Schizophrenia Flashcards
Schizophrenia definition
(psychosis) a psychological disorder characterised by profound disruption of cognition and emotion
basic details of schizophrenia
affects a persons language though perception, emotions and sense of self
sufferer believes things that can’t be true (delusions) or hears voices or sees visions (hallucinations)
affects 4 in a thousand people
Diagnosing Schizophrenia
DSM-5 (diagnostic statistical manual of psychiatric disorders) description of over 200 mental disorders grouped in terms of common features most recent in DSM-5
ICD-10 (international classification of diseases) used in Europe
Positive Symptoms (four)
usually an excess or distortion of normal functions
hallucinations bizarre unreal perceptions of the environment mostly, auditory, olfactory, visual, voice tell them what to do or persecutory
delusions a belief that seems real but it is not
paranoia can have a delusion of grandeur
delusions of reference
environment has more meaning
disorganised speech
speech is fragmented and organised switches from topic to another derailment
world salad speech that is hard to understand
disorganised or catatonic behaviour
inability or motivation to complete a task
reduced hygiene may act in ways that seem bizarre
reduced reaction to the environment
rigid postures or aimless motor activity
Negative symptoms
loss of normal functions
persist when they have
weakens a person’s everyday life
1/3 patients suffer from negative symptoms
respond poorly to anti-psychotic treatment but better
Deficit syndrome
presence of at least two negative symptoms for twelve months or longer
List of Negative Symptoms
1. speech poverty alogia blocked thought fewer words in a fewer time difficulty with saying things Avolition no self initiative disturbances of effect
Validity in classification two terms
- symptom overlap
2. co-morbidity
Symptom overlap
refers to the fact that symptoms of a disorder may not be unique to that disorder and that make it difficult to diagnose somebody
Co-morbidity
the extent to which two or more diseases occur at the same time for example schizophrenia and depression
Reliability in Schizophrenia
consistent/repeatable
Two types of reliability
inter-rater reliability
test re-test reliability
Definitions for inter-rater reliability and test re-test reliability
two researcher’s come to the same conclusion reaches a CAPPA score, indicates how in agreement the two researchers are, .7 or above is good
patient shows same schizophrenic symptoms at two different points in time
Psychologial explanations for Schizophrenia
one family dysfunction A double bind theory B expressed emotion 2. cognitive explanations A cognitive explanations of delusions
double bind theory (who and what?)
gregory bateson suggusted that children who receive contradictory messages from parents are more likely to develop schizophrenia for example, parents shouts ‘i love you’
expressed emotion
family communication style where members of family are critical or hostile or emotionally overinvolved example Kuipers 1983 found that high ee relatives talk more and listen less high levels ee influence relapse rate patient with family high in ee four times more likely to relapse than patient with family low in ee
Cognitive explanations
1 dysfunctional thought processing
2 cognitive explanations of delusions
3 cognitive explanations of hallucinations
dysfunctional thought processing
cognitive habits are beliefs which cause the individual to evaluate information inappropriately
cognitive explanations of delusions
patients interpretations of experiences controlled by inadequate information processing
degree to which individual percieves self as central to events egocentric
impaired insight - inability to recognise congitive distortions and substitute more realistic expectations for events
cognitive explanations of hallucinations
hallucinating individuals focus a lot of attention on auditory stimuli
Aleman 2001 suggest that hallucination prone individuals find it difficult to distinguish or differentiate between images and senses for them inner representation of an idea can override actual senses
hallucinating patients more likely to miss attribute source of a self-generated auditory experience than non-hallucinating patients
Evaluation of Family Dysfunction for Schizophrenia
Family relationships
in support Tienari 1994 adopted children with schizophrenic bio parents more likely to become ill than children with non-schizophrenic however only happened when the adopted family was also disturbed
Double Bind theory
Burger 1965 found that schizophrenia patients have more double bind statements from their mother’s than however liem found no difference Gibney states that the real value of double bind theory is that it lead to family therapy
Expressed Emotions
- not all patients with high ee families relapse and not all patients who live in low ee homes avoid relapsing not all patients are equally vulnerable to high levels of expressed emotion within the family environment
Evaluation of cognitive explanations of Schizophrenia
support for cognitive model of schizophrenia
Sarin and Wallin found supporting evidence for the claim that the positive symptoms of schizophrenia had origins in faulty cognition
therapists can use this information for techniques
support for success of CBT
claim that symptoms of Schiz have origin in faulty cognition reinforced by success of CBTp
effectiveness of CBTp demonstrated in NICE review founf consistent evidence that CBT was more effective than meds for social functioning
intergrated model of schizophrenia
problem with cog model is deals with one aspect of disorder (cognitive impairment) but fails to explain other aspects for example social adversity Hals and Murray 2014 addressed this problem with inergrated model of schizophrenia early vulnerability factors (genes, birth complications) together with exposure to social stressors sensitizes the dopamine system
