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Psychology > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

whats a positive symptom of schizophrenia?

A

reflect an excess or distortion of normal functions

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2
Q

define negative symptoms of schizophrenia?

A

appear to reflect a loss or decline of normal functions

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3
Q

explain delusions as a symptom?

A
  • positive
  • false beliefs firmly held despite being completely illogical
  • 3 types…
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4
Q

explain the three types of delusion for schizophrenia?

A

delusion of persecution- belief that others want to harm, threaten or manipulate you (paranoia)

delusion of grandeur- idea that your important individual even godlike or extraordinary powers

delusions of control- individuals may believe that they are under the control of an alien force that has invaded their mind of body

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5
Q

explain hallucinations as a symptom?

A
  • positive
  • distortions or exaggerations of perception in the senses
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6
Q

explain hallucinations as a symptom?

A
  • positive
  • distortions or exaggerations of perception in the senses
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7
Q

explain speech poverty as a symptom?

A
  • negative
  • lessening of speech fluency that reflective blocked thoughts
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8
Q

explain avolition as a symptom of schizophrenia?

A
  • negative
  • the inability to initiate and persist in goal directed behaviour (eg going to school/ work)
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9
Q

explain affective flattening as a symptom of schizophrenia?

A

a reduction in the range and intensity of a their emotional expressions

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10
Q

explain anhedonia as a symptom of schizophrenia?

A
  • negative
  • loss of interest or pleasure in all or almost all activities
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11
Q

explain catatonic behaviour as a symptom of schizophrenia?

A

pos or neg
- abnormal motor activity (loss of motor skills or extreme hyperactive motor activity eg psychomotor agitation)

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12
Q

give some aspects of the nature of schizophrenia?

A
  • psychosis (sufferer has no concept of reality)
  • the individuals thoughts emotions and senses are impaired
  • 15 to 35 (peak onset 25-35)
  • equally affects men and women altho men are often diagnosed earlier in life
  • affects 1% of the population (1/100)
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13
Q

explain the DSM and ICD differences in classifying a diagnosis of schizophrenia?

A

in the DSM (usa) the patient must show one positive symptom to be diagnosed whereas in the ICD (europe asia and africa) you must show two or more negative symptoms to be diagnosed

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14
Q

who developed the ICD?

A

world health organisation

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15
Q

define reliability?

A
  • whether the results are consistent
  • diagnosed of sz can be repeated
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16
Q

define validity?

A

does it measure what its intended to measure

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17
Q

define:
- test retest reliability
- inter-rater reliability
- cultural bias

A
  • reach same conclusion when test again
  • different clinician reach same conclusion
  • tendency to judge people in terms of ones own cultural assumptions
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18
Q

define:
- gender bias
- symptom overlap
- co-morbidity

A
  • the differences in treatment for men and women based off stereotypes instead of real differences
  • symptoms of the disorder may not be unique to that disorder but may also be found in another making accurate diagnosis difficult
  • the extent that two or more conditions occur simultaneously in a patient (eg schizophrenia and depression)
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19
Q

what are the impact of issues with classification and diagnosis?

A
  • misdiagnosis (wrongly diagnosed) - patient will not recieve the right support
  • missed diagnosis (mainly women)
  • impact of treatment on the economy
  • negative stereotypes / self fulfilling prophecy / stigma
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20
Q

in relation to SZ, talk issue evidence impact for reliability?

A
  • inter rater reliability:
    differnet clinicians reach the same conclusion with the diagnosis
  • measured by Kappa Score where 0.7 is deemed as good
  • 1 being perfect inter rater agreement
  • in the DSM-V the diagnosis of SZ had a kappa score of 0.46
  • DSM-III had a inter rater reliability correlation in diagnosis of SZ as low as 0.11
  • however, in the DSM 5 pairs of interviewers achieved inter-rater reliability of +0.97
  • people may miss out on diagnosis or be miss diagnosed purely based on the psychiatrist/clinician
21
Q

explain the issue impact and evidence for cultural bias is diagnosing SZ?

A
  • cultural bias is the tendency to judge people in terms of ones own cultural assumptions
  • diagnostic manuals such as the DSM can be described at ethnocentric as they are an imposed etic (created by white american men and pushed onto other cultures)
  • Escobar = Americans and English of Afro-Caribbean origin are several times more likely to be diagnosed with SZ due to issues with cultural bias not genetics - auditory hallucinations are seen as a social norm and accepted due to cultural beliefs that it is connecting with the ancestors
  • this means ethnic minorities are discriminated against and may suffer from misdiagnosis’s because of the diagnostic process being ethnocentric
22
Q

explain the issue (evidence and impact) of gender bias when diagnosing SZ?

A
  • the accuracy of diagnosis is affected by a patients gender due to the stereotypes associated with the label
  • Broverman states that the idea of being mentally healthy is linked to male behaviour and therefore women are more likely to be deemed as mentally unhealthy
  • study conducted where 290 randomly selected male and female psychiatrists read two cases of patients behaviour and asked to offer their judgement
    56% diagnosed when labelled ‘male’ or ‘not gender’
    20% diagnosed when ‘female’
  • females miss out on diagnosis which means they arent treated appropriately and therefore suffer in their daily life as it impacts their funcitoning
  • males are over diagnosed which influences the negative stereotypes involved with men with SZ in the media + issues with self fulfilling prophecy
23
Q

explain comorbidity as an issue when diagnosing SZ?

A
  • the extent that two conditions occur simultaneously in a patient
    eg SZ and depression (50%)
  • if conditions occur together a lot of the time then the validity of their diagnosis is questioned because it may be a singular condition
24
Q

explain symptoms overlap as a diagnosing SZ issue?

A
  • symptoms are not unique to that disorder and may be found in other disorders, making accurate diagnosis difficult
  • SZ and bipolar disorder involve positive symptoms such as delusions and negative symptoms such as avolition
  • questions the validity of the diagnosis
25
Q

what is a concordance rate?

A
  • rate of probability that two people with shared genes will develop the same disorder
26
Q

summarise the genetic factor to sz?

A
  • one cause may be hereditary
  • runs in families that 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 don’t
27
Q

if SZ is likely to be caused by a combination of genes what is it?

A

polygenic

28
Q

outline Gottesman’s findings?

A
  • strong relationship between the degree of genetic similarity and shared risk of schizophrenia
  • general population 1%
  • siblings 9%
  • DZ 17%
  • MZ 48%
29
Q

what did Josephs study find?

A

concordance rate for MZ of 40.4%
and 7.4% for DZ

30
Q

explain the diathesis stress model as a explanation for SZ?

A
  • interactionist approach
  • a result of both an underlying genetic vulnerability and an environmental trigger
  • trigger could be stress from life events or poor quality interactions with family
31
Q

explain the evaluation for genetic explanation- family studies alternative explanation?

A
  • may be due to “expressed emotion” in the family which is where they communicate in a hostile manner
  • and parents are overly critical
  • siblings exposed to same family environment so SZ may be due to family disfunction rather than genetic
32
Q

twin studies evaluation for genetic explanation?

A
  • concordance rate due to twins encountering more similar environment
  • mz more likely to do things together
  • and some suffer from identity confusion as they arent treated as individuals
    so concordance may reflect situational factors not genetics
33
Q

SZ genetic socially sensitive?

A
  • places passive blame and responsibility on family members and too deterministic
34
Q

explain the original dopamine hypothesis?

A
  • claims that an excess of the neurotransmitter dopamine in regions of the brain is associated with pos symptoms of SZ
  • due to increase of D2 receptors
35
Q

whats evidence to support the dopamine hypothesis? drug wise

A
  • drugs that increase dopaminergic activity-> amphetamines are a dopamine agonist -> normal person exposed to amphetamines can develop positive symptoms
  • drugs that decrease dopaminergic activity-> antipsychotics (dopamine antagonist) - alleviated pos symptoms
36
Q

what is the revised dopamine hypothesis?

A

Davis and Kahn
- positive symptoms caused by EXCESS of dopamine in SUBCORTICAL areas

  • negative symptoms caused by DEFICIT of dopamine in PREFRONTAL CORTEX
  • hyperdopaminergia is excessive levels of dopamine in the subcortical areas
  • hypodopaminergia is low levels of dopamine in prefrontal cortex
37
Q

what is evidence to support the revised dopamine hypothesis (negative symptoms)

A
  • Patel PET scans - low levels of dopmine in prefrontal cortex of SZ patients compared to controll
38
Q

what is neural correlates?

A

patterns of structure and function in the brain that correlate with a SZ experience
eg DOPAMINE HYPOTHESIS

39
Q

explain the neural correlate of grey matter and enlarged ventricles?

A

individuals with SZ have a reduced vol of grey matter in frontal and temporal lobe
- many displaying negative symptoms also have enlarged ventricles and this is a consequence of loss of grey matter

40
Q

what is the evaluations for the dopamine hypothesis?

A
  • drug therapy + PET scans
  • Noll claimed rhere is evidence against the effectiveness of antipsychotics - 2/3 of peoples positive symptoms are so not alleviated
  • also other neurotransmitters may produce positive symptoms of SZ so dopamine may not be the sole cause
41
Q

how do antipsychotics works?

A

reducing the action of dopamine is areas of brain associated with SZ

42
Q

AO1 for typical antipsychotics?

A

since 1950s - first generation
chlorpromazine
- 400 to 1000mg max dose
- often injection

43
Q

A01 for atypical antipsychotics?

A
  • 1970s second generation
  • clozapine
  • 300 to 400 mg
  • tablets
44
Q

how do typical antipsychotics work in the brain?

A
  • dopamine antagonists
  • bind but not stimulate dopamine receptors - block their actions
  • alleviate postive symptoms
  • sedation effect
45
Q

how to atypical antipsychotics work?

A
  • temporarily block dopamine receptors and rapidly dissociate to allow normal dopamine transmission
  • atypical antipsychotics act on other neurotransmitters such as serotonin which addresses the negative symptoms
46
Q

what are the side effects of typical and atypical antipsychotics?

A

typical - tardive dyskinesia loss of muscle movement in face and jaw
(found in 68% of people who had been on meds for 25 years+) - ethical issue as irreversible

atypical - less serious side effects
regular blood tests to avoid issues with blood conditions

47
Q

ao3 for antipsychotics

A

issues with informed comsent if ppt is in SZ episode

treat symptom not cause

chemical cosh - easier to deal with not for their benefit

mechanisms unclear - based on dopamine hypothesis but could be other explanations? interactionist?

48
Q

whats the evidence for effectiveness of antipsychotics?

A

reviewed studies comparing effects of chlorpromazine to controll conditions- 13 trials data (1121 ppts) showed reduced symptom severity for drug use oposed to controll placebo

atypical has been found 30-50% effective where typical did not work

Psychology (9 decks)

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