Schizophrenia Flashcards

1
Q

Validity in Schizophrenia

A

How accurately diagnosed is it?

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2
Q

Reliability in schizophrenia

A

How consistently diagnosed is schizophrenia. EG - across time, cultures , psychiatrists

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3
Q

Diagnosing

A

Completed by a trained professional. To identify an illness through the presentation of symptoms

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4
Q

Classification

A

How schizophrenia is clarified in diagnostic manuals and outlines which symptoms are expected eg - DSM

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5
Q

COMORBIDITY

A

The concept that two or more conditions occur together in the same person at the same time

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6
Q

Buckley 2009

A

Found cormobidity rates of schizophrenia and depression were 50%,

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7
Q

Symptom overlap

A

When symptoms of two disorders are found in both disorders making it difficult to diagnose lowering validity of diagnosis

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8
Q

Schizophrenic specific symptom

A

THERE IS NO SCHIZOPHRENIA SPECIFIC SYMPTOM MAKING IT HARD TO TELL APART FROM OTHER DISORDERS

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9
Q

Positive symptoms of schizophrenia

A

Delusions, hallucinations, disorganized speech, paranoia

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10
Q

Negative symptoms of schizophrenia

A

Apathy, extreme emotional withdrawal, lack of affect, low energy, social isolation

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11
Q

Cultural biases in schizophrenia

A

The notion that clinicians diagnose patients based on the clinicians culture not the patients culture

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12
Q

COCHRANE 1977

A

Incidence of schizophrenia in the west indies and britain to be similar at around 1%.

However afro Caribbean men are several times more likely to be diagnosed with schizophrenia when living in Britain

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13
Q

Cultural bias in classification

A

Schizophrenia may have different symptoms across cultures. Each cultures symptom pool may be different

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14
Q

Gender biases in diagnoses of SZ

A

Females suffering from schizophrenia may be misdiagnosed due to presumption that males suffer more

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15
Q

LONGNECKER et al 2010

A

Reviewed studies of incidences of schizophrenia and concluded that since the 1980s males have been diagnosed with schizophrenia more often than women. Prior to the 1980s this was not the case

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16
Q

Gender bias affecting reliability

A

Lowers reliability of diagnosing across sexes as there is no consistency between sexes

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17
Q

Gender bias affecting validity

A

A doctor could assume hallucinations are a result of schizophrenia in a male patient
but may be reluctant to diagnose it if the patient were female

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18
Q

IDIOGRAPHIC approach

A

Would be better way to diagnose individuals rather than trying to classify everyone under certain criteria

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19
Q

Genetic explanation

A

Strong correlation between family member having sz and hances of a close relative going on to also develop the disorder

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20
Q

Gottesman (1966)

A

Found a 48% concordance rate among twins.

Also found that DZ twins had a 17% chance of developing schiz if their twin did

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21
Q

Twin studies evaluation

A

NO research has ever found a 100% concordance rate, suggesting other influences than genetics

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22
Q

Benzel et al (2007)

A

Three genes; COMT, DRD4, AKT1 have all been associated with excess dopamine in specific D2 receptors

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23
Q

Evaluations of genetic theory

A

Biologically reductionist
Biogically determinsitic

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24
Q

Original dopamine hypothesis

A

The brain of a schizophrenic produces more dopamine than a normal person leading to positive symptoms

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25
Q

Evidence for dopamine hypothesis

A

The fact that amphetamines increase the amounts of dopamine.
- Large doses of amps given to people with no history of psychological disorders produce behaviour which is very similar to paranoid schizophrenia.
- Small doses given to ppl already suffering with schiz also worsen their symptoms

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26
Q

New dopamine hypothesis

A

There are more dopamine receptors leading to more firing and an over production of messages. Specifically the D2 receptors

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27
Q

Dopamine antagonists

A

Block D2 receptor sites on the post synaptic neurone meaning fewer d2 receptors can be activated. Increasing the dopamine re uptake so it doesnt hang around in the synapse for very long

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28
Q

3rd proposal of dopamine hypothesis

A

Overactive dopamine pathway in the mesolimbic area is responsible for positive symptoms
Underactive dopamine pathway in the mesocortical area of brain is responsible for negative symptoms

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29
Q

Neural correlates explanation

A

3 abnormalities
- Enlarged ventricles
- Hyprofrontality
- Hippocampus amygdala region

30
Q

Enlarged ventricles

A

Strong correlation between an individual having schiz and enlarged ventricles within the brain

31
Q

Hypofrontality

A

State of decreased cerebral blood flow in the prefrontal cortex of the brain.

32
Q

Hippocampus - Amygdala region

A

Tend to be smaller in volume and size leading to a dulled emotional state (flat effect)

33
Q

Family dsyfunction

A

Families with disjointed relationships and constant stress are more likely to cause or influence the onset of schizophrenia

34
Q

3 factors contributing within dsyfunctional family

A
  1. High levels of interpersonal conflict
  2. Poor communication, or difficulty in communication
  3. Being overly critical and controlling of children
35
Q

Double bind theory

A

Confusing and contradicting situations can lead to individual experiencing learned helplessness which can lead to the onset of schizophrenia

36
Q

Schizophrenogenic mother

A

Mothers who lacked the necessary emotional warmth and were cold and rejecting with their children caused the onset of schizophrenia

37
Q

Expressed emotion theory

A

Families reactions to a deteriorating mental state can have a huge effect on the client, if they react with expressed emotion it can become hostile and very critical and untolerant to the patient

38
Q

Linszen et al 1997

A

High levels of Expressed emotion are most likely to influence relapse rate.

A patient returning to a family with EE is about 4 times more likely to relapse than a patient whose family is low in EE

39
Q

Berger 1965

A

Empirical support finding that schizophrenics reported a higher recall of double bind statements by their mothers than non schizophrenics.

Suggesting there is wider academic credibility for the idea of contradictory messages causing schizophrenia

40
Q

Cognitive theories for schizophrenia

A

Faulty thought processes responsible for onset and maintenance of schizophrenia

41
Q

Cognitive explanation for delusions

A

Delusions are seen as occuring due to processing information irrationally

42
Q

SAS

A

An executive monitoring system that oversees and controls contention scheduling by influencing schema activation probabilities

allowing for general strategies to be applied to novel problems or situations during automatic attentional processes

43
Q

Egocentric biases in schizophrenia

A

Patients with schizophrenia have a jumping to conclusions bias
where they make hasty decisions and cannot be persuaded from their own thinking

44
Q

Two factors which are related to schizophrenia experiences and behaviours

A

Cognitive deficits - impairments in thought processes such as perception, memory and attention

Cognitive biases - when people notice pay attention to or remember certain types of info better than others

45
Q

Dysfunctional thought processing explanation

A

Frith 1992 suggested schizophrenics fail to monitor their own thoughts orrectly, misattributing them to the outside world

46
Q

Metacognitions

A

How people monitor their thought processes.

47
Q

Metacognitions schiz have issues with this

A

How people monitor their thought processes.

48
Q

Central control

A

The cognitive ability to suppress automatic responses. Disorganised speech and thinking could result from an inability to do this

49
Q

Typical antipsychotics

A

Can be taken as tablets, syrups or injections.

Work by acting as antagonists in the dopamine system by blocking the receptor sites to reduce positive symptoms

50
Q

Side effects of typical antipsychotics

A

Anticholinergic - Dry mouth, urinary problems
Noradrenergic - Low blood pressure, sexual dsyfunction

51
Q

Atypical antipsychotics

A

This type of drug works on serotonin and glutamate receptors as well as the dopamine receptors relieving the negative symptoms of schizophrenia.

Given to patients at risk of suicide

52
Q

Mesolimbic pathway

A

Relevant to psychotic symptoms this system plays a key and complex role in motivation, emotions, reward and positive symptoms of schiz

53
Q

Side effects of atypical antipsychotics

A

Weight gain.
There are fewer side effects compared to typical

54
Q

Liberman et al 2005

A

Compared effectiveness of typical and atypical antipsychotics in 1,432 patients with chronic schiz

He found 74% of patients discontinued their treatments due to side effects

55
Q

Example of atypical antipsychotics

A

Clozapine
Risperidone

56
Q

Example of typical antipsychotics

A

Chlorpromazine, loxapine, thioridazine

57
Q

CBT

A

Aims to change the maladaptive thinking of schizophrenic individuals. It is a teaching and active therapy.

58
Q

Stages of CBT

A

Identification of irrational thinking
Teaching of origins of symptoms
Relaxation techniques
Homework - diary

59
Q

Bighelli et al 2018

A

44%. reached a 20% reduction in overall symtpoms and 13% of patients reached a 50% reduction of overall symptoms

Showing CBT to be effective

60
Q

Family therapy

A

Attempt to fix the faulty and dysfunctional family dynamic causing schiz

61
Q

Aims of family therapy

A

Improve postiive and decrease negative forms of communication
Increase tolerance levels and decrease criticism
Decrease feelings of guilt and responsibility for causing illness

62
Q

Token economies

A

aimed to change negative symtpoms of schiz by applying positive reinforcement by rewarding desirable behaviours

63
Q

Law of effect

A

Whatever behaviour is rewarded is likely to be repeated

64
Q

Alogia

A

Rewarding someone with a token for instigating conversation by themselves

65
Q

Token economy negative reinforcement

A

Negative reinforcement employed by removing their tokens to increase desired behaviour. Tokens used for things like food

66
Q

Gholipour et al 2012

A

Found that a token economy approach reduced negative symptom scores by 46% from scores of 77 to 41

67
Q

Interactionist approach

A

Belives many different things put together cause the onset of schizophrenia

68
Q

Diasthesis - stress model

A

Certain people are more vulnerable to developing schiz and have predisposition
Childhood trauma or stress can trigger vulnerability leading to onset of schiz

69
Q

Meehls original diathesis stress model

A

Suggested sufferers had a schizogene that was triggered by a stressful event, however no one single gene has ever been recorded

70
Q

Interactionist treatments of schiz

A

Combination of biological and psychological treaments. as recomended by NICE

71
Q

Guo et al

A

Found that patients who receive a combo of antipsychotics and a psychological therapy have improved insight quality of life and social functioning than those taking antipsychotics alone