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PSY1008 > Week 9 - Schizophrenia > Flashcards

Week 9 - Schizophrenia Flashcards

1
Q

What is schizophrenia?

A

Psychological disorder that involves severely distorted beliefs, perceptions and thought processes

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2
Q

What are the five subtypes of schizophrenia?

A
  • Paranoid subtype (Delusions centred on ideas of grandiosity or persecution)
  • Disorganized subtype (Disorganized speech patterns)
  • Catatonic subtype (Non-normal activity of motor system)
  • Undifferentiated subtype (Signs not fitting any of the three major subtypes)
  • Residual subtype (No longer display traditional symptoms of delusions and hallucinations)
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3
Q

Define positive symptoms and describe the positive symptoms of schizophrenia

A
  • Definition: Things that shouldn’t be there and are added to a person

Positive Symptoms of Schizophrenia:
- Delusions
- Hallucinations
- Disorganized thought processes, speech and behavior

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4
Q

Describe the delusions experienced in schizophrenia

A
  • Persecutory delusions (Beliefs about being followed or watched)
  • Grandiose delusions (Beliefs about being a famous or special person)
  • Delusions of Thought Control
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5
Q

Describe the hallucinations experienced in schizophrenia

A
  • Distorted perceptions of reality which could affect all five senses
  • Most common altered perception is hearing voices or other sounds (auditory perception), followed by visual hallucinations
  • The hallucinations may tell the person to perform certain acts or may be frightening
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6
Q

Describe the disorganized behaviour experienced in schizophrenia

A
  • Disorganized speech: Lack of associations between ideas and events
  • Disordered behaviour: Unusual or repetitive behaviours and gestures
    (ex. head-banging, finger-flapping, etc.)
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7
Q

Describe the catatonia experienced in schizophrenia

A
  • Catatonic stupor: Absence of motor behaviors, totally motionless and rigid
  • Catatonic excitement: Agitated, fidgety, shouting, swearing or moving rapidly
  • Either of the two can last for hours
  • Neither a positive nor negative symptom
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8
Q

Define negative symptoms and describe the negative symptoms of schizophrenia

A
  • Definition: Things that should be there but aren’t there in a person

Negative Symptoms of Schizophrenia:
- Flat affect
- Alogia (reduced speech)
- Avolition (lack of follow through)

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9
Q

Describe the flat affect experienced in schizophrenia

A
  • Definition: Lack of emotional expression
  • Passive with immobile facial expression
  • Vocal tone does not change
  • Do not respond to events with emotion
  • Speech lacks the inflection that communicates mood
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10
Q

Is schizophrenia temporary or chronic?

A
  • Onset typically occurs during young adulthood
  • 25% of those who experience schizophrenia recover completely
  • 25% experience recurrent episodes of schizophrenia
  • 50% schizophrenia becomes a chronic mental illness, and the ability to function may be severely impaired
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11
Q

Explain the genetic factors (family) in schizophrenia

A
  • Based on family, twin and adoption studies,
    *50% risk for a person whose identical twin has schizophrenia
    *If biological parent of an adopted individual had schizophrenia, there is a greater risk to develop schizophrenia
  • Schizophrenia clusters in certain families -> The more closely related a person is to someone who has schizophrenia, the greater the risk of schizophrenia
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12
Q

Explain the genetic factors (chromosomes) in schizophrenia

A
  • Chromosomes associated with genes that influence brain development, memory and cognition seem related
  • No specific patterns of genetics can be identified as “cause” of schizophrenia but the presence of variations increase susceptibility
  • Bipolar disorder and schizophrenia might share genetic origins
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13
Q

Explain the social factors in schizophrenia

A

Being raised in a psychologically healthy environment lowers your chances of developing schizophrenia

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14
Q

Explain the effect of paternal age on schizophrenia

A
  • Age of fathers can increase the rate of mutation; The “manufacturing” of sperms in a man gets less and less accurate as he ages, hence the chances of mutation
  • 45-49yo: 2x more likely to develop schizophrenia, compared to fathers younger than 25 years
  • 50+ years: 3x more likely to develop schizophrenia, compared to fathers younger than 25 years
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15
Q

Explain the biological factors (abnormal brain structures) in schizophrenia

A
  • 50% of people with schizophrenia show some type of brain abnormality
  • Most consistent finding: Enlargement of the ventricles
  • Loss of gray matter tissue and lower overall volume of the brain (Gray matter = cell bodies, White matter = myelinated axons)
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16
Q

Describe the default mode network and explain its relation to schizophrenia

A
  • Default mode network: Parts of the brain under wakeful rest (ex. the part that is active when you’re zoned out)
  • Normally, people would switch between this and executive functioning but for schizophrenics, they tend to stay in the default mode network (difficulty switching between it and the executive functioning)
17
Q

What are the issues with neurotransmitters in schizophrenia?

A
  1. Activity with dopamine neurons
    *Dopamine neurons are overactive in schizophrenia in midbrain areas and underactive in higher cortisol areas
  2. Dopamine Imbalance Hypothesis
    *Activations influence other brain areas with dopamine projections
  3. Result in more creative thinking
    *Increased dopamine D2 receptor densities in the thalamus resulted in a lower gating threshold and thus increased information flow resulting in more creative thinking
  4. Glutamate linked to psychotic-like symptoms
    *Excitatory neurotransmitter, blocking of glutamate receptors in normal individuals leads to psychotic-like symptoms (Glutamate hypothesis)
18
Q

Describe the role of dopamine

A
  • Reward and reinforcement (responsible for feelings of euphoria)
  • Motor movements (responsible for feelings of euphoria)
  • Produced in brainstem, but has projections which affect activation in the cortex (surface of the brain)
19
Q

Explain the Dopamine Imbalance Hypothesis

A
  • Leads to both positive and negative symptoms
    *Overactivity in midbrain/brainstem -> Hallucinations/delusions
    *Underactivity in cortex -> Lack of motivation/flat affect
  • Changes in dopamine activity results in more creative thinking
    *Inability to stop influx of thoughts
    *Increased information flow resulting in more creative thinking
20
Q

Antipsychotic Medications: Chlorpromazine (Thorazine)

A
  • Discovered in 1945
  • Reduces dopamine activity in the brain
  • Reduces agitation, hostility, aggression, hallucinations, delusions
  • Increases time between hospitalisations
  • Does not change negative symptoms and cognitive deficits
    *Because these are due to the underactivity of dopamine
    *Early drugs only target the overactivity of dopamine
21
Q

Antipsychotic Medications: What are the side effects of Thorazine and other “typical” drugs?

A
  • Weight gain
  • Tardive dyskenia (movement disorder)
    *Involuntary movement of lower face, limbs
    *Affects dopamine neurotransmitters
    *“typical” -> first generation of antipsychotic drugs
22
Q

Antipsychotic Medications: What is the importance of dopamine?

A
  • Imbalance of dopamine activity in the brain
  • However, anti-dopamine drugs do not help upwards of 40% of those seeking treatment
  • First generation, typical antipsychotics also produce tardive dyskinesia (involuntary motor movements)
  • Medications which block dopamine are somewhat effective
  • Drugs that increase dopamine cause schizophrenic-like symptoms
  • However, typical antipsychotics mainly target positive symptoms like hallucinations and delusions
  • Link between dopamine and schizophrenia may be more complicated
23
Q

What are the advantages of atypical medications?

A
  • Less likely to cause movement-related dopamine side effects
  • More effective in treating the negative symptoms of schizophrenia
  • Target the dopamine imbalance, rather than just overactivity
24
Q

What are the disadvantages of atypical medications?

A
  • Weight gain, diabetes, cardiac problems
  • No greater improvements than with older antipsychotics
25
Q

What are the issues with all antipsychotic medications?

A
  • Does not actually cure schizophrenia
  • Unwanted side effects
  • “Revolving door” patter of hospitalisation, discharge and rehospitalisation
26
Q

Describe the atypical, second generation antipsychotics for schizophrenia

A
  • Target specific dopamine receptors, not all types of dopamine
  • Produces less tardive dyskinesia
  • Equal to, or sometimes more, effective than the typical, first generation of antipsychotic medication
27
Q

Psychosocial Interventions: How does family intervention help in schizophrenia?

A
  • Provide practical emotional support to family members
  • Provide information about support services
  • Help family develop model of schizophrenia
  • Modify unhelpful, inaccurate beliefs about schizophrenia
  • Enhance positive communications
  • Involve everyone in relapse prevention plan
28
Q

Psychosocial Interventions: How does Cognitive Behavioral Therapy help in schizophrenia?

A
  • Importance of individual’s interpretations of psychotic events
  • Understand client’s interpretations of past and present events
  • Normalize and reduce impact of symptoms
29
Q

Psychosocial Interventions: How does early intervention help in schizophrenia?

A
  • Seek out high-risk individuals
  • Develop cognitive skills to increase attention, memory, executive control, and other cognitive processes
30
Q

What are the environmental origins of schizophrenia?

A
  • Direct brain damage or injury details during early development
  • Prenatal complications
    *Stress, immune responses and starvation during pregnant
31
Q

What is the biopsychosocial model in psychology?

A
  • Models the interactions between genetics (biology, personality, psychology) and environment (social) and their impact on mental health
  • Proposed by George Engel, who suggested that mental health should be understood from more than just a biological perspective
32
Q

Explain the biological influences in the biopsychosocial framework

A
  • Biology is important but cannot explain everything; Some clinical disorders do not have reliable biological markers
  • ex. Only 50% chance of identical twin developing schizophrenia is other twin has the disorder
33
Q

Explain the psychological factors in the biopsychosocial framework

A
  • Personality approaches
  • Learned patterns of behavior
  • ex. Schizophrenia might develop through observational learning of parents with disorder
34
Q

Explain the social factors in the biopsychosocial framework

A

Social upbringing and environmental influences on a person’s mental health

35
Q

How is the biopsychosocial framework applied to evaluate mental health?

A
  • Intervention must address all three factors
  • Recognize relationships are central to treatment
  • Promote self-awareness among clients
  • Find out about the patient’s history and life circumstances
  • Decide which aspects of biological, psychological and social domains are most impactful on client’s health
  • Provide multidimensional treatment
36
Q

Explain the social factor of the biopsychosocial model of challenge/threat

A
  • Features in the environment which promote stress
  • ex. exam, interview, social interactions, etc.
37
Q

Explain the psychological factor of the biopsychosocial model of challenge/threat

A
  • How we interpret the situation
  • Evaluate the importance of performance
  • Determine if we have the ability to succeed
    *If we have confidence in our ability = challenged
    *If we have no confidence in our ability = threatened
38
Q

Explain the biological factor of the biopsychosocial model of challenge/threat

A
  • How our body reacts
  • Cardiovascular system
    *Blood flow (cardiac output)
    *Blood pressure (peripheral resistance)

PSY1008 (11 decks)

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