Schizophrenia Flashcards
(23 cards)
What is schizo
Thought process disorder, it disrupts a person’s perceptions, emotions and beliefs
Who gets affected by schizo
EQUAL for both genders
Males: late teens-20s
Females: 4-5 years later after men
What are the schizo characteristics
- Auditory hallucinations (hearing things)
- Social withdrawal
- Delusions (paranoia, controlled by someone else, etc.)
- Speech poverty, (odd speech).
- Avolition (lack of interest in goals).
- Lack of interest towards hygiene, care, emotion.
- Inappropriate emotions
What are positive symptoms and give examples
These are adding on to the psychosis.
- Hallucinations
- Delusions
- Unusual speech
- Disorganised behaviour
What are negative symptoms and give examples
These are take away something from the psychosis
- Speech poverty
- Avolition
- Lack of emotion
- Lack to function normally
What are the DSM features of diagnosing schizo
- Delusions
- Hallucinations
- Disorganised speech
- Disorganised behaviour
- Any negative symptoms
1/3 in the list needs to be present for 6months to be classified as schizo.
What are the problems with DSM diagnosing schizo
- May be affected by cultural bias, some races are diagnosed more because of their ethnic background.
- Study found that USA psychiatrists diagnosed schizo way more than UK ones when they were shown a patient in a video.
- More likely to diagnose schizo when they’re found out to be a man compared to a woman.
- Symptom overlap may misdiagnosis schizo for depression
- Rosenhan’s study where he put normal people into a mental health unit and found that the nurses didn’t think they were normal and every action they did was abnormal.
What is comorbidity
Comorbidity refers to having two or more conditions at the same time.
Having both depression and schizo is hard for professionals to distinct one from another.
What did Gottesman say about schizo and eval
Schizo may be genetic.
TWIN STUDIES
40 MZ twins had close 50% concordance rate whilst DZ was much lower.
SHOWS THAT
Schizo has a genetic basis bc MZ twins share 100% of genes.
EVAL
- Backed by adoption studies which suggest that genes has a bigger role than environment.
- However, it isn’t fully 100% showing that the environment plays a role (perhaps diathesis stress model).
What are the biochemical factors to schizo and give for+against
- PET scans and post-mortems show that schizo people have high levels of DOPAMINE.
Created the dopamine hypothesis which suggests that the synapses that use dopamine are overactive in the schizo brain.
EVIDENCE FOR
- Antipsychotic drugs have reduced symptoms of schizo by blocking dopamine receptors, suggesting that high levels of dopamine contributes to schizo
EVIDENCE AGAINST
- Antipsychotic drugs only work on positive symptoms like hallucinations.
- It may be that high dopamine levels is a symptom of schizo rather than the underlying cause.
What are the neurological factors to schizo and for+against
Abnormal brain structure could explain schizo.
EVIDENCE FOR
Johnstone compared the size of ventricles from schizo to normal. Found that schizo had bigger ventricles suggesting a smaller frontal lobe
MRI scans on schizo ppl found abnormalities in the prefrontal cortex.
EVIDENCE AGAINST
Enlarged ventricles doesn’t mean that you have schizo
Could be a symptom of schizo rather than the root cause
What is the evolutionary explanation to schizo for and against
Suggests that schizo gives an advantage to survival and that’s why it’s prominent in today’s generation.
How does family dysfunction affect schizo
Suggested that in a bad environment with dysfunctional families it can cause schizo
A cold, dominant ‘schizophrenogenic’ mother creates conflict within the environment and causes schizo.
What is the double bind theory and how does it affect schizo?
Faulty communication in families could lead to contradictory messages for children and later cause schizo
What is expressed emotion environments and how does it affect schizo for+against
These environments contain high levels of hostility and criticism towards the person with schizo.
It is found that in dysfunctional families and causes relapses of schizo.
FOR
Lidz: investigated families and proposed that dysfunctions such as emotionally distant parents and unequal marriages could have an impact on children and lead to schizo.
AGAINST
Ignores the biological factors for schizo and blames the family and parents. Most studies that support this theory are retrospective and outdated. Furthermore, the families were only studied after the disorder had developed, showing that the disorder may cause distress to family.
What is the cognitive explanation for schizo and for+against
Argue that schizo is caused by dysfunctional thought processing.
Leads to delusion, thought interference, language impairment and memory problems.
FOR
Neufeld:
Compared cognitive processes of people with schizo and without.
Found that schizo took longer to encode stimuli and showed STM problems. Shows processing information is impaired.
Studies show that they do worse in memory and reasoning tasks, as they have reduced activity in that area of the brain.
AGAINST
Biochemical research suggests that cognitive problems are caused by increased dopamine rather than faulty information processing.
They don’t explain the cause of schizo, biological may offer a better explanation.
What is the socio-cultural factors that affect schizo for/against
Suggests that people in lower social status are more likely to suffer from schizo than higher social status.
Could be bc of poverty, discrimination cause high stress and results in schizo
FOR
Harrison: found that people who were born in deprived areas more likely to develop schizo. Supports the claim of the bad environment factoring schizo
AGAINST
Doesn’t factor biological influences
Diathesis-stress model on schizo
A mix of biological vulnerability and environmental stressor = schizo.
Support from twin studies.
How can drug therapy help schizo? advantages/disadvantages
- Treatment is based on the dopamine hypothesis which suggested that there is high levels of dopamine in the brain.
Antipsychotics was made to block dopamine receptors.
There two types of antipsychotics
TYPICAL
- Developed in the 50s, they are less used due to the adverse side effects and only treat positive symptoms.
- It only blocks dopamine
ATYPICAL
- More modern and used to block serotonin and dopamine.
- Can treat both positive and negative.
ADVANTAGES
- Drug therapy is quick and easy to do.
- Can tackle a large number of patients with schizo.
- Less time consuming than CBT
DISADVANTAGES
- Doesn’t treat negative symptoms very well
- Doesn’t tackle the root cause of schizo where if they get off the drugs the schizo starts again.
- CBT may be a better treatment for schizo as it helps both positive and negative
How can CBT help with schizo? give a study to back CBT and advantage/disadvantage
It is based on the assumption that patients can be helped by identifying and changing their ‘faulty cognitions’.
It is also based on the ABC model and try to identify them.
They are pushed to challenge their beliefs and to question where the voices may have originated from.
Encouraged to have positive self-talk about themselves.
CHADWICK
- Case study about a man with schizo and believed that he had the ability to predict what people were about to say.
- The man was tested through a video to see whether he can predict what was gonna happen.
FINDINGS
- The man didn’t get one right
BECAUSE OF THIS
- The man stopped thinking like this because he was disproven.
CONCLUSION
- Small sample size so lacks generalisability
ADVANTAGES
- Sensky: found CBT was effective in treating positive and negative symptoms and improved afterwards.
DISADVANTAGES
- Difficult to measure the effectiveness of CBT, it relies on the patient’s self-report and therefore makes it less objective
- Patients may become dependent on their therapist
- Time consuming compared to drug therapy.
How does family therapy help schizo? adv/dis
- It based on the idea that family dysfunction can lead to an increased risk of relapse in people with schizo.
- Aim is to reduce conflict and high emotion among the family environment.
- Can happen by helping the family form alliances, reduce the burden of care and limit outbursts of anger.
ADV
- Support to show that family therapy reduced readmission in schizo patients.
- Good for patients who may not be able to correlate their own thoughts
DISAD
- Informed consent is hard to gain from all family members
- Families need to be open to change, not every family will.
How does token economies help to manage schizo? adv/disad
- Based on operant conditioning and learning through reinforcement.
- Token economies help encourage people in psychiatric institutions to perform desirable behaviour.
- Patients are given tokens which reinforce these behaviour.
- Tokens are exchanged for rewards.
ADV
- Can produce significant improvements in self care and desirable behaviour
- Works best in institutions
DISAD
- Can’t apply to the real world, they don’t get rewards when they do something special
- Superficial behaviour, they may only produce desirable behaviour because they know they’re going to receive a token.
- Ethical issues: taking away the right to smoke as a reward is unethical.
How does an interactionist approach help to treat schizo? give ad/dis
- Uses a combination of approaches to explain behaviour
- Holistic approach
ADV
- Various treatments to help schizo if a particular one isn’t working.
- Using all can cover all bases
DISA
- Time-consuming
- More severe levels of schizo may mean that the drug therapy affects CBT.
