Schizophrenia and related psychotic disorders Flashcards
Define Schizophrenia
Schizophrenia is a type of psychotic disorder where a person’s emotions, thinking and actions are affected
Give two examples of types of schizophrenic spectrum and psychotic disorders
Schizotypal disorder- a personality disorder that makes people aloof
Delusional disorder- people with this disorder are afflicted with delusions
An example of schizophrenic case study
Conrad (male aged 23)
-Had his first psychotic episode while on a vacation when he was 22 and was later diagnosed with schizoaffective disorder
-Was reluctant to seek treatment at the beginning because he was unsure if he would ever recover so he spent the first 8 months of his diagnosis in a psychiatric hospital
-Through trial and error he has found a drug that works for him and is doing better but he struggles maintain a healthy weight
Positive Symptoms of Schizophrenia
-Hallucinations
-Delusions
-Disorganized thoughts
-Catatonic behavior
Negative Symptoms
-Loss of normal functioning
-Loss of speech
-Lack of facial expressions (flat affect)
-anhedonia: inability to feel pleasure in normal pleasurable activities
-alogia: poverty of speech
-avolition: lack of motivation
Types of delusional disorders
Erotomaniac- Belief that somebody is in love with them
Grandiose- Convinced they have some great unrecognized skill or status
Jealous/Infidelity- Belief that partner is being unfaithful
Persecutory- Belief that the person is being conspired against or pursued by others who intend to harm them
Who proposed an alternative to traditional ways of diagnosing schizophrenia and in what year
Freeman, 2008
Why is it difficult to diagnose schizophrenia using normal methods
-relies on patient answering truthfully
-cannot rule out that the beliefs of persecution are unfounded
Strengths of using virtual reality for diagnosis
-allows social environments to be controlled so it can be neutral and standardized while assessing actual behaviour
-Ensures that paranoid thoughts and behaviour are genuine, as the social situation is totally artificial
Briefly describe the procedure of Freeman’s research
-trialed in a non-clinical population of around 200 students
-used validated measurement tools to assess each individual’s paranoid thinking prior to virtual reality test
-measures of persecutory thinking were also taken after being immersed in the virtual environment along with visual analogue rating scales and an assessment of their degree of immersion in the virtual environment
Briefly describe the results of Freeman’s research
-those who scored high in the questionnaire also experienced high levels of persecutory ideation in the VR trial
-auditory hallucinations were also experienced in VR
List out 7 applications for VR in schizophrenia
-symptom assessment
-identification of physiological arousal that correlates to symptoms
-developing treatment:
-how to cope with symptoms as they occur
-exposure to persecutory fears
-teach individuals about factors that make symptoms better or worse
-establishing causal factors
-identification of environmental predictors (by altering environmental elements that increase the likelihood of delusional ideas, hallucinations or social difficulties)
-to test the already established causal factors
-identification of predictive variables (for example participants who scored high in the paranoid questionnaire showed more persecutory ideation)
Evaluate the study by Freeman (2008)
-large sample; not representative of clinical population
-VR programme is standardized increasing validity
-low ecological validity since it involves a stimulated environment
-continues to rely on self-report leads to response bias
-VR program needs to be modified to avoid cultural bias
Practical issues of using VR
-a wide variability in the content of people with psychosis needing differing triggering environments
-still need to ask participants about their experience since positive symptoms such as delusional thoughts and hallucinations requires verbal report to establish
-individuals might suffer from simulator sickness (dizziness, nausea, headache, and eyestrain)
List out the three explanations of Schizophrenia
Genetic (Gottesman and Shields, 1972)
Biochemical (dopamine hypothesis)(Lindström et al., 1999)
Cognitive (Frith, 1992)
Briefly explain the procedure conducted by Gottesman and Shields (1972)
-carried out twin study research into the genetic inheritance of schizophrenia
-sample was taken from 467 twins who were registered at the Maudsley Hospital in London between 1948 and 1964 (longitudinal study)
-a series of tests were conducted on 57 pairs of twins: 24 MZ twins and 33 DZ twins.
-blood group and finger prints were used to classify twins as MZ or DZ
-Patients and twins were interviewed along with undertaking cognitive tests such as object sorting
-external of judges were used to evaluate case summaries of each independent participant to ensure validity of diagnosis
Briefly explain the results by Gottesman and Shields (1972)
-approximately 50% of MZ twins had a shared schizophrenic status while it was only 9% for DZ twins (showing that schizophrenia is caused significantly by genetics but relies on some environmental factors)
-the co-twin was more likely to have schizophrenia if the first twins illness was severe
-conclusion: found a higher concordance rate for schizophrenia in monozygotic (MZ) than dizygotic (DZ) twins
Evaluate the study by Gottesman and Shields (1972)
-large sample
-results are not generalizable to non-twin individuals
-results are less generalizable because sample was from one hospital
-researchers confirmed diagnosis of schizophrenia using an external panel of judges reducing researcher bias
-used quantitative measures to confirm if twins were MZ or DZ (raised validity of study)
-qualitative data was also collected (interview) gaining in-depth data about participants; subjective data is prone to interpretation and biased by the researcher’s opinions or feelings
-quantitative element of the study allows the results to be easily compared and analyzed
Nature Vs Nurture Debate in Gottesman and Shields (1972)
while this study does try to establish a casual link between genetics (nature) and mental disorder; we can’t rule out that maybe what actually caused the concordance of schizophrenia in MZ twins was because they were treated more similarly by the environment they grew up in (nurture) compared to DZ twins. Therefore all differences between MZ and DZ twins can be attributed to genetics.
What does the dopamine hypothesis state
-the brains of those with schizophrenia produce more dopamine than those without the disorder
-there is a link between excessive amounts of dopamine or dopamine receptors and positive symptoms of schizophrenia and related disorders
State the evidence that supports the dopamine hypothesis
-drugs that increase levels of dopamine in brain (cocaine) lead to more reported hallucinations and delusions
-when patients with Parkinson’s disease are treated with high doses of synthetic form of dopamine (L-dopa), it creates schizophrenic symptoms
-Wise et al found that brain fluid in post-mortem studies lack the enzyme used to break down dopamine suggesting it was present in large amounts
-PET scans by Nestler et al. suggests that decreased levels of dopamine activity in prefrontal cortex correlate with negative symptoms such as flattened affect in schizophrenia
What does the cognitive theory by Frith (1992) state
schizophrenia involves faulty mental processes rather than relying solely on physiological explanations
How does Frith (1992) explain schizophrenia
-describes schizophrenia as an abnormality of self monitoring
-patients fail to recognize hallucinations as just inner speech
- patients with incoherent speech as symptom performed worst at identifying source of speech which may be linked to memory and attention difficulties crucial to self-monitoring
-delusions arise from self-generated thoughts that appear to be from external source than become incorporated in the individuals sets of beliefs
-negative symptoms such as lack action have difficulty generating spontaneous actions
What are the 4 treatments to schizophrenia
-biochemical (antipsychotics and atypical antipsychotics)
-electro-convulsive therapy
-token economy (Paul and Lentz, 1977)
-cognitive behavioral therapy (Sensky et al., 2000)
