schizophrenia Flashcards
Schizophrenia
A severe mental illness which involves a break from reality, such as hallucinations. It is an example of psychosis
Positive Symptoms
Experiences or symptoms that are in addition to usual functioning, such as hallucinations or delusions
Negative Symptoms
Experiences or symptoms that involve the loss of usual functioning, such as avolition and speech poverty
Hallucinations
Positive symptom of SZ - sensory experiences of stimuli that do not exist, such as hearing voices or seeing things in a distorted way
Delusions
Positive symptom of SZ - involves having beliefs with no basis of reality, such as being the victim of a conspiracy (paranoia)
Avolition
Negative symptom of SZ - loss of motivation to carry out tasks and results in lowered activity levels
Speech poverty
Negative sympton of SZ - reduced frequency and quality of speech
Subtypes of schizophrenia
Different classifications of SZ (used by the ICD but not the DSM-V), such as paranoid (mainly delusions and hallucinations) or catatonic (immobility and avolition) schizophrenia
DSM-V
System of classification mostly used in the USA. It requires at least one positive symptom for a diagnosis of SZ
ICD-10
System of classification used worldwide, outside of the USA. Recognises subtypes of SZ and does not require any positive symptoms
Reliability of diagnosis
The extent to which different clinicians would agree on diagnosis (inter-rater) or the same clinician would be consistent in their diagnosis of the same patient (test-retest)
Validity of diagnosis
The extent to which diagnoses of SZ are actually correct - for example, is the clinician accidentally diagnosing depression as SZ instead? Does SZ actually exist as one condition?
Co-morbidity
The occurrence of two conditions in the same person - when two are frequently diagnosed together, it questions the validity of diagnosing of them as separate conditions
Symptom overlap
When two different conditions share the same symptom (e.g. avolition in SZ and depression) - it questions the validity of classifying them as separate conditions
Culture bias in SZ diagnosis
The presence of discrimination between cultures/ethnicities in diagnosis, such as the finding that Afro-Caribbean people in the UK/USA are significantly more likely to be diagnosed with SZ than white people
Gender bias in SZ diagnosis
The presence of discrimination between sexes in diagnosis, such as the finding that males are significantly more likely to be diagnosed than females (perhaps due to how they present symptoms differently)
Genetic basis of SZ
The theory that schizophrenia may be due to the influence of specific genes, or a combination of candidate genes
Candidate genes of SZ
The specific genes that are identified as causing, or being associated with, the presence of SZ. Ripke identified 108 separate candidate genes for SZ.
Neural correlates of SZ
Parts of the brain or neurotransmitters (e.g. dopamine) that are linked with the presence of SZ
Family studies of SZ
Schizophrenia is more commonly shared in biologically related relatives with the closer the genetic relatedness the greater the risk (e.g. Gottesman)
Twin studies of SZ
Study the relative contributions of genetics and environment by comparing concordance rates of MZ and DZ twins (e.g. Gottesman)
Adoption studies of SZ
Studies of genetically related individuals that are reared apart (e.g. Tienari)
Dopamine hypothesis
An excess of dopamine in certain regions of the brain is associated with positive symptoms of schizophrenia.
Revised dopamine hypothesis study
Davis and Kahn 1991 proposed positive symptoms of schizophrenia are caused by an excess of dopamine in subcortical areas of the brain , whereas negative symptoms are thought to arise from a deficit of dopamine in area of the prefrontal cortex.
Drug therapies
Tablets (or sometimes treatment in the form of syrup) given to treat disorders such as SZ
Typical antipsychotic drug
Drugs given that bind to dopamine receptors in order to reduce SZ symptoms. Examples include Chlorpromazine
Tardive Dyskinesia
An incurable disorder of motor control, especially involving muscles of the face and head, resulting from long-term use of antipsychotic drugs (especially typical)
Atypical Antipsychotic Drugs
Drugs used to treat SZ that work by binding to dopamine receptors but also serotonin and glutamate in order to cause fewer neurologic side effects involving movement
Antagonist
Chemicals that reduce the action of a neurotransmitter
Placebo
Something that looks like a drug being tested, but which has no active ingredients. Used as a comparison when testing the effectiveness of a drug.
Chemical cosh
A criticism of drug treatments of SZ, which claims that they are used to sedate patients for the benefit of staff rather than the patient themselves
Family dysfunction
Abnormal communication within a family unit, which has been given as explanation for SZ.
Schizophrenogenic Mother
Fromm-Reichmann’s explanation for SZ, involving a cold, rejecting and controlling parent who creates an environment of tension and secrecy
Double bind theory
Bateson’s explanation for SZ, where children receive mixed messages and inconsistent guidance, so always fear that they are in danger of doing or saying the wrong thing
Expressed emotion
An explanation for SZ, whereby the level of negative emotion (especially criticism, hostility and over-involvement) shown by a family to the patient are a source of stress
Cognitive explanations of SZ
An approach to explaining why people have SZ that focuses on internal mental processes, involving disruption to normal thinking patterns
Dysfunctional thought processing
A general term meaning information processing that is not functioning normally and produces undesirable consequences, such as SZ
Metarepresentation
The cognitive ability to reflect on thoughts and behaviour. Dysfunction here could lead to interpreting an inner monologue as a hallucination
Central control
The cognitive ability to suppress automatic responses. Dysfunction here could lead to speech poverty and disorganised speech, as they cannot avoid triggering associations
Cognitive Behaviour Therapy (CBT) for SZ
A psychological treatment for SZ which involves challenging the patient’s irrational thoughts and beliefs, and assigning them homework tasks to alter their behaviour
Family therapy for SZ
A psychological treatment for SZ which takes place with the patient’s family unit as well. This aims to treat family dysfunction in order to reduce relapse rates
Token economies for SZ
A psychological treatment for SZ where desirable behaviours are rewarded with vouchers that can be traded for treats, such as sweets or fun days out
Secondary reinforcers
A reward with no intrinsic value, but which can be exchanged for a primary reinforcer. The tokens used in token economies are an example of this.
Interactionist approach to SZ
A way of explaining and treating SZ that takes nature and nurture into account, considering biological and psychological factors
Diathesis-stress model of SZ
A way of explaining SZ that proposes our genotype determines our risk of developing SZ, but life experiences are required to trigger the onset
Cheniaux
Found very low inter-rater reliability between two psychiatrists. They diagnosed the same 100 people and found significant differences between their diagnoses, when using both ICD and DSM
Buckley
Found that 50% of people with SZ also had a depression diagnosis
Escobar
Found that white psychiatrists overdiagnose SZ in Afro Caribbean patients compared to white British patients, even though SZ is not significantly higher in Africa and the West Indies are not high
Longenecker
Reviewed studies of the prevalence of Schizophrenia and found that men had been diagnosed more often than women since the 1980s, suggesting a potential gender bias
Gottesman
Conducted family studies into Schizophrenia and found concordance rates of 48% for MZ twins, 17% for DZ twins, 9% for siblings and 6% between parents and children
Ripke
Found that there may be as many as 108 genes involved in the development of Schizophrenia, arguing against studies which show a ‘gene for Schizophrenia’
Tienari
Adoption study found that 6.7% of adoptees whose birth mothers had SZ developed the condition, compared to just 2% of adoptee controls. Child-rearing style affected SZ, with criticism, conflict and low empathy associated with higher risk of SZ
Fromm-Reichmann
Developed the theory of the schizophrenogenic mother as a psychological explanation. Mothers who were particularly cold, rejecting and controlling were more likely to have Schizophrenic children
Read
Suggested that family dysfunction increased the chances of developing Schizophrenia. 69% of women and 59% of men with schizophrenia had some history of child abuse
Stirling
Those with an SZ diagnosis took more than twice as long to complete the Stroop Test compared to non-SZ controls
Thornley
Found that Chlorpromazine was more effective than a placebo, after reviewing data from 1,121 patients
Meltzer
Found that atypical antipsychotics (specifically Clozapine) were more effective than typical antipsychotics, and had fewer side effects
Jauhar
Reviewed studies into the effectiveness of CBT for schizophrenia and found that it had a small but significant effect on both positive and negative symptoms
McMonagle and Sultana
Reviewed studies into the effectiveness of token economies for treating schizophrenia. Only three used random allocation, and only one of these showed a positive outcome for the treatment
Tarrier
Found that a combination of medication + CBT/counselling reduced symptoms more than medication alone
