schizophrenia

Question 1

features

Answer 1

1 in 100 affected 
onset 15-25 years old
unlikely to occur in childhood
more prevalent in men
1 in 4 attempts suicide with 10% dying

Question 2

difference between positive symptoms and negative symptoms

Answer 2

positive symptoms add to the experience and negative symptoms take away from normal behaviour

Question 3

positive symptoms (4)

Answer 3

Hallucinations = perceptual disturbances, seeing or hearing things that aren’t there (auditory)

Delusions = disturbances of thought including false beliefs

Thought or language disorder = speech difficult to follow, thought insertion, disorganised and incomprehensible speech

abnormal motor behaviours = disorganised behaviour that can affect daily life

• catatonia = fall in responsiveness to environment
• echopraxia = involuntary echoing of an observed persons movements of speech

Question 4

types of delusions

Answer 4

paranoid delusions
- belief you are being persecuted or conspired against

delusions of grandeur
- believe you are famous or very important

referential delusions
- belief that language or behaviour of others is directed at them

Question 5

negative symptoms

Answer 5

• lack of energy and apathy
• social withdrawal
• lack of emotion
• avolition
• not looking after self

Question 6

evaluate negative symptoms

Answer 6

many people show evidence of negative symptoms without positive does not mean they are schizophrenic

Question 7

why are negative symptoms different to positive

Answer 7

negative are tougher to treat and often start before positive symptoms (predromal period)

Question 8

types of schizophrenia

Answer 8

1. paranoid: delusions and hallucinations
2. disorganised: disorganised speech and moods
3. catatonic: withdrawn, isolated, little physical movement
4. residual: few positive and some psychotic symptoms
5. undifferentiated: person doesn’t fit any other types

schizoaffective disorder: not schizo but schizo mood and symptoms

Question 9

neurotransmitter theory explanation

Answer 9

• D2 receptors are responsible for how we react to dopamine
• schizophrenics overreact as they tend to have hypersensitive dopamine receptors
• D2 receptors have greater affinity to dopamine meaning they are more likely to bind to neurotransmitters when present in the synapse

Question 10

neurotransmitter theory supporting evidence

Answer 10

randrup and munkvad 1966 - injected rats with amphetamines which increases dopamine in brain and rats were more aggressive and isolated

lieberman et al 1975 - 75% of schizophrenics showed increased or new symptoms when using amphetamines or methylphenidate

brown and birley 1968 - 50% of patients reported a major life event 3 weeks prior to relapse (social factors)

owen et al 1978 - post mortum studies found overwhelming increase in density levels of dopamine receptors in cerebral cortex. This demonstrates that they may be hypersensitive to dopamine levels

Question 11

amphetamines

Answer 11

groups of drugs that increase activity of certain chemicals in the brain

Question 12

evaluation for neurotransmitter theory

Answer 12

SE- drugs phenothiazine blocks dopamine receptors and alleviates schizo symptoms as less dopamine is taking up
EV - drugs block dopamine receptors almost immediately but any calming effect is not seen until several days after. Suggests that other causes and hypothesis is highly reductionistic

SE - amphetamines can cause excess dopamine resulting in symptoms of psychosis (similar to + symptoms) suggests that dopamine is linked to schizophrenia
EV - amphetamines only produce positive and fails to take into account negative so dopamine hypothesis is not a sufficient explanation

SE - scanning shows when those with schizophrenia are given amphetamines there is a greater release of dopamine than non schizo. Suggests that those with schizo are more sensitive to dopamine and tend to overreact

CE - social and environmental factors also involved. Stressful event can cause excess dopamine and trigger schizoz Brown and Birley 1968. There is a link between social class and schizophrenia but correlation does not equal causation

Question 13

conclusion for neurotransmitter theory

Answer 13

these factors suggest the holistic explanation for schizophrenia may be far more complex and multi-faceted than suggesting it is only down to neurotransmitter functioning and sensitivity

Question 14

genetic explanation for schizophrenia

Answer 14

heritability factors are significant in development of schizophrenia. Those with family members who have schizophrenia may have a stronger predisposition to also developing it

Gottesman and shields 1966 - twin studies to determine concordance rates, population has less than 1% likelihood
MZ = 48%
1st degree relative = 6-17%
2nd degree relative - 2-6%

diathesis stress model
- genetic factors mean someone may have a high vulnerability but environmental trigger is required to activate it

Tienari et al 2002 - 7% adoptees who had biological mother with schizophrenia also developed the disorder. 2% of adoptees with schizophrenia whose mother not diagnosed

Question 15

genetic explanation evaluation

Answer 15

SE - Gottesman and Shield 1966
EV - MZ twins have 100% DNA so should have 100% concordance rate so other factors must (reductionistic)

CE - diathesis stress model (Brown and Birley 1968)
EV - difficult to separate out influence of nature vs. nurture

Question 16

social causation hypothesis

Answer 16

= higher rate of schizophrenia in lower classes

1% rate of schizophrenia in general population
4% concordance rate = white low social class and immigrant groups
(unemployed and living in deprived areas more at risk and tend to have different course and different treatment)

60s SCH suggested social class was the cause now other factors such as stress are included

Hjem et al 2004 - social adversity in childhood linked with developing schizophrenia later in life

Cooper 2005 - 
social class 5, unskilled labourer = 4.1x likely
social class 1, higher managerial = less likely 
afro caribbean and black immigrants 4x likely as they are disadvantaged in education, housing, social class and discrimination

Veiling et al 2008 - immigrants in areas where there own ethnicity did not dominate = higher incidence of psychotic disorder

Question 17

social causation hypothesis evaluation

Answer 17

strengths

• diathesis stress model - good face validity for SCH
• SE from studies

weakness

• social drift hypothesis = schizophrenia causes people to drift down social classes
• too many factors to isolate

Question 18

family therapy A01 and A03

Answer 18

A01
aims to provide SUPPORT NETWORK for patient and help develop a COLLABORATIVE RELATIONSHIP. enables patient to OPENLY TALK about symptoms and patient becomes EXPERT ON SCHIZOPHRENIA. e.g. explain how it feels to experience hallucinations so family can be supportive
Goldstein and miklowitz 1995 - family intervention effective when takes place alongside drug therapy. reduction in relapse rates

A03

• not a treatment and will not cure the disorder, just to help families cope and create manageable environment
• research shows FT reduces relapse rate when used alongside medication
• relies on whole family to be mentally/ cognitively involved

Question 19

drug therapy

Answer 19

typical - old 1950s

• first antipsychotics developed
• fluphenazine
• unpleasant side effect; muscle spasms and tremors tardive dyskenesia

atypical - new 1990s
- second generation antipsychotics developed
- olanzapine
- improve - symptoms and cognitive functioning
Bar et al 1997 - clozapine most effective/ popular as it addresses positive and some negative

Question 20

how do antipsychotics work?

Answer 20

• reduce dopamine levels in brain by blocking D2 dopamine receptors which prevents dopamine binding to receptors in synapse and evens dopamine
• newer antipsychotics bind less tightly to receptors and block 5HT2A (serotonin) receptors which is what scientist think supports reduction in unpleasant side effects from earlier

Question 21

evaluation for drug therapy

Answer 21

Pros

• earlier treatments were sterilisation or shock therapy so more humane and positive
• drug therapy medicalises schizos behaviour and takes away faults of behaviour
• strong biological evidence, dopamine hypothesis explains why drugs should work when blocking D2 receptors. Strong face validity

Cons

• bad side effects for typical antipsychotics so patients stop taking meds (tardive dyskenesia)
• atypical clozapine increases risk of developing agranulocytosis (increased risk of infections by decreasing WBC count)