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Schizophrenia Flashcards

1
Q

Diagnosis and classification of schizophrenia

1) what is schizophrenia?

A

1) a severe mental illness where contact with reality and insight are impaired - an example of psychosis

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2
Q

2) how is schizophrenia diagnosed?

A

2) doesn’t have a single defining characteristic, cluster of symptoms that appear to be unrelated

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3
Q

3) what are the 2 major systems for the classification of mental disorder?

A

3) WHO ICD 10 - international classification of disease and DSM-5 - both classify schizophrenia differently - ICD 10 2 or more negative symptoms and DSM 5 one or more positive symptom

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4
Q

4) what is the definition of classification of mental disorder?

A

4) the process of organising symptoms into catagories based on which symptoms cluster together in sufferers

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5
Q

5) what are the different subtypes of schizophrenia by ICD 10

A

5) paranoid schizophrenia - characterised by powerful delusions and hallucinations but few other symptoms
hebephrenic schizophrenia - primarily negative symptoms
catatonic schizophrenia - disturbance to movement - leaving sufferer immobile or alternatively overactive
simple schizophrenia - uncommon - progressive development of -ve symptoms no psychotic history
undifferentiated schizophrenia - previously called atypical - come criteria of a mix of the other groups

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6
Q

6) what are primary delusions?

A

false beliefs which continue despite evidence to the contrary

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7
Q

7) what are the 4 different types of delusions?

A

a) delusions of grandeur - believe you are more important than you are - e.g king
b) delusions of persecution - belief people are plotting against you or being interfered with certain people or organised group
c) delusions of reference - belief objects/ events have personal significance - usually negative
d) delusions of nihilism - belief nothing really exists and all things are simply shadows - common person thinks they are dead and watching world from before

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8
Q

8) what are positive symptoms of schizophrenia?

A

8) aytpical symptoms experienced in addition to normal experiences - hallucinations and delusions

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9
Q

9) what are hallucinations?

A

9) a positive symptom of schizophrenia - sensory experiences of stimuli that either have no basis in reality or are distorted perceptions of things that are there.

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10
Q

10) what are delusions?

A

10) positive symptom of schizophrenia - involve beliefs that have no basis in reality - sufferer is someone else or that they are victim of conspiracy - paranoia - irrational beliefs

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11
Q

11) what are negative symptoms of schizophrenia?

A

atypical experiences that represent the loss of a usual experience such as clear thinking or ‘normal’ levels of motivation

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12
Q

12) what is avolition?

A

loss of motivations - lowered activity levels

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13
Q

13) what is speech poverty?

A

reduced frequency and quality of speech

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14
Q

biological explanations for schizophrenia

14) what is the genetic basis of schizophrenia?

A

schizophrenia runs in families - although weak evidence because family members generally share same environment - strong relationship found between degree of genetic similarity and shared risk of schizophrenia - Gottesman (1991) large-scale family study

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15
Q

15) what are candidate genes?

A

individual genes believed to be associated with risk of inheritance. schizophrenia = polygenic. different studies identified different candidate genes - schizophrenia = aetiologically heterogenous, - different combinations leading to condition - ripke et al (2014) genome wide study 37000 patients compared to that of 113000 controls - 108 separate genetic variations found - inclusing neurotransmitters

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16
Q

16) evaluate the genetic basis of schizophrenia

A

strong evidence for genetic vulnerability to schizophrenia - gottesman 1991 shows genetic similarity and shared risk of schizophrenia is closely related
adoption studies pekka tienari et al 2004 - children of schizophrenia sufferers still at heightened risk if adopted into families with no history of schizophrenia
genetic factors therefore do make people much more susceptible to schizophrenia however cannot say entirely genetic or ignore environmental factors - evidence to suggest genetic vulnerability = very important

17
Q

17) explain the dopamine hypothesis

A

neurotransmitters - brains chemical messengers work differently in schizophrenic patient - dopamine DA – important in functioning of several brains systems may be implicated into symptoms of schiophrenia

hyperdopaminergia in subcortex - original version - high levels of activity of DA in subcortex - central brain areas e.g brocas area - speech poverty or auditory hallucinations

hypodopaminergia in cortex - abnormal DA in cortex - goldman-rakic et al 2004 identified roles for low DA levels in prefrontal cortex - thinking and decision making in -ve symptoms of schizophrenia
possible that both high and low levels od DA = responsible for schizophrenia

18
Q

18) evaluate the dopamine hypothesis

A

support for abnormal dopamine functionally in schizophrenia - DA agonists - amphetamine that increase levels of DA make schizophrenia worse and can produce schizophrenia-like symptoms in non-sufferers - curran et al (2004)
anti psychotic drugs reduce DA activity - both type of drugs suggest important role in schizophrenia
radioactive labelling studies found chemicals needed to produce DA are taken up faster in that of schizophrenic patients therefore possibly more is produced
also evidence to suggest dopamine doesn’t provide complete explanation for schizophrenia - there are other neurotransmitters - glutamate evidence for DA hypothesis = mixed

19
Q

explain neural correlates of schizophrenia

A

measurements of structure or function of the brain that correlate with an experience - +ve and -ve symptoms have neural correlates
neural correlates of -ve symptoms - avolition loss of motivation - anticipation of reward - ventral striatum therefore abnormalities in ventral striatum may be involved in avolition development
juckel et al 2006 - measured activity levels in VS in schizophrenia and found lower levels of activity than controls - -ve correlation between activity in VS and severity of -ve symptom - VS = neural correlate of -ve symptoms of schizophrenia
neural correlates of +ve symptoms - allen et al 2007 scanned brains of patients experiencing auditory hallucinations and compared to control - lower activity levels in superior temporal gyrus and anterior cingulate gyrus found in hallucination group - made more errors than controls - reduced activity in these areas is a neural correlate of auditory hallucinations.

20
Q

20) evaluate neural correlates of schizophrenia

A

correlation-causation problem
number of neural correlates of schizophrenia symptoms - -ve and +ve symptoms - leaves important questions unanswered - which causes what symptom cause abnormality or abnormality causes symptoms - or possibility of third factor influencing both neural correlate and symptom - not great explanation of schizophrenia

21
Q

Psychological explanations of schizophrenia
family dysfunction
21) what is the idea of family dysfunction

A

that there is a link between schizophrenia and childhood and adult experience of living in a dysfunctional family

22
Q

22) what is a schizophrenogenic mother

A

psychodynamic explanation for schizophrenia - Fromm-reichmann 1948 - based on accounts she heard from patients about childhood - many patients spoke of particular type of parent - schizophrenogenic mother -= cold rejecting and controlling creating a family climate of tension and secrecy - leads to distrust later developing into paranoid delusions and ultimately schizophrenia

23
Q

23) what is double-bind theory

A

Gregor bateson et al 1975 agreed family climate is important in development of schizophrenia - emphasised role of communication style within family - trapped in situations fear doing the wrong thing but dont know what it is - ‘get it wrong’ = withdrawal of love - world is confusing and dangerous - disorganised thinking and paranoid delusions = risk factor

24
Q

24) what is expressed emotion

A

level of emotion - particularly -ve expressed towards a patient by their carers
- verbal criticism - sometimes violence
- hostility - anger and rejection
- emotional over-involvement - needless self-sacrifice
serious source of stress and main cause of relapse - also possibly trigger onset for someone already vulnerable

25
Q

25) what are the cognitive explanations of schizophrenia

A
  • focuses on mental processes - schizophrenia associated with abnormal info processing
    schizophrenia characterised by disruption to normal thought processing e.g ventral striatum and -ve symptoms whilst reduced processing info in temporal and cingulate gyri = hallucinations
26
Q

26) what is dysfunctional thought processing

A

metareprensentation - cognitive ability to reflect on thoughts and behaviour - own intentions and goals - interpret actions of others - dysfunction will mean unable to recognise actions as own and thoughts - so hallucinations and voices of delusions e.g voice insertion
central control - suppress automatic responses - perform deliberate actions instead- disorganised speech and thoughts

27
Q

27) evaluate family dysfunction

A

read et al - 46 studies of child abuse and schizophrenia - 69% adult women with schizophrenia had history of physical abuse, sexual abuse and both - men = 59%
adults with insecure attachments are more likely to have schizophrenia
lots of evidence linking schizophrenia to family dysfunction - however info about childhood carried out after development of symptoms and schizophrenia may have distorted recall = validity
results from studies from childhood = inconsistent

28
Q

28) evaluate family-based explanations

A

not much evidence to support schizophrenogenic mother or double bind theory
parent-blaming - suffered seeing child go through schizophrenia now being blamed

29
Q

29) dysfunctional information processing

A

stirling et al 2006 - compared 30 patients with schizophrenia to 18 controls on range of cognitive tasks - stroop test - patients took x2 longer to name ink colour than controls supporting central control
links between faulty cognition and symptoms are clear but no origin is known - proximal causes but not distal causes

30
Q

30) what is the interactionist approach

A

a broad approach to explaining schizophrenia which acknowledges that a range of factors are involved in development of schizophrenia

31
Q

31) what is the diathesis-stress model

A

an interactionst approach to explaining behaviour - schizophrenia is a result of underlying issues - genetics (diathesis) and a trigger both necessary for schizophrenia to start - early version vulnerability was genetic and triggers were psychological - now both genes and trauma are diathesis and stress can be psychological and biological in nature

32
Q

32) explain the diathesis -stress model

- original stress model

A 
meehls model (1962) diathesis = entirely genetic as a result of single schizogene - schizotypic personality - one characteristic - sensitivity to stress 
according to Meehl no amount of stress could leas to schizophrenia if schizogene wasn't present - however in gene carriers chronic stress e.g schizophrenogenic mother could result in development of condition
33
Q

33) explain the diathesis -stress model

- new stress model

A

now clear many genes increase genetic vulnerability - ripke et al
range of factors become diathesis beyond genetic such as psychological trauma - becomes diathesis rather than stressor
read et al 2001 neurodevelopmental model in which early trauma alters developing brain - child abuse can affect brain development such as HPA being overactive

34
Q

34) modern understanding of stress

A

in original stress was psychological - parenting in particular
modern definition includes anything that risks triggering schizophrenia - much research involves cannabis use -cannabis is a stressor - interferes with DA system

35
Q

35) treatment for interactionist model

A

combining CBT and anti-psychotic medication - unusual to treat by only psychological

Schizophrenia (1 decks)

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