Schizophrenia Flashcards
Symptoms and features
•positive symptoms - symptoms that add on to reality
• negative symptoms - ie.reduced speech, ahnedonia
•cognitive deficits - memory , attention
•using DSM-t psychiatrist looks for symptoms -> diagnosis can only be made once person has experienced one month of active symptoms and experienced disturbances to life and function for at least 6 months
• Key symptoms : 1. Thought insertation (implanted by an external source) 2.hallucinations (invalid,vivid experiences that occur in absence of external stimuli) 3. Delusions (fixed beliefs that do not change even when presented with evidence) 4. Disorganised thinking -> switching from one topic to another
Genetic explanation - gottesman and shields
•genetic component to schizophrenia
•diathesis stress model
Biological explanation for schizophrenia AO1
•dopamine is a neurotransmitter that regulates mood, movement , reward and motivation
•dopamine hypothesis suggests that schizophrenia is caused by too much dopamine or too many dopamine receptors in key areas of the brain
• over activity in mesolimbic pathways -> causes positive symptoms
Biological explanation for schizophrenia AO3
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•dopamine hypothesis backed up by the use of recreational drug use which boost dopamine activity + antipsychotic meds that block dopamine receptors
•kornhuber et al- high density of dopamine receptors in post mortem of schizophrenia patients
•dopamine hypothesis led to development of antipsychotics -> improving lives of schizophrenics
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•theory is reductionist and ignores cognitive thought process which may be a cause of schz suggests schz is caused by faulty attention span
•does schizophrenia cause faulty dopamine or does faulty dopamine cause schz
•social psychology claims low socioeconomic backgrounds cause schz
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Psychological explanation for schizophrenia AO1
•social causation hypothesis -> world plus people around you acts as a major cause for schizophrenia
•social adversity - some children grow up in areas which are less favourable then others and this can make them vulnerable to mental health disorders in the future (ie. Families affected by unemployment poverty etc) , people fr lower socioeconomic groups may not be able to access treatment -> more vulnerable and exacerbating their problems.
•urbanity- city life is more stressful then rural life -> long term exposure to stress may trigger an episode (ie stressors such as noise crime etc) . increase population density makes life more competitive -> increases experience of chronic social defeat (stressor which gives schz symptoms)
• social isolation - people with schizophrenia withdraw from social contact -> no longer told what behaviour / thoughts are appropriate - absence of feedback causes individual to start behaving strangely
Psychological explanation for schizophrenia AO3
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•research showing significant correlation between urban dwelling and schz-> vassos et al (risk is 2.37% higher for people living in urban environments)
• social causation hypothesis can help draw factors which affect mental health -> ie housing projects which reduce overcrowding and encourage neighbourhood cohesion could help reduce stressors in environment
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• not a complete explanation of schizophrenia -there is a genetic component - c5 gene sekar et al -> environmental factors may only trigger onset of schizophrenia in people already genetically predispositioned (diathesis stress model)
•data shows correlation not causation -> social drift hypothesis -> people with schz find it difficult to keep a job and this leads them to drift into lower social classes and migrate to deprived inner city urban areas ( schz causes urbanicity)
•reductionist - dopamine hypothesis
•not everyone who experiences stressors or social adversity develops schizophrenia (low concordance)
• may be a diagnosis issue -> higher incidence in lower socioeconomic groups as they are more likely to be identified as needing help
Biological treatment for schizophrenia AO1
•antipsychotics - block dopamine receptor sits - blocks dopamine from being taken up as much
•drugs that block receptor sites are called dopamine antagonists
•first generation antipsychotics -prevents positive and negative symptoms (side effects : tardive dyskinesia,dryness of mouth , weight gain)
•second generation of antipsychotics:
Bottlender- speed of treatment is critical , first 5 years of symptoms or is untreatable due to brain damage
CLOZAPINE (effective at reducing positive symptoms but causes death or white blood cells) , RISPERIDONE (effective with negative symptoms only prescribed to adolescents ) OLANZIPINE (good at reducing positive and negative symptoms , works best for starting symptoms)
Biological treatment for schizophrenia features
•may take a few days / weeks before taking effect
•people take antipsychotics for years even if symptoms stop -> if stopped too soon , symptoms may return
•at least 50% don’t take drugs as reccomended - may stop due to side effects
•25% of people are treatment resistant
•tardive dyskensia- can develop after long term use
Biological treatment for schizophrenia AO3
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• van putten- highly effective for 66% of schizophrenia patients
• cheap to produce ( compared to cbt)
•high concurrent validity according to dopamine hypothesis
• can allow people suffering with schizophrenia to live a fufilling life
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• considerable amount of side effects
• 25% are treatment resistant
• only treats symptom not cause ( palliative )
• Harlow et al - carried out 20 year study -> those who did not take their medication had fewer episodes
Psychological treatment for schizophrenia AO1
•cbt - form of psychotherapy that combines cognitive approach ( how a person thinks) with learning concepts which aim to change behaviour
•aim of cbt is to help clients identify irrational behaviours and try to change them -> people with schizophrenia often lack coping strategies to manage symptoms -> leaves them vulnerable to stress -> trigger relapse
•changing way person thinks/ feels to prevent decompensation ( a decline from normal functioning to psychotic episode )
•therapists can help patient to identify situations that precede decompensation and initiate coping strategies such as stress management
•can explain through process for delusion (challenge clients perceived reality through “reality testing” -> client can test their belief
• behavioural activation -> rewarding protocol behaviour and pleasurable activities
• Ellis ABC theory -> activating event -> belief about event > emotional consequence -> challenge irrational belief -> effective new beliefs replace irrational ones
Psychological treatment for schizophrenia features
•can be provided by NHS
• average session 50 minutes
•quick , effective , 10-20 minute sessions , reflective journals , weekly journals plus goals
• incorporates psychometric tests for evaluation
Psychological treatment for schizophrenia AO3
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• nice 2014 - meta analysis review of CBT for treating schizophrenia found that therapy led to great reductions of positive and negative symptoms
• has concurrent validity with the cognitive theory of the cause of schizophrenia
• gives schizophrenics life long coping skills and mechanisms
•effective for drug resistant patients ,kuiper et al found that drug resistant patients benefited greatly from CBT
• CBT effectiveness can be quantifiable measured through psychometric tests such as Kessler distress scale
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•requires motivation and commitment of the client
• expensive for individuals and for governments to provide for free on the nhs
• time consuming process compared to medication
• puts too much emphasis in thought patterns being responsible for schizophrenia ( dopamine hypothesis , reductionist)
•places blame on patients for their faulty way of thinking and behavioural issues ( ethical problems)
•mckenna and kingdon-> found that CBT was not effective at reducing relapse
