Year 2 - Schizophrenia Flashcards
what are positive symptoms of Sz?
additional behaviours or experiences beyond those of normal
give examples of positive symptoms
hallucinations
disordered thinking
delusions
what are negative symptoms?
atypical experience which represents a loss of normality
give examples of negative symptoms
alogia - poverty of speech
avolition - lack goal based behaviour
affective flattening - less emotional range
why is co-morbidity an issue in the classification of Sz?
means more than one illness is present such as Sz and personality disorder, frequent co-morbidity causes questions to be asked about the classification of Sz being separate
evaluate the diagnosis and classification of Sz
- lack of inter-rater reliability due to differences in diagnosis between DSM 5 and ICD
- poor criterion validity, more likely to diagnose with ICD
- Sz commonly diagnosed with other conditions, is it individual? (co-morbitity)
- symptom overlap e.g. severe cases of depression
- gender and cultural bias in diagnosis - black, afro-caribbean men most likely to be diagnosed
outline the research and findings of twin studies research into Sz
the concordance rates for MZ twins are never more than 48% suggesting genes play a strong role but are not the only factor
what are of the brain does hyperdopaminergia affect?
high levels of DA in the subcortex such as Broca’s area where it is associated with poverty of speech and auditory hallucinations
what areas of the brain does hypodopaminergia affect?
low levels of DA in the cortex e.g. prefrontal cortex causing negative symptoms
what role do neural correlates play in the ventral striatum?
negative correlation between activity levels and severity of negative symptoms activity in ventral striatum is neural correlate of neg.
what neural correlates where found in the superior temporal gyrus and anterior temporal gyrus?
neural correlates found between lower activation levels in gyrus and auditory hallucintaion
evaluate the biological explanations for Sz
- adoption studies show children of Sz sufferers still likely to suffer from Sz in different environment
- DA agonists e.g. drugs can increase Da production and induce temporary Sz type symptoms
- correlation or causation, neural correlates could show symptoms rather than causes
- mutation of male gametes shown to increase risk of Sz in children of men over 50
describe characteristics of a schizophrenogenic mother and how this may cause Sz
harsh cold uncaring dominant conflicting overbaring these cause family tension which leads to paranoia in child causing Sz in adult
outline the double bind communication theory
- mixed messages
- withdrawal of love
- sarcastic nature, not saying what you mean
- causes disorganised thinking and uncertainty
what is expressed emotion in relation to Sz?
- verbal criticism
- anger, rejection
- emotional smothering
these factors cause extreme stress and can trigger initial symptoms or most likely relapse in patients (caused by carers)
outline the possible cognitive explanation of Sz
dysfunctional thought processing :
- dysfunction to metrepresentation
- central control (lacking)
evaluate the psychological explanations for Sz
- support for family dysfunction 69% female and 59% male Sz in-patients had experienced abuse in childhood
- weak evidence for family based explanations
- stroop test provides strong evidence for dysfuntional information processing
- biological or psychological, can they really separately produce the same symptoms?
how do typical psychotics work? (give an example)
act as antagonistswhich reduce the action of DA through blocking of receptors in the synapses in the brain, e.g. chlorpromazine
what additional neurotransmitters do atypical drugs work on?
serotonin and glutamate
name the 2 most common atypical drugs used in the treatment of Sz
Clozapine
Resperidone
evaluate biological treatments for Sz
- research support for drugs over placebos
- severe side effects, such as tardive dyskinesia
- they work but we arent sure why
- studies only show short-term improvements not long-term benefits
outline how CBT can be used to treat Sz
help the patient to challenge delusions and help them make sense of how these delusions and hallucinations affect their behaviour
outline family therapy as a treatment for Sz
mostly focus on reducing the stress within the family that might contribute to a relapse for the patient, form an alliance with all family members and seek to reduce feelings of anger and guilt and other help
describe token economies
a form of behavioural therapy which rewards desirable behaviour with tokens which can be exchanged for treats in an institutional setting
outline 3 limitations of the token economy
- only usable in institutional settings
- only tackles behavioural symptoms
- ethically questionable
outline 3 positives of the token economy system
- enables patient to regain social skills
- agree goals are sought
- some research support
evaluate the psychological therapies for Sz (2)`
- evidence for effectiveness of CBT
- treat but don’t cure
what is the interactionist approach
broad explanation of Sz including biological factors
what is the diathesis-stress model?
Sz is explained by a pre-existing vulnerability and a trigger due to stress. genes and trauma recognised as diathesis
what treatment is most effective in the treatment of Sz according to the interactionist model?
the combination of the antipsychotic medication and psychological talking therapies, most commonly CBT
what are the limitations of the interactionist approach (2)
- classic stress model over simple, mutliple genes implicated and many forms of stress
- don’t understand how stress is a contributor to Sz
what are the positives of the interactionist approach (2)
- research evidence by Pekka Tienari
- support for combination treatments
