Schizophrenia Flashcards
Positive Symptoms (excess behaviour)
Hallucinations - seeing or hearing things that do not exist
Delusions - being controlled by outside forces
Thought insertions
Thought withdrawal
Thought broadcasting
Negative Symptoms (missing behaviour)
Poverty of speech - use as few words as possible
Social withdrawal
Flattening effect - monotone, no expression, no emotions
Dopamine Hypothesis - Negative symptoms
Excessive uptake of dopamine by the pre-synaptic neurone. This leads to a slowing down of firing in the post-synaptic neurone as there is not enough dopamine to trigger a response. This may account for negative symptoms – the absence of emotion and interest.
Dopamine Hypothesis - Positive symptoms
too many dopamine receptor sites on the post-synaptic neurone. There is then too much uptake and an action potential is fired too readily by this neurone, causing an overload of messages in the central nervous system.
Lindstroem et al.
Used PET scans and found that schizophrenics used the dopamine producing drug more quickly suggesting they create more dopamine than non-0schizophrenics. (10 of each).
Hemsley (93) - Cognitive Theory
Suggested that the central deficit in schizophrenia is a breakdown in the relationship between information that has already been stored in memory and new, incoming sensory information. He suggests that this processing break down in schizophrenia and those schemas are not activated. As a result, people with schizophrenia are subjected to sensory overload and do not know which aspects of a situation to attend to and which to ignore.
Frith’s model (92) - Cognitive Theory
An attempt to explain the onset and maintenance of the positive symptoms of schizophrenia. People with schizophrenia are cognitively impaired in that they are unable to distinguish between actions that are brought about and those that are generated internally. He believes that most of the symptoms of schizophrenia can be explained in terms of deficit in three cognitive processes: the inability to generate willed action, the ability to monitor willed action and the inability to monitor the belief and intentions of others. Faulty operation of this mechanism is due to a functional disconnection between frontal areas of the brain concerned with action arid more further back areas of the brain that control perception
Frith and Done (1989)
found delusions schizophrenics performed far worse when playing a video game where they had to monitor their own performance in comparison to the control group. (Unable to reflect on their own behaviour).
Biological Treatments (Drug Therapy)
Antipsychotic drugs. Help to reduce symptoms but don’t cure it. They work by blocking the dopamine receptors in the brain. This stops the dopamine being picked up and so minimises it’s effect. Reduces the effect of the disorder. However side effects such as drowsiness and skin rashes.
Drug Therapy Strengths
Drugs allow patients to live in society. Avoids institutionalisation. Also can be used in conjunction with other therapies and to reduce symptoms enough for other treatments to be looked into.
Pickar et al. Tested effectiveness of antipsychotic drug clozapine and found it helped even if patient hadn’t responded to drugs in past. Placebo was not effective.
Drug Therapy Weaknesses
Side effects can put people off taking the drug.
Have to be committed to keeping up drug treatment. Relapses are harmful in the long run.
Drug treatment isn’t a cure. Maintenance has to be kept up indefinitely to keep therapeutic effects.
Cognitive Treatment (CBT)
Based on Cognitive theory of schizophrenia. Involves a therapist. Belief that our beliefs about the world affects how we see the world and ourselves. The behavioural part aims to change behaviour. This is done by therapist identifying and challenging misconceptions and maladaptive thoughts about themselves and the world by questioning them. They can then understand their thoughts are incorrect and so can change them to more realistic thoughts. Is not a cure but helps patient function normally. Taught to ignore voices in their heads.
Chadwick et al.
22 schizophrenics. Heard voices. 8 hours of CBT. All had reduced negative beliefs about the power of the voices. Thus allowing them to live with them better.
Pfammatter et al.
carried out a meta-analysis on CBT. Found it was highly effective in reducing severe positive symptoms.
Other studies have found that it was effective on patients not responding to drugs. Plus no side effects!