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Psychology > Schizophrenia L1 - 2 > Flashcards

Schizophrenia L1 - 2 Flashcards

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1
Q

Schizophrenia:

A

Severe mental psychotic disorder characterised by disruption of cognition and emotion

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2
Q

Psychotic:

A

Mental issues causing abnormal thinking and loss of realism

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3
Q

Which 2 classification systems are used to diagnose schizophrenia?

A
  • DSM 5 (America)
  • ICD 11 (Europe and other parts of world)
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4
Q

Positive symptoms:

A

Symptoms that reflect an excess of normal functions

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5
Q

4 examples of positive symptoms:

A
  • Hallucinations eg auditory, olfactory, tactile, visual
  • Delusions
  • Disorganised speech
  • Grossly disorganised behaviour
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6
Q

Hallucinations v Delusions:

A
  • Delusions are irrational beliefs
  • Hallucinations are sensory experiences of stimuli
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7
Q

Negative symptom:

A

Symptom that reflects reduction of normal functions

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8
Q

3 examples of negative symptoms:

A
  • Speech poverty (alogia) –> reduction in amount and quality of speech
  • Avolition –> Loss of interest to do regular everyday tasks
  • Affective flattening –> no emotional expression in their speech
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9
Q

How many of each type of symptom is needed to diagnose schizophrenia according to both classification system?

A
  • DSM 5 –> 2 or more positive symptoms for a month and 6 months of social withdrawal
  • ICD 11 –> 1 positive and one negative symptom for a month
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10
Q

Who made a distinction between two types of schizophrenia and what are each?

A
  • Crow (1980)
  • Type 1: Characterised more by positive symptoms
  • Type 2: Characterised more by negative symptoms
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11
Q

Give 6 issues with the classification and diagnosis of SZ:

A
  • Reliability
  • Validity
  • Co-morbidity
  • Symptom overlap
  • Gender bias
  • Cultural bias
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12
Q

Give two studies showing weakness in reliability of diagnosis of SZ:

A
  • Whaley (2001) found low inter rater reliability score of +0.11 (DSM)
  • Cheniaux et al (2009)
  • Read et al (2004)
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13
Q

Cheniaux et al (2009):

A
  • 2 psychiatrists independently diagnose 100 schizophrenic patients using both ICD & DSM
  • One psychiatrist diagnosed 26 (DSM) and 44 (ICD) w/ SZ
  • Other psychiatrist diagnosed 13 (DSM) and 24 (ICD) w/ SZ
  • Low inter-rater reliability
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14
Q

Read et al (2004):

A

Test-retest reliability showed 37% concordance rate of SZ diagnosis

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15
Q

Give one study showing strength in reliability of diagnosis of SZ:

A
  • Flavia Osario et al (2019)
  • Found inter rated reliability between pairs of psychiatrists was +0.97 and test-retest reliability was +0.92 (using DSM)
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16
Q

How can the validity of SZ diagnosis be assessed?

A

Using criterion validity (when different assessment systems arrive at the same diagnosis for some patient)

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17
Q

What does Chiniaux’s study show about validity of SZ diagnosis?

A
  • Low validity
  • SZ is more likely to be diagnosed w/ ICD than DSM
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18
Q

Give one study showing a reason for lack of validity in SZ diagnosis:

A

Rosenhan (1973)

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19
Q

Rosenhan (1973):

A

1) 8 volunteers who weren’t suffering from SZ presented themselves to different hospitals claiming they could hear voices
2) Took between 7 and 52 days to be released, diagnosed as schizophrenics in remission (DSM) (decreased symptoms)
3) Normal behaviours were interpreted as SZ symptoms

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20
Q

Rosenhan (1973) follow-up study:

A

1) Informed hospital that some number of pseudo patients would be admitted over 3 months
2) 83/193 admitted aroused suspicions of being false patients
3) No acc pseudo-patients were admitted

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21
Q

Give one study showing strength in reliability of diagnosis of SZ:

A
  • Osario (2019)
  • Because DSM reliability is so high, validity would also be high
  • Suggests ICD needs more revision
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22
Q

Co-morbidity:

A

Idea that 2 or more mental disordered occur together at same time w/ same person

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23
Q

Give one study showing co-morbidity in SZ diagnosis:

A
  • Buckley et al (2009)
  • Around half of patients w/ SZ have also been diagnosed w/ depression/substance abuse
  • PTSD also occurred in 29% and OCD in 23% of cases
24
Q

Give one studies showing symptom overlap:

A
  • Ellason and Ross (1995)
  • Found that people with dissociative identity disorder acc have more schizophrenic symptoms than SZ diagnosed person
25
Q

Give one study showing gender bias in SZ diagnosis:

A
  • Fischer and Buchanan (2017)
  • Since 1980s ratio of men and women diagnosed w/ SZ is 1.4 : 1
26
Q

Give one study showing cultural bias in diagnosis:

A
  • Pinto and Jones (2008)
  • African American and English people of Afro-Caribbean descent are 9 times more likely to be diagnosed w/ SZ
27
Q

Give two possible reasons for increased SZ diagnoses in black people:

A
  • Auditory hallucinations may be acceptable there because of cultural beliefs in communication w/ dead ancestors but this is seen as a positive symptom of SZ in UK
  • Possibly racism –> doubting honesty of black people (Escobar, 2012)
28
Q

3 advantages of diagnosis of SZ:

A
  • Communication shorthand –> simpler to incorporate symptoms into single diagnosis to communicate between professionals
  • Easier to identify a treatment
  • Many w/ SZ have underlying biological abnormalities, which can lead to more effective treatment if diagnosed
29
Q

What 2 explanations does the biological approach include?

A
  • Neural correlate including dopamine hypothesis
  • Genetics
30
Q

What 3 types of studies usually test genetic factors?

A
  • Family
  • Twin
  • Adoption
31
Q

What have family studies shown about the effect of genes on the risk of getting schizophrenia?

A

The closer the genetic relations, there more likely you are to get schizophrenia

32
Q

Gottesman (1991):

A
  • If both parents are schizophrenic, the likelihood of the offspring also having SZ was 46%
  • If one parent is schizophrenic, the likelihood of offspring having SZ is 9%
  • 48% concordance rate for MZ twins
  • 17% concordance rate for DZ twins
33
Q

Joseph (2004):

A
  • Review of twin studies carried out up to 2001
  • Found concordance rate for MZ is 40%, whereas DZ is 7.4%
34
Q

Tienari et al (2001):

A
  • 164 adoptees w/ SZ biological mothers, where 6.7% were diagnosed with SZ
  • Compared to control grp of 197 adoptees where 2% had SZ
  • Link between genes and schizophrenia
35
Q

Is schizophrenia polygenic or monogenic and which studies showed this?

A
  • Polygenic
  • Gurling et al (2006), Benzel et al (2007), Ripke et al (2014)
36
Q

Gurling et al (2006):

A
  • Used family study evidence to show that SZ was associated w/ chromosome 8p21-22
  • Used gene mapping to show PCM1 gene was also implicated in being susceptible to SZ
37
Q

Benzel et al (2007):

A

Used gene mapping suggesting that NRG3 gene variants interact w/ NRG1 and ERBB4 gene variants to create susceptibility to SZ

38
Q

Ripke et al (2014):

A
  • Compared genetic makeup of 37000 SZ patients worldwide w/ 113000 controls
  • 108 separate genetic variations were associated with SZ
  • Those that were particularly vulnerable had some connection to certain neurotransmitters
39
Q

Strengths and weaknesses of genetic explanation for SZ: (+1, -4)

A

+ Research evidence –> Gottesman, Tienari, Joseph, Benzel, Ripke, Gurling
- Nature or nurture? –> even in adoption studies, often children are brought up by relatives who have similar rearing styles
- SZ can occur despite having no family history –> Brown et al (2002)
- Biologically reductionist –> ignores other factors and insinuates having the gene will mean SZ
- Diathesis stress model

40
Q

How can SZ occur despite there being no family history and what study shows evidence for this?

A
  • Mutation in parental DNA
  • Brown et al (2002)
41
Q

Brown et al (2002):

A
  • Positive connection between paternal age and increased risk of SZ
  • From around 0.7% in fathers under 25 to over 2% in fathers over 50
42
Q

What does the diathesis stress model suggest about vulnerability to SZ?

A

Genes can make you more vulnerable, however this is only likely to be triggered if there is a stress trigger in the individual’s life

43
Q

Neural correlates:

A

Patterns of structure/activity that occur in conjunction with an experience and may be implicated in the origins of this

44
Q

What structural changes have been shown within schizophrenics and which study showed each?

A
  • Enlarged ventricles –> Torrey (2002)
  • Impaired prefrontal cortex –> Weinberger and Gallhofer (1997)
  • Changes in hippocampus –> Conrad et al (1991)
45
Q

Torrey (2002):

A

Ventricles of someone w/ SZ is on avg abt 15% larger than normal

46
Q

Give 2 characteristics of a person w/ enlarged ventricles:

A
  • More negative than positive symptoms
  • Respond poorly to antipsychotic drugs
47
Q

What is the role of the prefrontal cortex?

A

Involved in executive control

48
Q

Conrad et al (1991):

A

Anatomical changes have been reported in hippocampus of SZ patients

49
Q

Strengths and weaknesses of neural correlates as an explanation for SZ: (+2, -3)

A

+ Research evidence –> Torrey, Weinberger and Gallhofer, Conrad et al
+ Face validity due to the availability of brain scanning, helping to tailor treatments
- Individual differences
- Cause and effect
- Difficult to pinpoint exact brain region causing the issue

50
Q

Give two functions of dopamine as a neurotransmitter:

A
  • Helps regulate movement, attention, learning and emotional responses
  • Contributes to feelings of pleasure
51
Q

According to the dopamine hypothesis, what do schizophrenics have too much of, which causes their symptoms?

A
  • D2 receptors
  • Leads to more dopamine binding and neurons firing
52
Q

2 consequences of dopamine hypothesis:

A

1) Hyperdopaminergia –> high levels of dopamine in subcortex
2) Hypodopaminergia –> low levels of dopamine in cortex

53
Q

Strengths and weaknesses of dopamine hypothesis as explanation for SZ: (+1, -2)

A

+ Drug research evidence –> dopamine agonists like amphetamines increase dopamine and worsen SZ symptoms, Tauscher et al (2014), Lindstroem
- Biologically determinist –> Moghadamm and Javitt (2012)
- Correlation-causation issue –> doesn’t mean high dopamine causes SZ, just a link

54
Q

Tauscher et al (2014):

A

Antipsychotic drugs reduce levels of dopamine in SZ patients, controlling SZ symptoms

55
Q

Lindstroem et al (1999)

A

Chemicals needed to produce dopamine are taken up faster in schizophrenics’ brains compared to controls

56
Q

Moghadamm and Javitt (2012):

A
  • Found that glutamate had been implicated in SZ
  • Excessive release of glutamate leads to cognitive impairments

Psychology (32 decks)

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