schizophrenia Flashcards
who does schizophrenia affect?
about 1% of the population, its more common in males, city dwellers and those of lower socio-economic groups
schizophrenia can often lead to homelessness and hospitalisation due to its symptoms severe interference in life
what two diagnosis systems do we use for schizophrenia?
- DSM-5, this requires at least one positive symptom
- ICD-10, this requires at least two negitive symptoms
what are the two positive symptoms and why are they called ‘positive’?
positive refers to having an additional experiences that people dont ordinarily experience
they are hallucinations and delusions
what are hallucinations and delusions?
hallucinations are an unusual sensory experience. they cn be related to any sense, eg visual (seeing people etc) and auditory (hearing voices etc) the person may see distorted faces or things that just arent there
delusions is aka paranoia, theyre irrational beliefs, commonly believing youre a famous historical figure (eg jesus), being followed by the government or aliens or believing that someone else is controlling them
what are the two negative symptoms and why are they called ‘negative’?
negitive refers to having a loss of ordinary abilities
they are speech poverty and avolition
what is speech poverty and avolition?
speech poverty is having changes in patterns of speech, this could be a reduction of the amount and the quality of your speech such as delayes replying. however nowadays disorganisation is emphisised although this is classed as a positive symptom, it refers to being incoherent, changing topic mid sentence etc
avolition or apathy is difficulty completing goal-directed activities. lots of schizophrenics experience reduced motivation for eg hygene, work, etc
why is co-morbidity an issue for diagnosing SZ?
conditions that commonly align cause issues for the validity of diagnosis because they might just be one condition.
half of people diagnosed schizophrenic also have a depression or substance abuse diagnosis
diagnosis of SZ is impacted by biases, explain these issues
gender bias: men are diagnosed more than women, this may be because women are less vulnerable or because they have more social support and so dont seek diagnosis because they can function better however this ultimatetly means women arent recieving the treatment they need
culture bias: hearing voices of loved ones who have died in African-Caribbean cultures is considered normal, as a result people from the culture are 9x more likely to be diagnosed, but only in other countries, this means they could be being discriminated against
what are the two biological origins of schizophrenia
genes
neural correlates (brain structure or function)
if SZ is genetic it could lead to having different brain structures
what have family studies told us about SZ?
its hereditable, with the likelyhood of you getting schizophrenia increasing with the more related you are to someone with SZ, eg a MZ twin youd have a 48% chance compared to 17% in DZ, 6% in parents etc
in the biological explanation, much like OCD, schizophrenia has/is:
candidate genes - genes involved in SZ, early research looked for a spesific schizogene but theres a number of genes involved
polygenic - ^ this means its polygenic, with multiple genes involved
ateologically hererogeneous - different variations of genetic combinations can lead to SZ in different people
what is the role of mutation in schizophrenia?
mutation in DNA can be because of poison, radiation, infection etc
sperm mutation increases with age, studies have shown a correlation between paternal (dads) age and SZ
what is the original dopamine hypothesis?
schizophrenia is a result of high dopamine levels in the subcortical areas of the brain, we know this because drugs used to treat SZ caused symptoms simular to parkinsons symptoms and that condition is linked to low dopamine levels
whats the updated dopamine hypothisis?
low dopamine levels - hypodopiminersia in the prefrontal cortex causes the hyperdopiminersia (high levels) in the subcortical area. the low dopamine could explain the negitive symptoms
what are the 6 psychological explanations for SZ (3 family, 3 cognitive)?
family dysfuntion: the schizophrenogenic mother, double bind theory, expressed emotion
cognitive explanations: dysfunctional thinking, meterepresentation dysfunction, cenderal control dysfunction
what is the schizophrenogenic mother?
based on patients desciptions of their childhoods, lots of people described whats now called the schizophrenogenic (SZ - causing) mother, ie. a cold, rejecting, controlling mother creating a family dynamic of tension and secrecy which develops into paranoia and ultimately SZ
what is the double bind theory?
this refers to the families communication style
the child fears doing the wrong thing, recieving mixed messages about what the right/wrong thing even is and feeling unable to ask for clarification. the child often gets it wrong and are punished through withdrawal of love
the child is confused, paranoia and disorganised thinking develops
what is expressed emotion?
this refers to the level of negitive emotion expressed in the family, this usually contains:
- verbal criticism, sometimes accompanied by violence
- hostility including anger and rejection
- emotional overinvolvement
this explanation states the stress in the environment causes SZ in an already vulnerable person, it also explains relapse
what is dysfunctional thinking
disruption to normal thought processing. reduced thought processing in the ventral striatum = negitive symptoms, reduced processing in the temboral and cingulate gyri = hallucinations
what is metarepresentation dysfunction
metarepresentation is the ability to reflext on thoughts and behaviours disruption would mean they ant recognise that their halucinations are from themselves and not out there by someone else
what is central control dysfunction
issues supressing automatic respoonses when performing deliberate actions, resulting in speach poverty and thought disorder because of things like derailment, when the person cant suppress their distractions and go off on tangents