Schizophrenia Flashcards
How are mental disorders such as schizophrenia diagnosed?
Mental disorders are diagnosed according to the DSM-IV (mainly USA) (only positive symptoms need to be present) or ICD-10 (worldwide) (only negative symptoms need to be present).
What are positive symptoms and examples of those found in Schizophrenia?
Positive symptoms are an excess or distortion of normal functions, including hallucinations and delusions. Positive symptoms for schizophrenia include:
-Hallucinations (auditory or visual, outside their head telling them how to behave)
-Delusions (false beliefs, paranoia)
-Psychomotor disturbances (rocking, twitching, repetitive behaviours)
-Catatonia (staying in position for long time)
What are negative symptoms and examples of those found in Schizophrenia?
Negative symptoms are where normal functions are limited: including speech poverty and avolition (reduction of goal-directed behaviour). Negative symptoms for schizophrenia include:
-Thought disorders (breaks in thought, illogical jumps, belief their thoughts are broadcasted onto others)
-Avolition (person becomes apathetic and sits for things to happen)
Evaluate the diagnosis and classification of Schizophrenia.
+ = Classificaiton and diagnosis allows doctors to communicate more effectively about a patient and can predict outcome and treatment of the patient → reliable
- = Classification labels the individual → adverse effects such as self-fullfiling prophecy and low self-esteem
- = Cost-benefit analysis → does benefits of classification (care and treatment) outweigh costs (misdiagnosis, predjudice)
- = Co-morbidity of mental disorders makes it difficult to diagnose
What is the genetic explanation for schizophrenia?
→Genetic explanation is studied with twin studies → eg Gottesman → found MZ twins as have a 48% risk
→ 3 genes involved including COMT → excess dopamine leading to positive symptoms
→ First-degree relatives more likely to obtain schizophrenia
- = Genetics only partly responsible otherwise concordance rate would be 100%
- = Difficult to seperate nature v nurture → diathesis-stress
- = Biological reductionism + simplistics → Schizophrenia result of multiple genes and environmental factors → research into gene mapping oversimplistic
What is the dopamine-hypothesis in association with schizophrenia?
Dopamine is a neurotransmitter → excess dopamine → overly high transmission → leads to positive symptoms
→ Amphetamines increase dopamine
→ Could be due to excessive dopamine receptors found in autopsies
- = Hard to differentiate between dopamine causing schizophrenia or being the result of it
- = Biological determinism
What is the neural correlates explanation of schizophrenia?
Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia
→Large ventricles in brain → lighter brain than normal
+ = High reliability of research → Use of MRI
- = Biological determinism
What is the psychological explanation for schizophrenia?
→ Family dysfunctions → Factors such as schizophrenogenic mother, mixed messages according to double-bind theory and stress levels from high levels of expressed emotion
→ Shizophrogenic mother → cold and rejecting → tense family environment which leads to paranoia and anxiety (positive schizophrenic symptoms)
→ Double-bind theory → Child recieves mixed messages from parents of what’s right and wrong → confliction means they see the world as confusing and unfair leading to disorganised thinking and paranoia
→ Expressed emotion → level of emotion from parents eg hostility and verbal critiscism → causes stress and relapse
Psychological approach to SZ evaluation
- = Hardly any evidence for importance of schizophrogenic mother or double blind theory → based on clinical observation → leads to parent-blaming
- = Reductionist
- = Not scientific
What is the cognitive explanation for schizophrenia?
→ Several types of abornal information processing → lower levelling = cognitive impairment
→ Metarepresentation = dysfunction of metarepresentation disrupts their ability to recognise own actions and thoughts as being carried out by ourseleves → explain hallucinations and delusions
→ Central control = Inability to central control (ability to suppress automatic responses whilst we perform deliberate actions) → disorganised speech and derailment of thoughts
+ = Research into dyfunctional thought processing → Stirling found those with SZ made more mistakes when completing a task than the control group
What are the drug therapies available for Schizophrenia?
→ Antipsychotics = Typical and Atypical
→ Antipsychotics are dopamine antagonists as they bind to complementary dopamine receptors and therefore prevent dopamine binding
→ Typical antipsychotics = Found in psychiatric instituions due to its sedative effects
→ Atpical antipsychotics = adds effectiveness to typical antipsychotics and alleviates side effects → also targets serotonin receptors
SZ drug therapy evaluation
- = Dependant on dopamine hypthesis → problematic as hypothesis recently found low levels of dopamine in cortex can cause symptoms
- = Side effects = eg atitation, weight gain, muscle rigidity → not offset by atypical antipsychotics → needs to be continuously monitored with blood tests
- = Research → problematic as it measures calmness of patients after taking medications which may not be accurate measure of symptoms
What are the psychological therapies for SZ?
→ CBT, family therapy, token economy systems
→ CBT allows patient to understand their symptoms, increases their self-awareness and questions the reality of their paranoia
→ Family therapy reduces stress living together as a family with a schizophrogenic mother → lowering levels of expressed emotion to reduce stress
→ Token economy systems → reinforcement → carrying out desirable behaviours to receieve reward in psychiatric institutions
SZ psychological therapies evaluation
- = None of the therapies treat patients and cure them from SZ → aims to improve QOL → interactionist approach may be preferred
- = Ethical issues with token economies → disallowing patients from rewards could be seen as unfair, eg those with sever SZ may struggle
What is the interactionist approach to SZ?
→ Suggests both biological and psychological explanations should be used for SZ → could be either biological or psychogical in nature and vice versa for the stressor
→ Psychological and biological treatments can work together
