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A2 Abnormality > Schizophrenia and psychotic disorders > Flashcards

Schizophrenia and psychotic disorders Flashcards

1
Q

What is Schizophrenia and psychotic disorder?

A

Schizophrenia: a particularly severe type of psychotic disorder that affects all aspects of a person’s thinking, emotions and actions.

Psychotic disorder- involve a major break from reality which the individual perceives their world in a way that is very different from how others perceive it.

Symptoms can be categorised into positive (e.g delusions, hallucinations, disorganised thoughts, and catatonic behaviour) or negative symptoms (e.g loss of speech)

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2
Q

What is delusional disorder

A

Delusional disorder- is a disorder characterized by persistent delusions, but people suffering from it otherwise have quite normal behaviour unlike those with classic schizophrenia

There are 4 types of delusional disorder
Erotomanic (Belief that another person is in love with them)
Grandiose (Convinced they have a great unrecognised skill or status)
Jealous (Belief that their partner is being unfaithful)
Persecutory (Belief that the person is being conspired against or pursued by others who intend to harm them
In order to receive a diagnosis of delusional disorder, the individual must have been experiencing symptoms for one month or longer.

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3
Q

Describe Freeman 2008, symptom assessment using VR, findings

A

They created a fake environment which was a specifically designed library or underground train scene

Measures of persecutory thinking were also taken after being in the virtual environment, along with visual analogue rating scales, and an assessment of their degree of immersion in the virtual environment

Findings
The researchers found that those who scored highly on questionnaire assessment of paranoia experienced high levels of persecutory ideation

Persecutory Ideation: the process of forming an idea that one is at risk of being ill-treated or harmed by others

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4
Q

What are the 4 types of delusional disorder?

A

Erotomanic (Belief that another person is in love with them)
Grandiose (Convinced they have a great unrecognised skill or status)
Jealous (Belief that their partner is being unfaithful)
Persecutory (Belief that the person is being conspired against or pursued by others who intend to harm them

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5
Q

How long must the individual experience the symptom for diagnosis?

A

experiencing symptoms for one month or longer

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6
Q

Describe what psychologists have discovered about characteristics of schizophrenia spectrum and psychotic disorders

A

P1 - define schizophrenia + psychotic disorder

P2 - Delusional disorder, 4 types

P3- Describe + findings from freeman

(those who scored HIGHLY on questionnaire assessment of paranoia experienced high levels of PRESECUTORY IDEATION)

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7
Q

What is persecutory ideation?

A

the process of forming an idea that one is at risk of being ill-treated or harmed by others

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8
Q

Describe what psychologists have discovered about EXPLANATIONS of schizophrenia spectrum and psychotic disorders

A

P1 - genetic (Gottesman and Shields)

P2 - biochemical (dopamine hypothesis)

P3 - cognitive (Frith)

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9
Q

Describe what psychologists have discovered about TREATMENTS of schizophrenia

A

P1 - biochemical

  • typical antipsychotic medication
  • atypical

P2 - ECT

P3 - behavioural

  • CBT
  • token economy
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10
Q

What is Chlorpromazine (antagonist)?

A

(inhibitory effect) a drug that blocks symptoms of schizophrenia, occupies the dopamine site on the receptor, preventing receptor activation by dopamine

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11
Q

Describe the synaptic transmission

A
  1. vesicles release neorotransmitter into the synaptic cleft
  2. neurotransmitter binds to receptors & activates them
  3. excess neurotransmitter is taken up, through reuptake by the presynaptic neuron
  4. vesicles are replenished with new & reused neurotransmitter
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12
Q

What is the typical antipsychotic medication?

A
  • first generation
  • chlopromazine is one type of antipsychotic drug
  • works by binding to dopamine receptors without activating them in cortex + limbic system
  • 1 week to take effect
  • feel less hostile
  • 2-3 weeks diminished positive symptoms
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13
Q

What is atypical antipsychotic medication?

A
  • second generation
  • clozapine
  • binds to specific types of dopamine receptors
  • without activating them
    — less likely to produce side effects
    — particularly effective, suicidal behaviour

—> rare side effects, blood disorders, can be fatal

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14
Q

How is ECT used?

A
  • small current passed through brain for about 0.5s
  • causes seizure which lasts for 1min
  • one electrode on non-dominant brain hemisphere + one electrode middle of forehead
  • 3 times per week, for up to 5 weeks
  • muscle relaxant drug, anaesthetic
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15
Q

Strengths for using ECT \

A
  1. effective when used together with other treatment, e.g. clopazine
  2. effective for depressed people who do not respond to drug treatment or are at high risk of suicide
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16
Q

Weaknesses for using ECT

A
  1. not ethical, lack of informed consent, sometimes without anaesthetic
  2. reductionist - doesn’t take into account the influence of any other causal factors, e.g. social,
17
Q

Strengths and weaknesses for typical antipsychotic medication

A

strength: short term beneficial 75%, long term 60%
weaknesses: side effects, weight gain, drowsiness

reduce +ve symptoms but little effect on -ve symptoms

18
Q

Strengths and weaknesses for atypical antipsychotic medication

A

strength: less side effect
weaknesses: rare side effect, fatal blood disorder

19
Q

Describe the token economy

A
  • behavioural modification therapy, based on operant conditioning
  • reinforcement to promote behaviours (token)
  • punishment to extinguish unwanted behaviours (token taken away)
  • different numbers of tokens are exchanged for primary reinforcer (sweet, freedom)
20
Q

Evaluate token economy (effectiveness)

A

Paul and Lentz study: reduction of both positive and negative especially catatonic behaviours and social withdrawal, less successful in reducing hallucinations and delusional thinking

21
Q

Describe CBT on key assumptions of cognitive and behaviourist approaches

A
  • Cognitive assumption that this disorder result from irrational thinking
  • Learned and unlearned
  • talking therapy, recognise thoughts underlie behaviour
22
Q

Evaluate CBT (effectiveness)

A

Sensky et al. (2002):
Randomised control trial to compare effectiveness of CBT and befriending (= informal, one-to-one discussions about hobbies, sports or current affairs)
Findings: both groups showed significant reduction of both positive and negative symptoms
CBT group continued to improve in reduction of pos. Symptoms but befriending grp did not.

23
Q

Describe Frith’s theory, cognitive explanation (brief)

A
  • patients have positive symptoms and negative symptoms
  • cognitively impaired
    1. inability to generate willed action (intention to action)
    2. inability to monitor willed action (origin)
    3. lack of ToM
24
Q

What is positive symptom in Frith’s theory?

A

Auditory hallucinations are misattributed inner speech as result of impaired ability to monitor willed action.
- thoughts are self generated instead appear to be coming from an external source, and incorporated in the individual’s set of beliefs

25
Q

What is negative symptoms in Frith’s theory?

A

e. g. lack of action
- impaired ToM
- problems in recognising the intention of others
- flattening of affect, social withdrawal

—> might also due to FUNCTIONAL DISCONNECTION between frontal areas of the brain concerned action and area control perception

26
Q

Descrive Gottesman and Shields, biological explanation

A
  • twin study, research into genetic inheritance of schizophrenia
  • genes / particular combinations of genes —> passed onto offspring, cause the disorder to develop
  • symptoms: abnormalities like sensory dysfunction, memory impairment
  • 50% MZ twins had a shared schizophrenic status, concordance lower in DZ
  • In MZ, co-twin was more likely to be schizophrenic if the illness of their twin was severe
27
Q

Describe the dopamine hypothesis, biochemical explanation

A
  • brains produce more dopamine than normal
  • link between excessive amounts of dopamine/receptors = positive symptoms
  • neurons use transmitter dopamine, fire too often, send too much info

Evidence to support this theory comes from drug trials involving those with schizophrenia and those without the disorder

28
Q

Describe belief modification in CBT

A
  • patient can be persuaded into substituting more rational interpretations for irrational ones
  • what triggers symptoms
  • analysing, rationalising
  • hallucinations, explain where the voice comes from
  • keep diaries, develop understanding of symptoms
  • coping strategies, pay attention to voices at specific times
29
Q

Evaluate CBT ( appropriateness)

A

Strengths:

  1. help improve patient’s response to drug treatments, increase adherence, improve self esteem
  2. reduce likelihood of rehospitalisation, give strategies that will enable them to function more adaptively everyday life
  3. no side effects

Weaknesses:

  1. delay effect - lengthy course of treatment, may not be achievable
  2. does not cure on its own

A2 Abnormality (5 decks)

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