Schizophrenia Flashcards
diagnosis of schizophrenia
What are the positive symptoms of schizophrenia
Hallucinations
Delusions
diagnosis of schizophrenia
What are the negative symptoms of schizophrenia
Speech poverty
Avolition
diagnosis of schizophrenia
What are the two manuals used to diagnose schizophrenia and where are they used
DSM-5: America, Britain
ICD-10: Australia, Europe
diagnosis of schizophrenia
What does the DSM set as the criteria to diagnose someone with schizophrenia
2 out of 5 symptoms
At least 1 positive symptom
diagnosis of schizophrenia
What does the ICD set as the criteria to diagnose someone with schizophrenia
Any two symptoms
diagnosis of schizophrenia
What are the 5 symptoms of schizophrenia in the DSM and ICD
Delusions
Hallucinations
Disorganised speech
Grossly disorganised or catonic behaviour
Decreased motivation/ diminished expressiveness
issues in diagnosis of schizophrenia
Is the reliability of the classification of schizophrenia hood or bad
Good
issues in diagnosis of schizophrenia
What is test retest reliability
When the same clinician reaches the same diagnosis for the same patient on multiple occasions
issues in diagnosis of schizophrenia
What was osorio’s experiment on test retest realisability of the classification of schizophrenia
Tested 180 patients in an assessment for schizophrenia
Found test retest reliability of +0.92 for the DSM
issues in diagnosis of schizophrenia
What is inter-rater reliability
When different clinicians come to the same diagnosis on the same patient
issues in diagnosis of schizophrenia
What was osorio’s experiment on inter-rater realiability of the classification of schizophrenia
Assessed 180 individuals
Found inter-rater reliability of 0.97 using DSM
issues in diagnosis of schizophrenia
Is the validity for the classification of schizophrenia hood or bad
Bad
issues in diagnosis of schizophrenia
What type of validity are we concerned with with the classification of schizophrenia and what is it
Criterion validity- how accurately the ‘test’ used to measure schizophrenia actually measures schizophrenia
issues in diagnosis of schizophrenia
What Cheniaux find about the validity of the classification of schizophrenia
100 patients assessed by one doctor using DSM and another using ICD
DSM- 39 diagnosed
ICD- 68 diagnosed
issues in diagnosis of schizophrenia
What was rosenhan’s study on validity of classification of schizophrenia
Three woman and five men Including himself were ‘pseudopatients’
They said that they heard a ‘thud’ repeatedly to try and gain admission into 12 psychiatric facilities in 5 states
All were admitted and diagnosed with psychiatric disorders
All were forced to admit to having a mental illness and take antipsychotic drugs as a condition of their release after saying they felt fine
The average amount of time spent in institutions was 19 days
issues in diagnosis of schizophrenia
What is co-morbidity and why is this a limitation
When two conditions often occur together
Questions weather two illnesses should be diagnosed separately instead of together and if schizophrenia is a distinct condition, or if it’s symptoms are just part of other conditions
issues in diagnosis of schizophrenia
What did Buckley find about co-morbidity
50% of schizophrenia sufferers suffer from depression
47% of schizophrenia sufferers suffer from substance abuse
23% of schizophrenia sufferers suffer from OCD
issues in diagnosis of schizophrenia
Why is symptom overlap a limitation of the classification of schizophrenia
Bipolar includes symptoms such as hallucinations delusions and avolition
biological explanations- genetic
What did gottesman find about biological explanations of schizophrenia
biological explanations- genetic
What was Ripke’s experiment
Compared the genetic makeup of 37,000 schizophrenia patients with 113,000 controls through combining research on genome-wide studies
biological explanations- genetic
What did Ripke find about genetic explanations for Sz
There are 108 candidate genes associated with a slightly increased risk of schizophrenia
biological explanations- genetic
What are the strengths of biological explanations for schizophrenia
Supporting evidence- Tienari found that orphans who’s biological parents had Sz were more likely to develop it than a control group even if adoptee parents didn’t have it
Supporting evidence- Hilke found 33% concordance rate in MZ twins and 7% in DZ twins
Real world application- genetic counselling can be used for parents likely to have a child with Sz
biological explanations- genetic
What are the limitations of biological explanations for Sz
Birth complications cause heightened chance of Sz development (Morgan)
Smoking cannabis in teenage years heightens risk (Di Forti)
Morkved found that 67% of people with Sz reported at least one childhood trauma compared to 38% in a control group
biological explanations- neural correlates
What is Seeman’s dopamine hypothesis
Unusually high levels of dopamine are associated with with schizophrenia as neurons that transmit dopamine fire too easily or too often or there is an abnormal amount of D2 receptors.
It has been found that an excess of dopamine in subcortical brain areas such as Broca’s area may explain positive symptoms
biological explanations- neural correlates
What is Davis’ updated dopamine hypothesis
Updated because found that not all schizophrenics have high levels of dopamine and clozapine was effective for treating Sz even though it does nothing to block dopamine
New theory is of hypodopaminergia- too little dopamine. This means that a lack of dopamine in areas such as the PFC can be seen to cause negative symptoms
Overall, can be seen that both hyperdopaminergia and hypodomaminergia in different brain areas are associated with different symptoms of schizophrenia
biological explanations- neural correlates
What are the strengths of neural correlates as an explanation for Sz
Currant- amphetamines increase dopamine and also worsen and induce symptoms of Sz
Tauscher- antipsychotic drugs reduce dopamine levels and intensity of symptoms
Ripke- some of the candidate genes proposed by Ripke act on production of dopamine
biological explanations- neural correlates
What are the limitations of neural correlates as an explanation for Sz
Role of glutamate ignored- McCutcheon found using brain scans and post-mortems of schizophrenics that they had increased levels of glutamate. Shows the dopamine theory is over-simplified
psychological explanations
what are the two psychological explanations for schizophrenia
Family dysfunction
Cognitive explanations
psychological explanations- family dysfunction
what is the definition of family dysfunction
the abnormal processes within a family, such as poor communication, cold parenting and high levels of expressed emotion
psychological explanations- family dysfunction
who proposed the theory of the schizophrenogenic mother
Reichmann-1948
psychological explanations- family dysfunction
what is the theory of the schizophrenogenic mother
when a mother is cold and distant yet dominating and controlling this can explain why a person is schizophrenic
psychological explanations- family dysfunction
who devised the double-bind theory
Bteson-1972
psychological explanations- family dysfunction
what is the double-bind theory
when a child is faced with a situation where they don’t want to do the wrong thing but don’t know what it is due to receiving mixed messages, then when the child makes the wrong decision (which happens frequently) they are punished
this is a problem because is that this miscommunication can lead. to a child thinking the world is a dangerous and confusing place
psychological explanations- family dysfunction
what symptoms of schizophrenia is the double-bind theory thought to cause
disorganised thinking
paranoid delusions
psychological explanations- family dysfunction
what is the expressed emotion theory
the theory that a schizophrenia sufferer is more likely to relapse due to the poor quality of interaction with their family- it refers to high amounts of emotion (mainly negative) being directed at the sufferer
psychological explanations- family dysfunction
what are the three types of expressed emotion
hostility- being angry with the sufferer and rejecting them
emotional over-involvement- being too controlling and sacrificing things for the sufferer
verbal criticism- insulting or putting down the individual
psychological explanations- family dysfunction
what is a strength of family dysfunction as an explanation for schizophrenia
good supporting evidence- Read found that adults with Sz were more likely to have insecure attachment types (C or D) and that 69% of women and 59% of men with Sz were physically or sexually assaulted as a child. this shows a link between childhood and developing sz
psychological explanations- family dysfunction
what are the limitations of family dysfunction as an explanation for schizophrenia
report techniques- evidence based off retrospective, subjective report techniques that can distort recollections (under-report good memories, over-report bad memories)- this means poor internal validity
socially sensitive- places blame on family and specifically mother- can induce guilt and increase likelihood of neuroticism leading to schizophrenogenic behaviour
psychological explanations- cognitive
What are the cognitive explanations of schizophrenia
Sz is associated with several types of dysfunctional though processing- as seen through the hallucinations and delusions that can be seen in sufferers
psychological explanations- cognitive
what are the two types of dysfunctional thought processing Frith identified as causing Sz
Meta-representation dysfunction
lack of central control
psychological explanations- cognitive
what is the definition of dysfunctional though processing
when a person struggles to reflect on their own thoughts and behaviour as well as struggling to interpret the thoughts and beliefs of others. This leads to a person not being able to recognise that their thoughts and and actions are caused by themselves, not others
psychological explanations- cognitive
what symptoms does dysfunctional thought processing cause
auditory hallucinations
delusions
psychological explanations- cognitive
why does dysfunctional thought processing cause auditory hallucinations and delusions
a person would not be able to tell their own thoughts from others
psychological explanations- cognitive
what is the definition of a lack of central control
when a person is unable to think before they speak or act- causing unusual behaviours.
This is because they are unable to suppress automatic responses when doing deliberate actions
psychological explanations- cognitive
what symptoms does a lack of central control cause in schizophrenics
disorganised thoughts, speech and behaviour
psychological explanations- cognitive
why does a lack of central control cause disorganised thoughts, speech and behaviours
because a person cannot suppress automatic responses
psychological explanations- cognitive
what is a strength of the cognitive explanations of schizophrenia
Stirling compared 30 schizophrenics to 30 controls and found that people with schizophrenia took twice as long to complete the Stroop test (word colours)- this shows a link between a lack of central control and schizophrenia as schizophrenics couldn’t suppress automatic responses
psychological explanations- cognitive
what is a limitation of the cognitive explanations of schizophrenia
cognitive are ‘proximal explanations’ not ‘distal explanations’ as they only show what is happening now that causes symptoms not explaining how it occurred initially- this shows that cognitive explanations to not explain the root of the problem, therefore they do not help with trying to treat the condition
psychological therapy- CBT
what is the assumption of cognitive behavioural therapy
schizophrenia is the result of dysfunctional thinking
psychological therapy- CBT
how many sessions of CBT does a schizophrenic usually have
5-20
NICE recommend 16
psychological therapy- CBT
how does CBT tackle schizophrenia
Recognising- patient recognises dysfunctional thought
Educating- explaining where patients symptoms actually come from (dopamine etc)
Normalising- make patient realise what they experience is normal (voices just an expression of thought)
(reality) Testing- testing if patients beliefs are actually true
psychological therapy- CBT
what are the strengths of CBT as a therapy for schizophrenia
supporting evidence- Jauhar conducted a meta analysis of 34 studies where CBT was used and found evidence for significant effects on positive and negative symptoms- better than drugs which only effect positive symptoms
supporting evidence- Pontillo found CBT reduced the severity of auditory hallucinations and the national institute for health and care excellence (NICE) recommended CBT for schizophrenia, showing both research and clinical experience suggest CBT
psychological therapy- CBT
what are the limitations of CBT as a therapy for schizophrenia
not standardised- Thomas pointed out that different studies use different CBT techniques on people with different symptoms- CBT may be more effective for some than it is for others
doesn’t cure issue- CBT is palliative not curative as Sz is biological and the treatment is psychological so it doesn’t tackle the root of the problem
biological therapy
how can drug therapy be used to treat sz
antipsychotic medication is prescribed to reduce symptoms
biological therapy
how do all anti-psychotics work
by reducing dopaminergic transmission
biological therapy
what are the two types of antipsychotics
typical
atypical
biological therapy
what is a type of typical antipsychotic
chlorpromazine