Schizophrenia

Question 1

What is schizophrenia?

Answer 1

Severe mental illness occurs in late adolescence/early childhood.

Question 2

What are positive symptoms?
Examples

What are negative symptoms?
Examples

Answer 2

An addition to normal life experiences like hallucinations, delusions, disorganised speech, catatonic behaviour

Detract from normal life like avolition/apathy(lack of motivation), alogia(speech poverty), affective flattening(difficulty showing emotion)

Question 3

What are the 2 ways of diagnosing Sz?

Answer 3

DSM 5 (Us): One positive symptom present continuously. 2 or more negative symptoms for 6 months

ICD 10 (Europe): One positive symptom or two negative symptoms.

Question 4

What is reliability in Sz diagnosis?
Types?
Study?

Answer 4

Reliability : how consistent the symptoms of patients is used to make same diagnosis.
Types: Inter-rater reliability (will 2 clinicians reach same diagnosis). Test Re-test (on separate visits, diagnosis remains constant)
Cheniaux : 2 psychiatrists diagnose 100 patients using DSM & ICD. Inter rater extremely poor. Psychiatrist 1 - 26 under DSM and 44 under ICD. Psychiatrist 2 - 13 under DSM and 24 under ICD

Question 5

What is validity?
How to assess?

Answer 5

Validity : Extent to which we are measuring what we intend to measure.
Criterion validity : Do different assessment systems get the same diagnosis.
Cheniaux low validity

Question 6

Ao3 for validity?

Answer 6

❌low validity. Cheniaux found high diagnosis with ICD. Suggests under diagnosis with DSM and over with ICD.
❌comorbidity (where other things also affect diagnosis. Like drugs or anxiety causing some Sz symptoms). Buckley et al estimates comorbid depression occurs in 50% of patients
❌symptom over lap (symptoms of one thing over lap with another. Sz and bipolar).

Question 7

Gender and cultural bias in diagnosis

Answer 7

Boverman. Us clinicians believed women to be less mentally healthy. So diagnosis were more common for women.

Copeland et al. patient description of 134US and 194Brits. 69% of US diagnosed and only 2% of Brits diagnosed

Question 8

Ao3 for gender and culture bias

Answer 8

❌Boverman found women judged as less mentally healthy. So women escape diagnosis as they have better interpersonal skills. Cause in valid diagnosis.
❌Copeland et al suggest individuals from some cultures are more likely to be diagnosed than others. Invalid.

Question 9

Bio explanation for Sz
Genetic explaination

Answer 9

Bio explanation focuses on genes abnormal dopamine and neural correlates.
Gottesmans family study found MZ twins have 48% chance of Sz and Dz have 17% shared risk. Concordance less than 100% show some env influence.
Candidate genes: individual genes associated with Sz. 1) polygenic - multiple genes give small risk increase 2) Aetiological Heterogeneous: genes combined with other factors increase Sz. Ripke looked at 37,000 genes compared to 113,000 controls. Found 108 genetic variations.

Question 10

Abnormal Dopamine as explanation for Sz

Answer 10

Dopamine hyp by Carlson says Sz caused my too much (hyperdopaminergic) and too little (hypodopaminergic) dopamine.
Hyperdopaminergic linked to positive symptoms and hypodopaminergic linked to negative.

Question 11

Neural correlates as explanation to Sz

Answer 11

Measurements of the structure of the brain that correlates to experiences. New technologies show Sz brains compared to healthy.
Negative symptoms due to abnormal Ventral Striatum
Positive symptoms due to loss of superior temporal gyrus & anterior cingulate gyrus.

Question 12

Ao3 of biological explaination

Answer 12

✅Genetic explanation - high scientific validity - Gottesman study shows genetic similarity - well established methods - respected by wider community
❌oversimplified - Doesn’t account for other factors e.g environmental. More multidimensional approach needed.
❌biologically deterministic - says certain genes lead to Sz - Behaviour is inevitable - ignores free will/individual difference and clearly shows some env involvement with gottesman twin studies.
✅prac app - early detection can be used to prevent. However some hallucinate despite normal dopamine levels. Important area of applied psych.

Question 13

Psychological explanations of developing Sz.

FF

Answer 13

Sz due to abnormal family communication patterns and upbringing. Involves Schizophrenogenic mother, double bind and expressed emotion

Question 14

What is schitzophrenogenic mother?

Answer 14

Reichmann - development of Sz due to mothers being cold, rejecting and controlling parents.
Explains positive symptoms and delusions

Question 15

Double-Bind Theory

Answer 15

Bateson at al - due to contradictory communication. E.g mother saying they love child. Then child being turned away when it wants affection
Leads to paranoia.