Schizophrenia AO1 Flashcards
3 types of family dysfunction?
- Schizophrenogenic mother - cold, rejecting mothers leading to distrust and paranoid delusions
- Double bind theory - child, confliction of what’s wrong and if ‘get it wrong’ love is withdrawn world confusing leading to disorganised thinking and delusions
- Expressed emotions - type of family communication style; hostility, verbal criticism + over involvement. High expressed emotions = stress = relapse risk
What makes it hard classifying and diagnosing Sz?
Symptom overlap - overlap symptoms of Sz and other conditions e.g. bipolar and Sz
Co-morbidity - another disorder alongside primary diagnosis e.g. Sz and personality disorder
Culture - variation in countries when diagnosing Sz e.g. 69% US psychiatrist diagnosed Sz but only 2% british did
Gender - DSM diagnostic categories may be biased to one gender than other, psychiatrist gender affect diagnosing ability
What does CBT aim to do
Link sufferer feelings and level of functioning
Cognitive explanation of Sz
Lower level of info processing = cognitive impairement
- Frith;
2 types of disfunctional though processing;
1) Metarepresentation - leads to hallucinations
2) Central control dysfunction leads to speech poverty, people with Sz - derailment of thought- each word triggers automatic association can’t suppress
Interactionist approach
- Orignial diathesis stress = meehl - no ‘schizogene’ = no Sz (stress caused by dysfunctional family dynamics
Updated model - Riplee, psychological trauma brain development, HPA overactive = increased stress
Stressor (negative psychological experience) triggers diathesis
Genetics family studies
- String relationship between degree of genetic similarity and shared risk of Sz
Gottesman found;
- aunt with Sz = 2%
- sibling with Sz = 9%
- identical twin with Sz = 48%
(chances of developing Sz)
Genetic- candidate gene explanation of Sz?
- Sz is polygenic and aetiologically heterogenous
- Ripke - 108 genes linked with increased risk of Sz
- Miyakwaw - defective PPP3CC (regulates immune system) = increased risk
- Brown - correlation paternal age and risk of Sz
Token economies
- Token is a secondary reinforcer as is given immediately after desirable behaviour and gets exchanged for rewards
- Based on operant conditioning
What happens in family therapy and what is the aim?
- Reduce EE by educating on disorder
- Therapist & family & patient = open discussion
(encourage probelm solving & communication skill)
How does CBT work?
& case study
- Helps sufferer identify and correct irrational belief
- Change maladaptive thinking
- Normalisation = explain hearing voices is an ordinary experience
Case study;
- Turkington - paranoid client believe mafia plotting to kill him
- therapist explain less scary possibilities and challenges client’s evidence
Negative symptoms of Sz?
- Speech poverty - reduced quality, short empty replies
- Avolition - unwilling to carry out goal directed behaviour
Cognitive techniques used in CBTp?
- distract from intrusive thoughts
- challenge irrational thoughts
- change level of social activity
- use relaxation techniques
Positive symptoms of Sz?
- Hallucinations - sensory experience, no basis in reality
- Delusion, delusion of grandeur (important individual), delusion of persecution (others want to harm you)
What is the neural correlates of Sz?
Original dopamine hypothesis
- hyperdopaminergia of subcortex, increased Dopamine associated with hallucinations & speech poverty
Updated dopamine hypothesis
- hypodopaminergic
- decreased dopamine in prefrontal cortex explain negative symptoms
Enlarged ventricles
- large fluid filled gaps associated with damage to central brain and prefrontal cortex
Typical antipsychotics and how they work?
Chlorpromazine - dopamine antagonist, eliminates hallucinations and delusions, ensures postsynaptic cell receives less dopamine
