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Schizophrenia Flashcards

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1
Q

What are positive symptoms?

A

Additional experiences beyond ordinary existence.

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2
Q

What are two examples of positive symptoms?

A

Hallucinations.
Delusions.

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3
Q

Define hallucinations.

A

Unusual sensory experiences.

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4
Q

Give an example of hallucinations.

A

Hearing and seeing things not there.

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5
Q

Give an example of delusions.

A

Others are trying to hurt them.

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6
Q

Define negative symptoms.

A

Loss of usual abilities.

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7
Q

Give 2 examples of negative symptoms.

A

Avolition.
Speech poverty.

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8
Q

Define avolition.

A

Lack of motivation to begin or keep up with goal directed activity.

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9
Q

What is speech poverty?

A

Changes in speech patterns.
Reductionism in amount of or quality of speech.

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10
Q

Define reliability.

A

Consistency.

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11
Q

What is reliability in the context of Sz?

A

Inter rater reliability - consistency across psychiatrists.

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12
Q

How do you achieve inter rater reliability?

A

Psychiatrists reach same diagnosis independently.

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13
Q

What does validity refer to?

A

Accuracy.
Measuring what we intend to measure.

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14
Q

Explain how CBT is used to treat Sz?

A

Identify and challenge irrational thoughts (delusions).
Positive self talk enables them to counter negative thoughts.
Overall aim to reduce distress and improve functioning.

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15
Q

Explain how CBT can be time consuming.

A

Time consuming - requires lots of time and effort from patients, may not be suitable for Sz patients as many suffer from avolition or depression.

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16
Q

Why may CBT not be suitable for all patients?

A

Patients may not be able to discuss symptoms - may suffer from speech poverty as part of disorder.

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17
Q

How does CBT compare to drug therapy?

A

Drugs loads cheaper and require less effort therefore patients may prefer drugs over extensive therapy.

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18
Q

What is the aim of family therapy?

A

Provide support for careers to make family life less stressful in hopes of reducing Sz relapses.

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19
Q

What things are done during family therapy to improve stress?

A

Improve understanding of the illness.
Improve patterns of communication - reduced double binds and expressed emotion.
Reducing anger and guilt.

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20
Q

Explain one advantage of family therapy.

A

Evidence to support use.
McFarland found it reduced relapse rates by 50-60%.
May be motivating for families to get involved/more likely to want to participate.

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21
Q

Explain one disadvantage of family therapy of a treatment for Sz.

A

Lots of time and effort required.
Can be challenging for all members to commit e.g. work.
Some may find it to be ineffective or just not able to find time.

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22
Q

What are token economies?

A

Operant conditioning.
Reward with tokens for good behaviour - positive reinforcement.
Tokens exchanged for rewards.

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23
Q

Explain how token economies may be unethical.

A

Discriminates against people too ill to participate.
Therefore may not motivate them to improve symptoms.

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24
Q

Explain why token economies may only be a short term solution.

A

Effectiveness not long term.
When patients in outside world they don’t receive rewards - may revert back to old habits.
Effects may only be temporary.

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25
Q

Compare token economies and drug therapy.

A

Drug therapy do not discriminate against some patients.
However don’t motivate patients to take part in daily activities e.g. making the bed, brushing teeth.

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26
Q

Compare family therapy and drug therapy.

A

Drug therapy does not involve the time and effort of family therapy.

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27
Q

What is validity in the context of schizophrenia?

A

If different assessment systems arrive at the same diagnosis for the same patient.

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28
Q

Evaluate reliability of diagnosis in schizophrenia using research evidence.

A

Rosenhan - 7 participants sent to 12 hospitals across different states, pretended to hear a voice but act normal once inside.
Did not all receive same diagnosis despite all showing same symptoms.
Shows assessment methods have poor reliability.

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29
Q

Evaluate the validity of diagnosis of schizophrenia with research evidence.

A

2 psychiatrists separately diagnose 100 patients using DSM and ICD with same notes.
Schizophrenia much more likely to be diagnosed using the ICD.
Lack of criterion validity across assessment methods.

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30
Q

Evaluate the diagnosis of schizophrenia in terms using gender bias.

A

Patients can display same symptoms and receive different diagnosis based on gender.
Same case notes - when male or no info given, 56% diagnosed - female, only 20%.
Suggests diagnosis can be influenced by gender.

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31
Q

Evaluate schizophrenia in terms of symptom overlap.

A

Overlap of symptoms such as delusions and avolition with bipolar disorder.
Suggests they may not be 2 separate conditions.
May lead to incorrect diagnosis.

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32
Q

Name the 3 biological explanations for Schizophrenia.

A

Genetics.
Neural correlates.
The dopamine hypothesis.

33
Q

Explain the role of genetics in schizophrenia.

A

Heritability could account for 50% of schizophrenia.
108 genes associated with increased risk - polygenic.
These genes include those that code for neurotransmitters such as dopamine.

34
Q

Explaining strength of the role of genetics in schizophrenia.

A

Research evidence.
Review of studies found concordance rates - Mz twins 48%, Dz 17%.
As Mz is higher than Dz shows there must be a genetic element.

35
Q

Give a counterpoint for the research evidence into genetics in schizophrenia.

A

Mz twins rate is not 100% so must be a some sort environmental factors.
Supports interactionist approach.

36
Q

What is the dopamine hypothesis?

A

Abnormal levels of dopamine.
Subcortex has high levels, is associated with Broca’s area - speech poverty, auditory hallucinations.
Prefrontal cortex has low levels - negative symptoms.

37
Q

What was the original version of the dopamine hypothesis?

A

Schizophrenia caused by high levels of dopamine.
Either by producing too much or having too many D2 receptors.

38
Q

What is the purpose of D2 receptors?

A

Influence attention and perception.
If they fire too often someone is likely to experience distortions in perception such as hallucinations.

39
Q

Define neural correlates.

A

When a specific brain activity or function relates to a behaviour or particular experience associated with schizophrenia.

40
Q

Explain how abnormalities in the amygdala relate to schizophrenia.

A

Responsible for basic feelings of fear, lust and anger.
Smaller in schizophrenics.
Link to flattening.

41
Q

Explain how abnormalities in the auditory and visual cortex correlate to schizophrenia symptoms.

A

Process visual and auditory information.
Same activity in these areas during hallucinations as hen we have genuine visual and auditory experiences.

42
Q

Explain one weakness of the dopamine hypothesis.

A

Oversimplifies the cause.
Drugs which act on serotonin as well as dopamine are most effective at reducing symptoms.
Issue because it suggests other neurotransmitters play a role.

43
Q

Explain one weakness of most biological explanations.

A

Alterations in the brain may actually be a symptom.
Perhaps the abnormalities are caused by the development of schizophrenia.
Suggests something else could’ve caused the disorder in the first place.

44
Q

How do typical antipsychotic drugs work?

A

Block the receptors for dopamine to reduce the amount.
Reduces neural activity associated with positive symptoms.

45
Q

How atypical antipsychotic drugs work?

A

Act on dopamine receptors but also serotonin and glutamate receptors.
Can improve mood, and reduce depression and anxiety so patients can be prescribed it at high risk of suicide.

46
Q

Explain one weakness of typical drugs.

A

Side effects.
E.g. weight gain, dizziness and 30% of users develop tardive dyskinesia.
Means patients may stop taking the drugs.

47
Q

Describe research support for the effectiveness of a typical drug.

A

Chlorpromazine.
Reviewed 13 trials of 1120 patients that proved the drug was better than a placebo.
Proves typical drugs are effective in at least reducing symptoms.

48
Q

Explain one strength of atypical drugs.

A

Can also reduce negative symptoms due to affects on other neurotransmitters.
Overall more effective treatment.

49
Q

Explain one strength of atypical drugs using an example.

A

Risperidone.
Binds more strongly to dopamine receptors.
Lower dose can be used.
Fewer side effects.

50
Q

Explain one weakness of atypical drugs using one example.

A

Clozapine.
Can have side effects of a fatal blood condition.
So users have to be tested regularly.
May cause an inconvenience.

51
Q

Define delusions.

A

Irrational beliefs.

52
Q

Evaluate the diagnosis of of schizophrenia in terms of comorbidity.

A

50% patients also suffers with depression.
Questions validity of classification of both disorders.
Can lead to problems such as misdiagnosis.

53
Q

Explain cultural bias in the diagnosis of schizophrenia and relate it back to reliability/validity.

A

Studies found people of West Indian origin are over diagnosed with schizophrenia by white doctors in Bristol.
Suggests patients can display same symptoms but be diagnosed differently because of background.
Perhaps due to differences in cultural norms e.g. hearing voices is normalised in some African cultures.

54
Q

Name the 2 psychological explanations for schizophrenia.

A

Family dysfunction.
Cognitive explanation.

55
Q

What are the 2 main concepts of family dysfunction?

A

Expressed emotion.
Double bound communication.

56
Q

What is double bind communication?

A

When the parent sends contradictory signals leaving the child feeling like they are unable to do the correct thing.

57
Q

Give one example of double bind communications.

A

When someone says they love you but look unhappy/forced when they say it.

58
Q

Explain the effects of double bind communication.

A

Child develops a disordered view of reality.
Resulting in symptoms of disorganised thinking and paranoia.

59
Q

Define expressed emotion.

A

Family communication style characterised by criticism, hostility and emotional over involvement.

60
Q

Define each characteristic of expressed emotion.

A

Criticism - negative comments.
Hostility - aggressive comments e.g. threats.
Emotional over involvement - interfering in other family members business.

61
Q

How does high levels of expressed emotion affect schizophrenia?

A

High stress levels can trigger schizophrenia - act as diathesis stress.
Also likely to cause a relapse.

62
Q

Adapt the interactionist evaluation for psychological explanations.

A

Psychological explanations are reductionist.
This is because they only consider psychological factors such as family dysfunction and dysfunctional thought processing however research has shown that biological factors such as genetics and neurotransmitters also play a role in the development of schizophrenia.
Therefore the best approach is the interactionist approach as it offers a more holistic explanation which refers to both psychological and biological factors in the diathesis stress model.

63
Q

Explain one weakness of the family dysfunction explanation.

A

Socially sensitive.
Implies parents are responsible for problems of their children.
Puts pressure on parents to parent ‘right’ plus makes them feel guilty.
Therefore unethical explanation.

64
Q

Explain one strength of the family dysfunction explanation.

A

Research support.
Berger - schizophrenia sufferers reported a higher recall of double bind statements from their mothers.
Suggests a link between exposure to this type of communication and the development of schizophrenia.

65
Q

What are the 2 types of dysfunctional thinking?

A

Meta representation.
Central control.

66
Q

What does the cognitive explanation suggest?

A

Schizophrenia has a biological basis which causes dysfunctional thinking.

67
Q

Define meta representation.

A

Relates to our ability to reflect on ours and other peoples behaviour.

68
Q

Explain how dysfunction in meta representation relates to schizophrenia symptoms.

A

Unable to recognise whether behaviour has been carried out by us or someone else.
Could explain thought insertion.

69
Q

What is central control?

A

Our ability to repress automatic responses while we perform other actions.

70
Q

How may dysfunctional central control relate to schizophrenia symptoms?

A

Disorganised speech - as difficult to think and speak clearly when lots of thought in mind.

71
Q

Explain one strength of the cognitive explanation.

A

Research evidence.
Stirling - schizophrenia sufferers performed poorly on strop test compared to control group, take 2x as long to identify correct ink colour.
Supports idea of issues with central control processing as success in strop test involves suppressing the urge to read the word rather than say the colour.

72
Q

Explain one weakness of the cognitive explanation.

A

Dysfunctional thought processing may be a symptom of schizophrenia.
Not a correlation - cannot prove cause and effect.
Explanation may be incorrect.

73
Q

Describe the original understanding of the diathesis stress model.

A

Someone had a genetic vulnerability and an environmental stressor would trigger schizophrenia symptoms.
If someone did not have the single schizogene, no amount of stress could trigger it.

74
Q

Describe the modern understanding of diathesis.

A

No one single gene - polygenic + 108 genetic combinations found to increase the risk.
Can also be early psychological trauma e.g. abuse as can alter brain chemistry.

75
Q

Explain the modern understanding of stress.

A

Includes psychological stressors and cannabis use.

76
Q

Explain one weakness of the diathesis stress model.

A

Model is unclear.
We have identified diathesis and stress however are not sure how they combine to cause schizophrenia.
Cannot use the model to accurately predict if someone will develop schizophrenia.

77
Q

Explain one strength of using the interactionist approach.

A

Created most effective treatments.
Research evidence - Tarrier, at Kent’s who received drugs and a form of therapy showed a greater reduction in symptoms than group just given drugs.
Suggests combination of biological and psychological treatments are most effective at treating schizophrenia.
Therefore suggesting there is a combination of elements to schizophrenia.

78
Q

Explain Tienari’s research in support of the interactionist approach.

A

Examined 19,000 children from schizophrenic mothers who were adopted.
Found that the ones most likely to develop schizophrenia were the ones who went into dysfunctional families.
Supports the idea that a combination of genetic and psychological factors influence schizophrenia.

79
Q

Explain how schizophrenia is treated using the interactionist approach.

A

Treat both biological and psychological treatments.
Commonly drugs and CBT.

Psychology (15 decks)

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