schizophrenia pt 1

Question 1

incidence of SZ

Answer 1

<1%

Question 2

gender differences in SZ

Answer 2

similar numbers
later onset and fewer hospital admissions for women –> therefore higher social role before illness therefore better outcome

Question 3

ethnicity differences in SZ

Answer 3

higher in ethnic minorities than white
due to racial prejudices for treatment in US
high stress from being in a minority is a trigger
for immigrants from LIDCs the stress and low economic status is a trigger

Question 4

schizophrenia meaning

Answer 4

splitting of psychic functions

Question 5

what comes first - pos or neg symptoms

Answer 5

positive - thought to then lead to withdrawals

Question 6

positive symptoms (8)

Answer 6

hallucinations - auditory and visual
-reality-monitoring deficit (distinguish what did and didn’t occur)
self-monitoring deficit (distinguish between thoughts they generated or others did)
can be aware it isn’t real, others are convinced it is

inappropriate reactions/affective states

delusions & paranoia

psychosis (prolonged)

speech - incoherence or motor issues (speech patterns etc.)

incoherent thought

odd behaviours

violence and aggression - more common in younger boys with history of violence and substance abuse (DSM-5, 2013)

Question 7

types of speech issues (5)

Answer 7

detrailment/loose associations = drift from one topic to another in speech and thinking

tangentiality = irrelevant answering

clanging = taking word sounds to mean related concepts e.g. rhyming

neologisms = made up words

word salad = no link between phrasing

Question 8

types of delusions (7)

Answer 8

grandeur, persecution, conspiracy, control, reference (think external events make reference to them), nihilism, erotomanic (think celeb is in love with you)

Question 9

negative symptoms (5)

Answer 9

social withdrawal
affective flattening (diminished emotions)
avolition (low/no motivation)
catatonia (motionless states - motor control)
anhedonia = inability to react to enjoyable events

Question 10

types of catatonic state (4)

Answer 10

• catatonic stupor = decreased reactivity to the environment
• catatonic rigidity = staying rigid and immobile
• catatonic negativism = resisting an attempt to be moved
• catatonic excitement/stereotypy = purposeless and excessive motor activity

Question 11

number of symptoms to lead to a diagnosis

Answer 11

2 frequently occurring for a month when one symptom is delusions, hallucinations, or disorganised speech

Question 12

causes of SZ (4) (very vague - general list)

Answer 12

genetic
dopamine levels in brain
drug induced psychosis
environmental (stress)

Question 13

R D Laing’s theory of SZ

Answer 13

antipsychiatry movement
society tells you you have it - distorted ideas of what is normal - “normal” is repressive
link with family - “sanity, madness, and the family” book

Question 14

Freud’s theory of SZ

Answer 14

paranoid delusions result from repressed sexual urges which are striving for expression

Question 15

SZ concordance in MZ and DZ twins

Answer 15

MZ = 45%
DZ = 10%

Question 16

define epigenetics

Answer 16

how behaviours change how genes work
is reversible
DNA sequence is same but is read differently

Question 17

genes for SZ

Answer 17

no single gene
related genes associated with:
brain development
myelination
transmission at glutaminergic and GABAergic synapses
changes in DA neuron physiology
link to other psychiatric and neurological disorders

Question 18

impact of stress on SZ

Answer 18

correlation between stress levels and episode severity

Question 19

environmental stressors

Answer 19

birth complications
maternal stress
prenatal infections
socioeconomic class
urban birth/living in urban setting
childhood adversity

these impact those with a genetic vulnerability

Question 20

eye movements with SZ

Answer 20

controls have smooth pursuit movements, jerky with SZ
visuomotor deficits, can cause day to day issues e.g. reading maps

Question 20

cognitive deficits with SZ - prepulse inhibition

Answer 20

startle response is less due to habituation from smaller stimuli in control - SZ don’t habituate and so are as startled as they would’ve been
result of dopaminergic changes

Question 20

wisconsin card sorting task and SZ

Answer 20

executive function task where cards are needed to be sorted by either colour, symbol, or number

impaired in SZ and frontal lobe damage patients
e.g. perseverance errors - asked to sort by colour and then number but they continue to sort by colour

Question 20

ToM and SZ vs ASD

Answer 20

differing theories:
some say ASD and SZ are opposite ends of the ToM spectrum (underactive in ASD and overactive in SZ - therefore delusions)
others say the comorbidity with ASD and SZ shows underactive ToM in SZ

Question 20

cognitive biases in SZ (5)

Answer 20

cognitive - overreport confrontational interactions
attentional - anxiety from attending to negative stimuli
reasoning - jump to conclusions
interpretational - hearing voices
attributional

Question 21

Seligman’s attributional model and SZ

Answer 21

attributions of negative events by 3 dimensions:
internal vs external
global vs specific
stable vs unstable
external, global, and stable = leads to delusions and paranoia

Question 22

family impacts on SZ

Answer 22

double-bind and paradoxical communication = verbal message contradicts implied message
communication deviance
expressed emotion

causality is complicated - SZ can also lead to poor communication

Question 23

SES and SZ

Answer 23

socioeconomic status
social drift = SZ have difficulty with employment and so have lower SES
sociogenic hypothesis = low SES – more stressful life (trigger for SZ)
dispute over whether parental SES at time of birth correlates with SZ

Question 24

non-drug treatments of SZ

Answer 24

social skills training
CBT - reattribution therapy (learn hallucinations cause)
personal therapy
cognitive remediation training
family interventions - psychoeducation, supportive and applied family management
community care