Schizophrenia

Question 1

What are the positive symptoms?

Answer 1

symptoms that reflect a distortion of normal functions.
(gain)
e.g. delusions, hallucinations, disorganised speech, catatonic behaviour.

Question 2

what are delusions?

Answer 2

bizarre beliefs that seem real to the schizophrenic. the delusions can cause paranoia.

Question 3

what are hallucinations?

Answer 3

bizarre, unreal perceptions of the environment that are auditory, olfactory or visual.

Question 4

what is disorganised speech?

Answer 4

where an individual has issues organising their thoughts which is often reflected in their speech.

Question 5

what is catatonic behaviour?

Answer 5

this is the inability or motivation to initiate a task or complete a task once it has been started.
can effect daily life and personal hygiene.

Question 6

what are negative symptoms?

Answer 6

reduction or loss of normal functions

e.g. speech poverty, avolition, affective flattening, anhedonia

Question 7

what is speech poverty?

Answer 7

lessening of speech fluency and productivity

Question 8

what is avolition?

Answer 8

this is the decrease in interest and desires

Question 9

what is affective flattening?

Answer 9

a reduction in the range and intensity of emotional expression.

Question 10

what is anhedonia?

Answer 10

a loss of interest or pleasure in almost all activities.

Question 11

what are the issues with the diagnosis of schizophrenia?

Answer 11

reliability and validity

Question 12

what is reliability?

Answer 12

• diagnostic reliability means that the diagnosis of SZ must be repeatable.
• refers to inter-rater reliability which is when clinicians reach the same conclusions.
• also refers to test-retest reliability which is when two clinicians reach the same conclusions at two different point in time.

Question 13

what issues are associated with reliability?

include study

Answer 13

-Cultural differences
-Copeland
134 US and 194 British psychiatrists
given a description of patient
69% of US psychiatrists gave the patient the diagnosis of SZ.
only 2% of British gave the same diagnosis.

Question 14

extra study to support the idea of cultural differences in reliability.
(Luhrmann - hallucination)

Answer 14

• 20 in each Ghana, India and US.
• each was asked about the voices they hear
• in Ghana and India there is positive reports with their voices however in the US it is described as hateful.

Question 15

what is the issue with gender bias in the diagnosis of schizophrenia? (Broverman et al)

Answer 15

• diagnosis can sometimes be dependent on the gender of individual
• Broverman found that in the US clinicians equated mentally healthy behaviour with mentally healthy ‘male’ behaviour. therefore women are perceived as less mentally healthy.

Question 16

what is symptom overlap?

Answer 16

• many symptoms of schizophrenia can be found in other disorders
• such as depression and bipolar disorder

Question 17

what is comorbidity?

Swets et al

Answer 17

• the extent that two or more conditions co-occur
• a meta analysis carried out by Swets et al showed that at least 12% of schizophrenic patients also fulfilled the diagnostic criteria for OCD.
• 25% also showed OCD symptoms

Question 18

what is the evaluation point for gender bias?

Answer 18

• Loring and Powell randomly selected 290 male and female psychiatrists.
• when described as male or no indication to their gender 50% gave the diagnosis of schizophrenia
• when described as female, only 20% were diagnosed
• gender bias between patients and clinicians, gender bias appeared more in male psychiatrists.

Question 19

what is the evaluation point for comorbidity?

Answer 19

-Weber et al looked at 6 million hospital records to calculate comorbidity. found that 45% were comorbid with other disorders

Question 20

what are family studies?

Answer 20

• Gottesman
• find individuals who have schizophrenia and determine whether relatives are also effected(biological relatives vs non biological relatives)
• the closer the genetic relativity the higher the risk of development
• children with two schizophrenic patients have a concordance rate of 46%
• children with one schizophrenic parent had a concordance rate of 13%

Question 21

what are twin studies? (Joseph)

Answer 21

• monozygotic and dizygotic twins
• concordance rates for mono = 40%
• concordance rates for di = 7%

Question 22

what are adoption studies? (Tienari et al)

Answer 22

• 164 adoptees whose mothers have been diagnosed with Sz.
• 11 were diagnosed with Sz
• compared to 4 out of 197 of control adoptees.

Question 23

what is the dopamine hypothesis?

Answer 23

• more dopamine being fired = more schizophrenic symptoms

- amphetamine is a stimulant which increases dopamine activity and can result in schizophrenic episodes

Question 24

what is the revised dopamine hypothesis?(Davis and Khan)

Answer 24

• proposed that positive symptoms are caused by an excess of dopamine in subcortical areas, especially the mesolimbic pathway
• neural imaging
• animal studies

Question 25

what are the evaluation points for genetic factors?

Answer 25

- common rearing patterns may explain family similarities - monozygotic twins are exposed to the same environment - adoptees selectively placed

Question 26

evaluation of the dopamine hypothesis

Answer 26

- evidence from antipsychotics | - inconclusive supporting evidence

Question 27

what are the biological explanations of schizophrenia?

Answer 27

``` Genetics -family -adoption -twin Dopamine hypothesis -revised dopamine hypothesis ```

Question 28

what are the psychological explanations of Sz?

Answer 28

``` Family dysfunction -double bind theory -expressed emotion Cognitive explanations -focus on delusions and hallucinations ```

Question 29

what is the double bind theory? (Bateson)

Answer 29

-children who receive contradictory messages are more likely to develop schizophrenia

Question 30

what is expressed emotion?

Answer 30

- communication in a hostile manner | - Kuipers found that high EE patients talk more and listen less

Question 31

evaluation points for family dysfunction

Answer 31

- family relationships and external stimuli can cause Sz. genetics aren't sufficient on their own - individual differences

Question 32

what are the two types of antipsychotics?

Answer 32

Typical and atypical

Question 33

what is a typical antipsychotic?

Answer 33

-drug that combats positive symptoms

Question 34

what are atypical antipsychotics?

Answer 34

-drug that combats positive symptoms and is also said to have an effect on negative

Question 35

evaluation of drug treatment

Answer 35

-antipsychotics vs placebo Leucht - meta analysis and found that patients that had their medication replaced with a placebo relapsed quicker than patients on antipsychotics - extrapyramidal side effects - ethical issues(relate to extrapyramidal side effects)

Question 36

what is family therapy?

Answer 36

-providing a family with a safe space to express their emotion and learn about schizophrenia

Question 37

what study supports the idea of family therapy?

Answer 37

- Pharoah et al - reviewed 53 studies - Europe, Asia and US - found that family therapy has an overall positive effect on patients compared to standard treatments

Question 38

what are the evaluation points for family therapy?

Answer 38

- economic benefits - impact on family members - is family therapy worthwhile? - individual differences

Question 39

what is a token economy?

Answer 39

- when a patient is rewarded for positive behaviour | - classical and operant conditioning

Question 40

evaluation of token economy

Answer 40

- difficult to assess the success of token economy - less useful for patients that have to live In the real world - ethics? - does it actually work?

Question 41

what is the stress diathesis model?

Answer 41

-a genetic predisposition that is triggered by environmental factors

Question 42

evaluation for the stress diathesis

Answer 42

- diathesis may not be exclusively genetic - urban environments are usually more stressful - difficulties in determining casual stress - implications for treatment

Question 43

what study supports the stress diathesis model?

Answer 43

- Tienari et al - adopted children with schizophrenic mothers vs ones with genetic vulnerability - assessed over 21 years (longitudinal study) - 14 adoptees developed schizophrenia, 11 from genetic vulnerable group