Schizophrenia Flashcards
(98 cards)
1
Q
DSM -5 schizophrenia diagnosis
A
at least one positive symptom plus two further symptoms ( could be pos or negative)
2
Q
positive symptom
A
extra things experienced by somebody with schizophrenia
3
Q
3 positive symptoms
A
delusion, hallucination, disorganised thinking
4
Q
negative symptom
A
symptoms that normal people experience but are impaired in people with schizophrenia
5
Q
3 negative symptoms
A
avolition , speech poverty , flattened effect
6
Q
4 types of hallucinations
A
Auditory, Visual , Olfactory , Tactile
7
Q
Auditory hallucinations
A
hearing voices
8
Q
visual hallucinations
A
seeing things
9
Q
olfactory hallucinations
A
false sense of taste or smell
10
Q
tactile hallucinations
A
feeling something
11
Q
Delusion def
A
irrational beliefs that have no basis of reality
12
Q
4 types of delusions
A
persecution
grandeur
control
erotomania
13
Q
delusion of persecution
A
beleif others want to harm you
14
Q
delusion of grandeur
A
belief they are an important person ( celeb)
15
Q
delusion of control
A
belief they are under control of an alien force
16
Q
erotomania delusion
A
belief someone is in love with them with no evidence
17
Q
speech poverty
A
loss of productive speech , difficulty to speak fluently or make much sense
18
Q
Avolition
A
massive lack of motivation - poor goal keeping , poor hygeine, lack of energy
19
Q
Issues with schizophrenia diagnosis- reliability
A
diagnosis is not consistent
20
Q
Issues with schizophrenia diagnosis- test retest reliability
A
consistency when a single clinician makes the same diagnosis on separate occasions
21
Q
Issues with schizophrenia diagnosis - inter rater reliability
A
consistency when individual clinicians make the same diagnosis for the same patient
22
Q
Chiniaux et al Procedure - Schizophrenia inter rater reliability
A
2 psychiatrist independently diagnosed 100 patients using DSM -5 and ICD
23
Q
Chiniaux et al Results - Schizophrenia inter rater reliability
A
ICD 10
1- 44/100
2-24
DSM-4
1- 26/100
2-13
24
Q
co morbidity
A
occurence of two conditions together
25
Issue co morbidity creates
confuses diagnoses and confuses validity of classification as could just be one disorder
26
Common co morbid disorders with schizophrenia
OCD , depression, Substance abuse
27
Buckley et al - co morbidity schizophrenia findings
50% also have depression
29% also have PTSD
23% also have OCD
28
symptom overlap
when 2 or more conditions share symptoms
29
what conditions does schizophrenia symptom overlap with
bipolar and cocaine abuse
30
what's made it easier to distinguish symptom overlap
Brain scans
31
Serper et al - symptom overlap
asses patients with either
schiz and cocaine abuse
cocaine abuse
schiz
and found symptom overlap but diagnosis was able to happen
32
Gender bias in schizophrenia diagnosis
more men diagnosed than women
33
Loring and Powell- Gender bias in schizophrenia diagnosis
290 pyschiatrits asked to diagnose 2 patients with identical symptoms
when told it was male patient - 56% diagnosed
when told it was female patient - 20% diagnosed
34
cultural bias in schizophrenia diagnosis
higher rates of schiz in afro craibeans living in UK
35
explanations for cultural bias in schizophrenia diagnosis
heightened stress as minority
more acceptable to hear voices in their culture
36
Cohrane - cultural bias in schizophrenia diagnosis
Afro Caribbean's in UK are 7x more likely to be diagnosed
37
Genetic explanation for schizophrenia
evident there is a genetic component to schizophrenia
38
Gottesman meta analysis Procedure- Genetic explanation for schizophrenia
40 family studies on concordance rates using MZ/DZ twins , siblings and cousins
39
Schizophrenia Concordance rate for twins
MZ- 48%
DZ- 17%
40
Schizophrenia Concordance rates for siblings and cousins
siblings - 9%
Cousins - 2%
41
what do the concordance rates show
genetics plays a part. Nurture is also important as siblings and DZ twins share same % of DNA however it's higher in DZ twins
42
Kety et al - support for Gottesman concordance
Located 33 adopted twins and found a 33% concordance rate
43
Implications of Genetic explanation for schizophrenia
could change how you live in a positive way if you are aware you're at risk
highly deterministic as lack of control
44
Schizophrenia - dopamine hypothesis
schizophrenia is caused by abnormal dopamine levels , a patient could experience both hypo/hyper levels
45
Van Rossum - high levels of dopamine
hyperdopaminergia in sub cortex is linked to positive symptoms
46
Davis et al - low levels of dopamine
hypodopaminergia in cortex linked to negative symptoms as effects decision making
47
dopamine hypothesis alternative explanations ( Glutamate)
Glutamate regulates dopamine and people with schiz have raised levels in several brain regions
48
dopamine hypothesis alternative explanations ( Seratonin)
people with schiz have excess seratonin in parts of the brain
49
Strength of dopamine hypothesis - drugs that increase dopamine
found medication that increases dopamine makes schiz symptoms worse or can give someone symptoms who doesn't have it
50
Strength of dopamine hypothesis - antiphyscotic drugs
drugs that reduce dopamine , reduce schizophrenia shwoing dopamine has a role to play
51
weakness of dopamine hypothesis - individual differences
not present in all schizophrenics and especially those who only suffer negative symptoms
52
abnormal brain structures in schizophrenia
80% of schizophrenics have enlarged ventricles which indicates brain damage and degenerative
53
strength of abnormal brain structures in schizophrenia
MRI and fMRI support this
54
weakness of abnormal brain structures in schizophrenia
not present in all
evidence of it in non schitz people
could be caused by medication
55
biological schizophrenia therapies in pre 1950s
euthanise , hydrotherapy
56
biological schizophrenia therapies in 1970s
development of atypical antiphyscotics
57
biological schizophrenia therapies in 1950s
development of typical antiphysoctic drugs
58
biological schizophrenia therapies in 1990s
better antiphyscotic drugs with fewer side effects
59
3 methods of administering drugs
tablets
syrup
injection
60
tablets
gradually increase dosage
61
syrup
absorbed faster than tablets so good for someone in a psychotic episode who needs help quickly
62
injection
taken every 2-4 weeks for people who don't take their meds
63
how schizophrenia treatment works
block the receptor on post synaptic neuron so less dopamine is absorbed and positive symptoms are reduced
64
pyschological explanation for schizophrenia - family disfunction
a family who aren't operating leading to a dysfunctional environment
65
psychological explanation for schizophrenia- Schizophrenogenic mother ( Freida Fromm)
a cold and controlling mother, and a passive and ineffectual father creating family tension and secrecy.
Leads to distrust from child and paranoid delusions in child
66
psychological explanation for schizophrenia- A03 Schizophrenogenic mother ( Freida Fromm)
retrospective - inaccurate
distorted memory as schizophrenic
correlation is not causation
temporal validty as dad's were not around enough in 50s to cause schizophrenia
67
psychological explanation for schizophrenia- double bind theory
contradictory messages from parents who say and act in different ways as creates a child who doesn't know how to respond.
leads to disorganised thinking and delsuions which leads to schizophrenia
68
A03 double bind theory
retrospective, schizophrenics may have distorted memories, ethical issues
69
Family dysfunction A03- alternative explanations - attachment type
adults with schizophrenia are likely to have an insecure attachment - either insecure resistant or disorganised
70
Family dysfunction A03- alternative explanations- abuse
65% of females and 59% of males with schizophrenia have a history of physical or sexual abuse.
Morkved et al - most adults with schizophrenia reported at least one childhood trauma
71
Brown et al - expressed emotion
when the emotions towards somebody with schizophrenia are negative or overprotective - can lead to relapse of patients who have returned to families.
When secret alliances are formed between family members can lead to delusion of persecution
72
A03 expressed emotion - Kavangh et al study
found relapse rate was 48% when schizophrenics returned to families with high EE
73
A03 expressed emotion - Application
therapy that focuses on reducing EE will reduce relapse rates
74
Cognitive explanations of schizophrenia - Frith et al Metarepresntation
Inability to recognise thoughts as own so believing they are coming from elsewhere.
This leads to delusions as they believe their mind has been overcome
75
Cognitive explanations of schizophrenia - Frith et al central control
Inability to suppress automatic responses so saying whatever pops into your head
This leads to disorganised speech and thoughts - derailment of thoughts that can't be switched off leading to spech poverty
76
Central control A03 - Stroop test
stroop test and compared 30 schitz's with 18 non schiz's
the schitz took twice as long
this shows they were struggling to supress the world
77
Central control A03 - applications
cognitive explanations can lead to CBT which is an effective treatment for schizophrenia
78
Central control A03 - alternative explanations
biological and socio cultural explanations not considered
79
Ellis ABCDE model - cognitive restructuring
A- identifying activating event
B- exploring beliefs
C- recognising consequences
D- disrupting irrational beliefs
E - restructuring belief
80
Chadwick et al - study of CBT (Nigel)
nigel believed he could predict what people were gonna say
Chadwick showed nigel 50 vids and paused them at random points asking Nigel to predict
he didn't get one correct
this restructered nigels beliefs
81
Nick Tarrier - specific form of CBT
specific form of CBT for schizophrenia focused on building a schizophrenia coping strategies for psychotic symptoms and stress they produce
82
Nick Tarrier - specific form of CBT 2 types of coping stratergies
cognitive strategies- distraction
behavioural strategies - relaxation techniques
83
Nick Tarrier - specific form of CBT- 2 types
develop a report and identify triggers
target specific symptoms and learn to cope with them
84
A03 CBT- positives
fewer side effects than drugs
gives patient applicable skills
85
A03 CBT- positives ( Sameer Jahur)
reviewed 34 studies of CBT and schizophrenia and found it effective on both positive and negative symptoms
86
A03 CBT- Negatives
not suitable for all patients
positive symptoms lack awareness
negative symptoms may lack motivation
doesn't treat symptoms but just helps cope with them
87
Family therapy
therapy including close family and friends of schizophrenia patient
lasts 9-12 months
based on family dysfunction
88
Family therapy Stage 1 - Psychoeducation
aim is
to educate family
understand behaviour's witnessed
educate schizophrenic on effect on family
educate both parties on how therapy can change behaviour
89
Family therapy Stage 2 - develop strategies
improve quality of communication
share burden of care between family members
create a balance between caring but maintaining lives
90
Family therapy A03- Mcfarlen meta-analysis
concluded a meta analysis about family therapies and found it reduced relapse rates by 50-60%
91
Family therapy A03-implications on economy
is expensive due to length however is cost effective due to family members and schizophrenic being able to return to work
92
Family therapy A03- Ethical implications
improves QOL of patient and family members
93
token economies
'tokens' given when a socially acceptable behaviour is presented , the tokens can then be exchanged for rewards
94
what type of technique is a token economy
a management technique not a treatment
95
token economies and schizophrenia
- doesn't cure schizophrenia but can improve QOL
as often improves negative symptoms
96
A03 - token economies ethical implications
- certain rewards ( cigs and alcohol) can cause withdrawal
- is the real motivation by staff to make their job easier
97
A03- token economies and individual differences
- not everyone will continue once they leave the institution
- good as can be tailored to individual
98
A03 - token economies research evidence - Glowacki et al
- identified 7 studies on token economies in hospitals
- found that all showed a reduction in negative symptoms and decline in frequency of unwanted behaviour
