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Schizophrenia Flashcards

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1
Q

what is schizophrenia

A

schiz is a mental disorder that happens when insight to reality is impaired

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2
Q

what is the percentage population of schiz in the world

A

1%

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3
Q

what is the DSM -5

A
  • a classification system used by America.
  • need 1 positive. symptoms to diagnose schiz.
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4
Q

what is classification of mental disorders.

A

the process of organising symptoms into categories based on where they cluster.

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5
Q

what are positive symptoms.

A

symptoms that add to the normal experience.
- hallucination and delusions.

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6
Q

what are hallucinations.

A

sensory experiences that have no basis in reality.

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7
Q

what are delusions.

A

beliefs that have no basis in reality.

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8
Q

what is ICD 10

A
  • a classification system used by the WHO to diagnose schiz.
  • need 2 or more negative symptoms to diagnose.
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9
Q

what are negative symptoms.

A

symptoms that take away from the normal experience.
- speech poverty, aviation.

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10
Q

what is speech poverty

A

the lack of coherent sentences.

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11
Q

what is avoliation.

A

loss of motivation and the ability to do goal oriented activities.

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12
Q

what was the aim of Rosenhan study

A

to study the validity and reliability of the way schiz is diagnosed.

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13
Q

method of Rosenhan study.

A
  • 8 confederates went to 12 diff hospitals.
  • complained about hearing voices.
  • acted as pseudpaitents.
  • gave fake occupations but real history.
  • stopped presenting symptoms as soon as they got in.
  • asked to be discharged.
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14
Q

what are the findings of Rosenhan study

A
  • 11/12 were diagnosed with schiz.
  • 1 was diagnosed with manic depression.
  • average stay was 11 days.
  • when asked to leave as they were only here for experiment they were declared insane and not allowed. - part of their delusions.
  • 30 real patients spotted out that these were not real schiz.
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15
Q

conclusion of Rosenhan study

A
  • has reliability but no validity.
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16
Q

two clinics study

EVALUATION - high reliability

diagnosis and classfication of sciz

strength.

A
  • study done on 2 clinics.
  • diagnosed 1 person.
  • gave the same diagnosis.
  • each clinic had 2 different psychs.
  • same diagnosis.
  • for 180 people.
  • inter rater reliability of 0.97
  • inter tester reliability of 0.42
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17
Q

low validity.

EVALUATION.

classfication and diagnosis and of schiz.

limitation.

A
  • a study of two clinics.
  • dignosis of 100 people.
  • using both DSM-5 and ICD-10.
  • diagnosed 39 people with schiz using the ICD-10.
  • diagnosed 68 for DSM-5.
  • either one is over or under diagnosing.
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18
Q

using one system

EVALUATION.

classfication and diagnosis of schiz.

HOWEVER - strength.

A
  • would work if they use one system
  • ecah system has diff classfications.
  • similiar results form clinics when using one system.
  • invalid comparison.
  • clearer when using one system.
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19
Q

women are less diagnosed than men

EVALUATION - gender bias.

classfication and diagnosis of schiz.

limitation.

A
  • men tend to be more diagnosed more than women.
  • psychs used to think it was because of genetic diffrances.
  • however been found that women have stronger relations with their support system.
  • would often seek help to sort out one symptom at a time.
  • can not cluster the symptoms better to give clearer diagnosis.
  • based on men’s clusters of symptoms.
  • women tend to not get the help they need.
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20
Q

co-morbility with depp and overlapping symptoms with ocd

EVALUATION - co-morbility and overlapping symptoms.

classfication and diagnosis of schiz.

limitation.

A
  • 50% of thoes diagnosed with schiz are also diagnosed with deppression.
  • co-morbility.
  • dont know which symptom caused by which illness.
  • if any illness is the root problem and caused the other ilness.
  • unclear.
  • overlapping symptoms with ocd such as audiatory hellucination.
  • can not give clear diagnosis.
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21
Q

UK vs Africa

EVALUATION - cultural bias.

classfication and diagnosis of schiz.

limitation.

A
  • african people are as 9x likey to be diagnosed with schiz in the uk as a white person.
  • not in africa.
  • different interpertations of the sysmptoms.
  • example: in africa hearing voices is communication with ansactore.
  • the classficaion systems are not universal.
  • lack ecological validity.
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22
Q

what did Ripke found about sciz.

biological explaination of schiz.

A

it is polygeneic.
- 108 genes.

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23
Q

what did Gottesman found about schiz.

biological explaination of schiz.

A

the closer relations the more likely to schiz to be passed down.
* shciz is genetically inheriated.
* 48% chance of monozygotic twins.
* hediatary.

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24
Q

Ripke study on polygenetics of schiz.

biological explaination of schiz.

A
  • compared 37000 people with schiz.
  • with 150000 people without schiz.
  • found that 108 genes could cause schiz.
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25
Q

what does it mean that schiz is genetically heteregenous.

biological explainatin.

A

multiple gene combination could cause it.

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26
Q

what is gene mutation that could cause schiz.

A
  • viral infections.
  • age,
  • chemcials
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27
Q

gene mutation as a cause of schiz study

biological explaination.

A
  • correlation study.
  • sperm mutation with age as a cause of schiz.
  • over 50 = thier children would have a 2% increase chance of developing schiz.
  • under 25 would 0.7 chance
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28
Q

what is the original dopamine hypothesis (hyperdopamenrgia)

A
  • high levels of dopamine in the subcortext of the brain.
  • explains positive symptoms.
  • found by an antipsychotic that lowers the level of dopamine = gives similar symptoms to Parkinson disease.
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29
Q

what is the new dopamine hypothesis (hypodepomanerigia)

A
  • low dopamine levels in the frontal cortex = near the brocha’s area.
  • explains negative symptoms.
  • causes hyperdopaminergia.
  • caused by genetic vulnerability.
30
Q

what is chloroplasm.

A
  • typical antipsychotic.
  • first form of antipsychotic.
  • made in the 50’s.
  • works as an antagonist in the dopamine receptors.
  • lowers DA.
  • dose is between 200 - 800 mg.
  • max dose is 1000 mg.
  • taken in the form of liquid, tablets or shoots.
  • has a sedative effect so used to calm paitents down.
31
Q

what is chlorzapine

A
  • atypical antipsychotic.
  • a supposed replica of chloroplasim but without the side effects.
  • made in the 70’s.
  • has sever side effects such as blood Agranulocytosis; a side effect where blood count is lowered.
  • can only be taken in the form of tablets or liquid.
  • no injection.
  • was banned, but brought back as a last resort.
  • paitents who take it must have regualr blood chekcs.
  • binds to dopamine and glutmate receptos.
  • improves mood so prescribed for sucidal people.
  • 400 - 800 mg.
  • 800 mg max
32
Q

what is risperidone

A
  • atypical antipsychotic.
  • made in the 90’s.
  • low dose of 4 - 8 mg.
  • 10 mg is max dose.
  • each dose lasts 2 weeks.
  • can be taken in the form of injections, tablets or syrup.
  • binds on dopamine and seratonine receptors.
33
Q

genes and family studies,

EVALUATON - research support.

biological explaination of schiz.

strength.

A
  • research support about genes being the cause of schiz by family studies.
  • Gottman’s research = showed high inheritance rate of schiz from parents.
  • pikka research = twin studies where compared bio parents with adopted kids = found high rate of inheritance.
  • twin studies showed that there is a 33% chance of monozygotic tiwns to get the disease if one twin has it.
  • genetic vunrability due to genes.
34
Q

family and twins share the same environment,

EVALUATION - environmental factors.

biological explaination of schiz

limitation.

A
  • families and twins share the same environment.
  • environment is more important than bio factors.
  • unclear which causes schiz.
  • psychological explaination explains causes better.
  • paitents mention early abuse in childhood.
  • other factros cause schiz such as smooking weed.
  • environment is more likely to cause schiz.
35
Q

amiphatomine worsens symptoms

EVALUATION - research support for dopamine hypothesis

biological explainations of schiz

strength.

A
  • research support for dopamine hypothesis,
  • amiphatomine.
  • increase dopamine.
  • wrosens symptoms for people with schiz and gives symptoms to people with no schiz.
  • compared to antipsychotics.
  • lowers dopamine levels = improves condition.
  • valid theory.
36
Q

glutmate

EVALUATION - incomplete explaination.

biological explaination of schiz.

limitation.

A
  • incomplete explaination.
  • post moretum of schiz people found that.
  • high levels of glutmate.
  • not mentioned in the dopmaine hypothesis.
  • incomplete explaination.
37
Q

EVALUATION - side effects

drug therapy for schiz.

limitation.

A
  • a lot of side effects.
  • low = jaw stifness.
  • mild = dopamine senstivity which causes involuntary face movements; draws attention to paitents makes them stop taking their medication.
  • low sex drive.
  • neurolaptic milgnant syndrom = severe = death = by high temps.
  • for some the consequences overweight the benefits.
  • high rate of relapse.
38
Q

incomplete explaination.

EVALUATION - unclear mechanism.

drug treatment for schiz.

limitation.

A
  • know that the drug works but not how.
  • unclear mechanism.
  • therefore an incomplete explaination.
39
Q

placebo

EVALUATION - support for effectivness

drug treatment for schiz.

ztrength and limitation

A
  • support for effectivness.
  • study used placebo and real drug.
  • drug workend.
  • however.
  • tested for short term effects.
  • study has major flaws.
40
Q

However, there is major flaws in research support for drug treatments.
- Schizophrenia, drug treatment 

A
  • Most research on drug treatments for schizophrenia are usually short term effect.
  • There are often no no longitudinal studies about the effect of such medication.
  • Positive results can be explained by the sedative effect of these medication .
  • These research are often conducted by drug companies, who might manipulate their results to make a look like it was effective.
  • Therefore, drug treatments cannot be supported by research effectively.
41
Q

What is family dysfunction?

A
  • The abnormal process within a family that leads to the development and maintenance of schizophrenia.
  • It’s a psychological explanation 
42
Q

What is a schizophrenogenic mother?

A
  • Riichman.
  • She found out from case studies of schizophrenic patients, a type of mother they all had in common.
  • The mother was called in rejecting, and the house was tense.
  • The father never stop the mother.
  • The mother was often pushes the child away.
  • A lead to paranoid delusions and Persecution, delusions
43
Q

Expressed emotions

A
  • When there is an over involvement in the patient’s life, followed by selfless sacrifice that is not needed and contributes to feelings of guilt.
  • It explains why schizophrenia is maintained.
  • It could have criticism and violence.
  • If patient returns to such environments, they will be high rate of relapse.
44
Q

Double-blind theory 

A
  • A type of communication style where parents are unclear and give kids mixed signals.
  • The child is punished by withdrawal of love.
    A
  • Child Is unable to express their opinions and voice, their emotions.
  • Child would often have a confused view on the world and would think life is unfair.
  • It often explains the negative symptoms.
  • Beatson.
    
45
Q

Research support.
- Psychological explanations 

A
  • There are research support that supports the fact that schizophrenia is developed due to the environment.
  • Study shows that 59% of men and 49% of the women who have schizophrenia and mention abuse and their life.
  • Another study shows that these people would often have insecure attachment no close relations to parents.
  • This supports the fact that schizophrenia is developed through environmental factors related to communication styles and abusive households.
    
46
Q

HOWEVER - There is no good evidence base for the original theories.
- Psychological explanation 

A
  • Although there is research evidence that environmental factors contribute to the development of schizophrenia.
  • There are no good evidence based on the original series, such as the schizophrenogenic mother.
  • These theories would often have a subjective evidence base, such as using case studies.
  • for example Reichmann.
  • Never interviewed the mother, and took the words of schizophrenic people who lost touch with reality.
  • Which means that the evidence obtained is not reliable
  • There is no systematic accurate evidence on the original theories.
  • This undermines the psychological explanations for the development and maintenance of schizophrenia 
47
Q

Parents blaming.
- Psychological explanations family dysfunction 

A
  • Series into family dysfunction are socially sensitive because they could lead to parents blaming.
  • Not having a good attachment with parents, sometimes due to external factors.
  • Furthermore, schizophrenia has a biological side of it, meaning that environmental factors do not count for all development of schizophrenia.
  • Therefore Series, such as the schizophrenogenic mother could be socially sensitive to mothers who had nothing to do with the development of schizophrenia with the child, because the evidence used on that is based on case studies.
48
Q

What is the cognitive explanation?

A
  • It states that people with schizophrenia have a faulty way of thinking
49
Q

What is dysfunctional thinking?

A
  • When does thought process are not functioning normally, and cause unwanted thinking
50
Q

What is metarepresentation?

A
  • The ability to distinguish between our own and others’ actions.
  • People with schizophrenia have low metapresentation.
  • It gives us insight on our own goals and other’s intentions.
  • Having low metarepresentation, explains things like auditory hallucinations.
51
Q

What is insesion

A

The ability to distinguish between our thoughts and others.
- people with schiz have low insertion.
- Could explain, paranoid delusions 

52
Q

What is central control?

A
  • Is the ability to carry out a deliberate action with suppressing the automatic response.
  • People with Schizophrenia have low central control.
  • It’s measured by stroop test 
53
Q

Research support.
- Cognitive explanation 

A
  • There is research support for the cognitive explanation of schizophrenia.
  • Through a stroop test.
  • Those with schizophrenia took longer to complete the stroop test, compared to thoes without.
  • Because of the low central control.
54
Q

Not a full explanation.
- Cognitive explanation of schizophrenia 

A
  • Ideas such as the central control and insertion explain symptoms however they’re not there origins.
  • They state that faulty thinking is a symptom of schizophrenia. However, they did not state where it came from, and the reason why people with schizophrenia have faulty thinking.
  • This means that such theories cannot be applicable to real life, because they do not tell us how to prevent getting faulty thinking
55
Q

It’s an unclear approach.
- Cognitive explanation of schizophrenia

A
  • It’s unclear.
  • Cognitive explanations state that symptoms are psychological however they are related to the brain which means it’s biological.
  • Therefore it’s unclear if the biological Origins is what causes the psychological symptoms 
56
Q

What is cognitive behavioural therapy?

A
  • It focuses on faulty thinking.
  • Test reality of thoughts and delusions.
  • It has 20 sessions.
  • Requires establishing of trust honesty, and unconditional acceptance .
  • Wax by giving techniques to manage symptoms.
    
57
Q

There is evidence for effectiveness.
- CBT 

A
  • There was a review of 34 clinical research supports studies about CBT.
  • They found a small but significant improvement in symptoms of schizophrenic people who had CBT as a treatment.
  • for both positive and negative symptoms.
  • Another study shows that CBT reduces auditory hallucinations as they test the reality of these hallucinations.
  • Furthermore, NICE Recommends the use of CBT as a treatment for schizophrenia.
  • This means that it has Clinical support and research support 
58
Q

However, there is low evidence quality.
- CBT 

A
  • CBT with often involve A range of different techniques and methods.
  • Different techniques are used for different clusters of for symptoms and each psychologist would use different ones based on what works for the patient.
  • There’s no standardisation of schiz.
  • Meaning that it’s unclear, which technique is more effective in which cluster universally 
59
Q

What is family therapies?

A
  • It focuses on the improvement of communication within the family.
  • It provides help for both the family and the patient.
  • Advice is the family on how to take care of the patient well not neglecting their personal life and gives them balance.
  • It helps Not maintaining schizophrenia.
  • And it reduces the rate of the rate of rehospitalisation.
  • It reduces the anger and the guilt of both the patient and the family.
  • It helps when patients take medication for them, not to stop and relapse 
60
Q

There is evidence for effectiveness.
- Family therapy 

A
  • Research found that it’s the most effective therapy out of all.
  • Especially when it comes to relapse rate.
  • A reduction of relapse rate by 50 to 60%.
  • House people to take their medication constantly.
  • NICE recommends it.
  • It has clinical + research support
61
Q

What is token economy?

A
  • It works on operant conditioning.
  • Used in psychiatrists wards.
  • Works by identifying wanted an unwanted behaviours and identifying wanted rewards.
  • If wanted, behaviours are displayed rewards are given in the form of tokens for exchanges.
  • He works on selective reinforcement Which operates based on the behaviours displayed.
62
Q

Limits patient.
- Token economy 

A
  • Token economy limits patients freedom
  • It gives too much control to psychiatrists.
  • It’s inhumane and unethical.
  • Easily abused.
  • There are there alternative such as art therapy, which the NICE recommends 
63
Q

Evidence for effectiveness.
- Token system 

A
  • Evidence for effectiveness from seven studies.
  • Shows that there is a reduction in Negative symptoms.
  • Through reward system and identifying wanted an unwonted.
  • However, the sample used is too small.
  • There is research bias as file drawer, problems pop up.
  • Research, could have picked the studies that show effectiveness of the method.
  • Shows that, although there is research support, it should be carefully looked at and taken into consideration
64
Q

What is the interactionist approach?

A
  • He uses the diathesis stress model To explain how there is biological and psychological Influences to schizophrenia, which operates together.
    
65
Q

Original model of the diathesis stress model for schizophrenia

A
  • States that there is biological vulnerability due to genetic factors.
  • They are triggered by the environmental stressors, such as abuse.
  • This leads to development of schizophrenia.
  • This model states that no amount of stress will cause schizophrenia if there is no genetic vulnerability.
  • This model is outdated
66
Q

The updated model of the interactionist approach of schizophrenia

A
  • Is it the vulnerability could be caused by the environment as well as the biological vulnerability
  • Are example, smoking, weed and childhood trauma can alter neurons in the brain which can be triggered by stressful events.
67
Q

How does the interactionist approach treat schizophrenia?

A
  • Through combining CBT and antipsychotics.
  • Antipsychotics treats, the direct cause, which is the dopamine levels.
  • CBT treatment the indirect courses which are irrational thoughts.
68
Q

Research support for genetic, vulnerability and triggers.
- Interactionist approach of schizophrenia.

A
  • Research done on children with biological parents with schizophrenia who adapted into different types of families.
  • Those adapted into good families had lower rates of developing schizophrenia compared to those who got Adopted into bad parents.
  • This shows that genetic vulnerability is triggered due to the environment, and it’s not only biological or only psychological.
  • This is the Finnish children study
69
Q

Oversimplification of the day thesis stress model.
- Interactionist approach of schizophrenia 

A
  • The original diastases model is the oversimplification.
  • The original diathesis stress model betrayed the diathesis as a single scizogene.
  • Later, research has found that actually schizophrenia is caused by multiple genes in multiple combinations.
  • Stress also comes in many forms including but not limited to dysfunctional parenting such as sexual abuse.
  • This is shown by a study done by Houston et al.
  • In which a lot of Schizophrenia patients had sexual abuse and would often smoke cannabis.
  • This means that there are multiple factors both biological and psychological effect in both decreases and stress, supporting modern understanding of both dithesis and stress, limiting the original model 
70
Q

RWA.
- Interactionist approach of schizophrenia.


A
  • A strength is that it combines Both biological and psychological treatment.
  • Studies show that combining treatments in houses there effectiveness, for example.
  • Research Where people were randomly allocated 315 participants to medication plus CBT medication plus counselling or a control group with medication only.
  • Participants in the two combination group with both drug treatment, psychological treatment Showed Noor symptoms following the trial compare to the medication only group.
  • This means that there is a clear practical advantage to Adopting an interactionist approach to treat schizophrenia 
71
Q

However- no clear link.
Interactionist approach of schizophrenia 

A
  • Researchers point out that a successful treatment of a mental disorder is not an enough justification or logical explanation.
  • This is a treatment causation fallacy.
  • Just because CBT and drug treatment work does not mean that the cause of schizophrenia is due to a diathesis stress model.
  • Therefore, we cannot assume that the success of combined therapies mean, interactionist explanations are correct 

Psychology (11 decks)

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