Schizophrenia Flashcards
Two systems
what is classification?
organising symptoms into categories based on which ones cluster together
ICD AND DSM
What is a diagnosis?
assigning a label of a disorder ( scz) to a patient
classification of scz
what are positive symptoms?
non-typical symptoms experienced IN ADDITION to normal experiences
classification of scz
what are negative symptoms?
non-typical experiences which represent a LOSS in normal experiences
classification of scz
what are delusions?
2 types
an unshakeable belief in something that is very unlikely
delusions of grandeur- belief of having an imaginary power or authority
paranoid delusions- belief that something or someone is deliberately trying to mislead or kill them
these make sufferers behave in ways that make sense to them but not others
classification of scz
what are hallucinations?
unusual sensory experiences experienced by any sense
e.g distorted perceptiond of things in environment
classification of scz
what is avolition?
3 signs
a person lacks desire to do anything
poor grooming and hygiene and lack of energy
classification of scz
what is speech poverty?
reduction in the amount and quality of speech in ppl with scz
classification of scz
what are the differences between ICD and DSM?
ICD- only 2 + negative symptoms to be present
DSM- one positive symptom present for diagnosis
6 issues
what are the issues with diagnosis and classification of scz?
Reliability
Validity
Co-morbidity
Gender bias
Culture Bias
Symptom overlap
Biological explanation
What is the genetic explanation of scz?
Family studies- risk of scz increases in line with genetic similarity to a relative with it ( 100% dna MZ twins= greater risk compared to sharing less auntt 25% dna)
Candidate genes- research suggests that SCZ is polygenic=many genes involved in development 108 genetic variations associated
also atiologically hetrogenous= diffrent combos cause it in diff ppl
Biological explanation
What are nerual correlates?
patterns of structures or activity in the brain that occur in conjunction with an experience
mainly focuses on the nt dopamine in the brain and its imbalances
Biological explanation
what is the DA hypothesis?
original- idea that scz is the result of high levels of da or excess da receptors in the subcortex= positve symptoms
recently- focused on low levels of DA in the cortex ( responsible for thinking)= negative symptoms + suggeted that hypo leads to hyper
* both hyper and hypo= scz
Biological explanation
What is hyperdopaminergia and hypodopaminergia?
Hyper- high da activity in subcortex either due to excess da or excess da receptors cauisng neurons that respond to da firing too often
hypo- abnormally low da activity in the cortex an area responsible for thinking
Concluded that combo of both= may explain scz
bio treatment
What are typical antiphychotics?
Dopamine antagonists- chemicals that reduce the action of a dopamine by blocking the D2 DA receptors in the synapses of the brain= da action is reduced
Chlorpromazine- causes da levels to increase when first taken then the production is reduced
This should work to reduce positive symptoms- caused by high levels of da in subcortex
Pychological explanation- fam dysfunction
What is the schizophrenogenic mother?
a pychodynamic explanation based on a type of mother who is cold, neglecting and controlling, tend to create tension in family environmentthis leads to distrust which later develops into deluions and ultimately scz
Pychological explanation- fam dysfunction
What is the double bind theory?
a child who frequently recieves contradictory messages from their parents ar emore liekly to develop scz
* e.g expressin glove whilst angry= child feeling traped in a situation where they fear doing wrong thing but is unable to seek clarification about what right thing is
* when the child gets it wrong= punished by parents withdrawing their love
* results in the child seeing the world as unfair and dangerous= manifests its sel as typical scz symptoms like delusions
not full explanation ut risk factor
Pychological explanation- fam dysfunction
what is expressed emotion?
the level of negative emotion expressed towards a pateint usually by family consiting of three elements:
verbal critism- negative comments
hostility- agressive comments e.g threats
emotional over involvemnt in their life
Pychological explanation- cognitive explanations
what is dysfunctional thinking?
Scz is charecterised by disruption to normal thought processing seen in
reduced thought processing in ventral striatum- associated with negative symptoms
reduced info processing in gyri’s- associated with hallucinations
Pychological explanation- cognitive explanations
what is metarepresentation dysfunction?
is dysfunctional in scz suffers so they fail to view their thoughts as their own and instead see them as being caused by someone/something else
Pychological explanation- cognitive explanations
What is central control dysfuction?
this is dysfunctional in scz sufferers as they cannot supress automatic thoughts resulting in them getting easily derailed when talking and performing other cognitive tasks- explains thoughts disorder
treating scz
what is the central aim of cbt?
to identify and alter irrational thinking e.g general beliefs, self image making paitents better able to cope with symptoms
what happens during the first stage of cbt?
an assessment
- paitent is encouraged to explain their concerns by describing delusions and outlining what they hope to achieve through the therapy
- therapist wins the trust of the paitent so that they can work together- requires honesty, paitence and unconditional acceptance
cbt
How does normalisation deal with irrational thoughts?
therapist tries to get paitent to view their symptoms as more normal to reduce negative emotions
e.g hearing voices= extention of normal thinking process
cbt
how does by explaining the origins of symptoms deal with irrational thoughts?
e.g auditory hallucinations caused by malfunctioning speech centres
this will help client cope with hallucinations as they will be less scary and threatening
cbt tackling faulty thinking
how does offering alternative explanations deal with irrational thoughts?
some symptoms mybe triggered by particular events
e.g paranoid scz thinking a friend wanting to hang out is a plot to hurt them- alternative could be freind just want to see them
challenges logic
cbt
what is coping stretergy enhancement?
another form of cbt- aims to tech ppl to develop and apply effective coping stratergies which will reduce the frequency intensity and duration of psychotic symptoms and alliviate the distress
cbt
what are the two components of cse ?
- working together to improve effectiveness of own stratergies and develop new ones
- specifc symptom selected for which cs wcan be used this is practicesd and client is helped and given hw to practice and keep record on how it worked
cbt
what are the two types of coping stratgeries used?
cognitive- distractions, or concentrating on a particular task
behavioural- relaxation or social withdrawl or increasing social contact
What are the aims of family therapy?
helping identified paitent and family to understand the condition
help family members balane their caring responsibilites with their own lives to reduce tension, anger and guilt- these ee = relapse
what methods are used in family therapy?
weekly family meetings- to resolve conflict and discuss individual needs
identifying strengths and weaknesses of fam members through observations and interviews
fam and pateint are taught facts about scz e.g causes and the effect of stress
teach fam to listen, express emotion and discuss things and skills e,g compramising and negotiation
what should the stratergies do?
reduces levels of ee and improve family ability to help patient reducing relapse risk
managing scz
why are token economies used?
aims to make patients behaviour more socially acceptable and functional after prolonged hospitlaiation= institutionalistaion
managing scz
what is involved in te?
token immediately given to individuals when they carry out desirable behaviour e.g taking antipsychotics full course or sit in a session of family therapy
the token can then be exchaged for a reward e.g going to the cinema
managing scz
Token economies are an example of….
operant conditioning
managing scz
Tokens are…
secondary reinforcers as they have no direct value but needed to get rewards
managing scz
rewards are…
primary reinforcers
managing scz
How are behaviours positively reinforced?
patient learns that when they carry out a particualr behaviour they are rewarded
How does the interactionist approach explain scz?
disathesis stress model- having a genetic vulnerability and an environmental trigger= scz to develop
interactionist approach
what is meehls model?
diathesis is entirely genetic, result of the schizogene= schizotypical personality= sensitive to stress
not having this gene means no amount of stress will lead to scz
interactionist approach
what is the modern understanding of diathesis?
non-gentectic factors are also considered e.g psychological trauma, early trauma can affect brain development
interactionist approach
what is the modern understanding of stress?
widened to anything that risks triggering scz e.g canabis THC usage increases the risk of scz up to seven times as it interferes with dopamine system but not all that smoke canabis deveop scz as they lack the diathesis
interactionist approach
what is the interactionist treatment of scz?
combo of antisychotic mediaction and the use of cbt ( biology and psychological therapy)
interactionist approach
what are the two types of dysfunctional thought processing?
metarepresentation dysfunction
centeral control dysfunction
bio treatments
What are atypical antipsychotics?
Target D2 da activity in the limbic system but not D3 receptors in other parts of the brain
Affect more nt’s than typical
Clozapine- dopamine, serotonin and glutamate antagonist working on negative symptoms improving mood reducing depression and anxiety
drug therapy
what are antipsychotics?
taken as a tablet syrup or injection
used short or long term
divided into typical (traditional) and atypical (newer)
drug therapy
details about typical and atypical antipsychotics
typical- taken any of the three ways if orally administered daily with doses being small then incresing gradually
atypical c= 300mg-450 daily r- a lot stronger so max dose 12mg
affect more nt’s than typical
managing scz
what is the rationale behind token ecnomies?
scz sufferes often get hospitalised for long periods of time= institutionalisation - get used to not doing things as they are cared for = bad habits
te tackles behaviours- personal care, avolition and social behaviours
by doing this paitients life quality within hospital= improved and it is made easier for them to move back into the world after being insti
