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schizophrenia Flashcards

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1
Q

What is Schizophrenia?

A

A severe mental illness where contact with reality and insight are impaired, an example of psychosis

NOT split personality or multiple personalities! This disorder is often misrepresented in the media and films

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2
Q

What are the two manuals used to diagnose Schizophrenia?

A
  1. DSM-5
  2. ICD-10
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3
Q

When should Schizophrenia be diagnosed?

(in regards to symptoms and time frames)

A

2 symptoms need to have been present for 6 months or more and active at least 1 month or more before a person can be diagnosed with Schizophrenia

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4
Q

What is a spectrum disorder?

A

A group of related mental disorders that have symptom overlap

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5
Q

What is symptom overlap?

A

Where two or more conditions share the same symptoms

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6
Q

What are the five subtypes of Schizophrenia?

A
  1. Catatonic
  2. Disorganised
  3. Paranoid
  4. Residual
  5. Undifferentiated
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7
Q

What are the three positive symptoms for Schizophrenia?

A
  1. Hallucinations
  2. Delusions
  3. Disorganised Thinking/speech
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8
Q

What are hallucinations?

A
  • Experiencing sensations that aren’t caused by anything or anybody around them
  • Auditory, visual, touch, taste and smell
  • The most common hallucination is hearing voices or other sounds
  • Hallucinations are real to those who experience them
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9
Q

What are delusions?

A
  • An unusual belief in something that is very unlikely, strange or obviously untrue
  • Develop delusions as a way to explain the hallucinations they are experiencing
  • Paranoid delusions are common and sufferers believe that something, or someone, is deliberately trying to mislead, manipulate, hurt or in some cases, even kill them
  • Delusions of grandeur, which is where an individual believes that they have some imaginary power or authority
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10
Q

What is disorganised thinking/speech?

A
  • A person displaying this symptom will find it hard to concentrate on anything
  • Thoughts will drift from one thing to another although there will be no connection between them
  • Trouble finishing reading an article or watching a TV programme and may also struggle with college work
  • Words may also become confused of jumbled making it difficult for other to understand what is being said, known as “word salad”
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11
Q

What are the four negative symptoms of Schizophrenia?

A
  1. Speech poverty
  2. Avolition
  3. Apathy
  4. Affective flattening
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12
Q

What is speech poverty?

A
  • Social withdrawals
  • Difficulty starting conversations or finding it hard to speak to people
  • Feeling uncomfortable with other people or feeling that they have nothing to say or will often give short one word answers
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13
Q

What is avolition?

A
  • Difficulty in planning/setting goals
  • No interest in socialising/hobbies
  • A person does not want to do anything and will sit in the house for hours or even days
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14
Q

What is apathy?

A
  • Lack of motivation
  • Neglecting household chores leading to poor grooming and hygiene
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15
Q

What is affective flattening?

A
  • A reduction or flattening of emotions
  • The range and intensity of facial expressions, tone of voice and eye contact are reduced
  • Body language becomes difficult to interpret
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16
Q

What is co-morbidity?

A

Refers to the presence of one or more disorders in addition to the primary disorder. These disorders can exist independently of each other or they may be related

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17
Q

What are three examples of co-morbidity?

A
  1. Physical illness - tumors, strokes, dementia
  2. Substance abuse - alcohol withdrawals, cannabis, amphetamines
  3. Other psychiatric conditions - OCD, PTSD, depression
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18
Q

How is validity measure with Schizophrenia?

A
  • The extent that a diagnosis actually reflects the actual disorder (how accurate the DSM-ICD is)
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19
Q

How is reliability measure with Schizophrenia?

A
  • How consistent one clinician is in diagnosing symptoms (test-retest)
  • How similar diagnosis is between clinicians (inter-rater)
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20
Q

What is intra-rater reliability in terms of Schizophrenia?

A

The extend to which a clinician reaches the same diagnosis about a person at different points in time

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21
Q

What is inter-rater reliability in terms of Schizophrenia?

A

The extent to which several clinicians reach the same diagnosis about a single person

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22
Q

What is predictive validity in terms of Schizophrenia?

A

The extent to which we can gauge a person’s likely outcome following a diagnosis

23
Q

What was Gottesman’s large family study?

(Biological explanation)

A

Concordance rates show that MZ twins are at a 48% risk of developing Schizophrenia if their twin has developed it and that DZ twins have a 17% risk. In contrast, the general population has a 1% risk, suggesting that Schizophrenia has a biological origin

24
Q

What is a criticism of Gottesman’s large family study?

(Biological explanation)

A

It doesn’t fully explain the cause of Schizophrenia as if it was solely a biological explanation then the concordance rate would be at 100%

25
Q

What was Ripke’s polygenic study?

(Biological explanation)

A
  • Genetic make-up of 37,000 patients (whole genome)
  • Control sample of 113,000
  • 108 separate genetic variations were associated with increased risk pf Schizophrenia
  • Link with genes which are associated with a number of neurotransmitters including dopamine
26
Q

What is The Dopamine Hypothesis?

(Biological explanation)

A

Dopamine appears to work differently in patients with Schizophrenia
- Dopamine, a chemical substance (neurotransmitter) manufactured in the brain, transmits messages between neurons (brain cells)

27
Q

What is Hyperdopaminergia?

(Biological explanation)

A

Excessive levels of dopamine in the sub-cortex i.e. Broca’s Area - may be associated with speech poverty/auditory hallucinations

28
Q

What is Hypodopaminergia?

A

Low levels of dopamine in the prefrontal cortex (PFC) - may be associated with avolition/apathy

29
Q

What is a Neural Correlate?

(Biological explanation)

A

Patterns of structure or function in the brain that correlates with a Schizophrenic experience. As they occur simultaneously this could lead us to believe that the patterns observed are implicated in causing Schizophrenia

30
Q

What did Juckel et al find in regards to avolition?

(Biological explanation)

A

Avolition which involves lack of motivation, has been associated with one of the main reward centres in the brain. The Ventral Striatum is crucial in the anticipation of reward. Juckel et al measures activity levels here and found lower levels of activity in those with Schizophrenia compared to controls

31
Q

What did Allen et al find in regards to positive symptoms?

(Biological explanation)

A

Positive symptoms also have neural correlates. Reduced activity in the Superior Temporal Gyrus and Anterior Cingulate Gyrus is a neural correlate for auditory hallucinations. Allen et al scanned patients with auditory hallucinations, compared to a control. Lower activation levels were found in the hallucination group

32
Q

What is a biological therapy for Schizophrenia?

A

Anti-psychotics

33
Q

What are the two types of anti-psychotics?

A
  1. Typical (traditional)
  2. Atypical (newer)
34
Q

What type of anti-psychotic is Chlorpromazine?

A

Typical

35
Q

What does Chlorpromazine do?

A

Blocks dopamine receptor sites and thus decreases dopamine activity

36
Q

What are the side effects of Chlorpromazine?

A

Muscle tightening in neck and jaw, tardive dyskinesia, decrease of spontaneous movement, decrease in emotional spontaneity and motivation, motor restlessness and fidgeting, sedation, dry mouth, constipation, weight gain, neuroleptic malignant syndrome (can be fatal)

37
Q

What research is attached to Chlorpromazine?

A

Barlow and Durand - Chlorpromazine is effective in reducing Schizophrenic symptoms in about 60% of cases. Most impact on positive symptoms. Treated patients may still suffer from severe negative symptoms

38
Q

What type of anti-psychotic is Clozapine?

A

Atypical

39
Q

What does Clozapine do?

A

Blocks both dopamine and serotonin receptor sites

40
Q

What are the side effects of Clozapine?

A

Similar to typical anti-psychotics but tardive dyskinesia is reduced. Fewer side effects than typical or first generation anti-psychotics

Rare side effects: agranulocytosis - dangerously low levels of white blood cells, can be fatal

41
Q

What research is attached to Clozapine?

A

Pickar et al compared Clozapine with other neuroleptics and a placebo and found Clozapine to n=be the most effective in reducing symptoms, even in patients who had previously been treatment resistant

42
Q

What type of anti-psychotic is Risperidone?

A

Atypical

43
Q

What do Risperidone do?

A

Blocks both dopamine and serotonin receptor sites

44
Q

What are the side effects of Risperidone?

A

Similar side effects to typical anti-psychotics: weight gain, severe anxiety, sedation, insomnia, sexual dysfunction, low blood pressure, muscle stiffness, muscle pain, tremors, increased salivation and stuffy nose. Also associated with diabetes, increased risk of suicide and tumours

45
Q

What research is attached to Risperidone?

A

Emsley found that patients who were injected with Risperidone early in course of disorder had low relapse rates and high remission rates: 84% of patients at least a 50% reduction in both positive and negative symptoms and 64% went into remission

46
Q

What is Family Dysfunction?

A

States how Schizophrenia is developed and maintained as a result of poor communication and/or faulty relationships within the family

47
Q

What is Double-bind theory?

A

Bateson et al, 1956:
- Communication between parent and child is sometimes contradictory - often called double-bind communication
- A parent will often say something but their body language of tone of voice will say something completely different
- These mixed and ambiguous messages cause confusion and mistrust - the child begins to question their own feelings and emotions as they cannot trust what the parent is telling them
- As a result they grow up mistrusting all communication (paranoia) and withdrawing from society (asociality) which explains many of the symptoms of Schizophrenia

48
Q

What is the Schizophrenogenic Mother?

A

Fromm Reichmann, 1948:
- Reported that parents who were emotionally cold or manipulative caused mistrust and conflict within the family and that this behaviour could lead to the child developing Schizophrenia in later life

49
Q

What is Expressed Emotion?

A

Brown et al, 1958:
- The level of emotion normally negative, expressed towards someone by their care-giver
- Proposed that family interactions that involved high levels of expressed emotion (EE) and emotional over-involvement, including hostility and criticism, could play a key role in maintaining the Schizophrenic behaviours

50
Q

What is Cognitive Malfunction?

A

Assumes that there is a breakdown in the person’s self monitoring process which makes it difficult for them to interpret their own thoughts and perceptions accurately, resulting in hallucinations and delusions

51
Q

What are the two kinds of Dysfunctional Thought?

A

Frith, 1979:

Meta representation - reflection of thought and behaviour as being our own

Central Control - ability to suppress automatic responses and perform deliberate actions

52
Q

What are the 4 aspects in family therapy?

A
  • Strategies: developing coping strategies so that the whole family can deal with the symptoms of Schizophrenia
  • Information: asking questions and gathering information helps to understand rather than finding blame
  • Discussion: encouraging discussions about day-to-day problems to help find solutions
  • Experiences: sharing experiences and feelings, which helps other family members understand the illness
53
Q

What studies are linked with Token Economy and Schizophrenia?

A

Allyon and Azrin, 1968: found that female patients with the illness, who had been hospitalised for over 16 years, increased the number of personal chores they performed from 5 to 40, when they were rewarded with tokens

Paul and Lentz, 1977: found that long -term hospitalised patients developed better social skills and were better able to look after themselves when they were rewarded for the appropriate behaviour

Psychology (11 decks)

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