Schizophrenia Flashcards
(24 cards)
Classification of Schizophrenia
ICD-10 - negative symptoms
DSM-5 - positive symptoms
Positive Symptoms
Hallucinations
Dleusions
Negative Symptoms
Avolition
Speech Poverty
Weakness of classification of Schizophrenia symptoms
Co-Morbidity - When two disorders or conditions are coexistent in a sufferer. Where two conditions are frequently diagnosed together it calls into question the validity of classifying the two disorders separately.
Symptoms overlap - Occurs when two or more conditions share symptoms. This calls into question the validity of classifying two disorders separately.
Biological explanations - Family studies
Schizophrenia runs in families.
This is quite weak evidence in itself for a genetic link as family members tend to share aspects of their environment as well as many of their genes.
However, there is a strong relationship between the degree of genetic similarity and shared risk of schizophrenia.
Biological explanation - Candidate genes
Individuals are believed to be associated with risk of inheritance.
Genes associated with increased risk included those coding for the functioning of a number of neurotransmitters including dopamine.
Biological explanation - The role of mutation
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The Dopamine Hypothesis - Hyperdopaminegia
Too much dopamine in the sub cortex i.e. the central areas of the brain such as Broca’s area.
It is said that Broca’s area may be associated with poverty of speech as well as the experience of auditory hallucinations.
The Dopamine Hypothesis - Hypordopaminegia
Too little dopamine in the cortex.
Neural correlates - Positive symptoms
Reduced area in the superior temporal gyrus and anterior cingulate gyrus is a neural correlate of auditory hallucination.
Neural correlates - Negative symptoms
Activity in the ventral striatum is a neural correlate of negative symptoms of SZ.
Psychological - Family dysfunction - The Schizophrenogenic mother
Reichmann (1948) proposed a psychodynamic explanation for SZ based on the accounts she heard from her clients about their childhoods.
The mother is cold, rejecting and controlling, and tends to create a family based on tension and secrecy.
This leads to distrust that later develops into paranoid delusions, and ultimately schizophrenia.
Psychological - Family dysfunction - Double Bind theory
Bateson et al. (1972) emphasized the role of communication style within a family.
The child is often going to receive mixed messages about what they ay do wrong and feel unable to comment on the unfairness of this situation or seek clarity.
Bateson made it clear that this was neither the main type of communication in the family of a person with schizophrenia nor the only factor, just a risk factor.
Psychological - Family dysfunction - Expressed Emotion
Expressed Emotion (or EE) is the level of emotion, in particular negative emotion, expressed towards a person with schizophrenia by their carers.
EE contains several elements:
- Verbal criticism of the person, occasionally with violence.
- Hostility towards the person, including anger and rejection.
- Emotional over-involvement in the life of the person, including needless self-sacrifice.
Cognitive explanation - Dysfunctional thinking
A general term meaning information processing that is not functioning normally and produces undesirable consequences.
Cognitive explanation - Meta-representation
The cognitive ability to reflect on thoughts and behaviour. This allows us insight into our own intentions and goals.
Dysfunction in metarepresentation would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else.
This would explain hallucinations of voices and delusions like thought insertion.
Cognitive explanation - Central Control
The ability to suppress automatic responses while we perform deliberate actions instead.
Disorganised speech and thought disorder could result from the inability to suppress automatic thoughts and speech triggered by other thoughts.
Biological therapy - Typical anti-psychotics
Chlorpromazine
Typical anti-psychotics act as antagonists to the dopamine system as they reduce the action of dopamine.
Effective against positive symptoms of schizophrenia but not negative symptoms.
Have more but less drastic side effects.
Biological therapy - Atypical anti-psychotics
Clozapine
A treatment for schizophrenia when typical anti-psychotics fail.
Attacks both positive and negative symptoms of schizophrenia.
Acts on serotonin.
Has less but more drastic side effects such as tardive dyskinesia.
Psychological therapy - Cognitive behaviour therapy
Usually takes place between five and twenty sessions, either in groups or an individual basis.
The aim of CBT involves helping people identify irrational thoughts and trying to change them.
This may involve an argument or a discussion of how likely the persons beliefs are to be true, and a consideration of other less threatening possibilities.
This will not get rid of the symptoms but can make it possible for people to cope with them.
Psychological therapy - Family therapy
Takes place with the aim of improving quality of communication and interaction between family members.
Pharoah et al. (2010) identified a range of strategies to improve functioning of a family:
- Forming a therapeutic alliance with all family members.
- Reducing the stress of caring for a relative with SZ.
- Reduction of anger and guilt in family members.
- Helping family members achieve a balance between caring for the individual and maintaining their lives.
- Improving families’ belief about and behaviour towards SZ.
Management of Schizophrenia - Token economies
Based on operant conditioning, Tokens are secondary reinforcers as they only have value once the patient has learnt that hey can be used to gain rewards.
In the form of social services, rewards may be having a room cleaned or privilege’s such as a walk outside the hospital.
Interactionist approach - The diathesis stress model
The diathesis stress model says that both a vulnerability to SZ and a stress-trigger are necessary in order to develop the condition.
Treatment according to the interactionist approach
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