Schizophrenia Flashcards
For the clinical characteristics of schizophrenia, how long does a person have to show at least one symptom for in list 1, to be diagnosed with schizophrenia?
1 symptom for 1 month
For the clinical characteristics of schizophrenia, how many symptoms does a person have to show in list 2, to be diagnosed with schizophrenia?
2 symptoms
What are the 3 characteristics in list 1?
Thought control
Delusions of control
Hallucinatory voices
What 3 characteristics are included in Thought control?
Thought withdrawal( belief that thoughts are being actively being removed from the mind) Thought insertion( the belief that thoughts are being actively put into the person's mind) Thought broadcast (The idea that a person's thoughts are accessible to others around them. they are being broadcast)
What is the definition of delusions of control?
The individual does not feel in control of their own thoughts, feelings and will
What is hallucinatory voices?
Hearing voices that do not exist. These voices are often negative in tone and may take form of running commentary on an individuals behaviour
What are the 3 characteristics from list 2?
Incoherent/ irrelevant speech
Catatonic behaviour
Negative symptoms
What is Incoherent/ irrelevant speech?
Arises when individuals’ train of thought is disrupted to the point where their speech may become jumbled and meaningless. May include neologisms( made up words)
What is Catatonic behaviour ?
Unusual body movements, May include odd postures, uncontrollable limb movements and frozen immobility
What are Negative symptoms?
The absence of behaviours that a normal person may show. (lack of motivation , drive and lack of emotion
There are different specific types of schizophrenia which are characterised by specific symptoms identified (list one and two) being dominant. For example ?
Catatonic Schizophrenia and residual type
What is catatonic behaviour?
Motor Abnormalities - main symptom. Need is paired with another condition
What is residual behaviour?
No symptoms but symptoms have occurred in the last 12 months
What issues of classification and diagnosis of schizophrenia are there?
No sole contributing factor. No objective test Different diagnostic tools are used (DSM and ICD) Cultural variations Over lapping symptoms
What are the differences are there between the 2 diagnosis tools (ICD and DSM) for schizophrenia?
DSM requires symptoms be shown for 6 months ICD for 1 month
Differ in how they define sub-types( 5 DSM 7 ICD)
DSM requires comparison to ‘normal’ person
Name the research studies into the classification and diagnosis?
Rosenhan
Beck et al
Jansson and Parnass
Cochrane
Describe the research of Rosenhan
8ppts 5m3f attempted to gain access to 12 mental hospitals accross the US. reported hearing the empty words ‘empty hollow thud’ otherwise acting normally. kept note whilst in hospital about behaviour of other staff.
7 diagnosed with schizophrenia 1 with bi polar. administered 2100 drugs
kept in hospital for period ranging from 7 to 52 days
note taking was taken as abnormal behaviour
Describe the research of Beck et al
Reported a 54% concordance rate between experienced practitioners diagnoses when assessing 153 patients. Soderberg et al reported a concordance rate of 81% using the DSM-IV-TR the most up to date form of DSM classification
Describe the research of Jansson and Parnass
Reviewed 92 polydiagnositic studies. these studies apply different definitions of disorder to same patient to assess reliability. Although reliability of the DSM and ICD were moderate , both were weaker in terms of their validity
Describe the research of Cochrane
Found that more African- Caribbean origin were 7 times more likely to be diagnosed with S than whites in the UK
What are the 2 biological explanations of schizophrenia and what are they?
Genetic explanation- S is inherited through genes
Dopamine hypothesis- suggests what S is the result of excessive Dopamine or excess Dopamine receptors. over activity of Dopamine
What are the twin studies research studies for the genetic explanation?
Gottesman and Shields (1972)
Gottesman and Shields (1976)
Describe the research of Gottesman and Shields (1972)
Medical records of 57 Schizophrenic twins between 1948 and 1964. 23 MZ and 34 DZ twins
if their twin did not have S they were followed for 13 yrs. 42% likelihood of MZ twins developing S compared to 9% for DZ twins
Describe the research of Gottesman and Sheilds (1976)
Meta-analysis of 5 studies. Reported concordance rates of between 75% and 91% for twins with severe form of S
What are the adoption research studies for the genetic explanation of S?
Tiernari (Finnish adoption study)
Describe the research of Tiernari( Finnish adoption study )
Followed 155 adoptees that born to S mothers
In adulthood, over 10% of adoptees with biological S mothers had developed the disorder. this compared to just over 1% of adoptees who developed the disorder who did not have a S mother
What are the family research studies for the genetic explanation of S?
Kendler et al
Dormas et al
Describe the research of Kendler et al
First degree relatives of S individuals were x 18 more likely to develop the disorder
Describe the research of Dormas et al
Followed 207 children who had S mothers. at a 27 year follow up, 16% had been diagnosed with S compared to 2% in a low risk group
What are the evaluation points for the genetic explanation of Schizophrenia?
Too simplistic
Methodological issues with adoption studies
Could be explained by both genes and the environment( diathesis stress)
Research suggests that genes cannot be the only factor involved in S
Methodological issues
What is the Dopamine Hypothesis ?
Dopamine is a neurotransmitter. Found in the Limbic system in the brain, the Limbic system is thought to be related to our emotional life. An increase number of dopamine receptors in the brain. Research has suggested abnormally high numbers of D2 receptors in the brain of S’s
What was found in the Post mortems of S?
Abnormally high levels of dopamine in the limbic system
What are Phenothiazines and what do they do?
It is an anti-psychotic drug found to reduce the symptoms of S. it reduces Dopamine activity by blocking the dopamine receptors.
What do Amphetamines and LSD do to a healthy individuals brain?
They have an effect on dopamine levels inducing states similar to S
What does L-DOPA do?
It stands for dopamine releasing drug. can induce symptoms resembling Paranoia symptoms in Parkinsons patients ( who have low levels of dopamine)
Which dopamine system are associate with positive symptom and which is associated with negative symptoms when high levels of Dopamine occur ?
Mesolimbic - Positive Symptoms
Mesocortical - Negative symptoms
What are the evaluation points for the Dopamine hypothesis?
Too simplistic (x2) Practical applications Cause and effect Other neurotransmitters may be involved Drug companies may have inappropriately promoted the dopamine hypothesis
What are the 4 research studies for research into the dopamine hypothesis?
Randrup and Munkvad
Iversen
Kessler et al
Wong et al