Schizophrenia Flashcards
What is the definition for Schizophrenia?
Schizophrenia is a severe mental illness where reality is distorted, causing disorganized thinking and unusual behavior.
Prevalence: Affects 1% of the population worldwide
What are the positive symptoms of Schizophrenia?
- 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.
What are negative symptoms of Schnizophrenia?
Symptoms that reduce normal function, such as speech poverty and avolition.
Avolition: Lack of motivation or goal-directed behavior.
What is speech poverty?
Reduced frequency and quality of speech, possibly showing a lack of coherent thought processes.
What is used for diagnosing Schizophrenia?
Two main systems used: ICD-11 and DSM-5.
DSM-5 requires at least one positive symptom.
ICD-11 includes positive or negative symptoms.
What are hallucinations?
These can involve any of the senses (auditory, visual, tactile).
Most common: hearing voices.
What are delusions?
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
What is avolition as a symptom?
Difficulties initiating/maintaining activities like self-care or work
What is speech disorganisation?
Frequent topic derailment or incoherence, making communication difficult.
What is the chronic nature of Schizophrenia?
Can lead to long-term challenges in daily functioning and relationships.
What is the ICD criteria vs the DSM criteria
ICD accepts negative symptoms more readily, while DSM focuses on positive
What is disorganised thinking?
Characterized by illogical connections between thoughts.
What impact has Schizophrenia got on social functioning?
People with schizophrenia often struggle with maintaining relationships or jobs.
What are the subtypes of schizophrenia?
Includes paranoid, catatonic, and hebephrenic types
When is the onset for Schizophrenia?
Typically occurs in late adolescence or early adulthood.
What is paranoid Schzophrenia?
Characterized by prominent delusions and hallucinations, often with themes of persecution or grandeur.
Individuals may seem high-functioning but struggle with intense paranoia.
What is catatonic schizophrenia?
Marked by significant motor disturbances, such as immobility, excessive movement, or repetitive behaviors.
May include echolalia (repeating words) or echopraxia (mimicking movements).
What is undifferentiated Schizophrenia?
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.
How is good reliability in diagnosis a strength of the diagnosis of Schizophrenia?
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.
What is a counter of good reliability in the diagnosis of Schizophrenia?
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.
How is gender bias a limitation of the diagnosis of Schizophrenia?
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.
How is culture bias a limitation of the diagnosis of Schizophrenia?
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.
What are the evaluation points for the diagnosis of psychology?
+) good reliability
C.P -> low external validity
-) culture bias
-) gender bias
What is the role of the dopamine hypothesis in explaining schizophrenia?
The dopamine hypothesis suggests that excess dopamine activity in certain brain areas is linked to schizophrenia symptoms.
How does increased dopamine activity in the subcortex relate to schizophrenia symptoms?
Increased dopamine activity in the subcortex is associated with positive symptoms like hallucinations and delusions.
Which symptoms of schizophrenia are associated with hyperdopaminergia in the subcortex?
Symptoms include auditory hallucinations and paranoia.
What is the significance of low dopamine activity in the prefrontal cortex?
Low dopamine activity in the prefrontal cortex is linked to negative symptoms, such as impaired decision-making and avolition.
How do amphetamines provide evidence for dopamine’s role in schizophrenia?
Amphetamines, which increase dopamine, can induce psychotic symptoms in non-schizophrenic individuals
What effect does L-dopa have on schizophrenia symptoms, according to the dopamine hypothesis?
L-dopa, used for Parkinson’s disease, can worsen psychotic symptoms in people with schizophrenia by increasing dopamine.
How does research into glutamate challenge the dopamine hypothesis
Glutamate research suggests that NMDA receptor dysfunction, not just dopamine imbalance, contributes to schizophrenia.
What has been proposed about the role of NMDA receptors in schizophrenia?
NMDA receptor dysfunction may explain cognitive impairments and negative symptoms of schizophrenia.
What are some of the symptoms of schizophrenia linked to glutamate deficits?
Symptoms include disorganized thinking, negative symptoms, and cognitive impairments.
How might NMDA receptor dysfunction explain the cognitive impairments seen in schizophrenia?
NMDA receptor dysfunction disrupts signaling in the brain, leading to issues with memory and decision-making.
Why is the term “central role of glutamate” used in recent research on schizophrenia?
It reflects growing evidence that glutamate impacts both positive and negative symptoms.
What type of drugs have provided support for the role of glutamate in schizophrenia?
Drugs targeting NMDA receptors mimic schizophrenia symptoms, providing evidence for glutamate’s role.
How is having a strong evidence base a strength of biological explanations for Schizophrenia?
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.
How is evidence for environmental risk factors a limitation of the biological explanations of Schizophrenia
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.
How is support for dopamine in the symptoms of Schizophrenia a strength?
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
How is evidence for a central role for glutamate a limitation of the biological explanations of schizophrenia?
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.
What are the evaluation points for the biological explanations of Schizophrenia?
+) strong evidence base
-) Glutamate may contribute to schizophrenia
+) genetics play a role
C.P ->Biological explanations cannot account for all S. Cases
How is a strong evidence base a strength of the biological explanations of Schizophrenia?
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
How is evidence saying that glumate plays a central role a limitation of biological explanations of Schizophrenia?
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
How is genetic factors playing a significant role a strength of the biological explanations of Schizophrenia?
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.
What is a counter of the role of genetics in the biological explanations of Schizophrenia?
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
What is the relationship between genetic similarity and the probability of developing Schizophrenia as shown by Gottesman?
They probability of developing schizophrenia increases with genetic similarity
MZ has a 48% risk
Siblings have a 9% risk
General population has 1% risk
How does the concordance rate of Schizophrenia differ between MZ and DZ?
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%
What does the term candidate gene refer to in the context of Schizophrenia?
Candidate genes are specific genes that are believed to contribute to Schizophrenia, particularly those involved in dopamine regulation and receptor activity
Why is Schizophrenia described as polygenic and heterogeneous?
Schizophrenia is polygenic because it is influenced by multiple genes and it heterogenous because different combinations of genes can contribute to the disorder
How can mutations in parental DNA contribute to Schizophrenia risk?
Mutations in parental DNA
Particularly associated with older paternal age
Are linked to an increased risk of Schizophrenia in offspring
What evidence links sperm mutation rates to the development of schizophrenia?
Higher sperm mutation rates often associated with older fathers have been correlated with an increased risk of Schizophreni in their children
What is the original dopamine hypothesis and how does it explain symptoms of Schizophrenia?
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
What are the evaluation points for family dysfunction?
+) evidence links family dysfunction to schizophrenia
-) poor evidence base for any explanation
What are the evaluation points for cognitive explanations?
+) evidence for dysfunctional thought processing
-) only proximal origins of symptoms explained
How is evidence for dysfunctional thought processing a strength of the psychological explanations of Schizophrenia?
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
How is only proximal origins a limitation of the psychological explanations of Schizophrenia?
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.
How is linking family dysfunction to schizophrenia a strength of family dysfunction as an explanation of schizophrenia?
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
How is poor evidence based a limitation of family dysfunction as an explanation of Schizophrenia?
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
What are the evaluation points for the biological therapy for Schizophrenia?
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).
How is the effectiveness of antipsychotics a strength of the biological therapy for Schizophrenia?
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.
How is side effects a limitation of the biological therapy for Schizophrenia
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.
How is an unclear mechanism of action a limitation of the biological therapy for Schizophrenia?
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.
What are the 2 main types of anti-psychotic drugs used to treat schizophrenia?
Atypical and Typical antipsychotics
What are the 2 effects of chlorpromazine?
1) Reduces symptoms of schizophrenia by reducing dopamine activity
2) acts as a sedative to calm agitated patients
What is the main goal of atypical antipsychotics?
To improve effectiveness in reducing symptoms while minimising side effects compared to typical antipsychotics
How does clozapine work and what additional effects does it have?
Clozapine binds to dopamine receptors and also acts as a serotonin and glutamate receptor, involving mood and cognitive function
Why was risperidone developed and why does it differ from clozapine?
It was developed to avoid a blood condition caused by clozapine. Risperidone binds more strongly to dopamine receptors and is effective in smaller doses
What % of Schizophrenics commit suicide and how does Clozapine adress this?
50% clozapine improves mood, reducing risk of suicide
What is a significant risk of clozapine that risperidone avoids?
Agranulocytosis - potentially fatal blood condition
What do atypical antipsychotics do?
target dopamine and serotonin to treat schizophrenia, reducing symptoms and side effects.
What do typical antipsychotics do?
block dopamine receptors to reduce positive symptoms of schizophrenia but often cause severe motor side effects, such as tardive dyskinesia.
What do dopamine antagonists do?
block dopamine receptors in the synapse , reducing action of dopamine
What is risperidone?
Atypical antipsychotic
Developed because clozapine, deaths
What are the 2 psychological explanations for Schizophrenia?
Family dysfunction and cognitive explanations
What explanations are part of the family dysfunction as an explanation for Schizophrenia?
1) Schizophrenogenic mother
2) Double-bind theory
3) expressed emotion
What is the concept of the Schixophrenogenic mother?
cold, domineering, rejecting, controlling parent
Thought to have caused scizophrenia in their children
Introduced by Fromm Reichamn (1948)
What is the double-bind theory?
child recieves contradictory messages from parents
Leads to internal conflict that could manifest as Schizophrenia
Proposed by Bateson et al (1956)
What is The concept of expressed emotion?
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
What is the concept of metarepresentation?
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
What is the concept of central control?
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
