schizophrenia ao1 Flashcards
psychology paper 3
what are the two major systems for classifying a mental disorder?
ICD-10 and DSM-V
what are differences between the ICD and DSM system?
in DSM patients must be present with positive symptopms whereas ICD two or more negative systems is sufficient
what are positive symptoms of schizophrenia?
experiences that are added to ordinary existence eg delusions or hallucinations
what are types of delusions?
delusions of persecution - others want to harm/threaten you
delusions of grandeur - thinking youre an important individual
what are negative symptoms of schizophrenia?
experiences which cause a decline in functioning eg speech poverty or avolition (no longer goal driven)
what is reliability of schizophrenia?
in diagnosis when two or more mental health professionals arrive at the same diagnosis for same patient and give the same diagnosis again on same person on two different occasions (consistency)
what is validity of schizophrenia?
check criterion validity if different systems arrive to same diagnosis for same patient
what is comorbidity in schizophrenia?
when two or more conditions occur together questions validity of both cases eg severe depression can be seen as SZ and vice versa better to see as one condition
what is symptom overlap in schizophrenia?
similar symptoms of schizophrenia and other conditions eg bipolar and schizophrenia both share positive symptoms questions validity of classification
what is culture bias in schizophrenia?
symptoms mean different things in different cultures
what is gender bias in schizophrenia?
treatment and representation of men and women based off stereotypes
what is the genetic basis of schizophrenia?
- evidence SZ runs in families/genetic
- family studies show closer genetic relationship with someone with SZ increases chance of you developing SZ
- high concordance rates in MZ twins than DZ twins
- research stats : 2% chance of developing SZ if aunt with SZ 9% with sibling and 48% in MZ twins
what are candidate genes in schizophrenia?
- SZ maybe polygenic
- SZ may be aetiologically heterogenous (formed from different combo of genes)
- genes with risk include those coding for functioning of neurotransmitters
what is the original dopamine hypothesis?
- hyperdopaminergia in sub cortex
- high levels of dopamine activity in brain
- eg excess dopamine in brocas area = associated with speech production = potentially associated with speech poverty
what is the updated dopamine hypothesis?
- hypodopaminergia in cortex
- identified low levels of dopamine in prefrontal cortex in negative symptoms of SZ
overall conclusion for dopamine hypothesis?
hypo and hyperdopaminergia are correct but in different regions which involved in SZ also genes and stress contribute to emergence of SZ
what are neural correlates of negative symptoms?
- avolition is loss of motivation involving anticipation of reward
- certain areas of brain believed to be involved (ventral striatum)
- so abnormalities in areas of brain cause abnormalities
what are neural correlates of positive symptoms?
- researchers compared brains of patients with auditory hallucionations and compared to control
- patients with hallucinations found lower activation levels in superior temporal gyrus and anterior cingulate gyrus
what is family dysfunction?
abnormal processes within a family like poor communication seen as risk to developing SZ
what are schizophrenogenic mothers?
- researchers proposed psychodynamic explanation based off patients accounts from childhood
- schizophrenogenic means SZ causing like cold and controlling climates creating tension/secrecy
- leads to distrust later and develop paranoid delusions
what is the double bind theory?
- contradictory communication between tone of voice and content by parent
- eg ‘come give mum a hug’ then freezes when hugging
- leads to social withdrawals
- prolonged exposure makes child think world is confusing (reflected in symtopms of disorganised thinking etc)
what is expressed emotion?
- family communication style
- members are critical hostile and over involvment in patients life
- pateint returning to family with high EE 4x likely to relapse than one with low EE
- peopel with SZ have lower tolerance for intense emotional situations
- lead to stress beyound patients coping mechanism
what is metarepresentation?
cognitive ability to reflect on thoughts and behaviour
what is central control?
cognitive ability to suppress automatic responses while perfoming actions
what is dysfunctional thought processing?
metarepresentation - dysfunction disrupts ones ability to recognise our own thoughts could lead to delusions and hallucinations
central control - dysfunction could be result of speech poverty as no control of these automatic thoughts
how is CBT used to help schizophrenia?
- help patient identify irrational thoughts and try change then
- help make sense of delusions and hallucinations
- help understand where symptoms come from can be useful
- reality testing (examining likely hood beliefs are true)
what is family therapy?
- therapy in aaim to improve communication and interaction between members
- look at root cause or reduce stress within families
- reduce EE esp negative ones like guilt
- improve family ability to help encourage to make therupeutic environments
- all reduces chances of relapse
wha is the model for family therapy?
1 - share basic information and provide emotional support
2- identify resources
3 - encourage mutual understanding create safe space for everyone
4 - identify unhelpful patterns
5 - stress management techniques
6 - looking at relapse prevention
7 - maintenance
what is token economy?
- token are given for good tasks etc which can be swapped for rewards
- based off operant conditioning tokens are secondary reinforcers
- manages schizophrenia
what is token economy used for?
- tackle institutionalised behaviour like personal care and social behaviour
- TE used to improve quality of life and prepare for outside hospital
- tokens are secondary reinforcers and exchanged for primary reinforcers eg sweets
what is the interactionist approach to explaining schizophrenia?
acknowledges biological (genetic vulnerability etc) psychological (stress etc) and societal factors in developing SZ
what is the diathesis stress model?
vulnerability to SZ and a stress trigger is necessary to develop SZ eg genetic vulnerabilty and SZ is triggered by stress
what was the Meehls orginal diathesis stress model?
believed diathesis was entirely genetic resulting from schizogene leading to developemt of biologically based schizotypic personality one characteristic is sensitivity to stress
what did Meehl say if a person doesnt have schizogene?
no amount of stress could lead to schizophrenia but carriers of gene stress through childhood could lead to SZ hence demonstrating interaction between biology and environment
what is modern understanding of diathesis?
- many genes may increase vulnerability of SZ and many other factors like psychological trauma
- trauma becomes diathesis rather than stressor
- researchers proposed a neurodevelopment model in whcih early trauma alters developing brain eg HPA becomes over active
what is modern understanding of stress?
- stress includes anything that risks triggering SZ like cannabis
- originally just seen as psychological
- cannabia increases risks of SZ 7x as interferes with dopamine system as it ineracts with other vulnerability factors
what is treatment of SZ according to interactionist model?
- combines antipsychotics with CBT alongside family therapy etc
- it is standard practice to combine two treatments in britian odd not to
what are typical antipsychotics and what form is it taken in?
- chloropromazine
- taken as tablets syrups injection
- max 1000mg dose (usually 400 - 800mg)
how is typical antipsychotics associated with dopamine hypothesis?
- chloropromazine acts as antagonists in dopamine system
- reduce action of dopamine as block receptors in brain
- production is reduced and according to hypothesis it normalises neurotransmitters in brain and reduces symptoms
does chloropromazine have sedative properties?
- it has sedative properties
- has an affect on histamine receptors but not understood how
- used to calm down patients with SZ and other conditions
- usually in syrup form
what are atypical antipsychotics and what form is it taken in?
- founded to imrpove effectiveness of drugs and minimise side effects
- clozapine used to treat SZ if other treatments fail
- patients have regular blood tests to make sure not developing agranulacytosis
- small does as tablets or syrup 300 - 400 mg
how does clozapine work and what does it improve?
- binds to dopamine receptors but also acts on serotonin and glutamate receptors
- action helps improves mood and reduce depression and anxiety in patients
- sometimes prescribe when patients at high risk of suicide
what is risperidone and what form is it taken in?
- atypical antipsychotic made to be as good as clozapine without serious side effects
- taken in tablets syrup or injection
- first small doses like other drugs and increased (min 4-8 mg and max 12mg)
- binds to dopamine/serotonin and binds more strongly so lower doses
name a typical antipsychotic
chlorpromazine
name atypical antipsychotics
clozapine and risperidone
