Schizophrenia Flashcards
Positive Symptoms
A01
Syptoms which add something new to the patients life
* hallucinations
* delusions
* speech disorganisation
Negative Symptoms
A01
Symptoms which take something away from the sufferer’s life
* speech poverty
* avolition
Schizophrenia
A01
A severe mental disorder that affects 1% of the population, where the sufferer cannot distinguish between the real and imagined
Diagnosis
A01
DSM-5
* 2 positive symptoms
* disturbance lasting 6+ months
* failure to function
ICD-10
* 2 negative or 1 positive symptom
* includes a range of subtypes such as paranoid schizophrenia
Classification and Diagnosis
A03
- Criterion validity (39 vs 69 out of 100)
- Culture bias
- Co-morbidity (50% depression)
- Gender bias
Typical Antipsychotics
A01
Dopamine agonists, based on the old dopamine hypothesis
* Blocks action of D2 receptors
* Reduces positive symptoms
* Can cause side effects
Atypical Antipsychotics
A01
Based on the new dopamine hypothesis
* designed to reduce side effects
* blocks D2 receptors temporarily to allow for normal dopamine transmission
* acts on serotonin and glutamate
* reduces positive and negative symptoms
Drug Treatments
A03
- Side effects
- Effectiveness
- Issues with research
- Atypical better than typical
Diathesis Stress
A01
A person who has a vulnerability to develop SZ, but only develops it after encountering a stressor
Diathesis
* Genes
* Complications with pregnancy
* Childhood trauma
Stress
* family dysfunction
* trauma
* general life stress
* cannabis use
Treat with CBT and drugs
Diathesis Stress
A03
- Concordance
- Parenting (Tiernari)
- Treatment
CBT for halucinations
A01
Explains symptoms as being due to malfuctioning systems in the brain
Does not fix symptoms, but helps with coping
CBT for Delusions
A01
ABCDE model
* disputes beliefs through discussions
Critical collaborative analysis
* gentle questioning to help patient challenge beliefs
CBT
A03
- NICE (reduces hospitalisation and symptoms)
- Quality of evidence is mixed
- Independent effect
- General evaluation
Family Therapy
A01
Family centred therapy used alongside other treatment
Psychoeducation to teach family about SZ
* Improve communication
* Reduce conflict
* Teach practical coping skills
* Teach signs of relapse
* Create a more supportive home environment
Family Therapy
A03
- Effectiveness (26% rerlapse vs 50% drugs)
- Appropriateness (cheeper)
- Effectiveness (medication compliance)
- Difficult to assess individually
Psychological Explanations
A01
- Cognitive explanation
- Family dysfunction
Cognitive Explanation
A01
Central control dysfunction
* can’t supress automatic responses
* unable to explain why
* try to rationalise
Meta representation dysfunction
* can’t identify thoughts as own
* not able to keep track of thoughts
* beliefs of being controlled
Cognitive Explanation
A03
- Stroop test
- Word identification test
Family Dysfunction
A01
Schizophregenic Mother
* cold, rejecting, controlling
* tense, secretive environment
* leads to paranoid delusions
Double bind
* mixed messages and poor communication lead to feeling unable to do the right thing
Expressed emotion
* how caregiver reacts to patient
* burden
* critisism
* hostility
* control
Family Dysfunction
A03
- Family (Tienari)
- Comunication (caused by not cause of)
Token Economies
A01
Operationalise behaviour with tokens (secondary reinforcers) to be traded for rewards (primary reinforcers)
Standardised training
Relies on conditioning
Token Economy
A03
- Effectiveness (only if staff are consistent)
- Application (easy)
- Ethics (dehumanising?)
- Does not aim to treat
- Issues with research
Biological Explanation
A01
Family and adoption studies show 58% concordance
108 genetic variations - polygenic
Neural correlates
* structures that correlate with symptoms
Dopamine
* L-dopa given to healthy people = SZ symptoms
Dopamine Hypotheses
A01
Old
* SZ cause by high levels of D2 receptors
* Too many in Broca’s area lead to too much language produced
* hallucinations
New
* SZ caused by high and low levels of D2 receptors
* Too few in prefrontal cortex lead to difficulty chosing words
* speech poverty
Biological Explanations
A03
- Concordance (not 100%)
- RWA drugs
- Post mortems (high dopamine)
- Glutamate (not just dopamine)
