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Schizophrenia Flashcards

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1
Q

Classification (5)

A

Hallucinations
Delusions
Disorganised speech
Disorganised or catatonic behaviour
Negative symptoms (e.g. avolition)

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2
Q

What is reliability? (sz)

A

The consistency of the measuring tool (e.g. DSM) or other tests used in diagnosis (must be valid to be reliable)

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3
Q

Methods of testing reliability (sz)

A

test-retest –> same conclusions at two different point of time

inter-rater –> different doctors must reach the same conclusions regarding a diagnosis

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4
Q

I&D reliability

A

Culture bias
- positive symptoms may be more acceptable in African cultures because of cultural beliefs in communication with ancestors
(can be misinterpreted in western cultures)

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5
Q

What is validity? (sz)

A

The extent to which a diagnosis is accurate and meaningful
- ensures it measures schizophrenic symptoms that differ from other mental disorders

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6
Q

I&D Validity

A

Gender bias
- Powell asked 290 male and female psychiatrist to read 2 cases describing a patients behaviour
– 56% said schizophrenic when patient was male + 20% when female

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7
Q

What can reduce validity?

A

Symptom Overlap
- Ellason and Ross (1995) found that people with DID have more schizophrenic symptoms than people diagnosed w schizophrenia
(e.g delusions, illogical thinking, avolition)

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8
Q

What is Co-morbidity?

A

When a person is diagnosed has having more than mental disorder at the same time

Buckley et al –> estimated that co-morbid depression occurs in 50% of patients

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9
Q

What are neural correlates?

A

the brain activities or parts of the brain that are linked to particular thoughts, feelings, or actions
e.g a neural correlate of schizophrenia

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10
Q

What do family studies imply about biological explanations for schizophrenia?

A

Gottesman (92)
- children with 2 bio sz parents had a ccr of 46%
- children with 1 bio sz parent had a ccr of 13%
(have an impact but not 100% ccr)

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11
Q

What do twin studies imply about biological explanations for schizophrenia?

A

MZ = 48%
DZ = 17%
- more likely to have grown up in similar conditions if MZ
(not 100% ccr)

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12
Q

I&D Genetics

A

NATURE V NURTURE
- favours nature
- researchers now accept –> common rearing patterns or other environmental factors
- MZ ccr should be higher

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13
Q

What is dopamine?

A

A neurotransmitter that generally has an excitatory effect and is linked to the sensation of pleasure.
high = schizophrenia
low = Parkinson’s disease

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14
Q

Hyper/ hypodopaminergia

A

hyper = overactive (high levels) –> positive symptoms
hypo = underactive (low levels) –> negative symptoms
- dopamine in the subcortex

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15
Q

Strength of the dopamine hypothesis

A

PRACTICAL APPLICATION
- drug therapies to balance (usually lower) the level of dopamine

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16
Q

Neural correlates of Avolition

A

Damage to the ventral striatum
- linked to the anticipation of reward for certain action

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17
Q

Neural correlates of auditory hallucinations

A

Reduced activity in the superior temporal gyrus
- STG contains the auditory cortex

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18
Q

Difference between typical and atypical antipsychotics

A

TYPICAL
- older
- focus on blocking dopamine receptors
- blocking D2 receptors in other areas of the brain can cause Parkinson’s

ATYPICAL
- newer
- focus on dopamine a serotonin receptors (target positive and negative symptoms)
- improves cognitive impairments and reduces depression and anxiety

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19
Q

Research support for typical antipsychotics

A

Thomley et al –> data from 1121 patients showed that Chlorpromazine was associated with better overall functioning + reduced symptom severity (compared to placebos)

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20
Q

What does schizophrenogenic mean?

A
  • schizophrenogenic = ‘schizophrenia-causing’
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20
Q

Research support for atypical antipsychotics

A

Meltzer et al –> concluded that clozapine that typical antipsychotics (effective in 30-50% of treatments resistant cases)

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20
Q

Consequences of having a schizophrenogenic mother

A
  • leads to an atmosphere of distrust and the development over time into paranoid thoughts which become delusions (e.f beliefs of being persecuted by others)
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20
Q

I&D drug therapy

A

NATURE V NURTURE
- doesn’t work for everyone –> other factors must be implicated in the cause of schizophrenia
- drug therapy implicates a purely biological cause
A BETTER STRAGETY
- use drugs in conjunction with psychological therapies

21
Q

Side effects of typical antipsychotics

A

associated with a range inc dizziness, agitation, sleepiness etc
- long term use can result in tardive dyskinesia (involuntary repetitive body movements)
MOST SERIOUS (very very rare)
- neuroleptic malignant syndrome (when dopamine is blocked in the hypothalamus)
– high temp, delirium, coma, death

21
Q

Characteristics of a schizophrenogenic mother

A
  • cold
  • uncaring
  • suspicious
  • controlling
  • creates tension
  • secrecy
22
Q

What is the double bind theory?

A
  • describes how children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia
23
Q

How does the double bind theory develop into schizophrenia?

A

the messages invalidate each other so the child is unable to respond which in turn prevents the development of the internally coherent construction of reality

24
Q

What is ‘expressed emotion’?

A

The level of emotion expressed towards the patient (e.g criticism, hostility, and emotional overinvolvement)
- the family of the patient talk abt the patient in a critical manner or in a way that indicates over concern in their behaviour

25
Q

How might expressed emotion trigger schizophrenia?

A

Suggests that people with schizophrenia have a lower tolerance for intense interaction and the negative emotional climate

26
Q

Cognitive explanation for auditory hallucinations

A

A lack of metarepresentation
- not reflecting on ones thoughts as their own may cause patients to believe there is an additional voice

27
Q

Cognitive explanation for delusions

A

Inadequate information processing
- a critical characteristic is egocentric bias –> leads to jumping to false conclusions abt external events (‘impaired insight’)

28
Q

Cognitive explanation for hallucinations

A
29
Q

Research support for cognitive explanations

A

John Stirling et al –> Stroop task
- name font colours of colour-words (suppress the tendency to read the words aloud)
– people with schizophrenia took over twice-as-long on average
(impaired cognitive processing)

30
Q

I&D cognitive explanations

A
31
Q

What is Cognitive Behavioural Therapy used for? (2)

A
  • to help the patient identify + correct faulty interpretations of events
  • to help establish links between their thoughts, feelings or actions + their symptoms in order to consider alternative explanations
32
Q

Effectiveness of CBT

A
  • NICE found that, when compared to drug therapy alone, CBTp was effective in reducing hospitalisation rates
    – shown to be effective in reducing symptom severity and improving social functioning (compared to standard care - drugs)
33
Q

Appropriateness of CBT

A
  • Addington + Addington –> CBT is of little use in the early stages of a schizophrenic episode (better when calm)
  • Kingdon + Kirschen –> CBT is not suitable for all (esp those who are too thought disorientated, refuse needs or are too paranoid)
34
Q

I&D CBT

A

IDIOGRAPHIC V NOMOTHETIC
- idiographic (opposition to drug therapies)
- drugs are not suitable for all - idiographic approach may be more suitable in some cases
- to seek understanding and explain the disorder from the patient’s POV

35
Q

Other forms of CBT (linear)

A

ELLIS’ ABC MODEL
- activating event, belief (irrational), consequences (emotional and behavioural)
- rationalise their beliefs

36
Q

Other forms of CBT (DAE)

A

DEVELOPING ALTERNATIVE EXPLANATIONS
- patients develop their own alt explanations for their previous unhealthy assumptions (can be with therapist cooperation if the patient is not forthcoming)

37
Q

Expressed emotion (family therapy)

A
  • families are provided with information abt schizophrenia, shown ways of supporting the individual and resolving practical problems
  • relationships are improved and family members are encouraged to listen to eachother
  • the individual is also encouraged to talk to their family and discuss support and boundaries
38
Q

What do token economies do?

A
  • encourage ‘correct’ behaviours in the patient and discourage ‘incorrect’ behaviours
39
Q

what symptoms do token economies focus on?

A
  • negative symptoms (depression, social withdrawal, lack of motivation)
40
Q

What are primary reinforcers?

A

WHAT THEY WANT
- e.g sweets, free time, magazines, day trips

41
Q

What are secondary reinforcers?

A

TOKENS
-exchanged for the reward (what they want)

42
Q

What is operant conditioning?

A

Learning through consequence

43
Q

Appropriateness of token economy (AO3)

A
  • difficult to continue outside of the hospital setting
    BUT
  • some people with sz may only be able to live outside if their personal care and social interaction is improved
44
Q

Effectiveness of token economy (AO3) - research support

A

Glowacki et al –> meta-analysis of 7 studies (effectiveness in hospital)
- decreased negative symptoms
- decrease in the frequency of undesirable behaviour

45
Q

I&D Token economy

A

ETHICS
- join token economies w/o consent
- manipulate behaviour (lab rats)
- brings abt the debate - who decides what is desirable behaviour

46
Q
A
47
Q

What is the diathesis-stress model?

A

suggests that diathesis and stress add together in some way to produce sz
- the amount of stress needed depends of the level oof vulnerability

48
Q

What is diathesis? (sz)

A

A person’s genetic vulnerability (to schizophrenia)
- MZ have a higher ccr than DZ(genetic component)

49
Q

What is ‘stress’? (sz)

A

stresses that may trigger schizophrenia
(e.g childhood trauma, urbanised living, cannabis use )

50
Q

‘Stress’ research support

A

Brzustowicz et al –> early trauma (a threat to physical, emotional or sexual integrity at a young age) was significantly associated with expression of sz in families demonstrating genetic predisposition

51
Q

Diathesis-stress research support

A

Tienari et al –>
- 19,000 Finnish children with bio sz mother
- in adulthood, high genetic risk comp to low risk (adoptees w no sz family history)
- high expressed emotion was highly associated with sz ONLY FOR HIGH RISK

52
Q

I&D Diathesis-stress

A

REDUCTIONIST V HOLISTIC
- Holistic (considerers all factors)
- bio approach is reductionist
- DS avoids by combining different factors

Psychology (4 decks)

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