Schizophrenia Flashcards

1
Q

Name 2 criterion A symptoms of Schizophrenia

A

Delusions, Hallucinations

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2
Q

What are criterion B symptoms?

A

One or more major areas of functioning (work, relations etc) below the level achieved prior to the offset

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3
Q

What are criterion C symptoms?

A

Duration. Symptoms must be present for at least 6 months.

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4
Q

Name 2 positive symptoms of schizophrenia

A

Hallucinations, delusions

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5
Q

Name 3 negative symptoms of schizophrenia

A

Speech poverty, avolition, anhedonia, alogia, affective flattening

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6
Q

Define schizophrenia

A

A psychotic disorder, where the individual has lost touch with reality.

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7
Q

Define delusions

A

False/ bizarre beliefs.

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8
Q

Name 3 types of delusions

A

Paranoid, everyday and grandeur

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9
Q

Define hallucinations

A

Auditory or visual, hearing and seeing things that aren’t there.

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10
Q

What is affective flattening?

A

Loss of expression

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11
Q

What is anhedonia?

A

Loss of pleasure in activities that you used to enjoy

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12
Q

What is avolition?

A

Withdrawing, lack of purposeful willed behaviour, failing to function adequately

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13
Q

Define alogia

A

Loosing normal thoughts

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14
Q

What % of the population are likely to suffer schizophrenia

A

1%

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15
Q

When is the onset of schizophrenia most likely

A

Between 15-35 years

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16
Q

What is early onset schizophrenia?

A

Schizophrenia occurring earlier in childhood than 15 years

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17
Q

In terms of recovery, what does the “rule of thirds” suggest will happen to sufferers of schizophrenia?

A

1/3 will recover completely
1/3 will have episodic impairments
1/3 will experience chronic decline

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18
Q

What are chronic clinical characteristics of schizophrenia?

A

Obvious signs such as hallucinations and delusions.
Symptoms will appear quite quickly, usually after an activating event.
Individual shows very disturbed behaviour within a few days.

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19
Q

What are acute clinical characteristics of schizophrenia?

A

Gradually loosing drive and motivation, drifting away from friends.
Happens slowly over time, and is therefore less noticeable.

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20
Q

ICD or DSM- which identifies subtypes of schizophrenia?

A

ICD (10)

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21
Q

Name the 5 subtypes of schizophrenia identified in ICD 10

A
Paranoid
Catatonic
Disorganised
Undifferentiated
Residual
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22
Q

What are bizarre symptoms?

A

Hallucinations or delusions. Only one is needed to classify someone as schizophrenic

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23
Q

How does culture influence the diagnostic process?

A

African and Indian schizophrenics reported positive experiences with voices unlike in the US. (Luhrmann et al)

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24
Q

Why may diagnosis not be fully reliable?

A
Unreliable symptoms (what defines bizarre?)
Lack of inter rater reliablility
Culture differences
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25
How does inter rater reliability influence diagnosis?
It makes it less reliable, Whaley found inter rater reliability correlations as low as 0.11
26
How does gender impact diagnosis?
Clinicians may base their judgement on stereotypical beliefs held about gender. Boverman et al found clinicians associated mentally healthy adult behaviour with males, resulting in the tendency for females to be perceived as less mentally healthy.
27
How do co-morbidities impact on diagnosis?
They're common amongst patients with schizophrenia. Sometimes classifications for different psychosis overlap making classifications difficult.
28
Name 3 biological explanations of schizophrenia
Neural correlates Dopamine Hypothesis (and revised) Genetics
29
Explain the genetic (biological) explanation of schizophrenia
That schizophrenia is inherited, through a gene. Having a parent or other close family member with schizophrenia will increase an individuals risk of having the disorder.
30
Explain the dopamine hypothesis
Levels of dopamine are higher in schizophrenics, this induces positive symptoms.
31
Describe research in to the dopamine hypothesis
Using El Dopa in Parkinson's patients often causes them to display schizophrenic symptoms Leucht showed that getting dopamine levels to normal was significantly better than a placebo Blocking D2 receptors can help to alleviate the symptoms Real world application- cannabis
32
Describe research in to the genetics explanation for schizophrenia
Tienari studied adoptees and confirmed genetics was a key factor. However parenting style may also play a part.
33
Describe the revised dopamine hypothesis
High levels of dopamine in some sectors as well as low levels of dopamine in other areas of the brain may be factors in explaining both positive and negative symptoms of schizophrenia.
34
How does cannabis use support the biological explanation of schizophrenia?
Shows that there must be a chemical explanation to trigger schizophrenia
35
Define neural correlates as an explanation of schizophrenia
Suggests schizophrenics have abnormal brain structures
36
Describe research in to the neural correlates explanation of schizophrenia
Andreason et al: CT scans found schizophrenics have significantly larger ventricles compared to the control. This means there's less grey matter. May be linked with negative symptoms.
37
How might the biological explanation be challenged?
Diathesis stress: EE families revolving door syndrome suggests a bio-social explanation Narrowness: Noll et al showed 1/3 don't respond to dopamine treatments. Reductionism. Alternative approaches: psychological & social-psychological. Diathesis stress may be most valid.
38
Name 4 psychological explanations of schizophrenia
Schizophrenogenic mother Double-bind theory Dysfunctional thought processing Expressed emotion
39
Name 2 family dysfunction explanations of schizophrenia
Double bind theory | Expressed emotion
40
Describe the schizophrenogenic mother explanation
Fromm-Reichman proposed a psychodynamic explanation. A certain type of mother is experienced by many patients: Cold, rejecting, controlling, tends to create a family climate characterised by tension and secrecy
41
Describe double bind theory
Bateson et al: a child often receives contradicting messages (e.g.- one on a verbal and another on a psychical level) which leaves them with a confusing understanding of the world, a faulty internal working model and disorganised thinking.
42
Describe dysfunctional thought processing as an explanation of schizophrenia
A persons information processing is not functioning normally and produces 'undesirable consequences'.
43
Describe the Expressed Emotion theory as an explanation of schizophrenia
A person will receive verbal criticism, occasionally accompanied by violence, hostility including anger and rejection and emotional over- involvement from parents as well as needless self sacrifice
44
Name 2 cognitive explanations of schizophrenia
General control and meta-representation
45
What is "general control" as a cognitive explanation of schizophrenia?
The cognitive ability to suppress automatic thoughts whilst performing deliberate ones instead. Disorganised speech and thought may result from the inability to suppress automatic thoughts
46
What is "meta-representation" as a cognitive explanation of schizophrenia?
The ability to reflect on your own thoughts and behaviour. A dysfunction would disrupt the ability to recognise your own actions, possibly explaining hallucinations and thought insertion in schizophrenics.
47
Name 2 biological therapies for schizophrenia
Typical and Atypical drug therapies
48
Describe typical drugs
Well established drugs, introduced in the 50s. | Effective at reducing positive symptoms of schizophrenia
49
Give an example of a typical drug
Chlorpromazine
50
What does Chlorpromazine do?
Blocks D2 receptors
51
Describe Atypical drugs
Introduces later than typical drugs (70-80s). Claims to deal with both positive and negative symptoms however have more harmful side effects than typical drugs so are used as a second line of defence
52
Give an example of Atypical drugs
Clozapine
53
Discuss reliability of biological (drug) treatments
Most research supporting drugs comes from drug companies who may selectively publish results. This will generate profits but may not be reliable
54
Discuss ethical issues associated with biological (drug) treatments of schizophrenia
Patients with sz have lost touch with reality so may not be able to give informed consent. The calming effect of antipsychotics is used to keep patients passive and docile but may be seen as an abuse of human rights.
55
Discuss effectiveness of biological (drug) treatments of schizophrenia
Short term benefit in 75% of patients Long term benefit in 60% Davis et al showed much less relapse in patients treated with drugs rather than placebos
56
Discuss appropriateness of biological (drug) treatments of schizophrenia
Drug therapies treat the patient as passive Side effects such as tardive dyskinesia is likely to develop in 30% Patients are more likely to relapse if they stop taking the drugs
57
Name 4 psychological therapies used in the treatment of schizophrenia
Family intervention therapy CBT(p) Coping strategies Token economy
58
What does family intervention therapy do?
Re-educates the family of a patient, gives them information, shows them ways of supporting the individual, gives them strategies to help solve practical problems
59
Name 2 advantages of family therapy
It's cheap | Helps reduce relapse through medication compliance
60
Give examples of research in to family therapy
NICE reccomend family therapy, and state there's an economic benefit Pharaoh et al showed interventions were very effective in reducing relapse Philling et al found family therapies helped with medication compliance
61
How long is family therapy offered for?
Between 3-12 months and consisting of at least 10 sessions
62
In what context is token economy used?
Institutions
63
Describe token economy as a psychological treatment of schizophrenia
An institutionalised therapy Changes the way individuals behave though operant conditioning Rewards acceptable/ normal behaviours Tokens are secondary reinforcers
64
Name a disadvantage of token economy
Doesn't cure psychosis
65
Name an advantage of token economy
It helps to integrate individuals back in to the community | It is a helpful coping strategy
66
Describe research in to token economy
Ayllon and Azrin found this works in the context of hospitals Cromer suggested patients may have improved due to the Hawthorne effect
67
What are the ethical concerns to do with token economy?
Manipulating people's behaviours by controlling food and entertainment etc may be seen as denying an individual their rights