Schizophrenia Flashcards

1
Q

What are positive symptoms?

A
  • Symptoms experienced in addition to normal experiences, they include hallucinations and delusions
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2
Q

What are negative symptoms?

A
  • Symptoms that represent the loss pf a usual experience such as clear thinking or ‘normal’ levels of motivation
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3
Q

What are hallucinations?

A
  • Distortion of stimuli that have either no basis reality or are distorted perceptions of things that are there
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4
Q

What are delusions?

A
  • Beliefs that have no basis in reality, for example, that the sufferer is someone else or that they are the victim of a conspiracy
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5
Q

What are experiences of control?

A
  • A type of delusion where people believe their thoughts and behaviour is being controlled by external forces
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6
Q

What is speech Poverty (Alogia)?

A
  • A negative symptom of schizophrenia which involves reduced frequency and quality of speech
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7
Q

What is Avolition?

A
  • A negative symptom which involves loss of motivation to carry out tasks and results in lowered activity levels
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8
Q

What is Affective Flattering?

A
  • Loss of a range of emotional expression
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9
Q

What is the Genetic Theory of schizophrenia?

A
  • Schizophrenia is down to specific candidate genes which impact dopamine.
  • SZ is aetiologically heterogenous = different combinations of genes are implicated in the disorder
  • Ripke = Should see higher rate of SZ in family members of those with disorder
  • Gottsman = More genetic material shared, more likely to develop disorder
  • Joseph = Meta analysis of twin studies -> 40% concordance for MZ but 17% for DZ
  • Tienari = Compared rates of SZ in adoptees with SZ mothers with control group as well. -> 6-7% of adoptees also had SZ compared to 2% of control group -> Compare to raised in Psychologically dysfunctional adoptive families, rose to 36.8%
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10
Q

Evaluate genetic theory

A

+ Lots of supporting evidence
- Concordance is not 100% in MZ suggesting other factors may be involved in development of SZ
- MZ have same upbringing so SZ could be on environment meaning we’re not sure of genetic link

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11
Q

What are Neural Correlates?

A
  • Prefrontal Cortex: Reduced activity in prefrontal cortex - Responsible for logical thinking, organising thoughts + Emotional regulation -> Relate to delusions, flattened affects, abolition
  • Amygdala: Smaller in people with SZ - Leads to irritability, flattened affects, avolition
  • Dopamine Hypothesis
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12
Q

Evaluate Neural Correlates:

A

+ Significant evidence to support specific brain areas as a result for SZ
- Data is correlational = May be that neural correlates cause SZ or SZ caused brain changes. OR drug treatments led to brain changes = Matters because Neural correlates doesn’t really tell us about true cause of SZ

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13
Q

What is the Dopamine Hypothesis?

A
  • Excess of dopamine neurotransmitter in certain brain regions is responsible for positive symptoms of SZ.
  • SZ’s have abnormally high numbers of D2 receptors = More dopamine binding = More firing -> Hyperdopaminergia
  • Revised DH = High levels of dopamine in Mesolimbic Pathway + Deficit of dopamine in prefrontal cortex
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14
Q

Evaluate the Dopamine Hypothesis?

A

+ Research = Drugs that increase dopamine levels produce psychotic SZ Symptoms = Supports domaines role in SZ
- Clozapine acts on serotonin as well = Serotonin clearly involved but DH fails to consider this
- High levels of dopamine could be symptom of SZ = Can’t be sure that abnormal levels of dopamine cause SZ
+ Excess number of dopamine receptors found in Broca’s area = Speech production + Auditory hallucinations = Supports Hyperdopaminergia theory
+ Low levels of Dopamine linked to negative symptoms of SZ = Evidence for Hyperdopaminergia theory

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15
Q

What are Typical antipsychotics?
- Give example

A
  • First drugs developed to treat schizophrenia
  • Chlorpromazine
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16
Q

What are atypical antipsychotics?

A
  • Second more recent round of drug treatments
  • Clozapine
17
Q

Evaluate drug treatments:

A

+ Lots of research evidence = review over 200 studies and found antipsychotics far more effective than placebos
+ Evidence to support use of atypical over typical = review over 200 studies and found atypical far more effective than typical + Had fewer side effects
+ Patients given combined of CBT + Antipsychotics had best improvement in symptoms + Fewer hospital stays
- May only be surprising symptoms of SZ, may not be tackling underlying cause = Limits effectiveness + Utility of treatments = Cannot be sure cause is biological in origin.

18
Q

What are the characteristics of a Schizophrenic mother and why might this lead to development of SZ?

A
  • Cold, Rejecting, Controlling mother
  • Passive Father
  • Create stress + tension in family =could lead to paranoid thinking + Feeling of persecution
19
Q

What is double bind theory?

A
  • Family climate key in SZ development
  • Communication in families affects wellbeing
  • Child receives conflicting communication of right + wrong
  • Child doesn’t know what response to take
  • Become trapped with fear of getting it wrong
  • Feel unable to communicate
  • Form of manipulation + punished with withdrawal of love
20
Q

What its high expressed emotion?

A
  • Expressed emotion relates to a negative emotional climate characterised by family communication style of criticism, hostility and emotional over-involvement.
  • Hostility = aggressive behaviour
  • Emotional over-involvement = over-protective parenting and family members can become overly moralistic
21
Q

Evaluate Family Dysfunction?

A

+ Patients who return from hospital to a family high in hostility, criticism + Emotional over-involvement = 4x more likely to relapse - Shows FD is a valid explanation

+ Berger = non-schizophrenics reported higher recall of double bind statements by their mothers than non-schizophrenics = Shows FD is valid explanation for development of SZ not just relapse

+ Kalafi + Tobari = Negative emotional climate in Iranian culture led to higher relapse = Evidence for NEC as a cause + also shows it is culturally relative = Not culturally bias

  • High expressed emotion among families could be symptom rather than cause = Shows might not be a separate factor leading to SZ but rather a result of SZ
22
Q

What is the Cognitive Explanation of SZ?

A
  • SZ is a result of abnormal thought processing
  • Supported by Neural Correlates = reduced processing in prefrontal cortex -> Observations suggest cognitions likely to be impaired in SZ
23
Q

What is metarepresentation in Abnormal Thought Processing?

A
  • Cognitive ability to accurately reflect on our own thoughts and behaviours
  • Aware of our intentions + goals
  • Can Interpret behaviour of others accurately
24
Q

What is Central Control in Abnormal Thought Processing?

A
  • Suppresses automatic responses, allowing us time to reflect on our behaviour + make deliberate choices
  • In SZ, disorganised speech + thought disorder come from inability to suppress automatic thoughts + Respond with speech
  • SZ’s often experience derailment of thoughts. Each word spoken triggers another thought/ association, and they lack ability not to respond to these.
25
Q

Evaluate the cognitive explanation of SZ:

A

+ Myer-Lindenberg found reduced activity in prefrontal cortex of Schizophrenics when did a task involving working memory = Shows reduced neural correlates affects cognitive function -> Leads to impaired cognitions

+ Stirling conducted troop task with SZ people -> Took twice as long as non-SZ people to identify font colours correctly = Shows SZ patients have difficulty with central control = Validity

  • Dysfunctional thinking could be a consequence rather than a cause = SZ means some patients have inability to suppress thoughts = Goes against what the theory says -> Reduces validity
26
Q

What is CBTp?

A
  • Assumes SZ is the result of dysfunctional thought processes
  • Aims to identify and challenge faulty cognitions
  • Every 10 days -> 16 sessions
  • Deals with long term symptoms
27
Q

Evaluate CBTp:

A

+ Drury - Faster recovery for patients given CBT + Drugs = CBT Valid -> Drugs make CBT work
+ Fewer side effects = More likely to stick to CBT -> Expensive

28
Q

What is Family Therapy?

A
  • Family dysfunction is key
  • Improves positive and reduces negative communication + Reduces expressed emotion
  • Reduce criticism + Increases praise
  • More openness
  • Develop more understanding + compassion for patients by educating family about illness
  • Months to a year
29
Q

Evaluate Family Therapy:

A

+ Cost effective - reduces relapse = Reduces revolving door phenomenon = cheaper for NHS
- Should be used alongside drugs = not affordable for individual families = Inequaity
+ ‘Pharaoh’ reduces relapse as increases drug compliance = effective treatment = drugs could be thing that is having a real effect

30
Q

What is Token Economy?

A
  • Behaviourist approach
  • Rewards given for ‘good’ behaviour
  • Operant conditioning = Reward -> Positive reinforcement
  • Desirable behaviours = Brushing teeth, social engagement
  • Rewards = TV time, cigarettes
  • Token has to be given straight away to have an effect
31
Q

Evaluate Token Economy:

A
  • Comer -> Poor controls in research -> no control groups = Poor quality research = DOn’t know why it works
  • Token economy doesn’t work well outside of hospital = Not useful in real world
  • Humiliating/ patronising -> Treating people as children -> Rewards could be argued to be basic human rights
    + Hospital environment became better for staff = Safer for staff
  • Reductionist
32
Q

What is the interactionist approach to understanding Schizophrenia?

A
  • Considers both biological and psychological factors in development of SZ
  • Encompasses Diathesis-stress model -> Biological and Environmental factors
  • Several genes identified to increase vulnerability to SZ. -> Genetic factors also linked to faulty dopaminergic systems
  • Original Diathesis stress model argues stress is psychological in nature + context of SZ it was caused by dysfunctional family dynamics.
  • Nowadays, broader definition has been adopted and refers to anything that risks triggering schizophrenia -> E.G Cannabis use is a stressor so can disrupt body’s cycle
33
Q

Evaluate the interactionist approach to SZ:

A

+ Barlow and Durand found that a family history of SZ pointed to a genetic link. -> When combined with dysfunctional the risk of developing SZ increased -> Supports Interactionist approach

  • Not precisely known how risk factors contribute to Diathesis-Stress interaction = Hard to identify cause and effect = over simplistic explanation
  • Idea of vulnerability being biological and stress being environmental is dated and over simplistic = We know more about stressors and so know what stress is far more complex than just being about environmental factors