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Psychology Aaaaah > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

What is schizophrenia

A

A severe mental disorder where contact w reality and insight are impaired

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2
Q

Positive symptoms

A

Atypical symptoms experienced in addition to normal experiences
- hallucinations and distortions

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3
Q

Negative symptoms

A

Atypical experiences represent a loss of a usual experience
- speech poverty and avolition

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4
Q

5 key symptoms in diagnosis of psychotic disorders

A

Delusions
Hallucinations
Disorganised speech
Catatonic behav
Negative symptoms

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5
Q

DSM 5 diagnosis criteria

A

2 of 5 of the key symptoms and at least one must be positive

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6
Q

ICD 10 diagnosis criteria

A

2/5 of the symptoms present both can be negative

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7
Q

Reliability of diagnosis

A

Using DSM inter rater reliability = +0.97
Test retest reliability = +0.92
We can be sure that diagnosis of Sz is not reliant on subjective clinician but the symptoms themselves

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8
Q

Validity of diagnosis

A

Cheniaux 2 psych assess same clients using both DSM and ICD
68 under ICD and 39 under DSM
Sz is either under/over diagnosed
Validity is low

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9
Q

Rosenhans study

A

Rosenhan and other participants faked auditory hallucinations to gain admission into psych hospitals
All said they were fine but we’re forced to admit had Sz
Perfectly healthy patients diagnosed shows poor validity

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10
Q

Biological explanations

A

Genetics
Neural correlates

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11
Q

Genetic basis for Sz concordance

A

Gottesman - as genetic similarity increases so does the probability of sharing Sz 48% for identical twins 17% dizyg

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12
Q

Candidate gene

A

Sz is polygenic controlled by multiple genes
Ripke studied 37000 patients with Sz compared to more than 110k controls
Found 108 separate genes were related increasing risk of sz

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13
Q

Aetiologically heterogeneous

A

Different combinations of genetic variation can lead to development of Sz

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14
Q

Mutation and Sz

A

Parental dna mutate as increased exposure to radiation
Sperm mutation - 0.7% chance child has Sz if father under 25 2% in fathers over 50 ( Brown et al)

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15
Q

Original dopamine hypothesis

A

-Dopamine has excitatory effect
-Unusually high levels associated to Sz with positive symptoms- hallucinations
-Neurones fire too easily or too often
-Sz thought to have abnormally high levels of D2 receptors

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16
Q

Updated hypothesis - Davis et al

A

High levels of dopamine not found in all Sz
Modern drug clozapine very little blocking still works
Could be due to both too high dopamine and too low

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17
Q

Hypodopaminergia

A

Too low dopamine - negative symptoms
Prefrontal cortex responsible for thinking

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18
Q

Hyperdopaminergia

A

Too high dopamine production
Poverty of speech or auditory hallucinations
Subcortical areas - Broca’s area

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19
Q

Family dysfunction

A

A family that fails to provide for and meet the needs of one or all of its members. Typically characteristics are poor communication and cold parenting - develop Sz

20
Q

Schizophrenogenic mother

A

-Causes disorder by being cold and distant but controlling and dominant
-Child show emotion towards her but is also punished creates a tense atmosphere - explain distrust and paranoid delusions

21
Q

Double bind theory

A

Bateson - child think they’re doing wrong but receive mixed messages what the wrong thing is
Unable to comment on the unfairness
When wrong punished removal of love
Cause disorganised thinking and paranoid delusions

22
Q

Expressed emotion

A

Focus on relapse rather than cause
- hostility- parent hostile including anger rejection and blame
- emotional over involvement - needless self sacrifice and overprotective
- verbal criticism - name calling threats and violence

23
Q

Cognitive explanation

A

Focus on the role of mental processes
Brain areas / structures when not working properly seem to affect thought processes

24
Q

Ventral striatum

A

Deals with dopaminergic neurones signals cause expectation of reward
When Sz scan show reduce firing - avolition (lack motivation)

25
Q

Temporal and cingulate gyri

A

Temporal contains auditory processes
Cingulate is connected to the Broca’s area
Sz scans show reduced function thus causing hallucinations

26
Q

Meta represntation

A

Ability to reflect on own thoughts and behav as well as others - dysfunctional or impaired cannot recognise our thoughts are caused by ourselves
Explains hallucination and delusions

27
Q

Central control

A

Ability to suppress automatic responses while performing actions if this is impaired unable to speak before act
Lack causes disorganised speech
eg stroop test colour and word takes longer

28
Q

Biological therapy

A

Antipsychotic drugs reduce intensity of symptoms in particular positive symptoms

29
Q

Typical antipsychotics

A

First generation of Sz drugs they block dopamine receptors in the brain normalising dopamine levels reducing hallucinations

30
Q

Chloropromazine

A

400-800mg a day
Block dopamine receptors
Side effects: sedation of patient stiff jaw weight gain
NMS results in camera 1% of patients

31
Q

Atypical antipsychotics

A

Target a range of neurotransmitters such as dopamine serotonin and glutamate - mood enhancing prescribed if at risk of suicide

32
Q

Clozapine

A

1970s 300-450mg a day
Acts on serotonin and glutamate as well as dopamine
Helps improve mood and sedative- suicide
Dizziness headaches etc
Agranulocytosis- low wbc infection risk

33
Q

Risperidone

A

90s 4-12mg a day
Binds more strongly to dopamine receptors so more effective in smaller doses
Fewer side effects - agitation anxiety blurred vision

34
Q

Psychological therapies

A

Cognitive behavioural therapies
Family therapies
Token economy

35
Q

Cognitive behavioural therapy

A

CBT aims to help patients to identify dysfunctional thoughts (voices) and reality test to reduce distress
5-20 sessions

36
Q

How cbt works

A

Recognise - patients taught to recognise dysfunctional help to avoid thoughts
Educating - explaining where delusions and hallucinations-stop believing
Normalising- help patient realise it’s normal no need to stress
Testing (reality) - therapist would ask for proof that the govern is out to kill them

37
Q

Family therapy aims

A

Reduce negative emotions - reduce levels of expressed emotions such as anger and stress
Improves the family ability to help - all improve beliefs about Sz ensure to keep balance w life and care for Sz

38
Q

Stages of family therapy

A
  1. Basic info sharing (emotions)
  2. Identifying resources what fam offer
  3. Encourage mutual understanding
  4. Identify unhelpful patterns of behav
  5. Skills training (stress management)
  6. Relaps prevention training
  7. Maintenance for future
39
Q

Token economy system

A

Behavioural modification where desirable behaviours are encourage ld by the use of selective reinforcement
Tokens (secondary reinforcer) were swapped for ward privileges (primary reinforcer)

40
Q

Tackling institutional behaviour- positive effects of token economy system

A

Improves persons quality of life within hospital setting- make-up for someone who would normally take pride in appearance
Normalises behaviour - easier for people who spent time in hospital do adapt back into community

41
Q

Interactionist approach

A

Development of sz due to both biological and psychological factors

42
Q

Diathesis stress model

A

Sz is a result of underlying vulnerability (diathesis) and a trigger (stressor) which are both necessary for onset Sz

43
Q

Meehls model

A

Vulnerability entirely genetic - one sz gene and presence of sz mother could lead to development

44
Q

Modern understanding of diathesis and stres

A

Diathesis - Sz is polygenic and trauma can also be classed as a vulnerability affects brain development vulnerable to stress
Stresser- trigger by cannabis 7x more likely to develop Sz as it interferes with dopamine system

45
Q

Interactionist treatments

A

Combination of antipsychotic drugs and CBT
In uk most common treatments

Psychology Aaaaah (23 decks)

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