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Psychology > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is the definition for Schizophrenia?

A

Schizophrenia is a severe mental illness where reality is distorted, causing disorganized thinking and unusual behavior.
Prevalence: Affects 1% of the population worldwide

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2
Q

What are the positive symptoms of Schizophrenia?

A
  • Symptoms that add to a person’s behaviour, like hallucinations and delusions.
  • Hallucinations: Perceiving things that aren’t there (e.g., hearing voices).
  • Delusions: Fixed false beliefs, often paranoid.
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3
Q

What are negative symptoms of Schnizophrenia?

A

Symptoms that reduce normal function, such as speech poverty and avolition.
Avolition: Lack of motivation or goal-directed behavior.

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4
Q

What is speech poverty?

A

Reduced frequency and quality of speech, possibly showing a lack of coherent thought processes.

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5
Q

What is used for diagnosing Schizophrenia?

A

Two main systems used: ICD-11 and DSM-5.
DSM-5 requires at least one positive symptom.
ICD-11 includes positive or negative symptoms.

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6
Q

What are hallucinations?

A

These can involve any of the senses (auditory, visual, tactile).
Most common: hearing voices.

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7
Q

What are delusions?

A

Beliefs that have no basis in reality. They make a person with Schizophrenia behave in ways that make sense to them but would be bizarre to others

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8
Q

What is avolition as a symptom?

A

Difficulties initiating/maintaining activities like self-care or work

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9
Q

What is speech disorganisation?

A

Frequent topic derailment or incoherence, making communication difficult.

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10
Q

What is the chronic nature of Schizophrenia?

A

Can lead to long-term challenges in daily functioning and relationships.

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11
Q

What is the ICD criteria vs the DSM criteria

A

ICD accepts negative symptoms more readily, while DSM focuses on positive

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12
Q

What is disorganised thinking?

A

Characterized by illogical connections between thoughts.

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13
Q

What impact has Schizophrenia got on social functioning?

A

People with schizophrenia often struggle with maintaining relationships or jobs.

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14
Q

What are the subtypes of schizophrenia?

A

Includes paranoid, catatonic, and hebephrenic types

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15
Q

When is the onset for Schizophrenia?

A

Typically occurs in late adolescence or early adulthood.

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16
Q

What is paranoid Schzophrenia?

A

Characterized by prominent delusions and hallucinations, often with themes of persecution or grandeur.
Individuals may seem high-functioning but struggle with intense paranoia.

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17
Q

What is catatonic schizophrenia?

A

Marked by significant motor disturbances, such as immobility, excessive movement, or repetitive behaviors.
May include echolalia (repeating words) or echopraxia (mimicking movements).

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18
Q

What is undifferentiated Schizophrenia?

A

A diagnosis given when symptoms don’t fit neatly into other subtypes.
Includes a mix of positive and negative symptoms without dominance of one pattern.

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19
Q

How is good reliability in diagnosis a strength of the diagnosis of Schizophrenia?

A

Point: One strength of schizophrenia diagnosis is its good reliability.
Evidence: Research shows that clinicians using the DSM-5 have high inter-rater reliability when diagnosing schizophrenia.
Explanation: This means that different clinicians are likely to agree on a diagnosis, increasing the consistency of diagnostic practice.
Link: High reliability enhances the credibility and utility of the diagnostic systems used for schizophrenia.

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20
Q

What is a counter of good reliability in the diagnosis of Schizophrenia?

A

Point - Despite progress, reliability in diagnosis is not perfect.
Evidence - Osorio et al. (2019) found excellent inter-rater reliability of 0.97 using the DSM-5, suggesting significant improvement.
Explanation - However, this study was conducted under controlled conditions, and reliability may not always be as high in real-world clinical settings.
Link: While reliability appears strong, practical and cultural variations can still influence consistency in diagnoses.

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21
Q

How is gender bias a limitation of the diagnosis of Schizophrenia?

A

Point: A limitation of schizophrenia diagnosis is gender bias.
Evidence: Men are more frequently diagnosed with schizophrenia than women, even when presenting similar symptoms.
Explanation: This could be because women’s symptoms are less severe or better masked by social factors, leading to under-diagnosis in women.
Link: Gender bias in diagnosis undermines the validity of schizophrenia research and treatment strategies.

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22
Q

How is culture bias a limitation of the diagnosis of Schizophrenia?

A

Point: Schizophrenia diagnosis is affected by culture bias.
Evidence: African-Caribbean individuals in the UK are far more likely to be diagnosed with schizophrenia than white individuals, despite no genetic difference.
Explanation: This suggests that cultural norms, clinician bias, or misunderstanding of cultural behaviors may lead to over-diagnosis.
Link: Culture bias reduces the validity of diagnosis, as it reflects differences in perception rather than true disorder prevalence.

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23
Q

What are the evaluation points for the diagnosis of psychology?

A

+) good reliability
C.P -> low external validity
-) culture bias
-) gender bias

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24
Q

What is the role of the dopamine hypothesis in explaining schizophrenia?

A

The dopamine hypothesis suggests that excess dopamine activity in certain brain areas is linked to schizophrenia symptoms.

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25
Q

How does increased dopamine activity in the subcortex relate to schizophrenia symptoms?

A

Increased dopamine activity in the subcortex is associated with positive symptoms like hallucinations and delusions.

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26
Q

Which symptoms of schizophrenia are associated with hyperdopaminergia in the subcortex?

A

Symptoms include auditory hallucinations and paranoia.

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27
Q

What is the significance of low dopamine activity in the prefrontal cortex?

A

Low dopamine activity in the prefrontal cortex is linked to negative symptoms, such as impaired decision-making and avolition.

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28
Q

How do amphetamines provide evidence for dopamine’s role in schizophrenia?

A

Amphetamines, which increase dopamine, can induce psychotic symptoms in non-schizophrenic individuals

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29
Q

What effect does L-dopa have on schizophrenia symptoms, according to the dopamine hypothesis?

A

L-dopa, used for Parkinson’s disease, can worsen psychotic symptoms in people with schizophrenia by increasing dopamine.

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30
Q

How does research into glutamate challenge the dopamine hypothesis

A

Glutamate research suggests that NMDA receptor dysfunction, not just dopamine imbalance, contributes to schizophrenia.

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31
Q

What has been proposed about the role of NMDA receptors in schizophrenia?

A

NMDA receptor dysfunction may explain cognitive impairments and negative symptoms of schizophrenia.

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32
Q

What are some of the symptoms of schizophrenia linked to glutamate deficits?

A

Symptoms include disorganized thinking, negative symptoms, and cognitive impairments.

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33
Q

How might NMDA receptor dysfunction explain the cognitive impairments seen in schizophrenia?

A

NMDA receptor dysfunction disrupts signaling in the brain, leading to issues with memory and decision-making.

34
Q

Why is the term “central role of glutamate” used in recent research on schizophrenia?

A

It reflects growing evidence that glutamate impacts both positive and negative symptoms.

35
Q

What type of drugs have provided support for the role of glutamate in schizophrenia?

A

Drugs targeting NMDA receptors mimic schizophrenia symptoms, providing evidence for glutamate’s role.

36
Q

How is having a strong evidence base a strength of biological explanations for Schizophrenia?

A

Point: Evidence for dopamine’s role in schizophrenia is indirect.
Evidence: Dopamine levels are inferred from post-mortem studies or cerebrospinal fluid metabolites.
Explanation: These methods can be inconsistent or influenced by external factors, reducing reliability.
Link: The dopamine hypothesis lacks direct, conclusive evidence, which weakens its explanatory power.

37
Q

How is evidence for environmental risk factors a limitation of the biological explanations of Schizophrenia

A

Point: Environmental risks play a key role in schizophrenia.
Evidence: Prenatal factors like maternal infections and low birth weight increase schizophrenia risk.
Explanation: These factors likely interact with genetic predispositions, contributing to the disorder.
Link: Schizophrenia is best explained by the diathesis-stress model, combining genetic and environmental factors.

38
Q

How is support for dopamine in the symptoms of Schizophrenia a strength?

A

Point: Dopamine is strongly linked to schizophrenia symptoms.
Evidence: Amphetamines, which increase dopamine, worsen symptoms; antipsychotics, which block dopamine, reduce symptoms.
Explanation: This shows a clear connection between dopamine levels and schizophrenia symptoms, particularly psychosis.
Link: The dopamine hypothesis is supported by pharmacological evidence

39
Q

How is evidence for a central role for glutamate a limitation of the biological explanations of schizophrenia?

A

Point: Glutamate plays a crucial role in schizophrenia.
Evidence: NMDA receptor dysfunction is linked to cognitive impairments and schizophrenia symptoms.
Explanation: Drugs targeting glutamate receptors can replicate symptoms, showing its importance in the disorder.
Link: Glutamate research opens pathways for new treatments beyond the dopamine hypothesis.

40
Q

What are the evaluation points for the biological explanations of Schizophrenia?

A

+) strong evidence base
-) Glutamate may contribute to schizophrenia
+) genetics play a role
C.P ->Biological explanations cannot account for all S. Cases

41
Q

How is a strong evidence base a strength of the biological explanations of Schizophrenia?

A

P - strong evidence supporting the dopamine hypothesis
Ev - candidate genes linked to dopamine production and receptor regulation have been identified
Ex - highlights dopamine’s key role in Schizophrenia symptoms
L - thus, biological factors provide insight into the disorder’s development

42
Q

How is evidence saying that glumate plays a central role a limitation of biological explanations of Schizophrenia?

A

P - Glutamate may also contribute to Schizophrenia
Ev - Post-Morten studies show raised glutamate levels in individuals with the disorder
Ex - implies multiple neurotransmitters are involved, broadening understanding
L - focussing on dopamine alone may oversimplify explanations

43
Q

How is genetic factors playing a significant role a strength of the biological explanations of Schizophrenia?

A

P - genetic factors play a significant role
Ev - higher concordance rates in identical twins show heritability
Ex - shared genetics increase schizophrenia vulnerability
L - demonstrates biology’s role in the disorder.

44
Q

What is a counter of the role of genetics in the biological explanations of Schizophrenia?

A

P - cannot account for all cases of Schizophrenia
Ev - environmental factors like childhood trauma are also linked to Schizophrenia
Ex - these influences suggest a multi-factorial model is necessary
L - so biological explanations alone are incomplete

45
Q

What is the relationship between genetic similarity and the probability of developing Schizophrenia as shown by Gottesman?

A

They probability of developing schizophrenia increases with genetic similarity
MZ has a 48% risk
Siblings have a 9% risk
General population has 1% risk

46
Q

How does the concordance rate of Schizophrenia differ between MZ and DZ?

A

MZ has a higher concordance rate 48% compared to DZ twins 17% because they share 100% of their genes while DZ twins only share 50%

47
Q

What does the term candidate gene refer to in the context of Schizophrenia?

A

Candidate genes are specific genes that are believed to contribute to Schizophrenia, particularly those involved in dopamine regulation and receptor activity

48
Q

Why is Schizophrenia described as polygenic and heterogeneous?

A

Schizophrenia is polygenic because it is influenced by multiple genes and it heterogenous because different combinations of genes can contribute to the disorder

49
Q

How can mutations in parental DNA contribute to Schizophrenia risk?

A

Mutations in parental DNA
Particularly associated with older paternal age
Are linked to an increased risk of Schizophrenia in offspring

50
Q

What evidence links sperm mutation rates to the development of schizophrenia?

A

Higher sperm mutation rates often associated with older fathers have been correlated with an increased risk of Schizophreni in their children

51
Q

What is the original dopamine hypothesis and how does it explain symptoms of Schizophrenia?

A

The original hypothesis suggests that high dopamine activity in the subcortex causes symptoms like hallucinations and poverty of speech due to overactivation in dopamine hypothesis

52
Q

What are the evaluation points for family dysfunction?

A

+) evidence links family dysfunction to schizophrenia
-) poor evidence base for any explanation

53
Q

What are the evaluation points for cognitive explanations?

A

+) evidence for dysfunctional thought processing
-) only proximal origins of symptoms explained

54
Q

How is evidence for dysfunctional thought processing a strength of the psychological explanations of Schizophrenia?

A

P - research evidence for dysfunctional thought processing
Ev - Stirling et al (2006) compared performance on a range of cognitive tasks in people with and without Schizophrenia. Schizophrenics +2x more time to name font colours
Ex - supports view that the cognitive processes of people with Schizophrenia are impaired
L - psychological explanations are useful at explaining Schizophrenia

55
Q

How is only proximal origins a limitation of the psychological explanations of Schizophrenia?

A

P:** Perhaps schizophrenia is better explained as biological.
E:** Abnormal cognition is likely partly due to genetic factors and abnormal brain development.
E:** Although schizophrenia has psychological symptoms, such as disorganised thinking, these are likely a result of biological issues in the brain.
L:** This suggests that schizophrenia is primarily a biological condition, and treatments should focus on addressing these underlying brain abnormalities, even though psychological factors also play a role.

56
Q

How is linking family dysfunction to schizophrenia a strength of family dysfunction as an explanation of schizophrenia?

A

P - links family dysfunction to Schizophrenia
Ev- Read et al (2005) reported that adults with schizophrenia are likely to be insecurely - attached. 69% women and 59% men with s. Have a history of physical/sexual abuse
Ex - strongly suggests that family dysfunction does make people more vulnerable to schizophrenia
L - good explanation

57
Q

How is poor evidence based a limitation of family dysfunction as an explanation of Schizophrenia?

A

P - poor evidence base
Ev - no evidence to support the importance of trad family-based theories
Ev - double bind and schixophrenogenic are based on clinical observations of patients and informal assessment of the personality of mothers
Ex - means family explanations have not been able to explain the link between childhood trauma and Schizophrenia

58
Q

What are the evaluation points for the biological therapy for Schizophrenia?

A

Strength (Effectiveness): Antipsychotics reduce symptoms (e.g., Thornley et al.).
Counter: Short-term studies may exaggerate effectiveness.
Limitation (Side Effects): Antipsychotics cause serious side effects (e.g., tardive dyskinesia, NMS).
Counter: They still enable engagement in therapies like CBT.
Limitation (Unknown Mechanism): The mechanism of action is unclear.
Counter: Despite this, antipsychotics remain effective, especially in treatment-resistant cases (Meltzer).

59
Q

How is the effectiveness of antipsychotics a strength of the biological therapy for Schizophrenia?

A

Point (Strength): Antipsychotics are effective in treating schizophrenia symptoms.
Evidence: Thornley et al. (2003) found that chlorpromazine improved functioning and reduced symptoms compared to placebo.
Explanation: This shows that antipsychotics can effectively manage symptoms.
Counter (Limitation): However, short-term studies may exaggerate their effectiveness (Healy).
Link: Therefore, while effective, more long-term research is needed to fully assess their benefits.

60
Q

How is side effects a limitation of the biological therapy for Schizophrenia

A

Point (Limitation): Antipsychotics cause serious side effects.
Evidence: Side effects include tardive dyskinesia and neuroleptic malignant syndrome (NMS).
Explanation: These side effects limit their long-term use and patient adherence.
Counter (Strength): Despite this, antipsychotics help patients engage in therapies like CBT.
Link: Side effects are a concern, but antipsychotics are still crucial for symptom stabilization.

61
Q

How is an unclear mechanism of action a limitation of the biological therapy for Schizophrenia?

A

P - The mechanism of action of antipsychotics is unclear.
Ev - It’s uncertain if antipsychotics reduce dopamine or act through other pathways.
Explanation: This raises doubts about whether antipsychotics address schizophrenia’s root cause.
Counter (Strength): Despite this, they remain effective in reducing symptoms, particularly in treatment-resistant cases (Meltzer).
Link: Although their mechanism is unknown, their benefits justify their use.

62
Q

What are the 2 main types of anti-psychotic drugs used to treat schizophrenia?

A

Atypical and Typical antipsychotics

63
Q

What are the 2 effects of chlorpromazine?

A

1) Reduces symptoms of schizophrenia by reducing dopamine activity
2) acts as a sedative to calm agitated patients

64
Q

What is the main goal of atypical antipsychotics?

A

To improve effectiveness in reducing symptoms while minimising side effects compared to typical antipsychotics

65
Q

How does clozapine work and what additional effects does it have?

A

Clozapine binds to dopamine receptors and also acts as a serotonin and glutamate receptor, involving mood and cognitive function

66
Q

Why was risperidone developed and why does it differ from clozapine?

A

It was developed to avoid a blood condition caused by clozapine. Risperidone binds more strongly to dopamine receptors and is effective in smaller doses

67
Q

What % of Schizophrenics commit suicide and how does Clozapine adress this?

A

50% clozapine improves mood, reducing risk of suicide

68
Q

What is a significant risk of clozapine that risperidone avoids?

A

Agranulocytosis - potentially fatal blood condition

69
Q

What do atypical antipsychotics do?

A

target dopamine and serotonin to treat schizophrenia, reducing symptoms and side effects.

70
Q

What do typical antipsychotics do?

A

block dopamine receptors to reduce positive symptoms of schizophrenia but often cause severe motor side effects, such as tardive dyskinesia.

71
Q

What do dopamine antagonists do?

A

block dopamine receptors in the synapse , reducing action of dopamine

72
Q

What is risperidone?

A

Atypical antipsychotic
Developed because clozapine, deaths

73
Q

What are the 2 psychological explanations for Schizophrenia?

A

Family dysfunction and cognitive explanations

74
Q

What explanations are part of the family dysfunction as an explanation for Schizophrenia?

A

1) Schizophrenogenic mother
2) Double-bind theory
3) expressed emotion

75
Q

What is the concept of the Schixophrenogenic mother?

A

cold, domineering, rejecting, controlling parent
Thought to have caused scizophrenia in their children
Introduced by Fromm Reichamn (1948)

76
Q

What is the double-bind theory?

A

child recieves contradictory messages from parents
Leads to internal conflict that could manifest as Schizophrenia
Proposed by Bateson et al (1956)

77
Q

What is The concept of expressed emotion?

A

High expressed emotion = critical comments, emotional over-involvement, hostility
Brown et al (1972) found patients returning to families with high EE were more likely to relapse than patients returning to families with low EE

78
Q

What is the concept of metarepresentation?

A

Metarepresentation is the cognitive ability to reflect on thoughts and behaviours - Frith et al (1992)
Dysfunction disrupts out ability to recognise our thoughts as out own and this leads to hearing voices , and experience of having thoughts inserted into our mind by others

79
Q

What is the concept of central control?

A

explanation of speech poverty
Cognitive ability to suppress the automatic responses while performing deliberate actions
Schizophrenics experience derailment of thoughts because each word triggers automatic associations they cannot suppress

80
Q
A

Psychology (12 decks)

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