Schizophrenia Flashcards
Characteristics of Schizophrenia
No one definitive symptom + involves range of pos/neg symptoms to be diagnosed
Positive:
Hallucinations (Visual, Auditory, Tactile, Olfactory give examples)
Delusions (Grandiosity, Reference, Persecution give examples)
Disordered Thinking (Can’t organise thoughts- manifests in speech e.g. derailment, word salad, thought insertion)
Negative:
Alogia (Speech poverty, delayed responses)
Avolition (No motivation for daily tasks e.g. brush teeth)
Anhedonia (No pleasure from pleasurable activities)
Flatness Of Effect (No emotion/ Intonation)
Catatonic Behaviour (Abnormal movement e.g. Echopraxia- copying movements)
Prodomal (Early signs):
Loss of interest, avoiding company, no work/school
-Wouldn’t get diagnosis with these alone
Low Reliability For Dianosis:
DSM-5 = 6 months deterioration before diagnosis
IDC-10 = No deterioration required for diagnosis
Dopamine (Biological)
INITIAL HYPOTHESIS:
SZ whole brain has Hyperdopaminergia E.g. excess D in Broca’s = auditory hallucinations
Research: Parkinson’s med L-Dopa raises D + caused Pos Symptoms in some patients
However, too simple as D reduction meds didn’t help Negative Symptoms
REVISED HYPOTHESIS:
Now there is focus on limbic system in causing SZ
Mesolimbic- VTA+NA have hyperdopaminergia = Pos Symp
Mesocortical- Carries signals from VTA to frontal lobe, hypodopaminergia cause Neg Symptoms
Genetics (Biological)
Assumes SZ inherited through genes passed down + closer relation = higher SZ chance e.g. first-degree relatives share 50% DNA
Research- MZ Concordance- 42%,
DZ Concordance- 9%- Supports as identical share 100% DNA
Psychodynamic Approach (Individual Differences)
Thought SZ caused by Oral Fixation and Oral Regression, as a SZ has more of a mind of an infant. Oral stage = 0-18 months
FIXATION IN ORAL STAGE:
Occurs due to Over/ Under-gratification
Causes narcissism/ impulsivity
-Fixation here as baby causes regression in adult life
REGRESSION TO ORAL STAGE:
Regression= Ego Defence Mechanism
Contact with disturbing thoughts/stress= regress rather than deal with issues in adult way
Freud said SZ patients regress back to new born state
LINK TO SZ SYMPTOMS:
An adult mind that is detached+ self-focused = Creation of Alt Realities e.g Pos Symptoms
No Ego present at Oral Stage = Self-obsessed, cause delusions of grandeur?
SCHIZOPHRENOGENIC MOTHER:
SZ caused by overly-dominant mothers e.g. Cold, Insensitive, Fearful Of Intimacy (Confusion)
-Child feels emotionally insecure, causes distrust= Paranoid Delusions + Then SZ
Cognitive Approach (Individual Differences)
MALADAPTIVE THINKING:
May explain auditory hallucinations E.g.
Inputs (Sleep Deprivation) Cause Faulty Process (Hear Voice + Interpret as Devil) Output (SZ Behaviours e.g. Avolition
LACK OF PRE CONSCIOUS FILTERS:
May explain positive symptoms, SZ result of breakdown of thought filtering = Disordered Thinking (word salad), Hallucinations, Delusions
Bentall- SZs= Perceive stimuli as threatening = Delusion of Persecution
Dysfunctional Families (Social Psychological)
DOUBLE BIND THEORY:
SZ is due to abnormal communication patterns within families
Communication is destructively ambiguous E.g. Mother says she loves child, but with a tone that suggests irritation AND may be accompanied with contrasting para-linguistic features
Causes a double bind as child is in a conflict and cannot win
-Pos Symptoms as way of escaping conflict
-Neg Symptoms e.g. Avolition
EXPRESSED EMOTION:
High EE= Relapse as family talk about patient in hostile way
Critical Comments- “They’re so lazy”
Hostility- Hostile behaviour towards patient
Emotional OverInvolvement- OverProtective + Excessive Self Sacrifice, likely due to guilt for patient
Give examples + contrast with low EE components
Compared to:
Warmth and Positive Regard in Low EE households
Socio-Cultural Factors (Social Psychological)
URBANICITY:
SZ higher urban areas
Research: SZ higher Chicago centre, compared to suburbs
-Urban stresses (high drug rates, overcrowding, pollution) don’t suit evolutionary traits of humans (hunter-gatherers)
SOCIAL ISOLATION:
Few friends + family contacts = No one to correct inappropriate behaviours (delusions)- Devs into SZ eventually
ETHNICITY:
Research: Afro-Caribbean 7X more likely to be diagnosed with SZ
Most likely due to discrimination received as psych is white-male dominated field
Anti-Psychotics (Method Of Modifying)
OVERVIEW:
Taken as tablets, syrup, injections (for those at risk of missing meds)
Two types: Conventional + Atypical
CONVENTIONAL:
1st gen, dopamine antagonists, tardive dyskinesia
E.g. Chlorpromazine
-Block D2 + Subtypes, unlike atypcial (temp occupy)
-PreSYNeuron release D into synapse, PostSYN Sites blocked = Eventually less D production
ATYPICAL:
2nd gen, less side effects
E.g. Clozapine
Temp block D2 in mesolimbic pathway, dopamine bind at slower rate- reduce Pos symptoms
Bind to serotonin receptor in mesocortical = reduce Neg symptoms
CBTp (Method Of Modifying)
AIMS OF CBTp:
Change disordered thinking (cog restructure)
Can’t prevent pos symptoms, but manage when arise
Empower patient to tackle negative symptoms
COMPONENTS:
-Assessment (Client + Therapist meet, discuss goals e.g. attend work + client explain own symptoms)
-Engagement (Built rapport, talk at length about symptoms, therapist empathise)
-Normalisation (Normalise psychotic symptoms + helps client understand them)
COGNITIVE STRATEGIES:
-Dysfunctional thought diary (Belief rating)
-Skills training (E.g. pleasant activity schedule *explain how)
-Relapse Prevention (Identify warning signs + discuss ways to cope with episode)
