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SCHIZOPHRENIA Flashcards

1
Q

define schizophrenia

A

a mental disorder which affects thoughts and emotions to the point they loose touch of reality
- affects 1% of population between 15-35
- most common psychotic disorder

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2
Q

positive symptom of schizophrenia

A

addition to normal life
1. hallucinations
2. delusions

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3
Q

negative symptoms

A

atypical experiences that represent loss of function
1. avolition- lack of activity levels
2. speech poverty

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4
Q

ICD-10

A

created by world health organisation
used across world
recognises subtypes
2+ negatives

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5
Q

DSM-10

A

american psychiatric association
USA only
previous subtypes removed since DSM 1
1+ positive symptom

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6
Q

validity in schizophrenia

A

the extent to which schizophrenia is accurately classified as a unique syndrome with symptoms

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7
Q

whats criterion validity

A

evaluates accuracy a test measures

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8
Q

whats symptom
overlap

A

symptom overlap considers overlap in symptom of disorders
lowers validity of diagnosis of a unique syndrome

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9
Q

whats co morbidity

A

the extent to which 2 or more conditions occur together and common in patients eg: depression

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10
Q

rosenhan aim

A

how well can psychiatrists distinguish real schizophrenia from 8 pseudo patients who gained admission in 12 hospitals by 1 fake symptom

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11
Q

procedure 1

A

8 pseudo patients ( 2W, 5M )
they arrived at 12 hospitals around 5 states in USA
symptom: hearing voices ( empty hollow and thud )
after admission, patients acted normal and acted as if they wanted to leave
- no medication swallowed
- recorded doctors answers
- no further symptoms

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12
Q

results from procedure 1

A

all were admitted, average stay was 19 days
range between 7-52
released with diagnosis of schizophrenia
30% of cases- real patients made comments that fake patients was fine

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13
Q

procedure 2 of Rosenhan

A

nurses and doctors made aware that these pseudo patients would come back in 3 months
doctors had to rate likability that patients were fake

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14
Q

results from procedure 2

A

41/193 were rated fake
all were real

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15
Q

3 strengths of rosenhan study

A

hospitals vary- generalised findings
design was simple, patients were asked to be themselves
replicated and reliable

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16
Q

weakness of rosenhan

A

symptom was valid, therefore results may be less suprisijg

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17
Q

how does rosenhans findings link to a lack in validity of diagnosis

A

lacks validity as sz was applied inappropriately.
the studies findings emphasise how professionals could not tell the difference between sane and insane individuals, questioning reliability and validity of psychiatric labels

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18
Q

cultural bias within validity of classification and diagnosis of sz

A

African Americans and english people of afro carribean origin are several times likelier to be diagnosed with sz
HOWEVER
rates of sz arent high in the west indied, thereofre diagnosis is a result of culturasl bias

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19
Q

extra note of cultural bias example within diagnosis of SZ

A

positive symptoms may be accepted in African cultures due to cultural beliefs ( eg communication with ancestors ) and not be viewed as SZ

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20
Q

Escobar 2012 study

A

white psychiatrist may over interpret symptoms of black people during diagnosis due to cultural differences and mannerisms
Thereofore, this suggests psychiatrists must pay more attention to cultural differences

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21
Q

gender bias within diagnosis of SZ study

A

290 psychiatrists were shown cases of patient behaviours
males 56% diagnosed
females 20%

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22
Q

issues with low validity

A

misdiagnosis- mistreatment- worsen symptoms- QOL- economy worsens

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23
Q

Serper et al 1999 study

A

assessed patients with co- morbid SZ and cocaine abuse, j ca and j sz
they found despite symptom overlap it was possible to make accurate diagnosis
INC VALIDITY AND QOL

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24
Q

Ketter 2005 study

A

points out that misdiagnosis due to symptom overlap can lead to years of delay in receiving relevant treatment, during which time suffering and further degeneration can occur
QOL DEC people endure years of suffering

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25
symptom overlap percentages
around half of patients with diagnosis of sz also have diagnosis of depression (50%) as well as substance abuse ( 47% ). PTSD also occured in 29% of cases and OCD 23%
26
cause of SZ: family dysfunction define
one cause of SZ is family dysfunction, suggested by frith. this is where psychologusts have tried to link SZ and living in a dysfunctional family
27
who came up with three theories of family dysfunction
frith
28
theory one: schizophrenogenic mother FROMM REICHMAN
mothers: cold, rejecting, controlling
29
impact of schizophrenogenic mothers
creates family of tension, secrecy and leads to distrust
30
what symptoms do schizophrenogenic mothers lead to
paranoid delusions and SZ
31
theory 2 cause of SZ: family dysfunction
double bind BATES 72’ child gets mixed signals and “cant do anything right”
32
theory 2: double bind IMPACT AND SYMPTOM
confusion eg: more independant but overbearing PARANOID DELUSIONS AND SZ
33
theory 3 cause of SZ: family dysfunction
expressed emotion high levels of emotion towards child eg: critisism
34
impact of expressed emotion
explains relapse of SZ patient eg: from psychiatric ward back home
35
strength of family dysfunction theory
read et al 05’ reviewed 46 studies of child abuse and SZ 69% women 59% men w SZ experienced abuse RESEARCH SUPPORT FAMILY DYSFUNCTION ASSOCIATED WITH HIGH SZ LEVELS
36
weakness of family dysfunction theory
even with evidence, none that supports traditional views CANT ACCOUNT FOR LINK BETWEEN TRAUMA AND SZ
37
weakness of family dysfunction theory 2
research linking FD to SZ is socially sensitive and leads to parent blaming ( specifically mothers ) PRODUCES HARM AND HIGHLIGHTS WHETHER WE SHOULD KEEP RESEARCHING
38
weakness of family dysfunction theory 3
doesnt account for nature factors ( biological ) cultural and social influences eg: poverty ignores individual differences between patients
39
explanation SZ two: cognitive dysfunction define
the study of how people think and process information, explaining SZ through dysfunction in cognitive processing.
40
theory one within cognitive dysfunction
Dysfunctional thought processing cognitive beliefs that cause someone to evaluate info inappropriately and produce neg consequences eg: reduced thought processing in ventral striatum- negative symptoms
41
theory two cognitive dysfunction
metarepresentation cognitive ability to reflect on own thoughts and behaviours dysfunction affects ability to recognise thoughts as our own leads to hallucinations and delusions
42
theory three cognitive dysfunction
central control dysfunction ability to suppress automatic responses whilst performing deliberate actions dysfunction leads to inability to suppress these thoughts LEADS TO SPEECH POV AND DERAILMENT OF THOUGHTS
43
strength of cognitive dysfunction
stirling 06’ investigated performance of people with SZ and control group using stroop SZ took 2x longer to read ink colour RESEARCH SUPPORT THAT CC IN SZ ARE IMPAIRED
44
weakness of cognitive dysfunction
do cognitive dysfunctions cause SZ or vice versa cant establish cause and effect, we can only make inferences which means our understanding of SZ decreases
45
weakness 2 of cognitive dysfunction
reductionist - no cognitive factors/ biological - oversimplistic - validity decrease
46
whats the biological explanation
emphasises the role of inherited factors and dysfunction of brain activity in development of SZ
47
genetic explanation within biological
focusses on family studies, SZ increases in line with genetic similarity to someone with SZ
48
gottesman study and results
1991- conducted a large family study and found high concordance rates in MZ ( 48% ) in comparison to DZ (17%)
49
what does gottesmans study suggest
as genes have a role, we should identify candidate genes around 108 genes involved, making SZ polygenic
50
what does gottesmans study suggest
as genes have a role, we should identify candidate genes around 108 genes involved, making SZ polygenic
51
whats the neural explanation of SZ
brain structure/ function related to cause of SZ eg: the abnormality of ventral stratum is linked to avolition
52
what is the original hypotheses theory
SZ caused by high levels of dopamine in sub cortex areas of brain eg: excess of dopamine from sc and broca which may cause speech poverty
53
whats the revised hypotheses
SZ caused by too low of dopamine im cortex area eg: low in prefrontal explains cognitive issues
54
strength of genetic explanation
research support, gottesman and tienari adoption found children w SZ parents are still at high risk if adopted in family w no history LINK OF GENES TO SZ
55
strength of neural explanation
drugs developed based on original hypotheses. dopamine agonists inc dopamine and made SZ worse; antipsychotic dec levels of DA and levels dec of symptoms LINK TO NEURAL AND SZ
56
weakness of neural
arguments contradicting noll (2009) argues antispychotic drugs dont alleviate hallucinations in ab 1/3 of people. Also, in some people, hallucinations are present despite levels of dopamine being normal. DOPAMINE DOESNT AFFECT SZ AND DRUG ARE INEFFECTIVE IN SOME
57
weakness two of neural explanation
weakness of evidence studies are useful in determining parts of brain that may not be working, however this kind of evidence doesn’t prove that the activity in the brain causes symptom CANT ESTABLISH CAUSE AND EFFECT
58
whats token economy
a form of behavioural modification where desirable behaviours are encouraged using selective reinforcement
59
how does token economy work
patients are given tokens for every desirable behaviour immediately to condition the behaviour they can later swap this for rewards ( operant conditioning )
60
how are token and rewards named
rewards- primary tokens- secondary
61
strength of token economy
research and support showing effectiveness. researchers identified 7 high qual studies that showed token economy reduced symptoms and inc desirables suggests TE is effective and improves QOL allows us to focus on real symptoms instead of developed ones
62
weakness 1 of token economy ( ES )
ethical issues raised. gives professionals power to control behaviour, also takes away freedom. legal action from families have been taken which contributes to the decline suggests TE dehumanises and the negative outweigh the pos, raises the question?
63
weakness 2 of token economy
alternatives that are more beneficial for example, art therapy suggested by NICE may be good alternative doesnt carry ethical issues other approaches better chance of treating, te will decline
64
weakness 3 of token economy
lack of ability to further on outside difficult to maintain because behaviours cant be monitored as close and arent given to patients immediately MAY RESULT IN RELAPSE and may only be effective in hospital
65
what are the two psychological treatments to SZ
CBT and family therapy
66
whats CBT
recognises examples of dysfunctional thinking and advices on how to avoid acting on these
67
what thoughts does CBT alter
general beliefs self image methods of coping
68
what does CBT aim to do
rationalise thoughts normalise thoughts reduce confusion, stress and shame
69
strength of CBT within SZ
Jahuar reviewed 34 studies of CBT and SZ found cbt had small but significant effect on reducing pos and neg symptoms research report, QOL inc, go back to work, economy
70
weakness of CBT
requires motivation can be lengthy, has high drop out rates as pps need to be willing to engage eg: homework may not be effective if symptom of avolition
71
family therapy strength
review of studies found it was one of the most consistent effective treatments reduced symptoms by 50-60% effective and dec relapse rates
72
strength of family therapy
benefits whole family strengthens ability to support and therefore improves QOL
73
weakness of both family therapy and CBT
doesnt cure, however the do improve treatment may need to be LT which is hard to do
74
what are the two biological treatments of SZ
typical and atypical antipsychotics
75
what hypotheses does the typical relate to
original as it follows hyperdominergia
76
what does the typical antipsychotic do
reduces and blocks dopamine reduces positive symptoms and has calming effect
77
side effect of typical antipsychotics
involuntary movement eg: tardive dyskinesia
78
what theory does the atypical antipsychotic follow
revised dopamine hypotheses as it follows hypodominergia ( too little dopamin )
79
why was atypical made and what does it do
to improve effectiveness and sympt temporarily blocks receptors in only brain ( to red symp) acts on both dopamine and seratonin
80
side effects with atypical
still neuroleptic malignant affected, may result in coma or death
81
what do drugs reduce
the reuptake of neurotransmitters by blocking receptors binding to them
82
strength of biological treatment
thornley meta analysed 1000 patients and found chlorpromazine was associated with better functioning and reduced symptoms compared to placebo SHOWS THEY ARE EFFECTIVE
83
weakness 1 of biological treatments
side effects eg: NMC may lead to a decreased quality of life which means more time off work etc should be prescribed w caution
84
weakness 2 of biological treatments
ethical issues raised pps w severe conditions may not give consent to having the drug prescribed therefore raises the question of whether we should prescribe at all
85
weakness 3 of biological treatments
therapies more efficient no side effecrs and take more of an interactionist approach ALTERNATIVES
86
whats the interactionist approach also known as ?
biosocial model
87
define diathesis
caused by underlying vulnerability ( diathesis ) and a stress trigger
88
whats the diathesis stress model
diathesis - genetic, result of schizogene stress- childhood and adolescence
89
whats the modern understanding
diathesis- many genes increase genetic vulnerability and SZ can be a result of psychological trauma
90
strength of interactionist approach within schizophrenia
tarrier allocated 315 pps to medication and cbt or only meds found cbt and meds showed less symptoms clear practical advantage to adopting IA
91
strength 2 of IA
tienari studied 19000 finish adoptees whose bio mothers had SZ they found adoptive parents with high level of critisism along w bio mothers had SZ shows combination of genetic vulnerability and stress can lead to inc in risk of Sz, supports IA
92
strength 3 of IA
clear evidence to show that env factors also inc SZ eg: the fact that concordance rates in MZ twins was not 100% suggests other factors genetic factors alone cant explain, IA is worth adopting
93
weakness of IA
original diathesis model portrayed diathesis and single gene and stress being schizophrenogenic parenting studies show multiple causes for both original model too simplistic and didnt take evidence to support modern

a level pyschology (18 decks)

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