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schizophrenia Flashcards

1
Q

What are positive symptoms?

A

the presence of abnormal functions

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2
Q

What are negative symptoms?

A

the absence/loss of normal functions

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3
Q

What are the three positive symptoms?

A

hallucinations
delusions
disorganised thinking and speech

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4
Q

What does hallucinations mean?

A

false sensory experience that may not have any identifiable source

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5
Q

What are delusions?

A

false beliefs, not based on fact/evidence that are very difficult to disprove

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6
Q

What is meant by disorganised thinking and speech as a positive symptom for schizophrenia?

A

this symptom makes it hard to concentrate on anything and thought drift from one thing to another although there will be no connection between them

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7
Q

What are the four negative symptoms?

A

speech poverty (alogia)
lack of emotion (flat affect)
avolition (social withdrawal)
apathy

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8
Q

What is meant by speech poverty?

A

A reduction in communication, which is thought to result from the slowing/blocking of thoughts

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9
Q

What is lack of emotion as a negative symptom of schizophrenia?

A

A reduction or flattening of emotions - range and intensity of facial expressions, tone of voice, and eye contact

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10
Q

What is meant by avolition?

A

Difficulty in planning and setting goals. There is no interest in socialising or hobbies

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11
Q

What is meant by apathy?

A

a lack of motivation - neglecting household chores leading to poor grooming and hygeine

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12
Q

What is meant by the inappropriate affect as a symptom of sz?

A

emotional expressions are unsuitable for the situation

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13
Q

What percentage of the population are affected by sz?

A

1%

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14
Q

What age are men and women most likely to be diagnosed with sz?

A

men - mid-20s
women - early 30s

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15
Q

What kind of disorder is schizophrenia?

A

a psychotic disorder

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16
Q

What is meant by a psychotic disorder?

A

A severe mental disorder that causes abnormal thinking and perceptions

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17
Q

According to Bleuler’s longitudinal study when are symptoms of sz most severe?

A

In the first 5 years after the onset of sz

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18
Q

Who found that the symptoms of sz are the most severe during the first 5 years of onset?

A

Bleuler’s

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19
Q

What are the 6 diagnostic criteria’s for classifying schizophrenia?

A

characteristic symptoms
social/occupational dysfunction
duration
schizoaffective and mood disorder exclusion
exclusion of known organic causes
relationship to autistic spectrum disorder

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20
Q

What is meant by the character symptoms in the diagnostic criteria for sz?

A

two or more symptoms must be present for 1 month:
delusions, hallucinations, disorganised speech, negative symptoms

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21
Q

What is meant by social/occupational dysfunction in the diagnostic criteria for sz?

A

for a significant portion of the time since the onset of the disturbance, level of functioning in one or more major areas is marked below the level achieved prior to the onset

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22
Q

What is meant by duration in the diagnostic criteria for sz?

A

continuous signs of the disturbance persist for at least 6 months

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23
Q

What is meant by schizoaffective and mood disorder exclusion in the diagnostic criteria for sz?

A

schizophrenia affective disorder and mood disorder must be ruled out before a diagnosis of sz can be given

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24
Q

What is meant bu exclusion of known organic causes in the diagnostic criteria for sz?

A

the disturbance cant be due to the attribute of a substance (drugs, medication) or another medical condition

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25
What is meant by relationship to autistic spectrum disorder in the diagnostic criteria for sz?
If an individual has autism then a sz diagnosis is only made if prominent delusions or hallucinations are present in addition to the other required symptoms of sz for at least 1 month
26
What is a syndrome?
when groups of symptoms occur together
27
What three areas can classifying and diagnosing disorders help in?
treatment identifying the causes of their disorder prognosis - predicting future course of the disorder
28
What is the main type of classification system used?
DSM classification system
29
When was the DSM first published?
1952
30
What is the current edition of the DSM called?
DSM V - 2013
31
What does the DSM contain?
Over 300 mental disorders arranged into several main categories
32
What is an alternative to the DSM?
The International Classification of Disorders (ICD)
33
What are the two topic heading for issues in the diagnosis of sz?
reliability and validity
34
What does reliability of diagnosis mean?
consistency of diagnosis
35
What does the validity of diagnosis mean?
the accuracy of diagnosis - including cultural and gender bias
36
Is it worth being diagnosed?
yes - allows for treatments to be given no - stigma around the label 'schizophrenia' may strip a person of their individual liberty
37
What two ways can the reliability of diagnosis be tested?
inter-rater reliability test-retest reliability
38
What is meant by inter-rater reliability?
occurs when clinicians make identical, independent diagnosis of the same patient with schizophrenia
39
What did Beck et al.'s research show about inter-rater reliability?
He found that when a group of 153 patients with schizophrenia were each assessed by two different psychiatrists the diagnosis agreement was only 54%.
40
What is meant by test-retest reliability?
This type of external reliability occurs when clinicians make the same schizophrenia diagnosis of the patient on separate occasions from the same information.
41
What are the two weaknesses of the reliability of sz diagnosis?
-Research by Copeland- 69% of US psychiatrists diagnosed a patient with sz will only 2% of british psychiatrists gave the same diagnosis -Reseach by Read- test-retest analysis is as low as 37%
42
What are the two strengths of reliability of the diagnosis of sz?
-Farmer found standardised interview techniques increase reliability of diagnosing - focus on frequency and severity of symptoms -The DSM have stripped the hard to differentiate criteria - Mojtubi and Nicholson
43
What is validity of diagnosis?
the extent to which we are measuring what we are intending to measure
44
What are the two ways that vaildity of sz diagnosis can be affected?
comorbidity overlapping symptoms
45
What is comorbidity?
refers to when more than one disorder or disease exists alongside a primary diagnosis, for example a person has both sz and a personality disorder at the same time
46
What is meant by overlapping symptoms?
none of the symptoms of sz are exclusive to the disorder (pathognomic). bipolar disorder, ocd, and autism are amongst many disorders that have overlapping, typical symptoms
47
What did Buckley et al find about the comorbidity of diagnosis?
around 50% of patients diagnosed with sz also have a diagnosis of depression (50%) or substance abuse (47%). Post traumatic stress occurred in 29% and OCD in 23%
48
What did Konstantareas and Hewitt find about overlapping symptoms?
when comparing 14 autistic patients and 14 sz patients they found that not all of the sz patients had autism symptoms but 50% of the autistic patients has symptoms of sz
49
What is a positive of the validity of sz diagnosis?
The use of a classification system such as the DSM can ensure that all psychiatrists are using the same criteria's to diagnose their patients creating consistency in diagnosis
50
What study did Rosenhan carry out?
'being sane in insane places'
51
What four aspects of cultural bias may affect the diagnosis of sz?
-cultural interpretations of sz symptoms affect diagnosis of the disorder -negative cultural attitudes to sz -the culture/nationality of the clinician affects the diagnosis of sz -race discrimination is evident in diagnosing sz
52
What is meant by the cultural interpretations of sz symptoms affect diagnosis of the disorder in the diagnosing of sz?
Some research shows that religious and cultural groups can have a marked effect on perceptions of sz, and what can be seen as 'insane' in one culture may be highly desirable in another
53
What is meant by negative cultural attitudes to sz in the diagnosing of sz?
psychological distress and mental health issues attract different levels of stigma in different cultures that will clearly affect the diagnosis of sz. This implies that without being diagnosed people with sz will continue to suffer needlessly and unable to access effective therapy
54
What is meant by the culture/nationality of the clinician effecting the diagnosis of sz?
The actual nationality/culture of the clinician can create reliability and validity issues with diagnosing schizophrenia. For many reasons some nationalities diagnose sz in very different ways.
55
What is meant by race discrimination being evident when diagnosing sz?
research has implied that some nationalities or countries have considerably more cases of sz than others. IT's suggested that mental health professionals perceive diverse ethnic and cultural groups very differently, and hence discriminate.
56
What are the 4 evaluation point for cultural bias in the diagnosis of sz?
-research by Malgady's- traditional costarican culture, hearing voice is spirits talking to you -research by copeland - us 69% and uk 2% -practical applications- training for psychologists into the difference in interpretation -allows for a symptom pool to be created for each culture
57
What are the three areas covered in gender bias and diagnosis of sz?
-unreported facts when diagnosing sz in men and women -biassed research -underdiagnosing of female patients suffering sz
58
What is meant by unreported facts when diagnosing sz in men and women in gender bias and diagnosis of sz?
men suffer more severe negative symptoms than women as well as suffering more from substance related disorders. Men are more likely to be involuntarily committed to psychiatric wards than women: Goldstein
59
What is meant by biassed research and the cultural bias surrounding the diagnosis of sz?
some psychologists claim research into sz has neglected to use many female patients, questioning its usefulness and representativeness
60
What is meant by underdiagnosing of female patients suffering from sz when it comes to cultural bias and diagnosing sz?
some research has suggested that women actually go under-diagnosed in comparison to men. This could have far reaching consequences as it implies many women could be denied access to treatment and have to continue suffering from the debilitating symptoms of sz
61
What is the key study for gender bias in diagnosing sz?
Loring and Powell 1988
62
What did Loring and Powell find in their research?
290 male and female psychiatrists read 2 cases and were asked to judge the condition, using standardised diagnostic criteria. When patients were described as make or no gender info was given, 56% were diagnosed. When patients were described as being female only 20% were diagnosed with sz
63
What are the three areas of biological explanations for schizophrenia?
genetic inheritance neural correlates further neural correlates
64
What is the basic suggestion made by the genetic inheritance explanation as to why people develop sz?
that some people may have a genetic predisposition to sz, and hence the condition is at least partly inherited. This means the disorder runs in the families through faulty genes
65
What did Ripke et al find?
reported that 108 genetic variants that could mediate a vulnerability to the disorder, including variations on chromosome 8 and 11 and the C4 gene.
66
What did Hong et al find when researching the genetic inheritance of sz?
A variation on the gene TPH was far more common with chinese patients with sz compared to chinese patients without sz
67
How does the faulty genes ultimately cause the development of sz?
due to inheriting a biochemical imbalance or brain structure abnormalities
68
What are the 2 strengths of the genetic explanation for the development of sz?
-research by Joseph- 40% concordance rate in mz twins for sz and 7% concordance rate in dz twins for sz -research - Ripke
69
What is the dopamine hypothesis?
Biochemical explanations argue that sz is caused by elevated levels of dopamine at key synaptic sites within subcortical regions of the brain e.g. mesolimbic pathway and the limbic system
69
What are two weaknesses of the genetic explanation for developing sz?
-incomplete explanation -reductionist -focuses only on the biological factors
69
According to the dopamine hypothesis, why does an excessive amount of dopamine cause sz?
the excess of dopamine is argued to cause a sort of 'system overload' where too many impulses are being transmitted. This arguably triggers positive symptoms of sz e.g. delusions
70
According to the dopamine hypothesis, what causes the excess if dopamine?
this could be caused by a number of factors, including the presynaptic neurons releasing too much dopamine
70
What is the revised dopamine hypothesis?
Davis et al pointed out that in the prefrontal cortex there are no D2 receptors and actually there appears to be a deficiency of dopamine in this region. He suggests that low levels of dopamine in this region are more responsible for negative symptoms of sz e.g. avolition
71
What is meant by hyperdopaminergia?
too much dopamine
72
What is meant by hypodopaminergia?
too little dopamine
73
What did Randrup and Munkvad find in their research into the dopamine hypothesis?
Gave rats excessive dopamine to see how they would react - they should long lasting abnormalities including behaviour such as being unable to filter out irrelevant sounds
74
What are two weaknesses of the dopamine hypthesis for explaining the development of sz?
-alternative explanations -reductionist
75
What is a strength of the dopamine hypothesis as an explanation for the development of sz?
practical application - antipsychotic drugs to reduce positive symptoms
76
As well as dopamine what other further neural correlates may cause sz?
enlarged ventricles hypofrontality hippocampus - amygdala region
77
What is meant by enlarged ventricles in relation to sz?
People with sz tend to have abnormally large ventricles - meaning the brain is lighter than normal and grey matter volume shrinks.
78
Why do individuals with sz have enlarged ventricles?
this could be a consequence of nearby part of the brain not developing properly or being damaged - this links to active loss of grey matter in the early stages of sz
79
What is meant by hypfrontality?
a state of decreased cerebral blood flow in the prefrontal cortex of the brain, meaning an under activation of the dorsolateral prefrontal cortex, particularly on cognitive activation linked to negative symptoms
80
What is meant by the hippocampus-amygdala regions in the development of sz?
Sz patients have a smaller volume in bilateral amygdala and hippocampus compared with healthy controls - the reduction in the volume of the amygdala was found in patients with early onset sz
81
What is a strength of the further neural correlates as an explanation for the development of sz?
research evidence from McEwen - argues that children are more sensitive to chronic stressors which can reshape the structure and organisation of the cortical regions, contributing to the symptoms of sz
81
What three areas were significant negative correlations found between, when looking at the hippocampus-amygdala region as an explanation for the development of sz?
-lower volume of left amygdala and thought disorder -lower volume of left hippocampus and negative symptoms -lower left anterior and posterior hippocampus volumes with positive and negative symptoms
82
What are three weaknesses of the further neural correlates as an explanation for the development of sz?
-alternative explanations -reductionist -methodological issues- we can't establish that neural correlates are the definitive cause of sz

Psychology (12 decks)

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