Schizophrenia Flashcards
Describe 2 positive symptoms of schizophrenia
- Hallucinations - experiences that have no basis in reality or distorted perceptions of real things (hearing voices)
- Delusions - believing things that aren’t real (they might think they are famous)
Read (2005) - What did they find about SZ and sexual abuse?
69% of women and 59% of men with SZ have a history of physical / sexual abuse.
Suggests a psychological cause.
Berger 1956 - What did they find about causes of SZ?
SZ patients reported higher levels of double bind than non-SZ patients
Tienari 2004 - what they find to support genetic causes of SZ?
7% of adoptees with SZ biological parents developed SZ compared to 1.5% of non SZ parents
Tienari 2004 - What were their findings on high EE?
High EE is associated with SZ only in children with SZ biological parents
Suggests interactionist approach is good explanation
Glowacki 2016 - findings on token economies
Token economies reduce negative symptoms and behaviours
Tarrier 2004 - findings on treatments for SZ
Combination of CBT and antipsychotics showed more improvements than antipsychotics alone.
Suggests combined approach is best
Juahar 2004 - findings on CBT effect on symptoms of SZ
CBT has effect on both positive and negative symptoms
Suggests CBT is effective
McFarlane 2016 - findings on family therapy for SZ
It is ‘consistently effective’. Reduced relapse rates by 50-60%
Meltzer 2012 - findings on atypical antipsychotics
Atypical are effective on 30-50% of typical non-responders
Thornley 2003 - findings on typical antipsychotics
Chlorpromazine (typical) gives more symptom reduction than controls.
X - 30% risk of tardive dyskenesia
Stirling 2006 - findings on dysfunctional central control
SZ group took twice as long on stroop test (unable to suppress automatic thoughts)
What things are stressors that can trigger SZ?
Birth complications, childhood trauma, smoking high THC cannabis
Chenaux 2009 - findings on validity of diagnosis
Using DSM - 39% were diagnosed with SZ
Using ICD - 68% were diagnosed with SZ
Suggests diagnosis systems are not valid
Rosenhan 1973 - findings on validity of diagnosis
All but 1 pseudo-patient was wrongly diagnosed with SZ
Osorio 2019 - improvements in reliability of SZ diagnosis
Using OPCRIT (operationalised symptom checklist)
Inter-rater reliability was 0.97
Suggests diagnosis is now much more reliable
Gottesman 1991 - findings on role of genetics in SZ
MZ twins = 48% concordance
DZ = 17% concordance
Suggests some genetic link but not completely - some environmental factors
Ripke 2014 - findings on candidate genes
108 candidate genes
Suggests that some genetic variation may increase risk factor
Brown 1958 - findings on high EE
SZ returning to high EE families have higher relapse rates
Suggests high EE may act as stressor and maintain SZ
How common is SZ? Who is affected most?
Affects 1% of population, mostly in males
What is needed for diagnosis using DSM-5 ?
One positive symptom
What is needed for a diagnosis using ICD-10?
2 or more negative symptoms (no positive symptoms needed)
Why is comorbidity a limitation of SZ diagnosis?
Some conditions have similar symptoms e.g avolition in depression and SZ.
So there may be misdiagnosis
What is an issue with gender bias and SZ diagnosis?
Men are more likely to be diagnosed with SZ. Maybe men are more vulnerable or women generally cope better, but means some women miss out on diagnosis
What is the dopamine hypothesis?
Overactive dopamine activity can cause positive symptoms such as hallucinations
What are the 3 elements of family dysfunction?
Schizophrenogenic mothers - (Fromm-Reichman) cold, rejecting and controlling mothers create tension and paranoia
Double bind theory - (Bateson) receiving conflicting messages and when they get something wrong they are punished by withdrawal of love
Expressed emotion - verbal criticism, hostility causes stress and trigger SZ or relapse
Pharoah 2010 - 3 ways in which family therapy helps improve function
Reducing negative symptoms
Psycho education
Forming a therapeutic alliance
What is Meehl’s model for SZ?
The original stress-diathesis model.
Believed SZ was entirely genetic (schizogene and schizophrenogenic mother), now we know there are candidate genes that increase risk when combined with a stressor
What is some evidence for interactionist approach for explaining SZ?
Tienari found high EE was significant in the ‘SZ parents’ group and not in control group
