negative
- reduce double-bind comments and high expressed emotion
Reduce conflict:
- work to reduce anger and guilt
- reduce the stress of caring for the patient
- done by helping family members with their care/life balance
Practical coping skills:
- developing coping skills to manage the everyday difficulties arising from having SZ in the family
Taught to recognise the signs of relapse:
- can then respond rapidly to reduce severity
how long does family therapy last for?
3-12 months with sessions every 2-4 weeks
