Schizophrenia

Question 1

What is schizophrenia?

Answer 1

A type of psychosis, a severe mental disorder characterised by a profound disruption of cognition and emotion so that contact with external reality and insight are impaired.

Question 1

What are positive symptoms?

Answer 1

Atypical symptoms experienced in addition to normal experiences.

Question 2

What are negative symptoms?

Answer 2

Loss of usual experiences.

Question 3

What are the positive symptoms?

Answer 3

Hallucinations and delusion

Question 4

Hallucination

Answer 4

Disturbances of perception. Many schizophrenics report hearing voices or seeing people, telling them to do something.

Question 5

Delusions

Answer 5

Firmly held irrational beliefs that have no basic reality.

Question 6

What are the different types of delusions?

Answer 6

• Persecution
• Grandeur
• Control
• Reference

Question 7

Persecution delusions

Answer 7

The belief that others want to harm you

Question 8

Grandeur

Answer 8

The belief that they are an important individual

Question 9

Control

Answer 9

The belief that their body is under external control

Question 10

Reference

Answer 10

The belief that events in the environment appear to be directly related to them e.g. messages communicated through the TV.

Question 11

What are the negative symptoms?

Answer 11

Avolition and speech poverty

Question 12

Avolition

Answer 12

Lack of purposeful willed behaviour. e.g. no longer interested in going out, meeting friends, poor hygiene and work or education

Question 13

Speech Poverty

Answer 13

Limited speech output with limited, often repetitive content. Sometimes accompanied by a delay in responses during conversation.

Question 14

What are the 3 main biological explanations for schizophrenia?

Answer 14

1. Genetic explanations
2. Dopamine Hypothesis
3. Neural Correlates

Question 15

Describe the genetic explanation of schizophrenia

Answer 15

There is considerable evidence that schizophrenia runs in families and is in part genetic.
Gottesman conducted a large scale family and found much higher MZ twins - 48% in comparison to DZ twins - 17%
Schizophrenia is thought to be polygenic and so different combinations of genes can lead to the condition. Research suggests that there are 108 genetic variations associated with increased risk of schizophrenia.

Question 16

Describe the updated Dopamine Hypothesis explanation

Answer 16

Davis and Khan suggested that the positive symptoms of schizophrenia are caused by higher levels of activity of dopamine in the sub cortex called hyperdopaminergic.
The negative symptoms of schizophrenia are thought to arise from lower levels of dopamine in the pre frontal cortex called hypodopaminergic.

Question 17

Describe the neural correlates explanation for schizophrenia

Answer 17

There are thought to be neural correlates of positive symptoms and negative symptoms.
Lower activation levels in the superior temporal gyrus and anterior cingulate gyrus have been found in those experiencing auditory hallucinations. Therefore, reduced activity in these two areas is a neural correlate of auditory hallucinations.
The ventral striatum is thought to be involved in the anticipation of reward. Juckel found a negative correlation between activity levels in the severity of overall negative symptoms.
Therefore, activity in the ventral striatum in a neural correlate of the negative symptoms of schizophrenia.

Question 18

What are the 3 theories for the family dysfunction of schizophrenia?

Answer 18

1. Schizophrenogenic Mother
2. Double Bind
3. Expressed Emotion

Question 19

Describe the theory for Schizophrenogenic Mother

Answer 19

It was proposed by Fromm Reichmann in 1948. He proposed that schizophrenia comes from being reared by a cold and dominant mother who is both overprotective but rejecting. Although such a mother appears self sacrificing, she actually uses the child to satisfy her own emotional needs. Therefore, individuals brought up with this mothering style develop schizophrenia as they are confused by their mothers overprotective but rejecting nature. Today this hypothesis is not taken seriously by most researches as researches have also found that this mothering style is implicated in many other disorders.

Question 20

Describe the theory of Expressed Emotions

Answer 20

The expressed emotion explanation is where families persistently exhibit criticism, hostility and a general negative influence upon recovering schizophrenics.
Expressed Emotion is a family communication style in which members of the family of the schizophrenic talk about the person in a critical or hostile manner or in a way which indicates emotional over involvement or over concern. This suggests that people with schizophrenia have a lower tolerance for intense emotional situations. It appears that the negative emotional climate in these families arouses the patient and leads to stress beyond the patient’s coping mechanism, therefore triggering an episode.

Question 20

Describe the theory of Double Bind

Answer 20

Proposed by Bateson in 1956. He suggested that schizophrenia is a reaction to a pathological parent presenting the child with a no win situation. This is created by contradictory communication between tone of voice and content. For example, a mother may say ‘come and give mummy a cuddle’ but then freezes when the child approaches and then tells the child off for not being affectionate. The theory states that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia. The child receives conflicting messages about their relationship on different communication levels. Prolonged exposure to such interactions prevents the development of an internally coherent construction of reality, which shows itself as symptoms such as delusions, hallucinations, incoherent thinking and paranoia.

Question 21

How do you classify schizophrenia?

Answer 21

DSM-5 needs only one positive symptom to be present for diagnosis. ICD-10 needs two or more negative symptoms.