Schizophrenia Flashcards
Describe characteristics of schizophrenia [ 10 marks ]
> SZ is a form of psychosis where the individual has lost touch with reality
> Individuals with SZ suffer from positive and negative symptoms
Positive symptoms include hallucinations and delusions. There are different types of hallucinations and delusions, e.g. auditory hallucinations (hearing voices) and delusions of persecution (believing someone is out to get you).
Negative symptoms include alogia - the poverty of speech, avolition - an extreme lack of motivation and flatness of affect - the inability to convey emotion.
> To diagnose SZ, the psychiatrist may use the ICD-10
The individual must demonstrate at least one positive symptom, and at least two negative symptoms
These symptoms must have lasted for at least a month and not be due to drug use for the individual to be diagnosed.
Describe biological explanations of schizophrenia [ 10 marks ]
( Dopamine & Genetics )
• Dopamine
> Proposed hypothesis: SZ = more dopamine in brain -> positive symptoms
> More recent versions focus on the limbic system
> 2 main nerve pathways associated with SZ
• Mesolimbic pathway , VTA&NAC
- hyperdopaminergia -> overstimulation = positive symptoms e.g. hallucinations
• Metocortical pathway
- hypodopaminergia in D1 receptors = negative symptoms e.g. flatness of affect
• Genetics
> SZ is inherited through genes passed down through families
> Evidence = closer the biological relationship, greater the risk of SZ
> Research: Family studies = heritability rate of SZ is higher when more genes are shared, closer biological relationship
> For example, MZ twins who share 100% of their genes had a 48% concordance rate
Evaluate biological explanations of schizophrenia [ 10 marks ]
( Dopamine & Genetics )
• DOPAMINE: STRENGTH: Research to support
> LSD increases dopamine levels
> Can cause positive symptoms e.g. hallucinations
> If SZ take LSD=symptoms worsen
> SZ=directly linked to dopamine
> However, doesn’t account for negative symptoms
• Genetics: WEAKNESS: Single gene??
> Unlikely SZ can be attributed to a single gene
> Most likely polygenic (determined by the combination of a number of different genes)
> Research: 108 regions in the human genome linked with SZ
• BOTH: WEAKNESS: Reductionist
• Too simple to suggest SZ is only caused by dopamine, may not be the only neurotransmitter involved in SZ e.g. serotonin
• Too simple to say that SZ is caused by genetic predisposition alone
e.g. consider environmental factor e.g. childhood trauma
• HOWEVER: being reductionist can be beneficial, allows scientific research to focus on one thing, easier to develop medicine/treatments
Describe individual differences explanations of schizophrenia [ 10 marks ]
( Psychodynamic & Cognitive )
• Psychodynamic: Role of schizophrenogenic mother
> Overly dominant towards child with SZ
> Characteristics: Moralistic about sex , fearful of intimacy
> Controlling & overprotective but also cold & distant -> stifles child’s development & leads to distrust
> Paranoid delusions -> SZ
• Cognitive: Lack of pre-conscious filters
> “Attention Deficit Theory” , SZ is the result of the breakdown of thought filtering processes
> Causes issues with attention -> disordered thoughts -> symptoms of SZ
> Possibly account for delusions, hallucinations and disordered speech
> SZ have attentional bias to threatening stimuli -> paranoid delusions of persecution
Evaluate individual differences explanations of schizophrenia [ 10 marks ]
( Psychodynamic & Cognitive )
• PSYCHODYNAMIC: WEAKNESS: OUT OF DATE > Unfalsifiable nature become increasingly problematic
> Deemed unfalsifiable due to lack of testable hypothesis and lack of ability to prove concepts such as the tripartite personality wrong
> Therefore, lack scientific rigour
• COGNITIVE: WEAKNESS: NOT A COMPREHENSIVE THEORY > Doesn’t explain what causes cognitive malfunctions
> Explains proximal causes e.g. hallucinations but not the distal causes e.g. faulty thinking
> Cannot explain the causes of disorder
> Dysfunctional thought processing may be understood better as another symptom, not explanation
COGNITIVE : STRENGTH: RESEARCH TO SUPPORT > Strong evidence to support the idea that information is processed differently in the mind of those with SZ
> SZ patients = more difficulty with the Stroop test than control group
> Supports lack of preconscious filters
> Stroop test acknowledged as a strongly scientific research method as it is highly controlled and tests cognition
Describe social psychological explanations of schizophrenia [ 10 marks ]
( Family dysfunction & sociocultural factors )
FD: > It is the relationships that we have with our family members that could be the catalyst for SZ development
> One theory is the double bind theory
> Caregivers paralanguage does not match words e.g. “I love you” with apathetic tone
> Conflicting messages 2 separate messages that contradict = conflict
> Links to negative symptom flatness of affect = unable to convey emotion
SF: > Aspects of our society & culture on which an individual lives that affects the behaviour of an individual
> Research = SZ higher in urban areas
> Urban living does not suit the evolutionary traits of humans
Evaluate social psychological explanations of schizophrenia [ 10 marks ]
( Family dysfunction & sociocultural factors )
FD: STRENGTH: PRACTICAL APPLICATIONS
> Family therapy-> improves communications within family-> reduce double bind & expressed emotion -> reduce relapse rates
SCF: WEAKNESS: URBANICITY
> Cannot be sure that living in an urban environment increases social stress, compared to living in rural
> General health better in urban because..
> May be a complex interplay of other environmental factors e.g. pollution
BOTH: WEAKNESS: CAUSE AND EFFECT
• FD: differences in parental communication may just be detecting parents having to adapt their communication styles as a result of having a SZ child
• SCF: does living in an urban environment lead to greater risk of SZ or does having SZ mean you are more likely to live in an urban environment?
Describe CBTp as a method of modifying schizophrenia [ 10 marks ]
> Major symptom = disordered thinking
CBTp aims to alter the way in which SZ think, may not prevent SZ from experiencing positive symptoms e.g. hallucinations, but may help deal&cope
> CBTp may help a patient correctly attribute the source of internal voices & challenge false beliefs that underpin delusions
Empower -> increase independence & confidence = tackle negative symptoms
> 3 components: Assessment, client and therapist meet & explain symptoms & set goals. Engagement, therapist tries to build rapport through empathising with perspective & feelings of distress. Normalisation, therapist normalises with psychotic symptoms -> client less stigmatised -> increase understanding
> 5 different cognitive strategies, one being the dysfunctional thought diary ..
Evaluate CBTp as a method of modifying schizophrenia [ 10 marks ]
ETHICS: STRENGTH & WEAKNESS
• S = client more control over therapy, more input & ownership = empowers and boosts self-esteem
• S = No medical side effects higher attrition rates
• W = CBTp places emphasis on faulty thinking being a cause for SZ = patient blame
• W = Psychiatric prejudice- therapist may decide client not suitable for CBTp during the assessment stage and prescribe antipsychotics without giving them a chance
SOCIAL IMPLICATIONS: STRENGTH & WEAKNESS
• S = Coping strats learned -> help live “normal” life (return work/education) positively effects wider society too
• W = Attending therapy could, in some ways, be more intrusive than antipsychotics as attending therapy and doing homework may not suit daily routines
WEAKNESS: Insufficient research
> Not all research suggests CBTp is an effective method
> “Small therapeutic effect”
> However, different study “CBTp significantly reduced symptoms of SZ”
> Overall, lack of conclusion = lowers validity = more research needs to be done
Describe antipsychotic drugs as a method of modifying schizophrenia [ 10 marks ]
> Numerous types of antipsychotic medication, broadly fall into the categories of conventional/atypical
• CONVENTIONAL: CHLORPROMAZINE
ANTAGONIST > Blocks the D2 dopamine receptors , amount of dopamine in the synapse decreases. Lower level of dopamine in the synapse in addition to the receptor sites being blocked leads to a decrease in neural activity
• ATYPICAL: Received more at D1 and D4 receptor sites and also antagonise the serotonin receptor 5-HT2A
Evaluate antipsychotic drugs as a method of modifying schizophrenia [ 10 marks ]
STRENGTH: EFFECTIVENESS
> Atypical more effective than conventional
WEAKNESS: ETHICS: SIDE EFFECTS
> Seizures
> Antipsychotics may also be administered without valid consent
WEAKNESS: ETHICS: CHEMICAL STRAIGHT JACKETS
> Simply a means of keeping people quiet and under control
> Are antipsychotics administered to alleviate suffering or increase compliance with society and social regimes?
Describe biological explanations of SZ [ 10 marks ]
( Dopamine and Genetics )
• Dopamine
> Proposed hypothesis: SZ = more dopamine = positive symptoms
> Recent versions: Focus on the limbic system
> 2 main nerve pathways associated with SZ
• Mesolimbic pathway, VTA&NAC
> Hyperdopaminergia->overstimulation & positive symptoms e.g. hallucinations
• Mesocortical pathway
> Hypodomaminergia at the D1 receptors -> negative symptoms e.g. flatness of affect
• Genetics
> SZ is inherited through genes passed down through families
> Evidence=closer the biological relationship, greater the risk
> Family studies= heritability rate of SZ showed the closer biological relationship & thus the more genes shared, the higher the risk
> For example, MZ twins 100% genes = 48% concordance rate
