schizophrenia

Question 1

What is a positive symptom of Schizophrenia?

Answer 1

An excess or distortion of normal functions e.g hallucinations

Question 2

What is a negative symptom of Schizophrenia?

Answer 2

A diminution or loss of normal functions e.g avolition

Question 3

What are auditory hallucinations? (positive)

Answer 3

The person often hears voices in their head. They might be angry or urgent and demand that they do things. It can sound like 1 voice or many. They might whisper, murmur, or be angry and demanding.

Question 4

What are visual hallucinations? (positive)

Answer 4

Someone might see lights, objects, people or patterns. Often it is loved ones who have passed. They may also have trouble with depth, perception and distance.

Question 5

What are olfactory and gustatory hallucinations? (positive)

Answer 5

These can include good and bad smells and tastes. Someone might believe they’re being poisoned and refuse to eat.

Question 6

What are tactile hallucinations? (positive)

Answer 6

This creates a feeling of things moving on your body, such as hands or insects.

Question 6

What are persecutory delusions? (positive)

Answer 6

These may make you feel that someone is out for you and you’re being stalked, hunted, framed or tricked.

Question 7

What are somatic delusions? (positive)

Answer 7

These centre on the body. The person thinks they have a terrible illness or bizarre health problem such as worms under the skin or damage from cosmic rays.

Question 8

What are erotomanic delusions? (positive)

Answer 8

A person might be convinced a celebrity is in love with them or their partner is cheating on them.

Question 9

What are religious delusions? (positive)

Answer 9

Someone might think they have a special relationship with a deity or that they’re possessed by a demon.

Question 10

What are psychomotor disturbances? (positive)

Answer 10

Some people with schizophrenia can seem jumpy. At times they’ll make the same movements over and over but sometimes they might remain perfectly still for hours at a stretch, which experts call being catatonic.

Question 11

What is Anhedonia? (negative)

Answer 11

The person may not seem to enjoy anything anymore.

Question 12

What is speech poverty (alogia)? (negative)

Answer 12

The inability to speak properly, characterised by lack of ability to produce fluent words. Thought to reflect slowing or blocked thoughts and can manifest itself as short and empty replies to questions.

Question 13

What is Avolition?

Answer 13

The reduction, difficulty or inability to start and continue with a goal- directed behaviour. It’s often mistaken for apparent disinterest.

Question 14

What is reliability?

Answer 14

Refers to the consistency of a diagnosis, including inter-rater reliability where the same diagnosis is made by 2 or more assessors.

Question 15

What are the cultural differences in diagnosis of schizophrenia?

Answer 15

Harrison et al (1984) suggested those of West Indian origin were over diagnosed by white docs in Bristol.
Copeland wt al (1971) gave a description of a patient to 132 US and 194 British psychiatrist. 69% of the US psychiatrists diagnosed schizo however only 2% of the British did. no research has found cause for this so suggests the symptoms of the ethnic minorities are misinterpreted.

Question 16

What is validity?

Answer 16

The extent to which the methods used to diagnose mental illness are accurate- e.g the methods are able to distinguish schizo from other similar disorders.

Question 17

What is Co-morbidity

Answer 17

extent to which 2+ conditions occur together calling into question the diagnosis validity. Buckley et al (2009) found around 1/2 the patients also had diagnosed depression. Could be that severe depression can present as schizo as they both have low motivation levels.

Question 18

What is symptom overlap?

Answer 18

Extent to which the symptoms of 1 disorder are also present in another disorder. E.G schizo and bipolar disorder both include symptoms like delusions and avolition.

Question 19

What is gender bias?

Answer 19

Since 1980s men have been diagnosed with schizo more commonly (7.5). Gender bias can either occur due to gender bias criteria in the DSM or clinicians allowing their diagnosis to be influenced by stereotypes.
Broverman found US clinicians equated mentally healthy with mentally healthy males.

Question 20

What is culture bias?

Answer 20

Cochrane (1977) reported the incidence of schizo in the West Indies and UK is 1%. Afro-Caribbean origin is 7x more likely to be diagnosed when living in the UK. Therefore the validity of the diagnosis for many people of the Afro-Caribbean origin might lack validity.

Question 21

AO3 for issues in diagnosis and classification- symptom overlap?

Answer 21

TOP: much supporting evidence that symptom overlap does impact the validity of the diagnosis.
POINT: Ophoff et al (2011) assessed genetic material from 50,000 ppts to find that of 7 gene locations on the genome associated with schizo, 3 were also associated with bipolar disorder suggesting a genetic overlap between the 2 and a reason.
TAIL: lack of distinction calls into question the validity of both the classification and diagnosis of schizo.

Question 22

AO3 for issues in diagnosis and classification- co- morbidity

Answer 22

TOP: there’s imperial support that co-morbidity can impact the validity of a diagnosis
POINT: schizo is commonly diagnosed with other conditions e.g half of those diagnosed also have a diagnosis of depression or substance abuse.
TAIL: impacts the validity of a diagnosis as patients may be diagnosed with co-morbid disorder but not the other. This can be especially true for patients diagnosed with schizo and depression as primarily negative symptoms are displayed and can be present as if the patient only has depression.

Question 23

AO3 for issues in diagnosis and classification- gender bias.

Answer 23

TOP: an issue with gender bias impacting the diagnosis is that not only do they lack validity but women may not receive the treatment they need.
POINT: according to Longenecker et al (2010) schizo diagnosis may suffer from gender bias due to the disproportionate number of men diagnosed with the disorder compared to women. Could be more men are diagnosed as they are more genetically vulnerable but also could be that women are able to function better with the disorder than men. Cotton et al (2009) said female patients seem more able to continue in work and have good family relationships
TAIL: although women may show the same symptoms, they don’t get a diagnosis meaning they don’t receive the adequate care which can have devastating consequences as if schizo isn’t treated brain atrophy can occur.

Question 24

AO3 for issues in diagnosis and classification- culture bias.

Answer 24

TOP: additional evidence culture bias can impact validity and reliability of a diagnosis but in this case over diagnosis can occur.
POINT: this might account for higher numbers of African-Americans and other Afro-Caribbean descent being diagnosed with schizo compared to in Africa and West Indies where rates aren’t as high. some African cultures have different attitudes to some positive symptoms like hearing voices- more acceptable because of their beliefs about communication with ancestors meaning some symptoms seen as acceptable 1 one culture but atypical in others.
TAIL: lack of cross cultural reliability can cause people from certain cultures to be given a label and medications that they don’t need, with potentially serious ramifications.

Question 25

What are genetic factors of schizo in terms of family studies? (AO1)

Answer 25

Kendler (1985) shown that 1st degree relatives of those with schizo are 18x more at risk than the general population. Gottesman (1991) found that schizo is more common in bio relatives of a schizophrenic and the closer the degree of genetic relatedness, the greater the risk?

Question 26

What are genetic factors of schizo in terms of family studies? (AO3)

Answer 26

Could also be explained in terms of the fact that genetically similar family members tend to spend more time together and are treated similarly due to similarities in looks so environment could also affect risk.

Question 27

What are genetic factors of schizo in terms of twin studies? (AO1)

Answer 27

Gottesman studied 40 twins and the concordance rates for monozygotic twins was about 48% and only 17% for DZ twins. Joseph (2004) calculated that the pooled data for all schizophrenia twin studies carried out prior to 2001 showed a concordance rate for MZ twins of 40.4% and 7.4% for DZ twins.

Question 28

What are genetic factors of schizo in terms of twin studies? (AO3)

Answer 28

Very difficult to separate out influence of nature v nurture. Fact that concordance rates aren’t 100% means schizo can’t be fully explained by genes and could be the individual has a pre disposition to schizo making them more at risk. Some environmental factors could also increase risk suggesting biological account can’t give a full explanation of the disorder. However adoption studies can help separate the influences of nature and nurture.

Question 29

What are genetic factors of schizo in terms of adoption studies? (AO1)

Answer 29

Tienary (2000) studied 164 adopted kids, whose bio mums had schizo- they had concordance of 6.7% compared to 2% in adopted kids without schizo parents. Very strong evidence that genetics are a risk factor for schizo.

Question 30

What are genetic factors of schizo in terms of adoption studies? (AO3)

Answer 30

Small populations studied due to the rarity of both adoption and schizo.

Question 31

What is the dopamine hypothesis?

Answer 31

Theory that too much dopamine in the subcortical and limbic regions of the brain may cause positive schizophrenic symptoms. Negative symptoms are associated with less dopamine in the prefrontal cortex.

Question 32

What evidence is there regarding dopamine receptors?

Answer 32

Autopsies have found that there are generally a larger number of dopamine receptors- Ownet (1987) and there was an increase in the amount of dopamine in the left amygdale- Falkai (1988) and increase in dopamine in the caudate nucleus and putamen.

Question 33

An example of different impacts of dopamine in the brain?

Answer 33

HALLUCINATIONS- may result from the interaction between excess dopamine in the stratal area of the brained the processing of sensory perception.

Question 34

What is a source of evidence: drugs that increase dopaminergic activity? 1

Answer 34

Amphetamine is a dopamine agonist, i.e it stimulates nerve cells containing dopamine, causing the synapse to be flooded with this neurotransmitter. Normal individuals exposed to large doses of dopamine- releasing drugs such as Amphetamines can develop the characteristic symptoms of a schizo episode, which generally appear with abstinence from the drug.

Question 35

What is a source of evidence: drugs that increase dopaminergic activity? 2

Answer 35

Although there are many different types of antipsychotic drug, they all have 1 thing in common, i.e they block the activity of dopamine in the brain. By reducing activity in the neural pathways of the brain that use dopamine as the neurotransmitter, these drugs eliminate symptoms such as hallucinations and delusions. The fact that these drugs alleviated many of the symptoms of schizo, strengthened the case for the important role of dopamine in this disorder.

Question 36

What is the 1st evaluation of the dopamine hypothesis?

Answer 36

TOP: much of the evidence supporting this comes from success of drug treatments that attempt to change dopamine levels activity in the brain.

POINT: Leucht carried out a meta analysis of 212 studies. They concluded that all antipsychotic drugs tested in these studies were much more effective than placebo in the treatment of positive and negative symptoms achieved by reducing effects of dopamine.

TAIL: Findings also challenge classification of antipsychotics into typical and atypical groupings because differences in their effectiveness were only small.

Question 37

What is the 2nd evaluation of the dopamine hypothesis?

Answer 37

TOP: Roll claims there’s strong evidence against both original and revised dopamine hypothesis.

POINT: He argued antipsychotic drugs don’t alleviate hallucinations and delusions in about 1/3 of people experiencing symptoms. also pointed out in some people these are present despite dopamine levels being normal.

TAIL: Suggests rather than dopamine being sole cause of positive symptoms other neurotransmitters systems, acting independently of the dopaminergic system, may also produce positive symptoms associated with schizo.