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Schizophrenia Flashcards

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
Characteristics of a schizophrenogenic mother
- cold - uncaring - suspicious - controlling - creates tension - secrecy
22
What is the double bind theory?
- describes how children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia
23
How does the double bind theory develop into schizophrenia?
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
What is 'expressed emotion'?
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
How might expressed emotion trigger schizophrenia?
Suggests that people with schizophrenia have a lower tolerance for intense interaction and the negative emotional climate
26
Cognitive explanation for auditory hallucinations
A lack of metarepresentation - not reflecting on ones thoughts as their own may cause patients to believe there is an additional voice
27
Cognitive explanation for delusions
Inadequate information processing - a critical characteristic is egocentric bias --> leads to jumping to false conclusions abt external events ('impaired insight')
28
Cognitive explanation for hallucinations
29
Research support for cognitive explanations
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
I&D cognitive explanations
REDUCTIONIST -
31
What is Cognitive Behavioural Therapy used for? (2)
- 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
Effectiveness of CBT
- 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
Appropriateness of CBT
- 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
I&D CBT
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
Other forms of CBT (linear)
ELLIS' ABC MODEL - activating event, belief (irrational), consequences (emotional and behavioural) - rationalise their beliefs
36
Other forms of CBT (DAE)
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
Expressed emotion (family therapy)
- 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
What do token economies do?
- encourage 'correct' behaviours in the patient and discourage 'incorrect' behaviours
39
what symptoms do token economies focus on?
- negative symptoms (depression, social withdrawal, lack of motivation)
40
What are primary reinforcers?
WHAT THEY WANT - e.g sweets, free time, magazines, day trips
41
What are secondary reinforcers?
TOKENS -exchanged for the reward (what they want)
42
What is operant conditioning?
Learning through consequence
43
Appropriateness of token economy (AO3)
- 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
Effectiveness of token economy (AO3) - research support
Glowacki et al --> meta-analysis of 7 studies (effectiveness in hospital) - decreased negative symptoms - decrease in the frequency of undesirable behaviour
45
I&D Token economy
ETHICS - join token economies w/o consent - manipulate behaviour (lab rats) - brings abt the debate - who decides what is desirable behaviour
46
47
What is the diathesis-stress model?
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
What is diathesis? (sz)
A person's genetic vulnerability (to schizophrenia) - MZ have a higher ccr than DZ(genetic component)
49
What is 'stress'? (sz)
stresses that may trigger schizophrenia (e.g childhood trauma, urbanised living, cannabis use )
50
'Stress' research support
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
Diathesis-stress research support
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
I&D Diathesis-stress
REDUCTIONIST V HOLISTIC - Holistic (considerers all factors) - bio approach is reductionist - DS avoids by combining different factors

Psychology (4 decks)

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