Schizophrenia Flashcards

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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
Q

How does inter rater reliability influence diagnosis?

A

It makes it less reliable, Whaley found inter rater reliability correlations as low as 0.11

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26
Q

How does gender impact diagnosis?

A

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.

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27
Q

How do co-morbidities impact on diagnosis?

A

They’re common amongst patients with schizophrenia. Sometimes classifications for different psychosis overlap making classifications difficult.

28
Q

Name 3 biological explanations of schizophrenia

A

Neural correlates
Dopamine Hypothesis (and revised)
Genetics

29
Q

Explain the genetic (biological) explanation of schizophrenia

A

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
Q

Explain the dopamine hypothesis

A

Levels of dopamine are higher in schizophrenics, this induces positive symptoms.

31
Q

Describe research in to the dopamine hypothesis

A

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
Q

Describe research in to the genetics explanation for schizophrenia

A

Tienari studied adoptees and confirmed genetics was a key factor.
However parenting style may also play a part.

33
Q

Describe the revised dopamine hypothesis

A

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
Q

How does cannabis use support the biological explanation of schizophrenia?

A

Shows that there must be a chemical explanation to trigger schizophrenia

35
Q

Define neural correlates as an explanation of schizophrenia

A

Suggests schizophrenics have abnormal brain structures

36
Q

Describe research in to the neural correlates explanation of schizophrenia

A

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
Q

How might the biological explanation be challenged?

A

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
Q

Name 4 psychological explanations of schizophrenia

A

Schizophrenogenic mother
Double-bind theory
Dysfunctional thought processing
Expressed emotion

39
Q

Name 2 family dysfunction explanations of schizophrenia

A

Double bind theory

Expressed emotion

40
Q

Describe the schizophrenogenic mother explanation

A

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
Q

Describe double bind theory

A

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
Q

Describe dysfunctional thought processing as an explanation of schizophrenia

A

A persons information processing is not functioning normally and produces ‘undesirable consequences’.

43
Q

Describe the Expressed Emotion theory as an explanation of schizophrenia

A

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
Q

Name 2 cognitive explanations of schizophrenia

A

General control and meta-representation

45
Q

What is “general control” as a cognitive explanation of schizophrenia?

A

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
Q

What is “meta-representation” as a cognitive explanation of schizophrenia?

A

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
Q

Name 2 biological therapies for schizophrenia

A

Typical and Atypical drug therapies

48
Q

Describe typical drugs

A

Well established drugs, introduced in the 50s.

Effective at reducing positive symptoms of schizophrenia

49
Q

Give an example of a typical drug

A

Chlorpromazine

50
Q

What does Chlorpromazine do?

A

Blocks D2 receptors

51
Q

Describe Atypical drugs

A

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
Q

Give an example of Atypical drugs

A

Clozapine

53
Q

Discuss reliability of biological (drug) treatments

A

Most research supporting drugs comes from drug companies who may selectively publish results. This will generate profits but may not be reliable

54
Q

Discuss ethical issues associated with biological (drug) treatments of schizophrenia

A

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
Q

Discuss effectiveness of biological (drug) treatments of schizophrenia

A

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
Q

Discuss appropriateness of biological (drug) treatments of schizophrenia

A

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
Q

Name 4 psychological therapies used in the treatment of schizophrenia

A

Family intervention therapy
CBT(p)
Coping strategies
Token economy

58
Q

What does family intervention therapy do?

A

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
Q

Name 2 advantages of family therapy

A

It’s cheap

Helps reduce relapse through medication compliance

60
Q

Give examples of research in to family therapy

A

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
Q

How long is family therapy offered for?

A

Between 3-12 months and consisting of at least 10 sessions

62
Q

In what context is token economy used?

A

Institutions

63
Q

Describe token economy as a psychological treatment of schizophrenia

A

An institutionalised therapy
Changes the way individuals behave though operant conditioning
Rewards acceptable/ normal behaviours
Tokens are secondary reinforcers

64
Q

Name a disadvantage of token economy

A

Doesn’t cure psychosis

65
Q

Name an advantage of token economy

A

It helps to integrate individuals back in to the community

It is a helpful coping strategy

66
Q

Describe research in to token economy

A

Ayllon and Azrin found this works in the context of hospitals
Cromer suggested patients may have improved due to the Hawthorne effect

67
Q

What are the ethical concerns to do with token economy?

A

Manipulating people’s behaviours by controlling food and entertainment etc may be seen as denying an individual their rights