Need To Know Schizophrenia Flashcards
(29 cards)
Schizophrenia definition
- severe mental disorder characterised by profound disruption of cognition & emotion
- affects persons language,thought, perception, emotions & even sense of self
- schizophrenic believes things that aren’t true (delusions) or hears voices or sees visions when there are no sensory stimuli to create them (hallucinations)
- Schizophrenia ranks among top 10 cases of disability worldwide
- affects about 4 in 1000 people at some time in their lives
Prevalence
- affects 1% of population
- men are more likely to suffer than women
- onset is typically in late adolescence and early adulthood (15-35)
- commonly diagnosed in cities and working class
- many symptoms of disorder although not every patient displays all symptoms
DSM 5 criteria for schizophrenia
1a) 3 top systems must be had duration of 6 months
1. delusions
2. Hallucinations
3. Disorganised speech
4. Catatonic behaviour
5. Negative symptoms
List negative symptoms
- avolition
- alogia
- affective flattening
- anhedonia
Describe negative symptoms
- alogia -reduction in range and intensity of emotional expression voice tone,eye contact and body language
- anhedonia-reduction of interests and desires as well as inability to initiate and persist in goal directed behaviour
- eg sitting in house for hours everyday doing nothing.
- distinct from poor social function or disinterest which can be result of other circumstances
- affective flattening-Lessening of speech fluency and productivity
- thought to reflect slowing or blocked characteristic signs
- may produce fewer words in given time on a task or verbal fluency
- avolition-loss of interest in pleasure in all or almost all activities
- may be persuasive ie all embracing or it may be confined to a certain aspect of experience
- physical type is inability to experience physical pleasures like pleasure from food, bodily contact and so on
List positive symptoms
- delusions
- hallucinations
- catatonic or disorganised behaviour
- disorganised speech
Describe positive symptoms
- hallucinations-sensory experiences
- Some hallucinations are related to events in environment whereas others bear no relationship to what senses are picking up from environment
- delusions-irrational beliefs delusions of grandeur involve being important historical, political or religious figures like Jesus delusions of paranoia
- grossly disorganised of catatonic behaviour- includes inability or motivation to initiate task or to complete it once it’s started leads to difficulties in daily living & can result in decreased interest in personal hygiene.
- Catatonic behaviours characterised by reduced reaction to immediate environment,rigid posture or aimless motor activity
- disorganised speech -result of abnormal thought processes where individual has problems organising his/her own thoughts & shows up in their speech
- may slip from one topic to another derailment even in mid sentence & in extreme cases speech may be so incoherent it sounds like complete gibberish
Family dysfunction A01
- refers to any forms of abnormal processes within a family
- such as:
- conflict
- communication problems
- cold parenting
- criticism
- control
- high levels of expressed emotions
- may be risk factors for development and maintenance of schizophrenia.
Family dysfunction studies, effects of EE and schizophrenogenic
- double bind communication
- Bateson 72
- child receives mixed messages and can’t do right thing
- results in disorganised thinking and paranoia
- high EE where family shows exaggerated involvement, control, criticism which increase likelihood of relapse (kavanagh 1992) relapse rate is doubled (butzlaff and Hooley)
- psychodynamic theorists recognised a schizophrenogenic mother
- typically cold, controlling and rejecting which leads to excessive stress which triggers psychotic thinking; father in such families is often passive
Biological explanations for schizophrenia
-3 explanations
- Genetic vulnerability
- role of the neurotransmitter dopamine
- Neural correlates
Difference between Agonist & antagonist
- Agonists= chemical that binds to receptor of a cell & triggers a response by that cell.
- An antagonist blocks or reduces effect of a neurotransmitter
The dopamine hypothesis explanation for schizophrenia
- amphetamine
- cocaine
- antipsychotic drugs (dopamine antagonists)
- amphetamine=dopamine agonist
- stimulates nerve cells containing dopamine
- causing synapse to be flooded
- large doses of drug can cause hallucinations & delusions of a schizophrenic episode
- Cocaine increase levels of dopamine in brain
- cause positive symptoms of schizophrenia
- exaggerate them in people who already have disorder
- Antipsychotic drugs (dopamine antagonists) block activity of dopamine in brain
- by reducing stimulation of dopamine system eliminates hallucinations & delusions
- By alleviating many symptoms of schizophrenia antipsychotic drugs strengthen case for dopamine being significant contributory factor
The Subtypes of schizophrenia
- disorganised - thought disorder
- paranoid- delusions/hallucinations
- Residual- -/+ symptoms, low intensity
- Undifferentiated- Symptoms don’t meet diagnostic criteria
- Catatonic - Marked absences
Genetic explanations for schizophrenia
- schizophrenia thought to be polygenic
- means it’s development isnt determined by single gene but few maybe as many as 108 genes
- there is little predictive power from this explanation
Classification
- number of symptoms by which we can classify abnormal patterns of thinking,behaviour and emotion into mental disorders
- systems not only classify abnormality but give guidance on how to diagnose them
- two most widely used systems of classification and diagnosis are DSM and ICD
- ICD- international classification of causes of disease and death (world health organisation) recognises range of subtypes
- DSM - diagnostic and statistical manual of mental disorder (American psychiatric association) used to also recognise subtypes but most recent DSM 5 have dropped these
What are positive and negative symptoms
- positive symptoms are those that appear to reflect an excess or distortion of normal functions
- negative symptoms are those that appear to reflect a diminution or loss of normal functions
Negative symptoms speech poverty avolition
-andreason 3 signs
3 signs of avolition
- poor hygiene and grooming
- lack of persistence in work/education
- lack of energy
Crow argues that individuals with + symptoms and acute onset should be diagnosed as type 1 schizophrenia. Individuals with chronic onset with symptoms should be diagnosed as type two schizophrenia
What’s acute and chronic
- acute- when person who was previously healthy develops symptoms of schizophrenia over short period of time
- chronic- long term state of schizophrenia
Classification
-schizophrenia doesn’t have a single defining characteristic. It’s a cluster of symptoms some of which appear to be unrelated
According to ICD 10, subtypes of schizophrenia disorder are what
- disorganised/hebephrenic schizophrenia
- primarily negative symptoms
- catatonic schizophrenia
- person is withdrawn mute,negative and often assumes very unusual body positions
- paranoid schizophrenia
- feels extremely suspicious or grandiose
- undifferentiated schizophrenia
- residual schizophrenia
The interactionist approach
-biological, societal and psychological factors
- acknowledges there are biological,psychological and societal factors in development of schizophrenia
- biological- genetic vulnerability and neurochemical and neurological abnormality
- psychological - Stress resulting from life events and daily hassles including poor quality interactions in family
Thé diathesis stress model
- vulnerability to sz and a stress trigger are necessary to develop sz
- one or more underlying factors make a person vulnerable but onset of condition is triggered by stress
Meehls model of diathesis
- believed diathesis was entirely genetic result of single schizogene
- led to development of a biologically based schizotypic personality one characteristic is sensitivity to stress
- according to Meehl if person doesn’t have schizogene then no amount of stress would lead to sz
- However in carriers of gene,chronic stress through childhood and adolescence particularly schizophrenic mother could result in sz
Modern understanding of sz
- now clear that many genes increase genetic vulnerability.
- no single schizogene
- modern views of diathesis also include range of factors beyond genetic including psychological trauma
- trauma becomes diathesis rather than stressor
- read proposed neurodevelopmental model in which early development in early trauma alters developing brain
- Eg hypothalamic pituitary adrenal system HPA becomes over active and person is more vulnerable to later stress
- psychological stress is still seen as important
- modern definition of stress includes anything that risks triggering sz eg cannabis
- cannabis is a stressor because it increases risk of sz x7 as it interferes with dopamine system
- however most don’t develop sz after smoking cannabis so there must be other vulnerability factors
Treatment interactionist approach
- approach acknowledges both biological and psychological factors and is compatible with both types of treatment
- model combines antipsychotics with psychological therapies such as CBT
- standard practice in GB to combine two and is unusual to treat using psychological therapies alone