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Schizophrenia Flashcards

1
Q

What percentage of the worlds population suffers from schizophrenia?

A

1%

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2
Q

What does DSM and ICD stand for?

A

ICD = International Classification of Diseases
DSM = Diagnosis and Statistical Manual

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3
Q

What is another word for positive symptoms of schizophrenia?

A

Psychosis

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4
Q

What is meant by the positive symptoms or “psychosis” of schizophrenia according to ICD?

A

Hallucinations
Delusions
Disorganised thinking

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5
Q

What are hallucinations?

A

Experiences that are not real/other people don’t experience. Most common is hearing voices or sounds however can affect any/all of our senses and grouped into auditory, visual, tactile (touch), gustatory (taste) and olfactory (smell).

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6
Q

What are delusions?

A

Unshakeable beliefs that don’t match up with how others see the world. They can take different themes such as paranoid delusions where the sufferer may believe they are being watched. Or a person may have delusions of grandeur where they believe they are a famous/important person.

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7
Q

What is disorganised thinking?

A

Talking very quickly or slowly, however the things the person is saying is not making sense. E.g. changing topics of conversation quickly with no obvious link.

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8
Q

What is meant by the negative symptoms of schizophrenia according to ICD?

A

Avolition - lack of motivation or apathy
Slow movement
Change in sleep patterns
Poor grooming or hygiene
Difficulty in planning and setting goals
Speech poverty - not saying much
Changes in body language
Lack of eye contact
Reduced range of emotion
Little interest in having hobbies
Little interest in sex
Tendency to not interact with people

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9
Q

What are the types of schizophrenia identified by DSM IV?

A

Catatonia
Paranoid
Disorganised
Hebephrenic
Undifferentiated
Residual

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10
Q

What is meant by a catatonia schizophrenic in DSM IV?

A

A person showing signs of alternating immobility and agitation

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11
Q

What is meant by a paranoid schizophrenic in DSM IV?

A

A person showing signs of delusions and therefore becoming untrustful and suspicous of other people and there intentious for them.

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12
Q

What is meant by a disorganised schizophrenic in DSM IV?

A

A person showing signs of disruption of speech patterns, disorganised thinking or emotions which dont fit their situation.

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13
Q

What is meant by a hebephrenic schizophrenia in DSM IV?

A

A person showing signs of being silly and immature emotionally

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14
Q

What is meant by an undifferentiated schizophrenic in DSM IV?

A

When the person meets the criteria to be schizophrenic but cannot be classified into any of the subtypes

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15
Q

What is meant by a residual schizophrenic in DSM IV?

A

When a person shows signs of be not grossly disturb however they are still acting unwell.

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16
Q

THE REST OF METHODS FOR DIAGNOSIS

A
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17
Q

Do the methods of diagnosis of schizophrenia show inter-rater reliability or not?

A

No, because it there have been so many changes to classification of schizophrenia. For example DSM 5 shows significant changes to classifications.

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18
Q

Do the methods of diagnosis of schizophrenia show test-retest reliability or not?

A

Assessment frameworks such as RBANS (repeated battery for the assessment of neuropsychological status) developed which are important as they are designed to measure progression of the condition. Wilkes (2003) administered 2 different test over/up to 134 days and found high test reliability (84% of tests showed the same).

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19
Q

What is meant by comorbidity?

A

When there are 2 separate conditions occurring at the same time.
Makes it hard to diagnose anything as could be other factors causing the issue

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20
Q

Do the methods of diagnosis of schizophrenia show comorbidity or not?

A

Weber et al (2009) found that giving a diagnosis of schizophrenia lead to lower levels of care being provided for other conditions. Meaning diagnosis of schizophrenia causes poorer outcome for patients.

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21
Q

Do the methods of diagnosis of schizophrenia show validity for the positive/negative symptoms or not?

A

Kloster Kotter et al (1994) found in Germany using positive symptoms rather than negative symptoms gave a more reliable diagnosis.
Positive/negative symptoms are the focus of ICD however DSM does not recognise these.

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22
Q

Do the methods of diagnosis of schizophrenia show gender bias or not?

A

Longenecker et al (2010) showed there is significant bias in diagnosis rate of males compared to females which has been occurring since the 1980s. Gender bias is shown when diagnosing schizophrenia.

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23
Q

Do the methods of diagnosis of schizophrenia show ethnocentric bias or not?

A

Yes people from african caribbean backgrounds are 3 to 5 times more likely to be diagnosed with schizophrenia than any other group. These people who live in the uk are also more likely to be diagnosed with mental health problems, diagnosed and admitted to hospitals, experience poorer outcomes from treatments.

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24
Q

What are the three explanations for the biological explanation of schizophrenia?

A

Genetic explanation
Dopamine hypothesis
Neural correlates of schizophrenia

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25
What are candidate genes?
Term given to individual genes which are deemed to have a direct link to the genetic transmission of certain characteristics.
26
What is meant by polygenic?
A term meaning the collection of genes which are required to cause a condition ie schizophrenia
27
What did Ripke et al (2014) find?
Found 108 gene sets within 37,000 schizophrenics. In addition these genes were found to be connected to the functioning of neurochemicals, particularly the function of dopamine
28
What can we use to show the genetic explanation of schizophrenia?
Family studies Twin studies adoption studies
29
Which can family studies be used to genetically explain schizophrenia?
Gottesman (1991) - looked at occurrence rates of schizophrenia within families. Between different relations.
30
What did Gottesman (1991) find concerning the genetic explanation of schizophrenia?
Found when one biological parent had schizophrenia the concordance rate was 13%. When both parents had it it rose to 46%, and when a sibling had schizophrenia concordance rate reduced to 9%
31
What did Joseph (2004) find about the genetic explanation of schizophrenia?
Concluded a meta analysis of all studies prior to 2001. Found in dizygotic twins concordance rate to be 7.4% whereas in monozygotic twins it was 40.4%.
32
What was found about adoption studies when explaining schizophrenia genetically?
Teinari (2004) Finland - compared 164 adoptees whose biological mothers had been diagnosed with schizophrenia. 6.7% developed schizophrenia compared to a control group of 194 children where just 2% developed schizophrenia.
33
What is dopamine?
A message carrier in the brain to let you know that something feels good.
34
What does oversensitivity of dopamine in the brain lead to?
Leads to frequent firing of neurones in the brain resulting in positive schizophrenic type symptoms.
35
What did Snyder (1974) and Comer (2003) find?
Schizophrenics are thought to have higher levels of D2 reception neurones which can affect perception and attention.
36
What is Hyperdopaminergia
Refers to unusually high levels of dopamine in the sub cortex, mainly the Brocas area. Can cause positive symptoms. May be higher number of dopamine receptors which cause over activity of dopamine furtherly causing sensory hallucinations.
37
What is Hypodopamineriga?
Refers to lower than usual levels of dopamine in the prefrontal cortex and is where less dopamine is being transmitted across the synapses. Can be linked to negative symptoms as reduces normal functioning.
38
What are amphetamines?
Work by stimulating dopamine, flooding the brain with dopamine and large doses causing schizophrenic episodes.
39
What are antipsychotics?
Work by blocking receptors of dopamine and cause a decrease of symptoms such as hallucinations and delusions.
40
What is a support for the dopamine hypothesis?
Davis et al (1980) proved the effectiveness of antipsychotics as a treatment. Found by a high level of 55% of patients who relapsed when given a placebo rather than real treatment which was only 19% of patients.
41
What is a criticism of the dopamine hypothesis?
Schizophrenic medications can take long amounts of time to work. Between 4 and 6 weeks to come into full effect.
42
What are neural correlates?
Structures in the brain which are directly correlated with certain experiences.
43
How were neural correlates in the brain found?
Using post mortem originally but now understood using fMRIs.
44
What does the discovery of neural correlates mean for schizophrenia?
When comparing images of non sufferers with schizophrenia, certain areas of the brain have been picked out as effecting the condition.
45
What did Allen et al (2007) find concerning in the neural correlates explanation?
Compared to a control group, schizophrenics who experience auditory hallucinations which had underachieve superior temporal gyrus and anterior cingulate gyrus. Show there are certain areas of the brain which correlate with schizophrenia.
46
What is a weakness to the neural correlates explanation for schizophrenia?
We are left with the issue of causality, as cannot track development of initial features of the condition. ie ventral striatum could cause avolition because of lack of stimulation or the avolition causes the ventral striatum to be under developed.
47
What does the family dysfunction psychodynamic explanation say is the cause of schizophrenia?
Families who are overly protective, emotional cold, rejecting, dominant and moralistic are important causes in the occurrence of schizophrenia in their children.
48
What did Fromm-Reichmann do?
Using Freuds theories observed children often focussed on one parent (often mother) meaning they would have a significant role in the development of schizophrenia.
49
What did Fromm-Reichmann (1948) suggest?
The schizophrenogenic mother - The idea that a mixture of maternal overprotection and maternal rejection could cause schizophrenia.
50
What did Read et al find about family dysfunction explanation?
Found in a Meta analysis of 46 studies, that child abuse and schizophrenia were related in 69% of cases of female in-patient.
51
What did Berry et al find about family dysfunction explanation?
Found that 59% of male schizophrenics had experience insecure attachments to their primary caregiver.
52
What is a criticism for the family dysfunction explanation?
Although set out in modern times both Read and Berry both fail to establish a 100% link.
53
What is double bind theory?
Bateson et al (1956) – suggests that the key to understanding schizophrenia is the communication style of the family, the mixed messages from care givers results in confusion within the child.
54
As of double bind theory what happens after the child begins to feel confused?
The child often finds themselves trapped in a situations where they think they are doing the wrong thing yet due to the mixed messages don't feel they can comment about it. The unfairness of the situation leaves them confused and scared.
55
As of double bind theory what happens after the child begins to scared?
Prevents the child from developing a rational, logical view of the world, instead creating a way of responding to the world which is perceived by others to be illogical and problematic, yet to them is.
56
What is a support of double bind theory?
Berger (1965) found schizophrenics reported higher level of double bind interaction with mothers than non schizophrenics. Bateson also said the issue was only a contributing factor and not a sole cause which could be a support or a weakness.
57
What is a criticism of double bind theory?
Lots of research in this area relies upon patient recall which is often not reliable. Bateson also said that many issues were only a contributing factors and not a sole cause which could be a support or a weakness.
58
What is a support for the psychodynamic explanation of schizophrenia?
Oltmanns et al (1999) said that parents and families do act different when there is a child with schizophrenia in the family, which could be a causal factor.
59
What is a criticism for the psychodynamic explanation of schizophrenia?
Evidence gained from schizophrenic patients about early life experiences is problem due; to both the nature of human memory, the difference in person perceptions and the actual events. But also as the person is recognised to be struggling to engage with reality as part of their condition so cannot be seen to be a reliable source of information.
60
What did Frith et al (1992) say?
Cognitive explanation for schizophrenia accepts the initial biological deficits can result in a person feeling abnormal sensations.
61
What does the cognitive approach say is the reason for schizophrenia?
Comes from the process that a person uses to try to understand faulty sensations.
62
What symptoms does the ventral stratum link to?
The negative symptoms and hallucinations that are a result of reduced function of the temporal lobe. Linked to cognitive and biological approach
63
What happens when a schizophrenic asks someone about sensations and they deny them?
To the person experiencing the hallucinations they are real. Logic tells them the person they asked must be lying about experiencing it too, which leads to delusions of persecution, conspiracy and paranoia.
64
What did Frith say the positive symptoms of schizophrenia are due to?
Metarepresentation where we process and reflect on our thoughts internally to consider our own actions and goals and to understand thought processes of others.
65
What did Frith say the negative symptoms of schizophrenia are due to?
The result of the “Central control” where their ability to use automatic response or to override them causing disorganised thought processes. This can cause problems with there speech patterns and actions often happen without there true intent.
66
What is a support for Frith's cognitive explanation of schizophrenia
Frith (1970) demonstrated issues in schizophrenic thought processes using a car prediction task. The findings he suggested showed that there central control process was not working effectively.
67
What is a criticism of Frith's cognitive explanation of schizophrenia?
Garety et al (2001) said the cognitive approach works with the biological approach however on its own does not explain things fully.
68
What did Hemsley (1996) say as a support for Frith's cognitive explanation of schizophrenia?
The approach leads to useful and effective treatments.
69
What is the behaviourists theory of explaining schizophrenia?
Labelling theory by Scheff (1966)
70
What do behaviourists say the reason for a person developing schizophrenia is?
Learning through punishment which may lead the child to retreat into a rewarding inner world which is when others the label them as odd or strange. ie the consequence of faulty learning.
71
What does Scheff say the reason for a person developing schizophrenia is?
Labelling theory suggests an individual labelled in this way will continue to act in the ways which conform to that label. The persons bizarre behaviour is rewarded with attention which becomes more and more exaggerated in a continuous cycle before being labelled as schizophrenic.
72
As of the behaviourist explanation what will happen if a child receives little or no social reinforcement early on in life?
Child will attend to inappropriate and irrelevant environmental cues rather than focussing on social stimuli in the normal way.
73
What are some supports for behaviourists explanation of schizophrenia?
Scheff reviewed 18 studies and found 13 to support the theory. Rosenhams "sane in insane places" once diagnosed therapists attributed many behaviours as abnormal despite it being normal behaviour.
74
What is a criticism of the behaviourists explanation of schizophrenia?
It explains how schizophrenic symptoms are maintained but does not adequately explain where they came from in the first place. Critics argue labelling theory ignores strong genetic evidence and trivialises a serious disorder.
75
What is the typical medication for schizophrenia?
Antipsychotics
76
Why are antipsychotics deemed successful treatment for schizophrenia?
They increase the persons ability to function in everyday life.
77
What theory are antipsychotics based upon?
Dopamine hypothesis used to treat schizophrenics and some manic depressives.
78
What is a common typical antipsychotic and what does it deal with?
Chlorpromazine and it deals with the positive/psychotic symptoms of schizophrenia.
79
What do typical antipsychotics work to do?
By blocking the receptors on the post synaptic neurone, which prevents the dopamine and other neurotransmitters from being received, thereby reducing over stimulation.
80
Why do typical antipsychotics do what they do?
By acting as an antagonist which reduce the effect of dopamine, preventing it from reaching the receptors, and there by seeking to normalise the level of neurochemical activity, reducing the frequency of the occurrence and the intensity of psychotic symptoms.
81
What did Thornley et al do and find?
Conducted a meta analysis which supports both typical and atypical antipsychotics for the treatment of schizophrenia. Atypical improvement in 23.5% whereas typical was 21.2%
82
What is a support of the use of typical antipsychotics as a medication for schizophrenia?
Thornley et al (2003) Based on dopamine hypothesis and seems to work
83
What is a criticism for the use of typical antipsychotics as a medication for schizophrenia?
Hill (1986) found that in 75% of antipsychotics the patients developed Tardive Dyskinesia, some of which became permeant.
84
What do atypical antipsychotics affect?
Serotonin and Glutamate receptors which improves cognitive function and increases mood state. Can also be prescribed to people suffering from suicidal or depressive thoughts.
85
What did Kapuar and Remington (2001) suggest?
Atypical antipsychotics are more selective about what they block, only blocking dopamine receptors, the D2 receptors, not serotonin or other neurotransmitters and reducing some side effects significantly.
86
What do atypical antipsychotics allow for?
Allow for some activity to occur as they only block receptors sites for a short period of time, which allows for a normal level of functioning.
87
What is a common atypical antipsychotic?
Risperidone.
88
What is a support for the use of atypical antipsychotics as a medication for schizophrenia?
Thornley et al (2003) Less people will stop taking medication due to less side effects.
89
What is a criticism for the use of atypical antipsychotics as a medication for schizophrenia?
Does come with risk of death if the person develops agranulocytosis which can be caused by the drug.
90
What is ECT?
Electroconvulsive therapy.
91
When is ECT used?
When the patient does not respond to drug treatments. Its used as a last resort as does not have a great history of success.
92
What does ECT seek to do?
Recreate the experience of an epileptic fit.
93
What did Karagulla (1950) find?
First study to look at ECT he found low rates of recovery compared to other patients.
94
What is the theory behind the use of ECT?
Works on the assumption that the electrical charge present in the seizures caused by epilepsy has a protective effect on the mental state of the sufferer.
95
What is a support for the use of ECT as a treatment of schizophrenia?
Tharyan and Adams (2005) reviewed 26 studies which covered 798 patients. Found a significant short term benefit than placebo versions of the treatment.
96
What is a criticism for the use of ECT as a treatment of schizophrenia?
Sarita et al (1998) found no difference in outcome between stimulate and real ECT for 36 patients.
97
What is the aim of CBT as a treatment of schizophrenia?
To improve the sufferers condition within 16-20 sessions.
98
What is the process of CBT as a treatment of schizophrenia?
Recognise the irrational beliefs Challenging the irrational beliefs Creating new beliefs Then testing out as homework and reviewing in following sessions
99
What is Becks ABC model
Activating event - what led to the start of the condition ie getting pulled over by the police Beliefs - negative beliefs following the event - ie believing the police are watching you Consequence - Consequences of those beliefs - ie beginning to start seeing police which aren't there
100
How does Jauhar et al (2014) support CBT as a treatment of schizophrenia?
Conducted a meta analysis of 34 studies into CBT showing a significant but small benefit.
101
How does Tarrier (2005) support CBT as a treatment of schizophrenia?

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