Schizophrenia

Question 1

What is meant by positive symptoms of schizophrenia? Give examples .

Answer 1

An excess or distortion of regular function , they include:
Hallucinations 
Delusions
Disorganised speech 
Catatonic behaviour

Question 2

What is the difference between a hallucination and a delusion ?

Answer 2

Hallucinations are a distorted perception of the environment and we usually auditory or visual e.g hearing voices.
Delusions are bizarre beliefs , they can be paranoid or delusions of grandeur .

Question 3

What are negative symptoms of schizophrenia? Give examples .

Answer 3

Symptoms reflect a diminished or loss of normal functioning. They weaken the ability to function without outside help. Symptoms include:
Speech poverty
Avolition - reduction of desires and unable to compete goal related behaviour.
Affective flattening
Anhedonia- loss of pleasure in activities

Question 4

Outline the nature of speech poverty and avolition,

Answer 4

Speech poverty: lessening of speech fluency and productivity , produce lower words.
Avolition: reduction of interests and inability to compete goal orientated behaviour.

Question 5

What is meant by reliability in the context of classifying and diagnosing schizophrenia?

Answer 5

Diagnosis must be repeatable test retest or inter rater reliability.
Measured by kappa score 1 perfect agreement 0 none.
Diagnosis of schizophrenia is 0.46

Question 6

What is validity ?

Answer 6

Is an observed effect genuine ?

Question 7

What is reliability?

Answer 7

The consistency of measurements - all measurements must produce successive same data.

Question 8

Outline the role of gender and culture bias in the classification/diagnosis of schizophrenia.

Answer 8

Gender bias- Broverman found US clinicians equated mental health to healthy male behaviour- women are therefore perceived as less mentally healthy.
Culture bias-Copeland gave 134 us and 194 British psychiatrists a patient description.
69% US diagnosis
2% British diagnosis

Question 9

Outline the role of co-morbidity and symptom overlap in the classification or diagnosis of schizophrenia.

Answer 9

Symptom overlap - many schizophrenia symptoms are also present in other disorders e.g depression or bipolar.
Co-morbidity-extent two or more conditions can occur, with schizophrenia these include substance abuse or depression.
Swets- 12% patients with schizophrenia also had OCD criteria with 25% having clear symptoms.

Question 10

Name a family study and it’s results .

Answer 10

Gottesman - children with two schizophrenic parents had a 46% concordance rate - one parent 13% and siblings 9%.

Question 11

Name a twin study and it’s results

Answer 11

Joseph
Mz twins 40.4% concordance rate. Dz twins 7.4%
However may be due to shared environment.

Question 12

Name an adoption study and it’s results.

Answer 12

Tienari in Finland 
164 adoptees with schizophrenic mother 
11 received schizophrenic diagnosis 
Compared to 
4 control adoptees

Question 13

What is the dopamine hypothesis?

Answer 13

Excess dopamine in regions of the brain associated with positive symptoms. More neutrons firing .

Question 14

Give two pieces of evidence for the dopamine hypothesis

Answer 14

Parkinson’s patients with low dopamine taking l-dopa increase dopamine and reduce symptoms. Amphetamines increase dopamine and cause schizophrenic symptoms.

Antipsychotics reduce dopamine eliminating symptoms.

Question 15

What is the revised dopamine hypothesis- give a supporting study.

Answer 15

Negative symptoms arise from dopamine deficit .
Wang and deutch- induced dopamine dilapidation in rats resulting in cognitive impairment, the reversed this using antipsychotics thought to benefit negative symptoms in humans .

Question 16

Outline family dysfunction explanations of schizophrenia.

Answer 16

Double blind theory
Children receive contradictory messages from parents as they cannot develop an internally coherent construction of reality.
Expressed emotion
Negative or expressed emotion in high amounts - parents are critical or hostile or over involved . High EE influence relapse rates with high EE patients four times more likely to relapse. Lower tolerance for environmental stimuli leads to stress and triggering a schizophrenic episode.

Question 17

Outline cognitive explanations of schizophrenia hallucinations and delusions.

Answer 17

Dysfunctional thought processing
Delusions:
Inadequate information processing, relate irrelevant events to themselves arriving at false conclusions. Impaired insight cannot recognise distortions and substitute realistic ones.
Hallucinations
Focus excessively on auditory stimuli so have higher expectancy for occurrence of voice . Inner representation can override a rush actual stimuli.

Question 18

What are typical and atypical antipsychotics?

Answer 18

Typical- combat positive symptoms that are the product of high dopamine e.g Chlorpromazine. Bind but don’t stimulate dopamine receptors blocking action.
Atypical- combat positive symptoms but also some effect of negative symptoms e. Clozapine . Lower extrapyramidal side effects (movement problems like Parkinson’s )

Question 19

What is meant by diathesis stress apply to schizophrenia.

Answer 19

Schizophrenia has a genetic vulnerability e.g seen in genetic studies. However this is only triggered by stress from the environment e.g childhood trauma.