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A-Level Psychology > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

What is schizophrenia

A

A mental illness where the person uses utility and there’s a splitting of thoughts and feelings leading to bizarre and maladaptive behaviour

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2
Q

Outline the two main types of schizophrenia

A

• Type I is acute and characterised by positive symptoms with better recovery prospects

• Type II is chronic and characterised by negative symptoms with poorer recovery prospects

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3
Q

What are the two types of symptoms that can be displayed

A

Positive and negative

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4
Q

What are positive symptoms of schizophrenia

A

• Involve behaviours concerning loss of touch with reality (hallucinations and delusions).

• They occur in short, acute episodes with more normal periods in between and respond well to medication

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5
Q

What are negative symptoms of schizophrenia

A

• Involve displaying behaviour that disrupts normal action and emotion, contributing to the sufferer not being able to function effectively in society.

• They occur in long-lasting, chronic episodes and are resistant to medication

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6
Q

Who proposed the positive symptoms of schizophrenia

A

Schneider (1959)

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7
Q

What are Schneider’s (1959) positive symptoms of schizophrenia

A
  1. Thought disturbances
  2. Hallucinations
  3. Delusions
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8
Q

What are the three types of thought disturbances

A
  1. Thought insertion
  2. Thought withdrawal
  3. Thought broadcasting
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9
Q

What’s thought insertion

A

An individual believes that thoughts are being inserted into their mind by external forces

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10
Q

What’s thought withdrawal

A

When the individual believes thoughts are being withdrawn from their mind by external forces

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11
Q

What’s thought broadcasting

A

The individual believes thoughts are being broadcast to everyone by a special transmitter

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12
Q

What are hallucinations

A

False or distorted sensory experiences that appear to be real perceptions

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13
Q

What are the 4 types of hallucinations

A

• Auditory
• Visual
• Tactile
• Olfactory

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14
Q

Outline auditory hallucinations

A

Experiencing voices, often insulting and obscene from inside an individuals head that form running commentaries or discuss behaviour, often occurring simultaneously with delusions

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15
Q

What are delusions

A

Ideas and beliefs that the Individual believes are true that are impossible or very unlikely to be true

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16
Q

Outline the 5 types of delusions (only need to outline 2)

A

• Delusions of Persecution:
Family/friends plotting against them

• Delusions of reference:
Random events are meaningful patterns

• Delusions of Grandeur:
Is famous/ has special powers

• Delusions of being controlled:
Thoughts/feelings/behaviour controlled

• Delusions of guilt:
Has done something terribly wrong

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17
Q

Who proposed the negative symptoms of schizophrenia

A

Slater and Roth (1969)

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18
Q

What are Slater and Roth’s (1969) negative symptoms of schizophrenia

A
  1. Though process disorder
  2. Disturbances of effect
  3. Psychomotor disturbances
  4. Avolition
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19
Q

What are thought process disorders

A

Sufferers appear to lack communication skills, muddle words, wander off topic and indulge in speech poverty, characterised by excessively brief replies and minimal elaboration

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20
Q

What are disturbances of effect

A

Sufferers appear uncaring to others and display inappropriate emotional responses, such as giggling at bad news

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21
Q

What are psychomotor disturbances

A

Sufferers adopt frozen ‘statue-like’ poses, exhibit tics and twitches and repetitive behaviours, such as pacing

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22
Q

What’s avolition

A

Sufferers display an inability to make decisions, have no enthusiasm or energy, lose interest in person hygiene and lack sociability and affection

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23
Q

What’s necessary for schizophrenia to be diagnosed

A

Two or more positive or negative symptoms present for at least one month along with reduced social functioning

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24
Q

How does chronic schizophrenia begin (Type II)

A

Sufferers become increasingly disturbed through gradual withdrawal and motivational loss over a prolonged period

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25
Q

How does acute schizophrenia begin (Type I)

A

Symptoms appear suddenly after a stressful incident

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26
Q

Outline 5 extra types of schizophrenia (extra knowledge- not on course)

A
  1. Paranoid- characterised by delusions of grandeur and/or persecution
  2. Catatonic- excitable and occasionally aggressive with a partent negativism where suffered fo the opposite of what they’re told
  3. Disorganised- bizarre behaviour with onset in early 20s experiencing auditory hallucinations, delusions, thought disturbances and disturbances of effect
  4. Residual- mild symptoms where sufferers previously exhibited symptoms that are not present currently
  5. Undifferential- doesn’t fit other subtypes or shares symptoms with several subtypes
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27
Q

How are mental disorders diagnosed

A

By reference to classifications systems that are based on the idea (similarly to physical illness) that a group of symptoms can be classed together as a syndrome with an underlying cause and separate from all other mental disorders

28
Q

What are the two main classification systems

A

• The diagnostic and statistical manual of mental disorders (DSM)

• The international classification disorders (ICD)

29
Q

Who produces the DSM

A

American psychiatric association (APA)

30
Q

Who produces the ICD

A

World health organisation (WHO)

31
Q

What’s reliability of diagnosis

A

• One issue with the diagnosis and use of classification systems is that of reliability

• This concerns the consistency of symptom measurements and affects diagnosis both through test-retest reliability and inter rater reliability

32
Q

What’s inter-rater reliability of diagnosis

A

Different clinicians make identical, independent diagnoses of the same patient

33
Q

How is inter-rarer reliability measured

A

The KAPPA score

34
Q

Outline the KAPPA score referencing schizophrenia

A

• Ranges from 1-0:
• A score of 1 indicates a perfect inter-rater agreement and 0 meaning no agreement at all, however 1 is difficult to achieve so a score of 0.7 is considered good

• Research from Beck et al (1962) demonstrated inter-rater reliability as they found a 54% concordance rate when assessing 153 patients

35
Q

What’s test-retest reliability of diagnosis referencing a study

A

• Occurs when a clinician makes the same diagnosis on separate occasions from the same information

• Baca-Garcia et al (2007) assessed 2,322 patients in Spanish psychiatric hospitals 10 times between 1992-2004 finding 2/3 kept their diagnosis

36
Q

What’s validity of diagnosis

A

• The issue of validity in diagnostic procedure of schizophrenia concerns how accurate diagnosis is

• For valid diagnoses, schizophrenia should be separate from all other disorders, as categorised by symptoms using classification systems. There are several ways in which this can be assessed including: predictive, descriptive and aetiological validity

37
Q

Outline an EVA for reliability of diagnosis of schizophrenia

A

• Read et al (2004) found test-retest reliability of schizophrenia diagnosis had a 36% concordance rate

• Furthermore, in their study of British and US psychiatrists it was found 69% of American and only 2% of British psychiatrists diagnosed schizophrenia on the basis of a case description

• TS diagnosis has never been reliable

38
Q

Outline an EVA for validity of diagnosis of schizophrenia

A

• Birchwood and Jackson (2001) found 20% of schizophrenics recover and never experience another episode but 10% are so affected they commit suicide

• TS too much inconsistency with outcomes of schizophrenia for predictive validity to be supported

39
Q

Outline an PEEL for reliability of diagnosis of schizophrenia

A

• One issue with the use of classification systems if the notion of the DSM being argued to be more reliable than the ICD

• TIAPB when compared, the DSM is argued as more reliable because the symptoms outlined are more specific, for example the DSM-5 specifies symptoms such as hallucinations and delusions while the ICD-11 specifies symptoms as either positive or negative which can be supported by Read et al (2004)

• TS when assessing patients for diagnosis of schizophrenia, the DSM may be the most appropriate and reliable classification system to use

40
Q

Outline an EVA for validity of diagnosis of schizophrenia

A

• One issue with the use of classification systems and the diagnosis of schizophrenia is the consequences of invalid diagnosis

• TIAPB label of schizophrenia has long lasting implications, such as in work prospects

• This is supported by Rosenhan (1973) whose research demonstrated how his 8 pseudo-patients we’re all released from psychiatric institutions with a label of ‘schizophrenia in remission’

• TS careful diagnostic procedures are required when diagnosing schizophrenia which seems questionable when there are validity issues

41
Q

What research can be used to support all types of validity in diagnosing schizophrenia

A

Rosenhan (1973)

42
Q

Outline Rosenhan (1973)

A

Tested the validity of schizophrenic diagnosis using the DSM-II by getting 8 volunteers with no mental illness to present themselves to psychiatric hospitals claiming to hear voices.

• All volunteers were admitted and proceeded to act normally, this normal behaviour was interpreted as signs of schizophrenia and they took between 7 and 52 days to be released

• Suggests schizophrenic diagnosis lacks validity as psychiatrists couldn’t distinguish between real and pseudo-patients

43
Q

What 4 factors affect the reliability and validity of diagnosis of schizophrenia

A
  1. Co-morbidity
  2. Cultural bias
  3. Gender bias
  4. Symptom overlap
44
Q

What’s co-morbidity

A

When one or more disorders or diseases occur simultaneously with schizophrenia causing confusion over which actual disorders being diagnosed

45
Q

What’s the biggest issue with co-morbidity

A

• Descriptive validity as having simultaneous disorders suggests schizophrenia may not be a separate disorder
• Eg. Schizophrenics often suffer from depression which could be confused with avolition

46
Q

What is AO1 and AO3 research for co-morbidity

A

Goldman (1999)

47
Q

Outline Goldman (1999)

A

Reported 50% of schizophrenics had a co-morbid medical condition such as substance abuse or polydipsia (excessive thirst)

48
Q

Outline an EVA for co-morbidity

A

Buckley et al (2009) reported estimated statistics of co-morbid disorders including 50% of schizophrenics having depression, 15% panic disorders, 29% post traumatic stress disorder and 23% OCD with an additional 47% of sufferers diagnosed with co-morbid substance abuse

49
Q

Outline a PEEL of co-morbidity affecting reliably and validity of schizophrenic diagnosis

A

• Consequences on the economy

• TIPB research has highlighted high levels of certain co-morbid disorders in schizophrenics leading to psychologists arguing over its influence as a factor in diagnosing schizophrenia

• Supported by Goldman (1999)

• TS co-morbidity may be more than a factor and could be a separate sub-type of the disorder- highlights need for further research to understand co-morbid conditions

50
Q

What’s culture bias

A

The tendency to over-diagnose members of other cultures as sufferers of schizophrenia

51
Q

What’s the issue with culture bias but what’s a counter point to this

A

• People of Afro-Caribbean descent are more likely than white people to be diagnosed as schizophrenic and placed in secure hospitals in Britain

• This could be due to an increased stress level people of minority groups experience (poverty, racism)

52
Q

What’s AO1 and AO3 research for culture bias

A

Cochrane and Sashidharan (1995)

53
Q

Outline Cochrane and Sashidharan (1995)

A

Argue racism and social deprivation immigrants sufferer are bound to negatively affect mental health, but clinicians wrongly attribute their behaviour to their ethnicity

54
Q

Outline an EVA for culture bias

A

• Cochrane (1977) reported incidence rates of schizophrenia in Britain and the West Indies to be similar at around 1%, but that people of Afro-Caribbean origin are 7x more likely to be diagnosed with schizophrenia in Britain

• TS they either have more stressors leading to schizophrenia or invalid diagnoses made due to culture bias

55
Q

Outline a PEEL for culture bias

A

• Issue of the influence of psychosocial issues on the reliability and validity of diagnosis

• TIPB factors such as racism and social deprivation immigrants suffer are bound to negatively affect mental health

• Supported by Cochrane and Sashidharan (1995)

• TS clinicians wrongly attribute behaviour to ethnicity rather than considering the importance of psychosocial factors that could impact R/V of diagnosis

56
Q

What’s gender bias

A

Disagreement between psychologists over the gender prevalence of schizophrenia, the accepted belief was that males and females were equally vulnerable but some argue that (majority male) clinicians have misapplied diagnosis criteria to women

57
Q

What’s the issue with gender bias

A

There may be 50% more male sufferers and clinicians often fail to consider males tend to suffer more negative symptoms (as they have higher levels of substance abuse) than females who have better recovery rates and lower relapse rates

58
Q

What’s AO1 and AO3 research for gender bias

A

Lewin et al (1984)

59
Q

Outline Lewin et al (1984)

A

• Found if clearer diagnostic criteria was applied the number of female suffers became much lower suggesting gender bias in original diagnosis

• Further supported by Castle et al (1993) who found that by using more restrictive diagnostic criteria the male incidence rate was more than twice that of females

60
Q

Outline an EVA into gender bias

A

Galderisi et al (2012) found males scores higher for negative symptoms and further support came from Haro et al (2003) who reported higher relapse in males but higher recovery rates in females

61
Q

Outline a PEEL into gender bias

A

• Issue of different factors between sexes

• TIAPB age difference in males and females experiencing schizophrenia may be related to different stressors both sexes experience at different ages and to age-related variations in females menstrual cycles

• Supporting evidence of differing stressors between genders comes from Haro et al (2008)

• TS gender specific approach required to produce a valid diagnosis of schizophrenia

62
Q

What’s symptom overlap

A

Symptoms of schizophrenia are often found with symptoms of disorders other than schizophrenia making it more difficult for clinicians to decide which disorder someone’s suffering from

63
Q

Examples of symptom overlap

A

• Bipolar disorder where depression and hallucinations are common

• Autism

• Cocaine intoxication

64
Q

What research can be used as AO1 and AO3 for symptom overlap

A

Ophoff et al (2011)

65
Q

Outline Ophoff et al (2011)

A

Assessed genetic material from 50,000 participants to find seven gene locations on the genome associated with schizophrenia. Three of them were also associated with bipolar disorder, suggesting a genetic overlap

66
Q

Outline an EVA into symptom overlap

A

Ketter (2005) reports that misdiagnosis due to symptom overlap can lead to years of delay in receiving treatment, during which time suffering and further degeneration can occur

67
Q

Outline a PEEL into symptom overlap

A

• One strength is potential practical applications

• TIGB research highlighting potential genetic overlaps between mental disorders suggests gene therapies might be developed that could simultaneously treat different disorders

• Supported by Ophoff et al (2011)

• TS potential benefits to sufferers, improving validity of diagnosis

A-Level Psychology (14 decks)

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