schizophrenia Flashcards

You may prefer our related Brainscape-certified flashcards:
1
Q

what is the symptom Avolition

A
  • It is a negative symptom
  • That is the reduction, difficulty, or inability to initiate and persist in goal-directed behaviour, often mistaken for apparent disinterest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what is the symptom of delusions

A
  • It is a positive symptom
  • Firmly held erroneous beliefs that are caused by distortions of reasoning or misinterpretations of perceptions or experiences
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is the symptom hallucinations

A
  • It is a positive symptom

- Distortions or exaggerations or perception in any of the senses, most notably auditory hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a negative symptom

A

appear to reflect a diminution or loss of normal functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is a positive symptom

A

appear to reflect an excess or distortion of normal functioning

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the symptom speech poverty

A
  • It is a negative symptom

- The lessening of speech fluency and productivity, which reflects slowing or blocked thoughts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what are the positive symptoms of schizophrenia

A

hallucinations
Delusions
Disorganised speech
catatonic behaviour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is the symptom of catatonic behaviour

A

it involves the inability or motivation imitate a task, or complete it once it is started, which leads to difficulties in daily living

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what are the negative symptoms of schizophrenia

A

speech poverty
avolition
affective flattening
Anhedonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the symptom affective flattening

A

the reduction in range and intensity of emotional expression including facial expression, voice tone, eye contact and body language.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is schizophrenia

A

it is a type of psychosis characterised by a profound disruption of cognition and emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what is the main issue with the reliability of diagnosis of schizophrenia

A

cultural differences
Copeland
Luhrmann

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what was the studies supporting the theory of cultural differences effecting the reliability of diagnosis

A

-research suggests there is significant difference between cultures in diagnosing schizophrenia.
Copeland (1971) gave 134 US and 194 British psychiatrist a description of a patient. 69%of the US psychiatrists diagnosed schizophrenia, but only 2% of the British ones gave a diagnosis.
- Luhrmann et al (2015) interviewed 60 adults with the disorder. 20 each from Ghana, India and the us. each were asked about the voices they heard. strikingly while the africans and Indians voices subjects were reported as positive symptoms, not one American reported the same thing. Luhrmann suggests the ‘harsh, violent voices’ so common in the west way may not be an inevitable feature of schizophrenia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what are the problems with the validity of the diagnosis of schizophrenia

A

Gender Bias- Broverman et al (1970)
Symptom overlap- Ellason and Ross (1995)
Co-morbidty- Buckely et al (2009)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is Co-morbidity

A

to the extent that two or more conditions or diseases occur simultaneously in a patient, for example schizophrenia and depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is symptom overlap

A

refers to the fact that symptoms of a disorder but may also be found in other disorders, making accurate diagnosis difficult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

define Reliability

A

is the data constant- we would expect any measurement to produce the same data if taken on successive occasions.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

define validity

A

referes to whether an observed effect is a genuine one

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what is the theory that idea of gender bias effecting the validity diagnosis of schizophrenia

A

There are Critics of the DSM diagnostic criteria argue that some diagnostic categories are biased toward pathologizing one gender rather than the other. Broverman et al (1970), found that clinicians in the US equated mentally healthy ‘adult’ behaviour. As a result, there was a tendency for women to be perceived as less mentally healthy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is the theory that the idea that symptom overlap effect the validity of diagnosing schizophrenia

A

Although the separation of symptoms to positive and negative symptoms was to make the diagnosis of schizophrenia more valid, many of these symptoms are found in other disorders. Ellason and Ross (1995) pointed out that people with dissociative identity disorder (DID) actually have more schizophrenic symptoms than people diagnosed as being schizophrenic. Most people who are diagnosed with schizophrenia have sufficient symptoms of other disorders that they could also receive at least one other diagnosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the theory that the idea Co-morbidty effects the validity of diagnosing schizophrenia

A

Psychiatric Co-morbidties are common around patients with schizophrenia, these include substance abuse, anxiety, and depression. Buckley et al (2009) estimated that co-morbid depression occurs in 50% of patients, and 47% of patients also have a lifetime diagnosis of co-morbid substance abuse. Schizophrenia and OCD are two distinct psychiatric conditions. roughly 1% of the population develop schizophrenia, while 2-3% develop OCD. Since both are fairly uncommon, we would expect that only a few people with schizophrenia would develop OCD and vis versa. However, evidence suggests that the two conditions appear together more often more than originally thought.
A meta-anaylsis by Swets et al. found at least 12% of patients with schizophrenia also fulfilled the diagnostic criteria of OCD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

evaluation of reliability in diagnosis and classification

A

lack of inter-rater reliability - Whaley found inter-rater reliability correlations in the diagnosis of schizophrenia as low as 0.11. Further problems with the inter-rater reliability of the diagnosis of schizophrenia are illustrated in the Rosenhan study.
unreliable symptoms- for the diagnostic of schizophrenia only one of the symptoms needs to be present, ‘if delusions are bizarre’. However, this creates problems for reliability of diagnosis. when 50 senior psychiatrists in the US were asked to distinguish the difference between ‘bizzare’ and ‘non-bizzare’ delusions, they produced inter-rater reliability correlations of only around 0.40, forcing the researchers to conclude that even this central diagnostic requirement lacks sufficient reliability for it to be reliable method of distinguishing between schizophrenic and non-schizophrenic patients.

23
Q

evaluation of validity in the diagnosis and classification

A

There is research to support for gender bias in diagnosis
-Loring and Powell (1998) randomly selected 290 Male and female psychiatrists to read two case vignettes of patients behaviour. They were then asked to offer their judgement on these individuals using standard diagnostics criteria. when the patients were described as ‘male’ or no information given about their gender, 56% of the psychiatrists gave a diagnosis of schizophrenia.
But when the patients were described as ‘female’, only 20% were given diagnosis of schizophrenia.
interestingly this gender bias was not so evident among female psychiatrists, suggesting that diagnosis is influenced not only by the gender of the patient but the psychiatrists aswell

24
Q

what is a biological education

A

emphasise the role of inherited factors and dysfunction of the brain activity in the development of a behaviour or mental disorder.

25
Q

what is the dopamine hypothesis

A

claims that an excess of the neurotransmitter dopamine is certain regions of the brain is associated with the positive symptoms of schizophrenia

26
Q

what is neural correlates

A

changes in neuronal events and mechanisms that result in the characteristic symptoms of a behaviour or mental disorder

27
Q

the key role played by dopamine was highlighted in two sources of evidence

A

Drugs that increase dopaminergic activity:
Amphetamine is a dopamine agonist (stimulates nerve cells containing dopamine, causing the synapse to be flooded with neurotransmitters). ‘Normal’ individuals exposed to high levels of dopamine can experience characteristics of hallucinations and delusions. This
generally disappears with abstinence from the drug.

Drugs that decrease dopaminergic activity:
All antipsychotics block the activity of dopamine in the brain. By reducing activity in the neural pathways of the brain that use dopamine a neurotransmitter, these drugs eliminate symptoms such as hallucinations and delusions . the fact that these drugs alleviate many of the symptoms of schizophrenia strengthened the case for the important role of dopamine in this disorder

28
Q

genetic factors

A

one possible cause pf schizophrenia may be hereditary. schizophrenia tends to run in families, but among individuals who are genetically related rather than related by marriage.
It is most likely that different combinations of genes makes individuals more vulnerable to schizophrenia.

29
Q

what type of studies are used to prove genetic factors play a role in the biological explanations.

A

Family studies - (Gottesman, 1991) f
Twin studies - offer a unique opportunity for researchers to investigate the relative contribution of genetic and environmental influences
Adoption studies

30
Q

what was the study that supports family studies as a way of biologically explaining schizophrenia

A

(Gottesman, 1991) find individuals who have schizophrenia and determine whether their biological relatives are similarly affected more often than non-biological relatives. For example, the findings from Gottesman study, children with two schizophrenic parents had concordance rates of 48%, where as children with one schizophrenic parent rate of 13% and sibling rate of 9%

31
Q

what was the study that supports adoption studies as a way of an biological explanation schizophrenia

A

There is difficulty in disentangling genetic factors and environmental influences for individuals who share genes and environment, so studies of genetically related to individuals who have been reared apart, are used. probably the most methodologically sound study of this type is the Tienari et al. study the was carried out in Finland.
Of the 164 adoptees who’s biological mothers had been diagnosed with schizophrenia, 11 also received a diagnosis, compared to just 4 of the 147 control adoptees. The investigators concluded that these findings showed that the genetic liability to schizophrenia had been ‘decisively confirmed’.

32
Q

how do twin studies support biological explanation for schizophrenia

A

twin studies offer a unique opportunity for researchers to investigate the relative contribution of genetic and environmental influences. If MZ twins are more concordant than DZ twins then this suggests that the greater similarity is due to genet factors.
Joseph (2004) calculated that the pooled data for all schizophrenia twin studies carried out prior to 2001 showed a concordance rate of MZ twins of 40.4% and 7.4% for DZ twins. More recent, methodologically sound studies have tended to report a lower concordance rate for MZ twins than in earlier studies.
Despite this, however, some studies still support the genetic position because they show a concordance rate for MZ twins that is many times higher than DZ twins.

33
Q

the Revised dopamine hypothesis

A

Davis and Kahn proposed that the positive symptoms are caused by an excess of dopamine in subconical areas of the brain, particularly in the mesolimbic pathway.
the negative symptoms are thought to arise from a deficit of dopamine in areas of the prefrontal Cortex - mescortical pathway -

34
Q

what is the evidence for the revised hypothesis (which comes from various sources)

A

Neural imaging - Patel et al. using PET scans to assess dopamine levels in schizophrenic and normal individuals, found lower levels of dopamine in the dorsolateral prefrontal cortex of schizophrenic patients
Animal studies - Wang and Deutch induced dopamine depletion in the prefrontal cortex in rats. This resulted in cognitive impairment that the researchers were able to reverse using olanzaine, an Atypical antipsychotic drug thought to have beneficial effects of negative symptoms
in humans

35
Q

what are the main psychological explanations for schizophrenia

A

Family Dysfunction - Double bind theory, Expressed emotion

Cognitive explanations - cognitive explanations of delusions, and cognitive explanations of hallucinations

36
Q

what is cognitive explanation

A

explanation of mental disorders propose that abnormalities in cognitive function are a key component of schizophrenia

37
Q

what is a dysfunctional thought process

A

cognitive habits of beliefs that cause the individual to evaluate information inappropriately

38
Q

what is family dysfunction

A

the presence of problems within a family that contribute to relapse rates in recovering schizophrenics, including lack of warmth between parents and child, dysfunctional communication patterns and parental overprotection

39
Q

what is a study to support the theory of double bind theory

A

Gregory Bateson et al. suggested that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia. For example, if a mother tells her son that she loves him, yet at the same Time turns her head away in disgust, the receives two conflicting messages about their relationship on different communication levels.
These interactions prevent the development of an internally coherent construction of reality, and in the long term this manifests itself into schizophrenic symptoms.

40
Q

how is expressed emotion thought to prove that family dysfunction is a psychological explanation

A

another family variable associated with family dysfunction is a negative emotional climate or more generally, high degree of expressed emotion.
this is where the family of a psychiatric patient, speak about them in a critical and hostile way, or in a way that indicates an over-involvement or over-concern with the patient or their behaviour.
Kuipers et al. found that high EE relatives talk more and listen less, thus increasing the relapse rate
a patient returning to a high EE is 4 times more likely to relapse than a patient returning to a low EE.
this suggests that people with schizophrenia have a lower intolerance for intense environmental stimuli, particularly intense emotional comments and interactions with family members.

41
Q

within cognitive explanations what are the key components

A

cognitive explanations of delusions

cognitive explanations of hallucinations

42
Q

what is the theory of cognitive explanations, as a way of explaining schizophrenia

A

compared to normal controls, research has found evidence of dysfunctional thought processing in people with schizophrenia, i.e. they process information differently to those without the disorder. Cognitive explanations of schizophrenia emphasises the role of dysfunctional thought processing particularly evident in those who display the characteristics of positive symptoms, i.e. hallucinations and delusions

43
Q

evaluation of psychological explanations of schizophrenia

Individual differences

A

Not all patients with high EE families relapse, and not all patients with Low EE avoid relapse. Research has found individual differences in stress response to high EE-like behaviours. supported why Altorfer et al. 1/4 of patients showed no no psychological responses to stressful comments from their relatives.

44
Q

evaluation of psychological explanations of schizophrenia

Double bind theory

A

There is some evidence to support this particular account of how family relationships may lead to in schizophrenia. Berger found that schizophrenics reported higher recall of double bind statements by their mothers than non-schizophrenics.
However, this evidence may not be reliable as patients recall may be affected by their schizophrenia. other studies are less supportive.
Liem measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families.
Hall and Levin, analysed data from various previous studies and found no difference between families with and without a schizophrenic member in the degree to which verbal and non-verbal communication wherein agreement.

45
Q

evaluation of psychological explanations of schizophrenia

family relationships

A

it has been shown that there is a great importance in family relationships in the development of schizophrenia, this is shown in the adoption study by Tienari et al. in this study those adopted children who had schizophrenic biological parents were more likely to become ill themselves than those children with non-schizophrenic biological parents. However, this difference only emerged in situations where the adopted family was rated as disturbed. In other words, with illness only manifested itself under appropriate environmental conditions. Genetic vulnerability was not sufficient on its own.

46
Q

explain the benefits of an Atypical antipsychotic

A

they carry a lower risk of extrapyramidal side effects, have beneficial effect on negative symptoms and cognitive impairment, and are suitable for treatment-resistant patients.

47
Q

what is an Atypical antipsychotic drug

A

Known as the ‘second generation’ of antipsychotics. they have beneficial effects on both positive and negative symptoms. The drug acts on the dopamine system by blocking D2 receptors. however, they only do this for a short period of time, then rapidly dissociate to allow normal dopamine transmissions (this is the cause for the low risks of extrapyramidal side effects).
However, Atypical drugs have a stronger affinity for serotonin receptors, and a lower affinity for D2 receptors. It is this characteristic that explains the different side affects.

48
Q

what does Typical antipsychotics do

A

they are dopamine antagonists in that they bind to but do not stimulate dopamine receptors and so reduce the symptoms of schizophrenia.

49
Q

what is an Typical antipsychotic drug

A

known as the ‘first generation’, the drug binds to the dopamine receptors and without stimulating a response, and thus blocking their action. By reducing stimulation of the dopamine system in the mesolimbic pathway, they eliminate hallucinations and delusions.
However, it is estimated that about 60-70% of receptors need to be blocked for the drug to have an effect.
Furthermore, if these drugs are taken for a long period of time you can get other side effects such as Tardive Dyskinesia, that can be up 75% perminant damage.

50
Q

what is the process of CBTp

A

Assessment - patient expresses their thoughts
Engagement - psychologist empathises with them
The ABC model - patient gives an explanation of the activating event (A), that appear to cause the emotional and behavioural (B) consequence (C)
Normalisation - by placing hallucinations and delusions under many different circumstances, reduces anxiety and the sense of isolation
Critica collaborative analysis - therapist using mental questioning
Developing alternative explanations - patient develops their own alternative explanations for the previously unhealthy assumptions

51
Q

what is CBTp

A

Cognitive Behavioural Therapy for Psychosis
The basic assumption of CBTp is that people often have distorted beliefs, which influence their feelings and behaviours in maladaptive ways.
NICE suggest at least 16 session
Can be delivered in groups but better on one-to-one basis
the aim of CBTp is for patients to establish links between their thoughts, feelings or behaviours with respect to their symptoms.

52
Q

what is the nature of CBTp

A

the patients are encouraged to trace back to the origins of their symptoms in order to get a better idea of how they might have developed. They are also encouraged to evaluate the content of their delusions of any voices, and consider ways in which they might test the validity of their faulty beliefs.
They can be set behavioural assignments to improve their general functioning.

53
Q

family therapy

A

The name given to a range of interventions aimed at the family of someone with a normal disorder.

54
Q

what is the key study that evaluated the effectiveness of family therapy

A

Pharoah et al
procedure - reviewed 53 studies published between 2002-2010 to investigate the effectiveness of family intervention. studies chosen were conducted in Europe, Asia, India and North America. the studies compared the outcome of family therapy to ‘standard’ care alone.
Findings -