Schizophrenia

Question 1

What are hallucinations

Answer 1

Positive symptom of schizophrenia. They are sensory experiences that have either no basis in reality or are distorted perceptions of things that are here

Question 2

What are Delusions

Answer 2

Positive symptom of schizophrenia. Involve irrational beliefs that have no basis in reality.

Question 3

What is Avolition

Answer 3

Negative symptom of schizophrenia. A loss of motivation to carry out tasks and results in lowered activity

Question 4

What is speech poverty

Answer 4

Negative symptom of schizophrenia. Involves reduced frequency and quality of speech

Question 5

What is Schizophrenia

Answer 5

a severe mental disorder where contact with reality and insight are impaired, an example of psychosis

Question 6

What are positive symptoms

Answer 6

Atypical symptoms experienced in the addition to normal experiences. Include delusions and hallucinations.

Question 7

What does the DSM-5 about diagnosing schizophrenia

Answer 7

Patients must display at least 2 main symptoms of schizophrenia for at least 6 months

Question 8

What was Rosenhans method

Answer 8

Conducted an observation study. 8 volunteers, who pretended to have schizophrenia, admitted into hospital. Rosenhan tested how long it took doctors to declare that the volunteers were healthy

Question 9

What were Rosenhans results

Answer 9

Took doctors between 7-52 days to realise the diagnoses were wrong, and that the volunteers were healthy. Study showed the diagnosis of schizophrenia can lack validity

Question 10

Evidence for inter-rater reliability

Answer 10

In 1962, a researcher called Beck found diagnoses for schizophrenia were 52% similar. In 2005, researchers found that for schizophrenia were 81% similar. This shows diagnoses of schizophrenia are becoming more reliable over time

Question 11

What are AO3 points for diagnosis and classification of schizophrenia

Answer 11

Good reliability
Low validity
Co-morbidity

Question 12

Diagnosis: Reliability

Answer 12

-Reliability means consistency. A diagnosis is said to be reliable when different diagnosing clinicians reach the same diagnosis for the same individual (inter-rate reliability) and when the same clinician reaches the same diagnosis for the same individual on two occasions.
-Prior to DSM-5 the reliability for diagnosing schizophrenia was low but has now improved.
-Osório et al report excellent reliability for the diagnosis of schizo in 180 patients using DSM-5. Pairs of interviews had a inter-rater reliability of +97.
-This means we can reasonably sure that the diagnosis of schizophrenia is consistently applied.

Question 13

Diagnosis: Low validity

Answer 13

-Validity concerns whether we assess what we are trying to assess. We assess validity of psychiatric diagnosis via criterion validity.
-Cheniaux et al had two psychiatrists independently assess same 100 clients using ICD-10 & DSM-4 criteria
-68 diagnosed with schizo under ICD and <39 under DSM
-Suggests schizo either over or underdiagnosed. Suggests hat criterion validity is low

Question 14

Diagnosis: Low validity counter point

Answer 14

-Osório et al study reported excellent agreement between clinicians when using two measures to diagnose schizo both derived from DSM
-Means criterion validity for diagnosing is actually good provided it takes place within a single diagnostic system

Question 15

Diagnosis: Co-morbidity

Answer 15

-when co-morbidity occurs this questions the validity of their diagnosis as it might be a single condition.
-Schizo is commonly diagnosed with other conditions. For example, half of those diagnosed had a diagnoses with depression or substance abuse.
-This is a problem as it means schizophrenia may not exist as a distinct condition, and is a problem for diagnosis as some people diagnosed may have unusual cases of conditions like depression

Question 16

Schizophrenia: family studies

Answer 16

Family studied have shown risk of schizophrenia increases with genetic similarity to a relative with the disorder. MZ twins have higher concordance rates (48%) than DZ (17%), general population is 1%

Question 17

Candidate genes for schizophrenia

Answer 17

-Schizophrenia was believed to be monogenetic but is polygenetic. Most likely genes would be those coding for neurotransmitters including dopamine.

Question 18

Ripke et al

Answer 18

Combined all previous data from genome wide studies. The genetic make up of 37,000 schizos against 113,000 controls, 108 separate genetic variations associated with slightly increased risk of schizo. Different studies identified different candidate genes it also appears schizophrenia is aetiologically heterogeneous

Question 19

Role of mutation

Answer 19

Schizophrenia can still arise When a family has no history of it. One explanation for this is mutation in parental DNA caused by radiation, poison or viral infection.

Question 20

Neural correlates

Answer 20

Patterns of structure or activity in the brain that occur in conjunction with an experience and may be implicated in the origins of that experience

Question 21

Original DA hypothesis

Answer 21

Hyperdopaminergia in subcortical brain areas may explain schizophrenia. This leafs to acute episodes and positive symptoms.

Question 22

Updated DA hypothesis

Answer 22

Abnormally hypodopaminergia in cortex leads to hyperdopaminergia in subcortical areas. Explain cognitive problems and negative symptoms.

Question 23

Evaluation points for biological explanations

Answer 23

Research support
Environmental factors
Evidence for dopamine

Question 24

Biological explanation: Research support

Answer 24

Strong evidence base for the genetic explanation. Gottesman’s family study shows risk increases with genetic similarity to a family member with schizophrenia. Teinari et al adoption study shows that biological children of paretns with schizophrenia are at heightened risk. Hilker et al showed with a twin study concordance rate of 33% for MZ twins and 7% for DZ. This shows that some poeple are more vulnerable to schizophrenia as a result of their genetic make up.

Question 25

Biological explanation: Environmental factors

Answer 25

environmental factors increase risk of schizophrenia. Includes both biological and psychological influences. Biological risk factors include birth complications (Morgan et al) and smoking THC as a teen (Di Forti et al). Psychological includes childhood trauma leaving people more vulnerable to schizo. Mørkved et al 67% people with schizo reported one childhood trauma compared to 38% ‘normal’. This means genetic factors alone cannot provide a complete explanation for schizophrenia.

Question 26

Biological explanation: Evidence for dopamine

Answer 26

support for DA involved in schizophrenia. Amphetamines increase DA and worsens schizophrenia symptoms and induces them (Currant et al). Antipsychotic drugs reduce DA and also reduce intensity of symptoms (Tauscher et al). Some candidate genes act on the production of DA or DA receptors. This strongly suggests that DA is involved in the symptoms of schizophrenia

Question 27

Family dysfunction

Answer 27

Refers to processes within a family such as poor family communication, cold parenting and high levels of expressed emotion. These may be risk factors for both the development and maintenance of schizophrenia.

Question 28

Fromm-Reichmann (1948)

Answer 28

Psychodynamic explanation for schizophrenia based on what she heard from patients about childhood speaking about a specific parent. Called the Schizophrenogenic mother. Mother is cold, rejection and controlling, creating family climate of by tension, secrecy and distrust

Question 29

Bateson et al (1972)

Answer 29

emphasised the role of communication style within a family. Developing child finds themselves in situations where they fear doing the wrong thing but receive mixed signals on what it is. Punished by a withdrawal of love. Think of the world as dangerous and confusing.

Question 30

Expressed emotion

Answer 30

level of negative emotion expressed to a person with schizophrenia by carers. high levels verbal criticism (violence) , hostility (anger, rejection) and emotional overinvolvement (needless self-sacrifice). These are a source of stress. Primarily an explanation for relapse in people with schizophrenia

Question 31

cognitive explanations

Answer 31

explanations that focus on mental processes such as thinking, language and attention

Question 32

Dysfunctional thinking

Answer 32

Schizophrenia is associated with several dysfunctional thought processing, these provide explanation for schizophrenia as a whole. Disrupted thought processing in ventral striatum can induce negative symptoms and temporal/ gyri can induce positive symptoms

Question 33

metarepresentation dysfunction

Answer 33

Frith et al identified two kinds of dysfunctional thought processes. Metarepresentation, the cognitive ability to reflect on thoughts and behaviour. Disruptive metarepresentation disrupts this ability and leads to thinking that own actions and thoughts are being carried out by someone else (voices)

Question 34

Central control dysfunction

Answer 34

Frith et al. People with schizophrenia tend to have derailment of thoughts because a word triggers associations and the person cannot suppress automatic central responses to these. This could result in Speech poverty and thought disorder.

Question 35

Dysfunctional thought processing

Answer 35

Information processing that does not represent reality accurately and produces undesirable consequences

Question 36

AO3 family explanations

Answer 36

Research support
Explanations lack support
Parent blaming

Question 37

Family explanations : Research support

Answer 37

Evidence linking family dysfunction to schizophrenia. Indicators of family dysfunction include insecure attachment and expose to childhood trauma. Read et al. adults with schizo are disproportionately likely to have insecure attachment (Type C or D). Also, 69% F and 59% M with schizo have history of physical/sexual abuse. Møkved et al. most adults with schizo reported on childhood trauma. Strongly suggests family dysfunction makes people more vulnerable to schizo

Question 38

Family explanations: Explanations lack support

Answer 38

Poor evidence base. Plenty evidence supporting childhood family-based stress associated with adult schizophrenia. No evidence supporting importance of traditional family-based theories such as schizophrengogenic mother and double bind. Both based on clinical observation. Informal assessment, but not systematic evidence. Family explanations cant account for the link between childhood trauma and schizophrenia.

Question 39

Family explanations: Parent-blaming

Answer 39

Research in this area may be useful in showing insecure attachment and childhood trauma affect individuals vulnerability to schizophrenia. Research linking family dysfunction to schizophrenia is highly socially sensitive because it can lead to parent blaming (Mothers). For mothers taking care of their schizophrenic child and watch their experience, to be blamed adds insult to injury

Question 40

Cognitive explanation AO3

Answer 40

Research support
A proximal explanation
Psychological or biological

Question 41

Cognitive Explanation: Research support +

Answer 41

Evidence for dysfunctional thought processing. Stirling et al. compared performance on cognitive tasks in 30 with schizophrenia and a control of 30. Tasks included naming font colours of colour-words, suppress tendency to read the words aloud. Predicted by Frith et al.’s central control theory people with schizo took longer. Means that cognitive process of people with schizophrenia are impaired

Question 42

Cognitive explanation: A proximal explanation -

Answer 42

Cognitive explanation only explains proximal origins of symptoms. These are proximal explanations because they explain what is happening now to produce symptoms. Possible distal explanations (what initially caused condition) are genetic and family dysfunction explanations. Unclear how genetic variation or childhood trauma might lead to problems with mearepresentation of central control. Means cognitive theories on their own provide partial explanations for schizo

Question 43

Cognitive explanation: Psychological or biological?

Answer 43

Cognitive approach provides an excellent explanation for symptoms of schizophrenia. Therefore an argument for seeing schizophrenia primarily as a psychological condition. However, appears abnormal cognition associated with schizo is party genetic in origin and result of abnormal brain development ( Toulopoulou et al.). This would suggest that schizophrenia is a biological condition