Schizophrenia Flashcards
Classification of schizophrenia
DSM-5: One positive symptom must be present
ICD-10: two or more negative are sufficient for diagnosis
Positive symptoms- additional experiences beyond those of ordinary existence
Hallucinations: auditory or visual perceptions of things that are not present. Imagined stimuli could involve any of the senses.
Delusions: False beliefs. e.g beliefs about being a very important person
Negative symptoms- loss of usual abilities and experiences
Speech poverty: reduction in amount and quality of speech. May include a delay in speech
Avolition: Severe loss of motivation to carry out everyday tasks
Issues in diagnosis
Co-morbidity: occurrence of two illnesses together which confuses diagnosis and treatment
System overlap: when two or more conditions share symptoms, questioning validity of classification
Biological explanations (Genetic basis)
Inherited through generations and transmission of genes that runs in families
Biological explanations (Dopamine hypothesis)
Linked to excess activity of the dopamine in subcortex (central areas of the brain) or to low activity of dopamine in the prefrontal cortex
Biological explanations ( Neural correlates)
have abnormally large ventricles in the brain. Ventricles are fluid filled cavities in the brain that supply nutrients and remove waste. This means that the brains of schizophrenics are lighter than normal.
Psychological explanations (Family dysfunction)
schizophrenogenic mother– typically cold, controlling and rejecting which leads to excessive stress which triggers
psychotic thinking
double-bind communication- child receives mixed messages and cannot do the right thing which results in disorganised thinking and paranoia
High expressed emotion where family shows exaggerated involvement, control, criticism which increases likelihood of relapse
Psychological explanations (Cognitive explanations)
Dysfunctional thought processing- lower levels of information processing in some areas of the brain suggest cognition is impaired
Metarepresentation- cognitive ability to reflect on thoughts and behaviours- dysfunction disrupts our ability to recognise thoughts as our own- hallucinations
Dysfunction of central control- sufferers cannot suppress automatic responses while performing deliberate actions
Typical antipsychotics
Dopamine antagonists block dopamine receptors in the synapses in the brain, reducing action of dopamine
Chlorpromazine
Atypical antipsychotics
aim was to improve effectiveness and minimise side effects.
Binds to dopamine AND serotonin receptors.
More effective than typical as it reduces anxiety and depression as well as improving cognitive functioning. Also improves mood
Clozapine and Risperidone
CBT
help patient identify irrational thoughts and try to change them
Helped to make sense of how hallucinations and delusions impact feelings and behaviour and offer explanations for the symptoms- reduces anxiety
Family therapy
Aims to improve communication and interaction in the family.
Try to reduce stress within the family to prevent relapse
Pharaoh’s strategies to reduce likelihood of relapse:
1.Reduce stress of caring for a relative with schi
2.Improve ability of family to anticipate and solve problems
3. Reduce guilt and anger in family members
4. Improve beliefs about and behaviour towards schi
Token economies
Reward system used to mange behaviour of patients with schi who spend long periods in hospitals
Tokens given to patients who carry out desirable behaviours
Reward enforces desirable behaviour as they are secondary reinforces- can be traded in for tangible rewards
Interactionist approach- Explanation
Diathesis- many genes linked to schi increase vulnerability before it was thought to be one ‘schizogene’
Stress-anything that risks triggering schi e.g smoking cannabis
