Schizophrenia

Question 1

(D+C) What are the positive symptoms of schizophrenia?

Answer 1

Hallucinations and delusions. Delusions has 3 topics:
-Delusions of grandeur (involve being an important, historical of political figure like Jesus)
- paranoid delusions (being persecuted by aliens)
- delusions of reference (events in environment are directly related to them)

Question 2

(D+C) What are the negative symptoms of schizophrenia?

Answer 2

Speech poverty and abolition. Speech poverty is lessening of speech fluency and productivity reflecting blocked thoughts. Avolition is finding it difficult to begin or keep up with goal directed activity.

Question 3

(D+C) What is the difference between positive symptoms and negative symptoms?

Answer 3

Positive – atypical symptoms in addition to normal experiences
Negative – atypical symptoms that represent a loss to normal experiences

Question 4

(D+C) How is schizophrenia diagnosed, and why is this problematic?

Answer 4

It does not have one defining characteristic and it is a cluster of seemingly unrelated symptoms therefore it is problematic. No reliable diagnostic bio markers. Diagnosis is done through interview and observation so it is subjective

Question 5

(D+C) Which symptoms are required for an ICD-10 based diagnosis of schizophrenia and for how long??

Answer 5

Internal classification of diseases need 2 or more negative symptoms for a month to diagnose schizophrenia. Positive symptoms not required

Question 6

(D+C) Which symptoms are required for a diagnosis of schizophrenia using DSM-V and for how long?

Answer 6

The diagnostic and statistical manual 5 outlines following criterion to make a diagnosis. Two or more of the following for at last 1 month period of time and at least 1 must be positive .

Question 7

(D+C) What is the differences in the classification systems?

Answer 7

Dsm states that some signs must be present for 6 months but Icd states one month is enough. Dsm states that there must be 1 positive symptom but icd says 2 negative are enough

Question 8

(BE) Is schizophrenia an inherited disorder?

Answer 8

People don’t inherit sz, they inherit genetic predisposition to the disorder

Question 9

(BE) What were Gottesman’s (1991) findings?

Answer 9

Concordance rate for sz:
-MZ twins 48%
-DZ twins 17%
-Siblings 9%
The results show closer degree of genetic relatedness, greater risk of developing sz

Question 10

(BE) What does it means to say that schizophrenia is polygenic?

Answer 10

Many genes are involved and each individual gene presents a small increased risk of sz

Question 11

(BE) What were the findings by Ripke et al. (2014)

Answer 11

Studied 37,000 patients and found 108 separate genetic variations associated with sz.

Question 12

(BE) What were the findings of Tienari et al. (2000)?

Answer 12

Carried out adoption study in Finland. 164 adoptees had biological mother with sz and 6.7% were diagnosed. Control group of 197 had only 2%. Supports genetic explanation for sz but only that it increases likelihood of developing sz.

Question 13

(BE) What is hyperdopaminergia

Answer 13

Excess activity of dopamine in the basal ganglia.

Question 14

(BE) what is hypodoperminergia

Answer 14

Low activity of dopamine in the cortex

Question 15

(BE) what is salience theory

Answer 15

Dopamine fires when something is salient. Those with sz get dopamine fires even when there is nothing salient. This causes sz patients to start linking things as to why dopamine fired causing irrational thinking.

Question 16

(BE) How does Goldman-Rakic’s (2004) work revise the dopamine hypothesis?

Answer 16

Identified low levels of dopamine in pre frontal cortex in negative symptoms such as avolition. Prefrontal cortex responsible for thinking and decision making

Question 17

(BE) Describe how the study by Juckel et al. (2006) on the neural correlates of negative symptoms

Answer 17

Found negative correlation between ventral stratum activity and overall negative symptoms of sz Ventral striatum part of the brain involved in reward pathway. Loss of motivation may be explained by low activity levels in this part of the brain.

Question 18

(BE) Describe the work by Allen et al. (2007) on the neural correlates of hallucinations

Answer 18

Found patients experiencing auditory hallucinations recorded less activation in superior temporal gyrus and anterior cingulate gyrus. Therefore reduced activation in these areas correlate to auditory hallucinations

Question 19

(BT) role of basal ganglia

Answer 19

Affects movement and thinking skills. Large can lead to motor dysfunction

Question 20

(BT) What are typical antipsychotics?

Answer 20

Dopamine antagonists which block the receptors of dopamine (agonists increase the amount of binding whereas antagonists stop then from binding)

Question 21

(BT) Why were atypical antipsychotics developed

Answer 21

Reduce the amount of negative symptoms

Question 22

(BT) side effects of atypical antipsychotics

Answer 22

Agranulocytosis (a blood disorder which can be fatal)
Weight gain
Cardiovascular problems

Question 23

(BT) What % of dopaminergic receptor blockade is thought to be required for clinical efficacy, and what are the problems with this?

Answer 23

60-70%
The drug isn’t selective so also blocks dopamine receptors in other areas of the brain.
This leads to side effects such as dizziness and agitation, and potentially in the long
term tardive dyskinesia

Question 24

(PE) (FD) schizophrenic mother

Answer 24

Reichmann (1948) proposed this psychodynamic explanation. Schizophrenic mother is cold, rejecting and controlling. this causes tension in family leading to paranoid delusions.

Question 25

(PE) (FD) double-bind theory

Answer 25

Bateson (1972) Developing children with sz fear they are doing the wrong thing but they receive mixed messages. When child gets it wrong they are punished with withdrawal of love. Makes the world confusing for them and causes paranoid delusions.

Question 26

(PE) (FD) Expressed emotion

Answer 26

level of emotion expressed to a person with sz from their parents or family members.

Question 26

(PE) (FD) elements of EE

Answer 26

-verbal criticism of the person
-hostility towards the person
-emotional over involvement in the life of the person.
These high levels of expressed emotion cause stress and could potentially see a result of the diathesis stress model causing an onset of sz

Question 27

(PE) (CE) dysfunctional thinking

Answer 27

sz characterised by disruption to normal thought processing. reduced thought processing in ventral striatum associated with negative symptoms. reduced processing of info in the temporal and cingulate gyri associated with hallucinations

Question 28

(PE) (CE) metarepresentatrion dysfunction

Answer 28

Frith et al (1992) identified metarepresentation (cog ability to reflect on thoughts and behaviour). dysfunction in metarepresentation would disrupt the ability to recognise our own actions and thoughts being carried out by ourselves than someone else.

Question 28

(PE) (CE) central control dysfunction

Answer 28

Frith et al found speech poverty could result from the inability to suppress automatic thoughts and speech triggered by other thoughts.