SCHIZOPHRENIA

Question 1

What happens to the personality of a person who has SZ

Answer 1

personality loses its unity

Question 2

what did Stafford-Clarke (1964) define SZ as

Answer 2

-generic name for a group of disorders characterised by a progressive disintegration of emotional stability, judgement, contact with and appreciation of reality > produces secondary impairment of personality, relationships and intellectual functioning

Question 3

what is SZ

Answer 3

-a serious mental disorder that affects a persons thought processes and ability to determine reality
-degree of severity varies among sufferers

Question 4

classification systems to diagnose SZ - cluster of symptoms :

Answer 4

• International classification for disease ( ICD-10) > used by WHO
• Diagnostic and statistical manual -(DSM-5) > Used in USA and UK

Question 5

How do diagnostic manuals differ in their classification

Answer 5

-under DSM , patients have 1 ‘positive’ symptom whereas ICD = 2/more ‘negative’ symptoms are sufficient for diagnosis

Question 6

positive symptoms

Answer 6

-atypical symptoms experienced in addition to normal experience
-eg hallucination and delusions

Question 7

negative symptoms

Answer 7

-atypical experiences that represent the loss of a usual experience such as clear thinking or ‘normal’ levels of motivation
-eg avolition and speech poverty

Question 8

positive symptom of hallucinations

Answer 8

-unusual sensory experiences > some related to events in environment whereas others bear no relationship to what the senses are picking up from the environment
-eg voices heard - talking to / commenting on a person , often criticising them
-can be experienced in relation to any sense eg see distorted facial expressions / occasionally people/animals that are not there

Question 9

positive symptom of dellisions (aka paranoia)

Answer 9

-irrational beliefs in a range of forms
-important historical, political, religious figure
-commonly also inv’ being ‘persecuted’ by government/ aliens/ having superpowers
-may believe they are under external control
-make people behave in ways that make sense to them but seem bizarre to others

Question 10

negative symptoms of speech poverty

Answer 10

-changes in speech pattern
-reduction in amount and quantity of speech in SZ
-sometimes accompanied by delay in verbal responses during conversations
-nowadays = more emphasis on speech disorganisation eg uncoherent speech , speaker changes topic mid-sentence
-BUT IN DSM THIS IS A POSITIVE SYMPTOM

Question 11

negative symptom of avolition (apathy)

Answer 11

-finding it difficult to being/keep up with a goal-directed activity
-reduced motivation to carry out a range of activities
-Andreas (1982) identified 3 signs of avolition : poor hygiene and grooming, lack of persistence in work/education , lack of energy

Question 12

Subtypes of SZ - ICD-10

Answer 12

Recognises a t age of subtypes of SZ (DSM-5 doesn’t recognize anymore)

Question 13

Subtypes of SZ - paranoid SZ

Answer 13

Powerful delusions and hallucinations

Question 14

Subtypes of SZ - hebephrenic SZ

Answer 14

Involved negative symptoms

Question 15

Subtypes of SZ- catatonic SZ

Answer 15

Disturbances in movement, leaving the sufferer immobile/ alternatively over active

Question 16

Prevalence for SZ

Answer 16

• overall < 1% world suffer from SZ
  -but prevalence rates vary from 0.33-15% so any valid explanation. Must be able to explain these facts.
  -onset of SZ most commonly occurs between 15-45 yrs old

Question 17

Who’s more likely to be diagnosed with SZ amongst males and females

Answer 17

Males

Question 18

Who tend to show onset at an earlier age

Answer 18

Males

Question 19

is SZ more commonly diagnosed in cities or countrysides?

Answer 19

Cities

Question 20

Is SZ more commonly diagnosed in working class/ middle class

Answer 20

working class

Question 21

biological explanations of sz - genetic explanation

Answer 21

-appears to run in families
-However, one problem with this research is that it is difficult to separate the genetic components from the environmental ones.
-Yet, genetic similarity with family members is associated with developing SZ.

Question 22

genetic explanation key study

Answer 22

-Gottesman (1991)
-Ran a controlled genetic study and found that the risk of an individual developing schizophrenia was proportional to the amount
of genetics they share with a schizophrenic.

MZ= 48% DZ = 17% CHILDREN = 13%. SIBLINGS = 9% PARENTS = 9%

Question 23

Shared environment

Answer 23

-As family members share the same
environment as well as a proportion of their genes, the correlation represents both, so caution is needed in interpretation of the results.

Question 24

Candidate genes

Answer 24

-SZ appears to be polygenic = its not caused by one gene but several. Most likely are those coding for neurotransmitters like dopamine.
-SZ also appears to be etiologically
heterogeneous = different combinations of factors can cause it.

Question 25

key study for candidate genes

Answer 25

-Gathered data from genome –wide studies (looked at whole human genome not just particular genes) of SZ. -37,000 patents genetic make up was compared to 113,000 controls. -108 separate genetic variations were associated with increased risk of SZ. -Genes associated with the risk included those coding the functioning of a number of neurotransmitters e.g dopamine.

Question 26

Role of mutation

Answer 26

-SZ can also have a genetic origin in the form of mutated parental DNA. This could be caused by radiation, poison or viral infection. -Evidence (Brown 2002) comes from positive correlations between parental age (sperm mutation) and risk of SZ. -Father under 25, 0.7% risk to fathers over 50, 2% risk.

Question 27

Neural correlates of Schizophrenia

Answer 27

-Research has shown that neural corelates i.e. brain structure or function could be the cause of SZ. -The best known neural correlate of SZ is the neurotransmitter Dopamine (DA). It is used in the brain systems elated to SZ.

Question 28

The original dopamine hypothesis

Answer 28

-Discovered as a result of treating patients with anti-psychotic drugs. -Anti-psychotics reduced the symptoms of SZ, but caused symptoms similar to the condition Parkinsons -Parkinsons patients suffer from low levels of Dopamine.

Question 29

Hyperdopaminergia in the subcortex (too much Dopamine)

Answer 29

-This is the original version of the hypothesis. -High levels of DA in subcortex areas of the brain i.e excess dopamine receptors in the Broca’s area may be associated with speech poverty and/or experience of auditory hallucinations.

Question 30

Updated version of the dopamine hypothesis (hypodopaminergia)

Answer 30

-Davis (1991) proposed the addition of the cortical hypodopaminergia, low DA in the brains cortex. -Low DA in the prefrontal cortex (thinking area) could explain cognitive problems like, negative symptoms. -It has been suggested that cortical hypodopaminergia leads to subcortical hyperdopaminergia, so both high and low levels of DA in different brain regions are part of the updated version of the hypothesis. -Current versions of the hypothesis try and explain the origins of the abnormal DA levels. -Both genetic and early experiences (stress), psychological and physical, make some people more sensitive to cortical hypodopaminergia and then subcortical hyperdopaminergia.

Question 31

psychological explanations of sz

Answer 31

psyhcs have attempted to link sz to childhood and adult experiences of living in a dysfunctional family

Question 32

schizophrenogenic mother

Answer 32

-Fromm-Reichmann (1948) proposed psychodynamic explanation for sz based on what she heard from patient about their childhood -she noted many patients spoke of a particular type of parent (schizophrenogenic mother) -SZ mother = cold, rejecting, controlling, create family climate characterised by tension and secrecy > leads to distrust that later develops into paranoid delusions and therefore sz

Question 33

double-bind theory

Answer 33

-Bateson et al ( 1972) agreed family climate is important in development of sz but emphasised role of communication style within family

Question 34

double-bind theory symptoms

Answer 34

-developing child regularly finds themselves trapped in situations where they fear doing wrong thing, but receive mixed messages about what this is and feel unable to comment on unfairness of this situation / seek clarification -'get it wrong' = child punishment with withdrawal of love > leaves them an understanding of the world as confusing and dangerous this is reflected in symptoms like disorganised thinking + paranoid delusions

Question 35

expressed emotion (EE)

Answer 35

-level of emotion, esp negative, expressed towards person with sz by carers who are often family members -ee contains several elements: - verbal criticism of person, occasionally accompanied by violence -hostility towards the person inc' anger and rejection -emotional overinvolvement in life of the person, inc' needless self-sacrifice

Question 36

what do direct high levels of EE cause

Answer 36

-serious source of stress -primarily and explanation of relapse in people with sz -may also be a source of stress that can trigger the onset of sz in a person who is already vulnerable (eg due to their genetic makeup)

Question 37

cognitive explanations of sz

Answer 37

explanations that focus on mental processes eg thinkig, language and attention

Question 38

dysfunctional thinking

Answer 38

-SZ is associated with several types of dysfunctional thought processing and this can provide a full explanation for SZ. -SZ ‘s can have information processing that doesn’t accurately represent reality. -SZ is characterised by disruption to normal thought processing. Simon (2015) -Reduced thought processing in the ventral striatum is associated with negative symptoms. -Reduced processing of info in temporal and cingulate gyri are associated with hallucinations.

Question 39

Metarepresentation dysfunction

Answer 39

-Metarepresentation = The ability to reflect on our thoughts and behaviours -Frith et al (1992) – identifies an inability to use meta representation in SZ patients. Therefore they cannot recognise their own actions and thoughts, and believe these are being carried out by someone other than themselves. -This explains auditory hallucinations and delusions like thought insertion.

Question 40

Central control dysfunction

Answer 40

-Frith also identifies inability to stop automatic responses while performing deliberate actions in SZ patients. -Speech poverty and thought disorder could result from the inability to suppress automatic thoughts and speech triggered by other thoughts. -For example … SZ patients can have derailment of thought because each word triggers associations, and the person cannot suppress automatic responses.