Schizophrenia Flashcards
(41 cards)
What I need to know (SPEC)
Classification of schizophrenia. Positive symptoms of schizophrenia, including hallucinations and delusions. Negative symptoms of schizophrenia, including speech poverty and avolition. Reliability and validity in diagnosis and classification of schizophrenia, including reference to co-morbidity, culture and gender bias and symptom overlap.
Biological explanations for schizophrenia: genetics and neural correlates, including the dopamine hypothesis.
Psychological explanations for schizophrenia: family dysfunction and cognitive explanations, including dysfunctional thought processing.
Drug therapy: typical and atypical antipsychotics.
Cognitive behaviour therapy and family therapy as used in the treatment of schizophrenia. Token economies as used in the management of schizophrenia.
The importance of an interactionist approach in explaining and treating schizophrenia; the diathesis-stress model.
What is used to diagnose SZ?
DSM-5 - Diagnostic and Statistical Manuel
ICD-10 - International Classification of Diseases
What is the ICD?
International Classification of Diseases which is used worldwide to diagnose SZ and only negative symptoms need to be present
What is DSM?
Diagnostics and Statistical Manuel which is mainly used in America where only positive symptoms need to be present
What is meant by positive symptoms?
Positive symptoms are an excess or distortion of normal functions, for example hallucinations, delusions and thought disturbances such as thought insertion.
What is meant by hallucinations?
Hallucinations are usually auditory or visual perceptions of things that are not present. Imagined stimuli could involve any of the senses. Voices are usually heard coming from outside the person’s head giving instructions on how to behave.
What is meant by Delusions?
Delusions are false beliefs. Usually the person has convinced him/herself that he/she is someone powerful or important, such as Jesus Christ, the Queen (e.g. Delusions of Grandeur). There are also delusions of being paranoid, worrying that people are out to get them.
What is meant by negative symptoms?
Negative symptoms are a diminution or loss of normal functions such as psychomotor disturbances, avolition (the reduction of goal-directed behavior), disturbances of mood and thought disorders
What is meant by avolition?
Avolition: Lack of volition (i.e. desire): in which a person becomes totally apathetic and sits around waiting for things to happen. They engage in no self motivated behavior. Their get up and go has got up and gone!
What did Slater & Roth (1969) say (A03 - )
Hallucinations are the least important of all the symptoms, as they are not exclusive to schizophrenic people.
What did Scheff (1966) say ( A03 -)
Diagnosis classification labels the individual, and this can have many adverse effects, such as a self-fulfilling prophecy (patients may begin to act how they are expected to act), and lower self-esteem.
What is meant by reliability?
Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms.
For the classification system to be reliable, differfent clinicians using the same system (e.g. DSM) should arrive at the same diagnosis for the same individual.
What did Jakobsen et al (2005) find out? (AO3 +)
Tested the reliability of the ICD-10 classification system in diagnosing schizophrenia. A hundred Danish patients with a history of psychosis were assessed using operational criteria, and a concordance rate of 98% was obtained. This demonstrates the high reliability of the clinical diagnosis of schizophrenia using up-to-date classification
What does comorbidity mean? (AO3 -)
Comorbidity describes people who suffer from two or more mental disorders. For example, schizophrenia and depression are often found together. This makes it more difficult to confidently diagnose schizophrenia. Comorbidity occurs because the symptoms of different disorders overlap. For example, major depression and schizophrenia both involve very low levels of motivation. This creates problems of reliability.
What did Loring and Powell? (1988) find out (AO3 -)
Some behavior which was regarded as psychotic in males was not regarded as psychotic in females.
What is meant by validity?
The extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms
What is meant by aetiological validity?
For a diagnosis to be valid, all patients diagnosed as schizophrenic should have the same cause for their disorder. This is not the case with schizophrenia: The causes may be one of biological or psychological or both
What did David Rosenhan (1973) find (AO3 -)
Pseudopatients (patients who pretend to act sick) led to 8 normal people being kept in hospital despite behaving normally. This suggests the doctors had no valid method for detecting schizophrenia. They assumed the bogus patients were schizophrenic with no real evidence. In a follow up study they rejected genuine patients whom they assumed were part of the deception.
Cultural bias (AO3 Validity -)
African Americans and those of Afro-carribean descent are more likely to be diagnosed than their white counterparts but diagnostic rates in Africa and the West Indies is low - Western over diagnosis is a result of cultural norms and the diagnosis lacks validity.
What are the three biological explanations fo SZ?
Genetics
The Dopamine Hypothesis
Neural Correlates
What did Gottesman (1991) find out (AO1)
Gottesman (1991) found that MZ twins have a 48% risk of getting schizophrenia whereas DZ twins have a 17% risk rate. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia
What did Benzel et al (2007) find out (AO1)
three genes: COMT , DRD4 , AKT1 - have all been associated with excess dopamine in specific D2 receptors, leading to acute episodes, positive symptoms which include delusions, hallucinations, strange attitudes
Evaluation of twin studies (concordance rates A03 -)
Shows how genetics is not only responsible as if it was the concordance rate would be 100%
What is dopamine?
Dopamine is a neurotransmitter. It is one of the chemicals in the brain which causes neurons to fire that regulates mood and attention
