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Schizophrenia > Sz > Flashcards

Sz Flashcards

1
Q

What are the 5 subtypes of schizophrenia?

A 
Paranoid 
Disorganised 
Catatonic 
Undifferentiated 
Residual
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2
Q

What are the signs of paranoid schizophrenia

A

Delusions of grandeur

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3
Q

What are the signs of disorganises schizophrenia

A

Speech/thought behaviour is disorganised

Flat emotion effect

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4
Q

What are the signs of catatonic schizophrenia

A

Fixed rigid postures

Severe motor abnormalities

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5
Q

What are the signs of residual schizophrenia

A

Social withdrawal

Flat emotional effect

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6
Q

What are the positive symptoms of schizophrenia

A

Delusions and hallucinations

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7
Q

What are delusion of grandeur

A

False belief of unrealistic powers/ that they are an important figure. Eg superman

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8
Q

Delusions of persecution

A

False belief they are being plotted against by friends and family

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9
Q

Delusions of reference

A

False Belief that random events have a meaning. Eg a radio show aimed st them

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10
Q

What are the 3 types of hallucinations?

A

Auditory- sounds
Visual- sights
Somatic- the thought of being eaten from the inside by insects

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11
Q

What are positive symptoms?

A

Things added to behaviour

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12
Q

What are the negative symptoms of schizophrenia

A

something which is missing from
Every day life

Eg- Avolition

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13
Q

What are the negative symptoms of schizophrenia

A

Avolition- loss of energy

Flat emotional effect- lack of emotional responses/ eye contact

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14
Q

How is schizophrenia diagnosed?

A

2 core symptoms for at least one month

Or

Other symptoms such as poor functioning which must have been present for 6+ months

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15
Q

What are the 3 stages in which schizophrenia occurs

A

Prodromal stage
Active phase
Residual phase

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16
Q

What is the Prodromal stage or schizophrenia?

A

Mainly negative symptoms, any positive symptoms are mild

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17
Q

What is the active phase of schizophrenia

A

Strong positive symptoms can last for years if untreated

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18
Q

What is the residual stage of schizophrenia

A

Most obvious symptoms have subsided but negative symptoms remain

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19
Q

Evaluation of classification/symptoms and diagnosis

A

❌ undifferentiated is too vague often confused with the different disorders
❌ catatonic type is rare and fluke be used by the drug treatment
❌often mistaken for schizoaffective disorder
❌ criteria used isn’t precise and therefore can lead to mis diagnosis- some ethnic groups and more readily diagnosed than others

✅eaton found that the more negative symptoms which are present: the more problems which occurred in education/ work

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20
Q

What is gottesmans study?

In relation to genetics

A

Looked at 40+ studies over a 60 year period, looking at genetic link for SZ. He found increase in SZ rates as genetic similarity increases.

Looked at twin studies. 17% DZ 48% MZ.
People with SZ parent have 1/8 chance of developing

Adoption studies- support it too.
Tienara- looked at 155 children who had schizophrenic biological mothers all who had been adopted at a young age. 10% found to be SZ In comparison to 1% from non- SZ mothers

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21
Q

what was tienaras study?

A

To look into adoption rates and SZ. He looked at 155 children who had schizophrenic biological mothers, and 185 children of non SZ mothers. All who had been adopted at an early age.

10% of children from SZ mothers found to have SZ

1% of non SZ mothers had SZ

22
Q

What is the dopamine hypothesis?

A

The idea that increased dopamine- a neurotransmitter, causes positive symptoms to occur.

This has been tested-
Cocaine use causes positive symptoms and exaggerates them in people with SZ

Post mortems show unusually high levels of Dopamine in this with SZ

Anti psychotic drugs which reduce dopamine levels also treat positive symptoms

23
Q

Abnormal brain structures- SZ

A

Lieberman and weyandt thought that englarged ventricles in those with SZ is strongly linked to negative symptoms

24
Q

Evaluation of biological explanation for SZ

A

❌ twin studies- MZ doesn’t show 100% concordance- must be environmental influence

❌ no single gene has been identified

❌ since many of these studies, diagnosing SZ had Changed and therefore they may not be valid as an explanation

❌ diathesis stress model is more strongly supported as it considers biological and environmental factors

25
Q

What is he psychodynamic explanation of SZ

A

that there is a conflict entered the personality. The ego is overwhelmed by the ID/ superego and therefore regresses back to childhood. This is said to explain why those with SZ have poor social skills. Hallucinations and delusions occur because the person struggles to gain a sense of reality.

The voices are the superegos critical opinions

26
Q

Evaluation of psychodynamic explanation

A

✅unfalsifiable- cannot be disproved
❌ doesn’t consider cognitive processes/ dopamine
❌ unscientific- occurs in the unconscious
❌ little evidence- Freuds theory was applied after
❌ research found no link between childhood and SZ after diagnosis

27
Q

What are the 2 socio-cultural explanations of SZ?

A

Labelling and family dysfunction

28
Q

What is labelling?

A

Szaz and modrow stated that when a person is labelled as SZ they may live up to this/ are influenced by it. Self-fulfilling prophecy

29
Q

What was rosenhans study? (Labelling)

A

Sent 8 psychologically health subjects into different hospitals complaining of voices in their heads. They were all diagnoses with SZ and sent to hospital. When they were there; they were told to act normal, and refuse treatment. They had to convince the staff they were sane. They were kept on the ward for an average of 17 days. Other patients realised they weren’t SZ.
They left with the diagnosis of SZ in recovery.

This shows that the label of schizophrenia caused normal behaviour to be seen as abnormal

30
Q

What is family dysfunction?

A

Where stress factors for developing schizophrenia are caused by relationship patterns are communication in a family

31
Q

What are the 3 dysfunctions characteristics parents of those with schizophrenia are said to have?

A

High interpersonal conflict
Communication difficulties
Critical and controlling personalities

32
Q

What was Browns study? (Family dysfunction)

A

Found that families where expressed emotion levers were high, resulted in 58% of people with SZ returning to hospital in comparison to only 10% with low emotion families

33
Q

Evaluation of rosenhan

A

❌ diagnosing schizophrenia is a lot more rigorous now than it was during Browns study
❌ he was criticised for purposely misleading professionals

✅ did show how the influence of labelling and self fulfilling prophecy affect things

34
Q

Evaluation of family dysfunction

A

✅fits with diathesis stress model

✅ treatments which work to reduce the levels of expressed emotions in families did reduce the relapse rates

35
Q

Biological treatments of schizophrenia

A

Conventional antipsychotic drugs- chlorpromazine

Atypical antipsychotics drugs- risperidone

36
Q

What are conventional antipsychotic drugs?

A

First used in 1950’s. Used to block the dopamine receptors in the synapses. Reduces firming of dopamine neurons and reduced positive symptoms.

Side effects similar to Parkinson’s- muscle tremors

37
Q

What are atypical antipsychotic drugs?

A

Used since early 1990’s. Reduce levels of dopamine in the brain but also reduce serotonin levels too. They alleviate negative symptoms as well as positives.
Clozapine can be used on SZ who haven’t responded to congenital drugs.

Side effects- nausea, weight gain

38
Q

Evaluation of drug use for schizophrenia

A

✅ both make a huge difference to the lives of people with SZ and bake families
❌ we don’t know if excess dopamine is a cause or effect of schizophrenia and therefore can affect treatment
❌some patients find the side effects too much
❌ not a cure- will return if you stop taking the drug

39
Q

Evaluation of conventional antipsychotic drugs

A

✅ dramatically reduced hospitalisation in the 1950’s
❌ unpleasant side effects
❌ must be taken regularly and all the time otherwise symptoms will return, and often they are worse

40
Q

Evaluation of atypical antipsychotic drugs

A

✅ effective with 25% of SZ who haven’t responded to conventional drugs
❌ some side effects- can lead to rare white blood cell condition which is life threatening
❌ symptoms return quickly if not taken

41
Q

What does psychoanalytic therapy aim to do?

A

Talk rationally about feelings and experiences to alleviate schizophrenia

42
Q

What is insight therapy?

A

One to one therapy where the therapist aims to gain the trust of the patient so they can talk about the patients disturbing thoughts

43
Q

What is family therapy?

A

Aims to change communication in family to reduce expressed emotion levels. Uses help groups and meetings with specialists. Aims to make family members less critical and more tolerant. Helps the family to feel less guilty about the disorder

44
Q

What was hogartys study? (Psychoanalytic Treatment for SZ)

A

Completed family therapy to 3 other therapies and find that 40% of people receiving drug therapy relapsed, and 20% who used drug therapy and social skills training relapsed.

Wheras those who received medication, social skills and family therapy have 0 relapse rate

45
Q

Evaluation of psychoanalytic therapy

A

❌ usually of little value. Patients are expected to talk about their condition and talk rationally about themselves which they cannot do
❌ found to make symptoms return in partially recovered schizophrenics
❌ Sullivan used this the rosy and found the suffered returned to a child like state

✅ trusting relationship can be built but this is very time consuming and expensive
✅ is evidence that family therapy used alongside other treatments is effective

46
Q

What is institutionalised care?

A

A patient is a resident at a facility where they will be cared for.

In early days, patients were treated awfully. Often held in straight jackets and kept away from society, with electro convulsive shock therapy and insulin induced comas were used.

When antipsychotic drugs were introduced patients positive symptoms subsided and the use of straight jackets and poor care was reduced. These places were seen as poor and became de-institutionalised and community care was developed

47
Q

Evaluation of institutionalised care

A

❌ all patients were dressed the same, forced to live the same lifestyle with no variety- batch living
❌ they may lose relationships if they are kept away from friends and family which may make treatment more difficult
❌ patients may not be able to fend for themselves when they come out of care
❌ social learning theory would state that there aren’t any positive models to learn from

✅ patients can’t be forgotten about like they can in community care

48
Q

What is community care?

A

Where patients live in the community- in sheltered housing with monitored medication and support networks. Individual tailored therapy is used, and social skills therapy can be used to avoid isolation for patients.

Resulted in the bigger decrease in hospitalisation for SZ. Enables patients to live a normal life- holding down employment etc

49
Q

What was stein and tests study? (Community care)

A

Compared effectiveness of hospitalisation and community care of SZ patients. Compared the 2 groups.

Found that unsupported hospital patients relapsed. 58/65 patients returned to hospitals. Whereas all of those who received community care, stayed in the community.

Community care is more effective in preventing relapse

50
Q

Evaluation of community care

A

✅ highly effective/ supported by stein and test
❌ expensive treatments- need specialist team to look after 10-15 patients
❌ if treatment is withdrawn due to cost, relapse occurs
❌ need the same care workers to have a positive effect which is difficult in some communities especially with agencies
❌ differences in the quality of care through different communities- depends on the funds in that area. Some patients don’t receive the correct care
❌ the stigma attached to mental illness is hard to battle with other members of the community who label the patients as, sick/weirdos

51
Q

Evaluation of treatments for schizophrenia as a whole

A

✅ most effective is a combination of drugs, psychotherapy and community care. This is very expensive though

✅ over time the treatments have be some a lot more effective. There are fewer side effects from drug treatments and there are new therapies being developed

❌ must always be on going as it will result in relapse otherwise

Schizophrenia (2 decks)

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