Schizophrenia Flashcards

1
Q

What are positive symptoms of schizophrenia?

A

They add to the patients reality

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2
Q

What are examples of positive symptoms?

A

Hallucinations
Delusions
Disorganised speech

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3
Q

What are negative symptoms of schizophrenia?

A

Where patients suffers a reduction or a loss of normal functions

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4
Q

What are examples of negative symptoms?

A

Speech poverty (alogia)
Avolition
Catatonic behaviour
Grossly disorganised behaviour

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5
Q

What is the DSM?

A

Published by American psychiatric association

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6
Q

What is the ICD?

A

Published by the World Health Organisation

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7
Q

What is reliability in the context of schizophrenia?

A

Asses how consistent the diagnosis of schizophrenia is

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8
Q

What is validity in the context of schizophrenia?

A

Does the DSM or ICD really measure schizophrenia

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9
Q

What studies are associated with reliability?

A

Copeland
Luhrman
Whaley

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10
Q

What was Copeland’s study?

A

134 US Psychiatrists - 69% diagnosis
194 British Psychiatrists - 2% diagnosis
Low inter-reliability reliability

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11
Q

What was Luhrman’s study?

A

Interview with 60 adults with schizo
20 in each Ghana, India and US
Africa and India, reported positive experiences with hearing voices compared to the US
Suggests schizo has a lack of consistent characteristics

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12
Q

What was Whaley’s study?

A

Found that inter-rater reliability correlations in the diagnosis of schizo was as low as 0.11

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13
Q

What are the studies associated with validity?

A

Broverman
Ellason
Buckley

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14
Q

What was Broverman’s study?

A

Mentally healthy behaviour = healthy male behaviour
Therefore women are perceived as less mentally healthy

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15
Q

What was Ellason’s study?

A

Symptom Overlap - Patients with DID have more schizo symptoms more than schizo patients

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16
Q

What was Buckley’s study?

A

Co-morbidity - Co-morbid depression occurs in 50% of patients and 47% of patients also have a lifetime diagnosis of substance abuse

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17
Q

What is the biological explanation of schizophrenia?

A

Genetics
Neural Correlates - Dopamine Hypothesis

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18
Q

What is the genetic explanation?

A

Schizophrenia is hereditary
No one gene responsible (108 genes)

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19
Q

What studies support the genetic explanation?

A

Shield
Gottesman
Teinari

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20
Q

What was Shield’s study?

A

2 Schizo parents - 46%
1 Schizo parent - 13%
Schizo parent - 9%

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21
Q

What was Gottesman’s study?

A

Summarised 40 twin studies
MZ twins - 48%
DZ twins - 17%

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22
Q

What was Tienari’s study?

A

164 adoptees who bio mothers have schizo
11 adoptees also diagnosed
Just 4 in the 194 control adoptees

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23
Q

What are some weaknesses of the genetic explanation?

A

Family rearing patterns may explain schizo link
Joseph - MZ twins are usually treated more similarly than DZ

24
Q

What are neural correlates?

A

Patterns of structure or brain that occurs with a schizophrenic experience

25
Q

What study supports negative symptoms neural correlates?

A

Juckel - Lower activity in the ventral striatum, is crucial in the anticipation of reward

26
Q

What study supports positive symptoms neural correlates?

A

Allen - Lower activity in the superior temporal gyrus and anterior cingulate gyrus

27
Q

What study supports neural correlates?

A

Suddan - MRI scans on twins, 1 has schizo
Easily identifiable enlarged ventricles in 12/15 pairs

28
Q

What is the dopamine hypothesis?

A

Positive symptoms = Excess dopamine, hyperdopamingeria
Negative symptoms = Deficit dopamine, hypodomingeria

29
Q

Who supports the dopamine hypothesis?

A

Falkai
L-dopa

30
Q

How does Falkai support the dopamine hypothesis?

A

Found increased dopamine levels in the left amygdala in post-mortems of schizophrenic patients

31
Q

How does the L-dopa drug support the dopamine hypothesis?

A

It’s a dopamine hypothesis medication
Increases dopamine levels in the brain
Resembles acute schizophrenia in non-psychotic patients

32
Q

Who argues against the dopamine hypothesis?

A

Javitt
Davis

33
Q

How does Javitt go against the dopamine hypothesis?

A

Found evidence of another neurotransmitter called Glutamate
Schizo’s also have a deficiency in glutamate function

34
Q

How does Davis go against the dopamine hypothesis?

A

Takes many weeks for antipsychotics to reduce positive symptoms even though they block dopamine receptors immediately

35
Q

What are the psychological explanations of schizophrenia?

A

Family dysfunction
Cognitive explanation

36
Q

What is family dysfunction?

A

1- Double Bind
2 - Expressed emotion

37
Q

What is the double bind?

A

Bateson - Child receives mixed messages and cannot do the right thing

38
Q

What is expressed emotion?

A

Family of a psychiatric patient talk about the patient in a critical or hostile way
Can cause patients to relapse

39
Q

Who supports expressed emotion?

A

Kuipers - Found patients returning to a high EE family is about 4 times more likely to relapse than a patient who has a low EE family

40
Q

What are some supporting studies of family dysfunction?

A

Berger - Schizo’s reported a higher recall of double bind statements by their mothers
Tienari - Children who had schizo bio parents were more likely to become ill themselves, only occurred in adoptive families as disturbed

41
Q

What is the cognitive explanation of schizophrenia?

A

Schizo’s had dysfunctional thought processes
Firth - Metarepresentation
Central Control

42
Q

What is metarepresentation?

A

Disrupt our ability to recognise our actions and thoughts as our own
Carried out by someone else

43
Q

What is central control?

A

The ability to suppress automatic responses
Disorganised speech and thought disorder

44
Q

What is supporting evidence of the cognitive model?

A

Sarin & Wallin - Delusional patients were found to show various biases in their information processing
NICE - CBT is more effective in reducing symptom severity

45
Q

What are weaknesses of psychological explanations of schizophrenia?

A

Deals with one aspect of the disorder but ignores other aspects such as neurochemical changes

46
Q

Who addresses the issue of the rigid psychological explanation?

A

Howes & Murray - Argue that early vulnerability factors together with exposure to significant social stressors increase the release of dopamine - dopamine hypothesis

47
Q

What are antipsychotics?

A

Work by reducing dopaminergic transmission

48
Q

What are typical antipsychotics?

A

Used against positive symptoms
reducing dopamine activity
e.g. chlorpromazine

49
Q

What are atypical antipsychotics?

A

Combat positive and negative symptoms
Block dopamine receptors
e.g. clozapine

50
Q

What are the side effects of typical antipsychotics?

A

Tardive dyskinesia
Muscle tightening
Decrease in motivation

51
Q

What study supports effectiveness of typical antipsychotics?

A

Barlow & Durand
Chlorpromazine effective in 60% of cases, patients still suffer from negative symptoms

52
Q

What are the side effects of atypical antipsychotics?

A

Side effects greatly reduced but similar to typical
Loss of motivation
Dry mouth

53
Q

What study supports the effectiveness of atypical antipsychotics?

A

Pickar-Clozapine most effective in reducing symptoms in patients that had been treatment resistant
Meltzer-Effective in 30-50% of cases where typical treatments failed

54
Q

Who supports antipsychotics?

A

Leucht - Meta analysis of 65 studies
Placebo - 64% of patients relapsed within 12 months
Real - 27% of patients relapsed within 12 months

55
Q

Who goes against the difference between side effects of atypical and typical anti-psychotics?

A

Crossley - Meta analysis of 15 studies
Found no significant differences between atypical and typical drugs in terms of side effects