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psychology (Q) > schizophrenia > Flashcards

schizophrenia Flashcards

1
Q

what is the nature of schizophrenia

A

psychosis- sufferer has no concept of reality
individuals thoughts, emotions and senses are impaired

15-35 years old ( peak onset is at 25- 30 and cases prior to adolescence are rare )

effects men and women equally ( men are diagnosed earlier)

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2
Q

what are positive symptoms

A

those that appear to reflect an excess or distortion of normal function

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3
Q

what is the definition of negative symptoms of diagnosing schizophrenia

A

those that appear to reflect a loss or decline of normal function

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4
Q

what are delusions

A

positive

false beliefs that are held despite being completely illogical or no evidence

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5
Q

what are the common types of delusions of schizophrenia

A

delusions of persecution - belief that others want to harm, threaten or manipulate you

delusions of grandeur- idea that you are an important individual, even god like , most frequent Jesus Christ

delusions of control- may believe under control of alien forces that has invaded their mind and body

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6
Q

what are the symptoms of SZ

A

delusions

hallucination

speech pov

avolition

affective flattening

anhedonia

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7
Q

what are hallucinations

A

Distortion or exaggeration of perception of any of the senses
EG auditory hearing voices visual seeing things

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8
Q

what are examples of positive symptoms

A

Delusions and hallucinations

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9
Q

What is speech poverty

A

less of speech fluency and productivity
Thought to reflect slow or blocked thoughts

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10
Q

what is avolition

A

Inability to initiate and persist in gold directed behaviour- severe loss of motivation

For example no longer being interested in going out and meeting with friends

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11
Q

what is affective flattening

A

A reduction in the range and intensity of emotional expressions

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12
Q

What is anhedonia

A

The loss of interest or pleasure in all or almost all activities

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13
Q

What are examples of negative symptoms

A

speech poverty , avolition, affective flattening anhedonia

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14
Q

what are the two different diagnostic criteria for SZ

A

DSM- one of positive symptoms

ICD - two or more negative symptoms

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15
Q

what is reliability

A

How repeatable something is- consistency- in SZ reliability means diagnosis can be repeated

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16
Q

What is test retest reliability

A

repeating a test how similar are the results- a clinician must be able to reach the same results twice

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17
Q

What is interrater reliability

A

two different psychologists must be able to reach the same conclusion- Kappa score

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18
Q

what is cultural differences or cultural bias

A

The tendency to judge people in terms of one’s own culture assumptions

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19
Q

What is validity

A

Does it measure what it intended to measure

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20
Q

What is gender bias

A

The differential treatment of men and women based off of stereotypes not real differences

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21
Q

What is symptom overlap

A

Symptoms may not be unique to that wonder disorder but may also be found in other disorders making accurate diagnosis difficult

22
Q

what is co morbidity

A

The extent to which two or more conditions occur simultaneously in a patient

23
Q

why is reliability an issue and what is the evidence/ case studies
what impact does it have ?

A

inter rater reliability- different clinicians must be able to reach the same conclusion. inter rater reliability is measured by a statistic called kappa score . kappa score of 7 or above considered good

whaley- found inter rarer reliability as low as 0.11

later found a kappa score of only .46

recently- seen to have an excellent reliability of .97

may miss out on diagnosis or be wrongly diagnosed

24
Q

why is cultural bias an issue?
what is the evidence?
how does it effect the diagnosis?

A

cultural bias is the tendency to judge people in terms of one’s own cultural assumptions

Evidence of this - Escobar saw that African Americans are several times more likely than white people to be diagnosed with schizophrenia. this is not due to genetic vulnerability but due to cultural bias. One issue is that auditory hallucinations is more acceptable within African cultures because of their beliefs in communication with ancestors.

this causes the overdiagnosis of ethnic minority groups and leads to them being treated different differently because they are seen as different or excluded

25
Q

what is the problem with validity?
What is the evidence/case studies to prove this ?
What impact does this have on diagnosing ?

A

Leeds to the differential treatment of males and females based on stereotypes not real differences

loring + powell- randomly selected 290 male and female psychiatrist to read two case studies of patient behaviour. Then asked to offer their judgement on individuals using the standard diagnostic criteria- when patients were described as males or no information about gender 56% of psychiatrists gave the diagnosis
When patients were described as female, only 20% were given diagnosis

This shows pronoun effects whether they are diagnosed which decreases validity

“she” - diagnosis missed can’t get access to treatment impacts functioning wrongly diagnosed impact on economy

“he “- overdiagnosed negative stereotypes e.g. violent
Self fulfilling prophecy

26
Q

what is the issue of comorbidity
What is the evidence to prove this ?
Why does this have an impact

A

Comorbidity is the extent that two or more conditions or diseases occur simultaneously in a patient

buckley et al- schizophrenia was also diagnosed with depression 50% of the time substance abuse 47% of the time PTSD 29% of the time

Issue different conditions have different treatments - may not know which ones to treat and maybe more complex to treat- costing more money and taking longer

27
Q

What is an example of a neural correlate

A

The dopamine hypothesis

28
Q

what was the dopamine hypothesis

A

claims that an excess of the neurotransmitter dopamine in certain regions is associated with positive symptoms of SZ

To have abnormally high numbers of D2 receptors resulting in more dopamine

29
Q

what was the drug evidence to support the dopamine hypothesis

A

Amphetamine- dopamine agonist- normal individuals exposed to large doses of dopamine releasing drugs can develop characteristic symptoms of SZ. EG hallucinations and delusions

Antipsychotic drugs - dopamine antagonist- block the activity of dopamine in the brain, alleviate symptoms of such as hallucinations and delusions

30
Q

what is the revised dopamine hypothesis

A

Davis and kahn-
- positive symptoms are caused by an excess of dopamine in subcortical areas of the brain
- Negative symptoms of schizophrenia to arise from deficit of dopamine in prefrontal cortex

hyperdopaminergia- excess

hypodopaminergia- low levels of

31
Q

Other than drugs what is the other evidence to support dopamine hypothesis

A

PET scans assess dopamine levels in schizophrenic and normal individuals and found lower levels of dopamine in prefrontal cortex of SZ patients

32
Q

What are neural correlates

A

Patterns of structure and function in the brain that correlates with schizophrenic experience

33
Q

what are the strengths of the dopamine hypothesis

A

Supporting evidence of successful drug therapy-
Found that antipsychotic drugs were significantly more effective than the placebo in the treatment of positive and negative symptoms

strength of neural correlates comes from support of influence of Gray matter deficit
Patient with SZ - higher reduction in cortical grey matter volume over time

34
Q

What is a weakness of the dopamine hypothesis

A

evidence for the dopamine hypothesis has been challenged claims that there is evidence against effectiveness of drugs

Antipsychotic drugs do not alleviate hallucinations and illusions in one third of people - these are present despite levels of dopamine being normal

Suggest that dopamine may not be the sole cause of positive symptoms
maybe other explanations

35
Q

what are the genetic factors in the biological explanation of SZ( + evidence)

A

Tends to run in families but only among individuals who are genetically related

The risk of developing the disorder among individuals who have family members with SZ is higher than it is for those who do not

No one gene is responsible for this disorder - polygenic condition

Gottesman- Large scale family study
Found that strong relationship between the degree of genetic similarity and the risk of sz

Identical twins 48%
Fraternal twins 17%
Siblings 9%

36
Q

what is the diathesis stress model

A

It is an interaction approach to explaining behaviour

Conditions are explained as a result of both an underlying vulnerability (diathesis) and a trigger

37
Q

What is a strength of the genetic evidence of SZ

A

there is support from other twin studies- another study calculated that concordance rates for MZ twins were 40%- and for DZ twins 7%

38
Q

What are the weaknesses of the genetic basis of SZ

A

does not take into account environmental factors
SZ may be more to do with child rearing patterns - maybe due to expressed emotion in the family when families communicate in a hostile manner (critical and overconcerned) - siblings are exposed to the same environment so maybe due to family dysfunction rather than genetics

Mz twins encounter more similar environments than DZ twins - MZ have a greater environmental similarity because they are more likely to do things together- same school same clothes- suffer from identity confusion
Often treated as twins rather than two distinct individuals
Concordance rates may reflect nothing more than situational factors

39
Q

What are antipsychotic drugs

A

Antipsychotic drugs work by reducing the action of the neurotransmitter dopamine in areas associated with the symptoms of SZ

40
Q

What are the two different types of antipsychotics

A

typical and atypical

Typical are the first generation ones

41
Q

when were typical antipsychotics first introduced

A

In the 1950s
Traditional antipsychotics
Prescribed dose has declined

42
Q

what is an example of a typical antipsychotic

A

Chlorpromazine- it can be taken as tablets syrup or injection

Administered daily initially doses are smaller and gradually to a max of 400 to 800 MG

Prescribed doses have declined over the last 50 years

43
Q

How do typical antipsychotics work in the brain

A

they bind but do not stimulate dopamine receptors thus blocking their action

By reducing the action of dopamine it alleviates positive symptoms

They have a sedative effect

However blocking dopamine receptors can be harmful for the person as negative symptoms may get worse

44
Q

what are the side effects of typical antipsychotics

A

There are lots of side-effects

Loss of muscle movement in face - involuntary movements( tardive dyskinesia) found in 68% of patience and it is irreversible( significant ethical issues as didn’t know would end up with an irreversible side-effect)

Normally the side effects lead to people stopping taking the drug which leads to relapse so symptoms come back

45
Q

what is information on the effectiveness and appropriateness of typical antipsychotics

A

Issues with informed consent- patience have no perception of reality

Treats symptoms not cause -passive- can cause relapse

Unclear on how they work - work better alongside therapy interactionist approach

Chemical cosh- in hospital situations it is believed that people are to make them easier to work with rather than to make the patient better

45
Q

what is information on the effectiveness and appropriateness of typical antipsychotics

A

Issues with informed consent- patience have no perception of reality

Treats symptoms not cause -passive- can cause relapse

Unclear on how they work - work better alongside therapy interactionist approach

Chemical cosh- in hospital situations it is believed that people are to make them easier to work with rather than to make the patient better

46
Q

When were atypical antipsychotics introduced

A

The 1970s

To maintain an improve effectiveness of drugs in suppressing symptoms and minimising side effects

47
Q

what is an example of an atypical antipsychotic

A

clozapine
Helps negative symptoms and regulate cognitive function

Withdrawn for a while due to the death of some patients

Discovered to be more effective than typical

Tablet form and lower dose

48
Q

how do atypical antipsychotics work in the brain

A

These drugs temporarily blocked dopamine receptors then rapidly dissociate to allow normal dopamine transmission

Also act on other neurotransmitters e.g. serotonin which also addresses negative symptoms

49
Q

What are the side effects of atypical antipsychotics

A

few side effects and typical and less serious so there’s a reduced risk

Blood condition -people on this drug have to take regular blood tests

If it has side-effects people stop taking the drug and it causes relapse

50
Q

What is the effectiveness and appropriateness of atypical antipsychotics

A

issues with ethical issues no informed consent as they have no perception of reality

Treat the symptoms not the cause means that patients don’t look at the root

Don’t know why they work and only work in 75% of cases alongside other therapy

Chemical cosh- hospitals may be given drugs to make them easier to work with rather than to make them better human rights abuse

psychology (Q) (5 decks)

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