Schizophrenia Flashcards
classification of mental diosrder
the process of organisisng symptopms into categories based on which symptoms frequenly clsuter together
What is schizophrenia
a severe mental disorder where contact wih reality and insight are impired an example of psychosis .
positive symptoms of schizophrenia
typical symptoms experienced in addition to normal experiences. They include hallucinations and delusions .
what are hallucinaitons
a positive symptom of shzophrenia . They are snesory eperiences that have either no basis inr ealit or are distored percpetions of things that are here .
what are delusions
a positive sympto of shciozphrenia . They involve beliefs tht have no basis of relity , for example a person beleives they are someone else or tht thye are a vicitm of conspiracy .
negative symptoms of schizophrenia
atypical experiences that represent he loss of a usual experience such as loss of cler thinking or loss of motoivation .
what is speech pvoerty
a egative symtpom of shxiophreni it invovled reduced frequenc and quality of speech
what is avoltion
a neagtive symtpom of shizophrenia it invovles loss of moviation to arry out taks and reuslts in lwoered activty lvels .
what is co morbidity
the occurence of two disorders or conditions otgether , for example a person ahs both chizophrenia and a personality disorder , when two condtioins are frequently diagnosed otgether it calls into questio the validy of classifying two disoerders separately .
what is symtpop overlap
occurs hwen two or ore conditons share ysmtpos . where conditons hsare manys mptoms this calls into quesition the validity of classifing the two disorders separetly .
first way to classify a disorder
world health organisation international classification of disease ICD-10 , version 11 has been published but wont be used for diagnosis until 2022 , nd the american psychiatric dms5
-differ slightly in their classificaiton of shciozopehrina .
DSM5 sid one of the positiv euspmpps must be present.
what is present dignosis
-resent diagsnosis wheres two or more negtive symptoms re sufficent under ICD .
-previous editions of ICD and DSM recognsided subtypes of shizophrenia paranoid sho invoeld mainly pwoerful hallucoantions and eluciosn
what do both DMS 5 nd ICD 10 have
they have driooed subtypes bevause the tended to be inconsistent , someone with a diagnsos of paranoid shxiophrenia , would not necessairly show the same symtpoms a few yers ler .
EVALUATION - issues in diagnosis and classifiction - GOOD RELIABILILTY
-One strength of the diagnosis of schizophrenia it is reliability . Reliability means constincey . A psychiatric diagnsois is said to be reliable when different diagnosisng clinicians , reach the same diagnosis , for the same individual (inter-ratre erlibaliti ) and when the same clincin reches the sam digsnosis for the sm eidnicudal on two occasions (test-retest reliabitlit ) .
EVALUATION - issues in diagnosis and classifiction - GOOD RELIABILILTY (2)
Prior to DSM-5 , reliability , for schizophrenia diagnosis was low but htis has now improved . Flabio , report excellent reliability for the diagnosis , of shizophrenia , in 180 indicusals using the DSM-5 , pairs of interviewrs achieved inter raer reliabilit +.97 . and test reetest relaibility of +92 .
THIS MEANS that we can be reasonablys ur the diagnsois of schizoprhenia is constanltya pplied .
EVALUATION - low validity
One limitation of the diagnosis of shizophrneia is its vlidity . In general validiry concerns , whether we assess what we are tryiing to asssess . One way to assess validity of a psychiatric diagnsoiss is criterion validity / Elli cHENIAUX Had two psyhitics independatly assess the same 100 clinets using icd - 10 , and dsm iv crtieria and found tht 68 were dignosed with schziophrenia , under the ICD ststems and 39 under DSM .
-THIS SUGGESTS that schizophreina is either over or undianosed according to the diagnositc sstem , either way this suggests that criterion valididy i lo .
kiw vakuduty - COUNTERPOINT
In the sorion , et al study reported , above there was excellent agreement between clincians when they use two measures to diagnose schizophrenia both derived fromt he DSM system . This means that the criterion validity for diagnsoiss schizoprhenia is actually good provided it takes place within a single diagnositc system .
EVALUATION - CO-momrbidity
another limitation of schizophrenia diagnosiis is its combrodbity with other conditons . I f conditions cocur otgther a lot of the tie then this calls into question the validity of their diagnosis , and classification because they might be a single ocndition .
COMORBIDITY 2
Schizophrenia , is commonly diagnosed , with other conditions . For example one review found that about hald of those diagnsoed with schizoprhenia also had a diagnosis of depression or subsance abuse .
–THIS IS A PROBLEM , for classification , because it measn schzioprhenia may not exist a distinc condition , and is a problem , for diagnosis , as a lest some people diagnosed with shcizoprhenia my abe unsual conditions liek depression
Gender bias in diagnosis - limitiation
- a further limitation , of schizophrenia diagnosis sis the existence of gender bias .
-Since the 1980s men have been diagnosed with shcizophreina , is more commnly than women . On epossible explanation for this is that womena re less vulenrable than men pehrap becuase of geenic facotrs .
gender bias in diagnosis (2)
however it seems , more likely that owmen are re underdiagnosed because they have cloer relationship and hence get support . This leads to women with schizoprhenia often functioning better than men . This underdiagnosis is a gender bias and means women may not therefore be receving better tretment servcies ight benef them
Culture bias in diagnosis
a further limitiation , of schziophrenia is that exisence of culture bias .
-Some symptoms of schizoprheina particualry heairng voices have differen meanings in different cultures . For example , Haiti , some eople beliee the voices are communications from ancestors . Birtish affircan caribean origing nien time likely to receive diagnsois , as white brithish people . althoguh people lviing in africa n carribean coutnries are not ruling out a geneitc vultnebrailty .
culture bias in diagnosis (2)
the most likle expalantion for this is culture bias in diagsnosis of clients by psychiarist froma diffeent ultural backrgound . This ppears to lad an overintpeatation of symtpops in black british people . This means that birtish african carirbena people may be discirmanted agisnt b a culturlaly biased diagnosic sytem .
EVALUATION - symptom overlap
a fnal limtiaition of schizoprhenia diagnosis is symtopm overlap with toher condiosn . There is consdierable overlap ebtwen the sytmpos of schiozphenaio and he symtops of ther condiions . For exmpal eboth SCHIZO AND BIPOALR invovle POSITIVE YSMTPOS SUCH AS DEULSIONS
AND NAGAIV ESUCH AS AVOLTION .
EVALUATION - symptom overlap (2)
-In terms of classification , this suggets that schzioprenia and bipolar diosrder may not be two different conditions but VARIATIONS of a single condition . INT ERM SOF DIGNSOIS , it means that shczoprhenia is HARD TO DISITNGUISH , from ipolar disorder
-AS WIHT COMBOBIIDTY , symtpom overlap emans that schziophrenia may not exist as a distinc condition nd hat even if it does it is ahrd to diagnose . SO BOTH ITS CLASSIFICATION ND DIAGNOSIS IS FLAWED .
Role of mutstion part two
Evidence For mutation comes from positive correlation between paternal age associated with increased risk of sperm mutation a risk of schizophrenia increasing from around 0.7% with Fathers under 25 to over 2% in fathers over and 50 (Brown, Ital, 2002)
Do. We actually know the causes of schizophrenia symptoms
No not. On a biological level, however research has identified some neural correlates brain, structure, or function of the best known correlate of schizophrenia is neurotransmitter. Dopamine is important the functioning of several brain systems Rota the system symptoms of schizophrenia
Neural correlates
Patterns Of structure or activity in the brain that occur in conjunction with an experience and may be implicated in the origins of the experience.
Dopamine
A neurotransmitter that generally has an extra artery affect and is linked to the sensation of pleasure. Unusually high levels are associated with schizophrenia and unusually low levels are associated with Parkinson’s disease.
Family. Studies
Family Studies have confirmed that risk of schizophrenia increases in line with genetic similarity to a relative with the disorder. This relationship is shown in the graph below. For example, someone with an aunt with schizophrenia has a 2% chance of developing it, increasing to 9%, if the individual is a sibling and 48%, if they are an identical twin.
Candidate genes part one
The. Next logical step is to identify candidates of jeans, jeans GNES early research in this area and looked for a single genetic variation in the belief that 140 if she could explain schizophrenia. However, it appears that a number of different genes are involved, or dirty.it’s Ophelia is poly genic. The most likely jeans would be those coding for neurotransmitters including dopamine, see the dopamine hypothesis below.
Candidate Jeans part two
In. One particular Large study, Steven RIPKEItal (2014), who combined all previous data from Gina white studies (I don’t eat those looking at the whole human Geno, as opposed to a particular jeans) schizophrenia. The genetic make up of 37,000 people with a genetic variation and diagnosed with schizophrenia was compared to 113,000 controls 180 separate genetic variations were associated with slight increase risks Of schizophrenia.
Because different studies have identified different kind of genes. It also appears that schizophrenia is etiologically heterogeneous different combination of factors, including genetic variation, can lead to the condition. 
The role of mutation part one
Schizophrenia Can also have a genetic origin in the absence of a family history of a disorder. One explanation for this is mutation in parents or DNA, which can be caused by radiation, poison or viral infection.
The Original dopamine hypothesis
The. Original hypothesis was based on the discovery that drugs used to treat schizophrenia (antipsychotics, which would you stay) cause symptoms similar to those in people with Parkinson’s disease condition associated Llodio levels (Simon, 1997).
Therefore schizophrenia might be a result of high levels of DJ (hyperdome Manarda hi, put me into high) in subcortical areas of the brain.
Examples in excess of the year receptors important, it’s from the subcortex subcortex to brokers are Brockers area responsible for speech production may explain specific symptoms of schizophrenia, such as poverty of speech and auditory hallucinations 
Updated. Versions of the dopey hypothesis part one
Kenneth David (1991) propose, the addition of cortical hyper domain urgent. I don’t eat abnormally low D8 on the bridge cortex. There’s two can explain the symptoms of schizophrenia.” Lodi eight in the pre-frontal cortex (responsible for thinking) could explain cognitive problems I don’t need negative symptoms of schizophrenia. It’s also been suggested that cortical hyperdome Monesia least it’s so cool to Hyperdemented Least subcortical hi Paul, but sober Tylenol levels of D8 in different brain regions are part of the updated version
Updated Version of the dopamine hypothesis, part two
As Well, as explained the links between abnormal tea levels and symptoms, current versions of the dopamine hypothesis try to explain the origins of abnormality a function, so it seems a boy is genetic variations (see above) in early experiences of stress, both psychological and physical make some people more sensitive to cortical hyper Aminata, and hence subcortical hyperdome inertia
Evaluation Research support
One. Strength of the genetic explanation is the strong evidence-based family said he’s such a Scotsman so that risks including genetic similarity to a family member With the schizophrenia. Adoption studies such as pick up so that biological treatment of parents with schizophrenia also heightened risk. Even if they grow up in an adopted family. A recent twin study by Hillcot said a concordance rate of 33% for identical twins and 7% for non-identical twins. This story is that some people are more vulnerable to schizophrenia as a result of genetic make up.
