Schizophrenia Flashcards
(45 cards)
What is Schizophrenia
A thought process disorder, it’s characterised by disruption to a person’s perceptions, emotions and beliefs. Can be acute (sudden onset, behaviour changes within days) or chronic (gradual deterioration in mental health over time). There are various sub types.
Psychosis
A term used to describe a severe mental health problem where the individual loses contact with reality, unlike neurosis where individual is aware they have problems
5 Sub-types of schizophrenia
Disorganised, Catatonic, Paranoid, Undifferentiated, Residual
Disorganised schizophrenia
Person’s behaviour is generally disorganised and not goal directed. Symptoms include thought disturbances like hallucinations, absence of expressed emotions, incoherent speech, social withdrawal, usually in young adulthood
Catatonic schizophrenia
Diagnosed if the patient has severe motor abnormalities such as unusual gestures or use of body language.
Echolalia: involuntary parrot-like repetition of a word or phrase spoken by another
Echopraxia: involuntary imitation or repetition of body movements of another
Paranoid schizophrenia
Involves delusions of various kinds (like persecution), patient remains emotionally responsive, more alert than patients with other types, tend to be argumentative.
Residual schizophrenia
People who, although have had an episode in past 6months and still exhibit some symptoms, do not have strong enough symptoms to merit putting them in other categories, mild symptoms
Undifferentiated schizophrenia
Category for patients who do not fit or clearly belong to any other category. Show symptoms but do not fit other types.
Positive symptoms
Where people experiencing something, feel that something is happening to them, or display certain behaviours: extra experiences not usually there, involves hallucinations, delusions, jumbled speech, disorganised behaviour
Negative symptoms
Where people don’t display ‘normal’ behaviours: lack of experiences which are normal, involves speech poverty, lack of emotion, avolition- become disinterested
Secondary symptoms
Result from the difficulties of living with the disorder, such as depression
How does DSM V classify schizophrenia
A person must have at least two of: hallucinations, delusions, disorganised speech, catatonic or disorganised behaviour, any negative symptoms. One must be from the first three, symptoms must be present for at least 6months with 1month of active symptoms. Believes schizophrenia does not have subtypes
Comorbidity
Occurrence of two illnesses or conditions occurring simultaneously. Creates a problem with reliability and validity, may be the case that some symptoms belong to one known disorder while others belong to and untreated disorder which is yet to be identified
Symptom overlap
Both schizophrenia and bipolar disorder involve positive symptoms like delusions and negatives like avolition. Questions the validity of the classification and diagnosis of schizophrenia
Rosenhan (1973)- validity of diagnosis
Conducted a study where people with no mental health problems got admitted into a psychiatric unit by saying they heard voices, became pseudo patients, behaved normally once admitted, behaviour was still seen as a symptom of disorder, lack of validity because once you are labelled as having a disorder, all behaviour can be interpreted as caused by the disorder
Positive for reliability of diagnosis of schizophrenia
Even if reliability of diagnosis based on classification systems is not perfect, they do provide forms of communication of research ideas and findings which may ultimately lead to a better understanding of the disorder and the development of better treatments
Biological explanations for schizophrenia
Genetic vulnerability, Dopamine hypothesis, Neural correlates
Genetic vulnerability (schiz)
It has been proposed that there is a genetic component to schizophrenia which predisposes the illness. Development is partly to do with genes. Sz is thought to be polygenic.
Family studies for schizophrenia
Shields (1962) found concordance rates for MZ twins was 48%, DZ was 17%. Theory can be seen as deterministic, predisposition from genes cannot mean we get the disorder, many researchers accept concordance in families may be due to environmental factors. Adoption studies had adopted children with biological mother with sz and a control group. None in control group diagnosed, 16% offspring diagnosed, suggest genes is more influential than environment
The dopamine hypothesis
Schizophrenia is linked to excess activity of the dopamine in sub cortex (hyperdopaminergia) or to low activity of dopamine in the prefrontal cortex (hypodopaminergia). Post-mortems and PET scans have shown this. High levels of dopamine in the subcortex (broca’s area) can cause poverty of speech. Low levels of dopamine in pre frontal cortex can also cause negative symptoms as it effects thought processes
Evidence for dopamine hypothesis
Antipsychotic drugs reduce the positive symptoms of schizophrenia by blocking dopamine receptors. Dopamine agonists stimulates nerve cells containing dopamine and large doses can cause hallucinations, delusions, positive symptoms
Evidence against dopamine hypothesis
The link doesn’t explain a cause and effect and therefore it may be that increased dopamine is a symptom of schizophrenia
Neural correlates of schizophrenia
The idea that schizophrenia is down to structural abnormalities in the brain. Activity in the ventral striatum has been linked to the development of avolition and negative symptom. Reduced activity in the superior temporal gyrus has been linked to development of auditory hallucinations, positive symptom. Some people with schizophrenia have abnormally large ventricles in brain meaning they have lighter brains than normal
Evaluation of neural correlates
MRIs make it possible to investigate living brains- more accurate, findings are generally inconsistent, cause and effect cannot be established with brain abnormalities
