Schizophrenia

Question 1

How do psychiatrists diagnose Schizophrenia?

Answer 1

Psychiatrists diagnose schizophrenia using a diagnostic manual such as a DSM.

Question 2

What are the positive symptoms of Schizophrenia?

Answer 2

• Hallucinations.
• Delusions.
• Disorganised speech (word salad).
• Grossly disorganised behaviour.

Question 3

What are the Negative Symptoms of Schizophrenia?

Answer 3

• Speech poverty
• Avolition
• Affective flattening
• Anhedonia

Question 4

How is inter rater reliability measured?

Answer 4

Inter rater reliability is measured by kappa score. A Kappa score of 0.7 or above is generally considered good.

Question 5

What does research say about cultural differences in diagnosis of schizophrenia?

Answer 5

Research says that there is a significant variation between countries when it comes to diagnosing schizophrenia.

Question 6

What is Symptom overlap?

Answer 6

Symptom overlap is the issue that many symptoms of schizophrenia can also be found in other disorders, therefore making misdiagnosis quite common.

Question 7

What is Comorbidity?

Answer 7

Comorbidity is when an individual has multiple conditions at once.

Some examples of conditions that can accompany schizophrenia are drug abuse, depression, anxiety and sometimes OCD.

Question 8

Are Genetic factors responsible for whether or not an individual develops schizophrenia?

Answer 8

The risk of developing SZ is higher for individuals that have family members with SZ than those who don’t. However having the genes does not necessarily mean that you will develop SZ.

Question 9

What have Family studies established?

Answer 9

Family studies have established that SZ is more common in individuals whose family members have the disorder..

(e.g. (1991) Gottesman)

Question 10

What were the findings from Gottesman (1991)?

Answer 10

• Children with two parents who have SZ have an average concordance rate of 46%.
• Children with one parent who has SZ have an average concordance rate of 13%
• Finally Children who have a sibling with SZ have an average concordance rate of 9%.

Question 11

What does the Dopamine hypothesis say?

Answer 11

The dopamine hypothesis says that too much neurotransmitter dopamine in certain areas of the brain is associated with the positive symptoms of SZ.

Question 12

What does the updated Dopamine hypothesis say (Davis and Khan)?

Answer 12

Davis and Khan (1991) said that positive symptoms are caused by an excess of dopamine in subcortical areas of the brain, particularly the mesolimbic pathway. Negative symptoms are thought to come from a lack of dopamine in the prefrontal cortex.

Question 13

Outline the findings and procedure of Joseph’s (2004) study?

Answer 13

Joseph gathered all info on schizophrenia with identical and non identical twins. There was a concordance rate of 40.4% for identical twins. 7.4% for non identical twins.

(Other studies show that concordance for identical twins might not be quite so high).

Question 14

What did Broveman find out about validity in the diagnosis of schizophrenia? (gender)

Answer 14

Broveman et al. found that clinicians in the US equated mentally healthy adult behaviour with mentally healthy male behaviour. As a result of this there was a tendency for women to be deemed less mentally healthy.

Question 15

What impact do problems in a family environment have on individuals who have or are at risk of developing SZ?

Answer 15

Problems within a family contribute to relapse rates in recovering schizophrenics. Examples of these problems are: lack of warmth between parents and child, dysfunctional communication patterns and parental overprotection.

Question 16

What is the cognitive explanation for delusions?

Answer 16

Faulty interpretations of experiences due to inadequate info processing. They perceive themselves as the center of attention in all situations. This leads to false conclusions. They cant reality test and don’t consider that they may be wrong.

Question 17

What is the cognitive explanation for Hallucinations?

Answer 17

Excessive focus on auditory stimuli. Leads to higher expectation of voices than normal people. Idea can override actual sensory stimulus and produce an auditory image that’s not actually real. Likely to misattribute sounds due to not reality checking.

Question 18

What are the two types of antipsychotics?

Answer 18

• Typical (Chlorpromazine)

- Atypical (Clozapine)

Question 19

What are the side effects of Typical antipsychotics.

Answer 19

• Loss of Sex drive
• Lethargy
• Anhedonia
• Avolition
• Weight gain
• Insomnia
• Anxiety
• Muscle spasm
• Tardive dyskinesia

Question 20

What are the side effects of Atypical antipsychotics?

Answer 20

These act on D2 receptors too, so they help with positive symptoms. Side effects are less severe too, since the blockage doesn’t last as long (rapid dissociation).
They also act on serotonin
This means they not only reduce SZ symptoms, but they also reduce depression and anxiety, which is great because 30-50% of SZ patients attempt suicide atleast once at some point.

Question 21

How do typical antipsychotics work?

Answer 21

They bind to D2 receptors but they don’t stimulate them (they block the action of dopamine).

Question 22

How does Token economy work?

Answer 22

Token economy works through Operant conditioning?

Question 23

Outline gender bias in the diagnosis of SZ ?

Answer 23

Clinicians found that mentally healthy ‘adult’ behaviour is equated more with mentally healthy ‘male’ behaviour than it is with ‘female’.

Question 24

Outline the Double bind theory?

Answer 24

Children who frequently receive contradictory messages from their parents are more likely to develop SZ.