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Yr 13 Psychology > Schizophrenia Unit 4 > Flashcards

Schizophrenia Unit 4 Flashcards

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1
Q

What are hallucinations?

A

Distorted perceptions from the senses e.g. Visual or auditory

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2
Q

What are behavioural disturbances?

A

Could be reactions to delusions and hallucinations e.g. Withdrawal, fear of others, peculiar mannerisms e.g. Catatonic stupor, psychomotor agitation

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3
Q

What is disordered thinking and speech?

A

Inability to concentrate or to sort thoughts into logical sequences, communication may be difficult and speech hard to follow e.g. Neologisms

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4
Q

What are negative symptoms?

A

Emotions may be blunted, flat or unexpected.

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5
Q

What is the biochemical explanation of schizophrenia?

A

Schizophrenics have too much dopamine. Dopamine plays a key part in guiding attention and schizophrenics have abnormally high levels of dopamine receptors.

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6
Q

What is L Dopa and how does it link to the biochemical explanation?

A

Biochemical - L Dopa is a drug given to people with Parkinson’s disease which increases levels of dopamine in the brain (Parkinson’s sufferers have low levels of dopamine). If the dosage is too high the Parkinson’s sufferers can have schizophrenic type symptoms.

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7
Q

What do antipsychotic drugs support the biochemical explanation of schizophrenia?

A

Biochemical - Antipsychotic drugs block the activity of dopamine in the brain and they are effective in eliminating symptoms such as hallucinations and delusions.

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8
Q

What did Davis et al do?

A

Biochemical - carried out a meta analysis of 29 studies comparing the effects of antipsychotic treatment against a control. Found that relapse occurred in 55% of patients using a placebo and 19% of those using antipsychotics

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9
Q

What did Wong et al do?

A

Biochemical - found using a PET scan that dopamine receptors were more dense in the caudate nuclei in schizophrenic patients

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10
Q

What did Falkai et al do?

A

Biochemical - found increased dopamine levels in the left amygdala in post-mortems of schizophrenic patients

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11
Q

What did Grilly do?

A

Biochemical - suggets that L Dopa medication can induce symptoms resembling acute schizophrenia

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12
Q

What did Copolov and Crook do?

A

Biochemical - neuroimaging studies have failed to provide convincing evidence of altered dopamine activity in the brains of people with schizophrenia

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13
Q

What did Haracz do?

A

Biochemical - suggests that most post mortem studies found that schizophrenics had raised dopamine levels BUT they had received antipsychotic drugs prior to death. The ones who had not received antipsychotic drugs did not have raised dopamine levels.

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14
Q

What is the viral hypothesis (Torrey and Peterson)?

A

Schizophrenics are more likely to have been born in the early spring. Their mothers would have been in the second trimester during the winter months when infections such as flu are more common. Perhaps the developing brain was exposed to infection which led to long term damage?

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15
Q

What did Takei do?

A

Viral hypothesis - found a higher rate of schizophrenia among people born during influenza epidemics

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16
Q

What did Mednick do?

A

Viral hypothesis - found that more schizophrenics were born during the Helsinki flu epidemic

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17
Q

What did Van Os do?

A

Viral hypothesis - found that schizophrenics have more fingerprint abnormalities (fingerprints develop during the second trimester so this is more evidence of exposure to infection at that time)

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18
Q

What is the neuroanatomical explanation of schizophrenia?

A

That schizophrenics have brain abnormalities that have led to the disorder

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19
Q

What did Brown et al do?

A

Neuroanatomical - schizophrenics have decreased brain weight and enlarged ventricles

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20
Q

What did Flaum et al do?

A

Neuroanatomical - schizophrenics have enlarged ventricles, a smaller thalamus, hippocampus and superior temporal lobes

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21
Q

What did Buchsbaum do?

A

Neuroanatomical - schizophrenics have abnormalities in the frontal and pre frontal cortex, basal ganglia, hippocampus and amygdala

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22
Q

What did Castner at al do?

A

Neuroanatomical - subjected monkeys to brain damaging x Rays when they were in the womb. Found that during puberty they developed schizophrenic symptoms such as hallucinations.

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23
Q

What is the genetics explanation of schizophrenia?

A

That schizophrenia has been inherited in the genes, and as a result it runs in families

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24
Q

What did Gottesman find?

A

Genetics - 48% concordance for MZ twins for schizophrenia and only 17% for DZ

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25
Q

What did Tienari do?

A

Genetics - Finnish adoption study. 7% of children who had schizophrenic biological mothers developed schizophrenia compared to 1.5% of controls.

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26
Q

What did Kendler et al do?

A

Genetics - first degree relatives of schizophrenics are 18 times more at risk than the general population

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27
Q

What is the socio cultural explanation of schizophrenia?

A

That lifestyle factors lead to development of schizophrenia, such as traumatic life events and/or dysfunctional family situation

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28
Q

What did Fromm-Reichman do?

A

Socio cultural - family - schizophrenogenic family (high emotional tension, many secrets, close alliances and conspiracies) and mother (domineering and insensitive, overprotective and rejecting, contradictory actions)

29
Q

What did Bateson do?

A

Socio cultural - family - double bind (when parents are contradictory and muddled in their communication)

30
Q

What did Lidz do?

A

Socio cultural - family - marital skew (one parent dominant the other submissive) and marital schism (parents emotionally distant)

31
Q

What did Linszen et al do?

A

Socio cultural - family - high expressed emotion (hostility, criticism, over involvement and over concern) leads to more relapse

32
Q

What did Hammersley and Read do?

A

Socio cultural - life events - reviewed 13 studies into abuse and schizophrenia, some found abuse rates as high as 97%

33
Q

What did Brown and Birley do?

A

Socio cultural - life events - 50% of their sample experienced a major life event in the three weeks prior to a schizophrenic episode (retrospective study)

34
Q

What did Hirsch et al do?

A

Socio cultural - life events - followed 71 schizophrenics over a 48 week period. Life events made a significant cumulative effect in the 12 months preceding relapse (prospective study)

35
Q

What is the cognitive explanation of schizophrenia?

A

The disorder is caused by faulty thoughts.
Zimbardo - rational path to madness - schizophrenics experience symptoms, turn to friends and relatives to confirm the, they don’t so the sufferer concludes that they are trying to hide the truth

36
Q

What did Frith do?

A

Cognitive - attempted to explain the onset and maintenance of some of the positive symptoms of schizophrenia, thought that they were unable to distinguish between actions that are brought about by external forces and those that are generated internally

37
Q

What did Yelowlees do?

A

Cognitive - developed virtual hallucinations to treat schizophrenia

38
Q

What did Hemsley do?

A

Cognitive - suggests there is a breakdown between information that has already been stored in memory (internal) and new incoming sensory information (external). People are subjected to sensory overload and do not know which aspects of a situation to deal with.

39
Q

What is the psychodynamic explanation of schizophrenia?

A

If the world of the schizophrenic has been particularly harsh then they may regress to the oral stage. This is before the ego develops and without this there is no concept of reality. Freud viewed schizophrenia as an infantile state.

40
Q

What did May do?

A

Psychodynamic - found that psychoanalysis doesn’t work for schizophrenics and can actually make things worse

41
Q

What is the behavioural explanation of schizophrenia?

A

Schizophrenia is learnt through social learning theory (imitating family members with schizophrenia which is why it runs in families) and operant conditioning (attention due to strange behaviour acts as a reward)

42
Q

What did Ullman and Krasner do?

A

Behavioural - hospital staff may pay more attention to schizophrenic behaviour which can act as a positive reinforcement

43
Q

What are the biological treatments for schizophrenia?

A

Drugs

ECT

44
Q

What are the psychological treatments for schizophrenia?

A

CBT

Psychoanalysis

45
Q

What are the biological explanations of schizophrenia?

A

Biochemical
Genetics
Infection
Neuroanatomical

46
Q

What are the psychological explanations of schizophrenia?

A

Socio cultural
Cognitive
Psychodynamic
Behavioural

47
Q

What are conventional antipsychotics?

A

They work by blocking the dopamine receptors.

48
Q

What are atypical antipsychotics?

A

Work by blocking dopamine and serotonin receptors

49
Q

What are delusions?

A

Distorted beliefs e.g. Delusions of persecution, delusions of grandeur ets.

50
Q

What did Vaugn and Leff do?

A

Drugs - found conventional antipsychotics only reduce relapse when the patient is living in a hostile environment (53% replapse with drugs, 92% relapse with placebo) but they make no difference if the patient is living in a happy home environment.

51
Q

What did Ross and Read do?

A

Drugs - argue that being prescribed medication takes too much attention away from other possible causes such as life history or home life

52
Q

What did Leucht et al do?

A

Drugs - meta analysis comparing conventional and new atypical drugs. Only 2 of the 4 new drugs came out as slightly more effective.

53
Q

What happens in ECT?

A

Given up to 3 or 4 times a week for up to 12 treatments.
Before each treatment a muscle relaxant and anaesthetic is delivered.
Electrodes are attached to the patients head via which an electrical shock is applied to induce a two minute seizure.

54
Q

What did Tharyan and Adams do?

A

ECT - reviewed 26 studies (798 participants) and found ECT was more effective than a placebo (simulated ECT) but not as effective as anti-psychotic medication, and did not work in the long term

55
Q

What happens in CBT?

A

Patients are helped to identify and correct faulty thoughts.
Patients are encouraged to trace back the origins of their symptoms.
They are encouraged to evaluate the context of their delusions or hallucinations and to consider ways they could test the validity of them.
They may be set behavioural homework with the aim of improving their general level of functioning.

56
Q

What did Drury do?

A

CBT - found benefits in terms of reduced positive symptoms and 25-50% reduction in recovery time.

57
Q

What happens in psychoanalysis?

A

Free association, hypnotic regression, dream analysis

Focus on uncovering unconscious conflicts

58
Q

What did Malmberg and Fenton do?

A

Psychoanalysis - argue that it is impossible to draw definite conclusions for or against the effectiveness of psychodynamic therapy.

59
Q

What did Karon and VandenBos do?

A

Psychoanalysis - found that patients treated with psychoanalysis improved more than those on medication alone.

60
Q

What affects reliability of diagnosis?

A 
The classification system is reliable if two or more clinicians provide the same diagnosis.
This may not happen due to...
The client (individual differences e.g. Ethnicity, behaviour may differ day to day)
The clinician (judgement can be influenced by lots of individual differences)
The assessment procedure (interviews conducted)
61
Q

What did Copeland do?

A

Reliability - gave a description of a patient to 134 US and 194 British psychiatrists. 69% of the US psychiatrists diagnosed schizophrenia compared to 2% of the British.

62
Q

What did Whaley do?

A

Reliability - found inter rater reliability correlations as low as 0.11 for DSM diagnosis

63
Q

What did Klosterkotter et al do?

A

Reliability - argued that schizophrenia is too broad a category for it to be a useful diagnosis. Two patients could have completely different symptoms.

64
Q

What did Mojtabi and Nicholson do?

A

Reliability - 50 US psychiatrists asked to distinguish bizarre and non bizarre delusions. Inter rater reliability correlation was 0.40

65
Q

What affects validity of diagnosis?

A

The classification system is valid if it provides accurate diagnosis

66
Q

What did Rosenhan do?

A

Validity - sane in insane places. Hospital incorrectly diagnosed people with schizophrenia.
In follow up, sent real schizophrenics away thinking they were pseudopatients.

67
Q

What did Bentall do?

A

Validity - comprehensive review of symptoms, prognosis and treatment concluded that schizophrenia is not a useful scientific category (too broad)

68
Q

What did Ellason and Ross do?

A

Validity - people with dissociative identity disorder have more ‘first rank’ symptoms (symptoms used to uniquely identify schizophrenia) than schizophrenics!

69
Q

What did Nazroo do?

A

Validity - the DSM was developed in Western culture and is culture biased, so inaccurate, in the UK African Caribbeans are up to five times more likely to be diagnosed with schizophrenia than the general population

Yr 13 Psychology (6 decks)

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