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Schizophrenia Flashcards

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1
Q

What is schizophrenia?

A

Psychotic disorder, person may not be able to distinguish between real and fake thoughts

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2
Q

Who coined the term schizophrenia?

A

Bleuler which is a split mind

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3
Q

How much of the population does it affect?

A

1%

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4
Q

Is it equally common in genders?

A

Yes

Males in mid 20s

Females in early 30s

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5
Q

What is the prognosis?

A

20% fully recover

40% never recover and gave positive an negative symptoms

40% only have positive symptoms

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6
Q

What are the symptoms of hallucinations?

A

Positive and negative

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7
Q

What are the positive symptoms?

A

Hallucinations - auditory and visual

Delusions - False Beliefs

Disorganised thinking and speech - can’t connect and communicate properly

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8
Q

What are the negative symptoms?

A

Speech poverty - Alogia

Lack of emotion - Flat effect

Social withdraw - Avolition

Apathy - lack of emotion

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9
Q

What is the diagnostic criteria for schizophrenia?

A

Characteristic symptoms - delusions / hallucinations

Social dysfunction - work

Duration - some signs of the Disorder must last for at least 6 months

Mood disorder exclusion - Ruled out of patient has not experienced any depressive stages

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10
Q

What is classification?

A

Identifying groups or patterns of behaviour to form a type of mental disorder that we can call a syndrome

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11
Q

Why is classification important?

A

Treatment

Prognosis

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12
Q

What is the DSM?9

A

First published in 1952, and for each disorder has a specific criteria

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13
Q

What are the 4 overlapping issues that we need to consider with the specification?

A

1) reliability
2) validity
3) cultural bias
4) gender bias

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14
Q

What is the reliability of diagnosis?

A

A) inter rater reliability

B) Test retest reliability

C) Unreliable symptoms

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15
Q

What is inter rater reliability?

A

Type of reliability when clinicians make identical, independent diagnosis of the same patient

Beck et al showed a 54% agreements rate with 2 different psychiatrists and 153 patients

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16
Q

What did Copeland study?

A

Gave a description of a patient to 134 US and 194 British psychiatrists and found a similarity between 69% of patients and 2% in British

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17
Q

What did Read report on?

A

Test retest analysis is as low as 37% for schizophrenia

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18
Q

What did Farmer report on for improving reliability ?

A

Standardised interview technique and focuses on the severity and frequency of symptoms

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19
Q

What is unreliable symptoms?

A

Some symptoms are quite problematic and bizarre

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20
Q

What did Mojtabi and Nicholson report on?

A

Asked 50 psychologists in US to differentiate between bizarre and non bizarre and they only had a 0.40 correlation rate

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21
Q

What is the valididty of schizophrenia?

A

Comorbidity

Overlapping symptoms

Predictive validity

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22
Q

What is comorbidity and the study with it?

A

When people have 2 or more mental health disorders

Buckley et al, those who have schizophrenia also has other Disorders like PTSD (23%)

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23
Q

What is overlapping symptoms and study with it?

A

None of the symptoms are exclusive to the disorder.

Konstantares and Hewitt compared 14 autistic and schizophrenia patients and and found that all schizophrenia parents had symptoms of autism

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24
Q

What is predictive validity and study with it?

A

Extent to which the diagnosis can predict treatment and prognosis

Bleuler and 20% fully recover and 40% stay with both symptoms and 40% recovers from positive symptoms

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25
What is the cultural bias of Schizophrenia?
Cultural interpretations Negative cultural attitudes Nationality of the clinician Race discrimination
26
What is the cultural interpretations and study?
What can be seen as insane might be seen as acceptable in another culture Malagady found Costa Rican cultures find voices as spirits
27
What are the negative cultural attitudes and study?
Without a diagnosis people will continue to suffer Kim and Berrios found that Asian cultures dislike metal disorders and only 20% come forward for a diagnostic
28
What is the culture / nationality of the clinician?
Copeland and his US v UK
29
What is race discrimination and the study with It?
Different psychologists perceive race differently when diagnosing Blake found clinic 6x more likely to diagnose a black person with Schizophrenia
30
What 3 aspects is there gender bias on a diagnosis?
Unreported facts in men and women Biased research Under diagnosing of female
31
What is unreported facts in gender bias?
Men more likely to be committed to involuntary psychic awards Cotton said men suffer more and relapse more often
32
What is biased research?
Neglected to use female participants Nasser found research was conducted men only and androcentric
33
What is the under-diagnosing of female patients suffering from schizophrenia?
Women under diagnosed and denied treatment Loring and Powell selected 280 male and female psychiatrists. 56% diagnosed for men with disorder but only 20% for females
34
What is the genetic inheritance of schizophrenia?
Genetic predisposition 76 genes that could have schizophrenia and problems with the 8 and 11 chromosomes Gene TPH
35
Children of 2 schizophrenia patients have a what chance of getting it?
46%
36
1st degree relatives have a what chance of getting schizophrenia?
13%
37
What did Joseph et al find with twin studies?
Found a 40% concordance with MZ twins
38
What did Tienari et al find with adoption studies?
Kids whose mothers had schizophrenia were put in families that didn’t have schizophrenia and found 11 of the children got schiz anyway
39
Give one ✅ and one ❌ of genetic inheritance
✅ Heston 1966 found 50 children whose mothers had schiz 10% contracted it compared to 1% in control group ❌ Genetic explanation is incomplete as MZ twins do not have a 100% schiz rate
40
What is the dopamine hypothesis?
Schiz accuses by elevated dopamine and causes a sustem overload
41
What are 2 observations that supports the hypothesis?
More dopamine levels seen in brian in post mortem in schiz patients Drugs that increase dopamine production make symptoms worse
42
What is the reversed dopamine hypothesis?
In pre frontal cortex there is low levels of dopamine and no D2 receptors, low levels in this region causes negative symptoms
43
What does glutamate do?
Low levels of this increases dopamine production
44
Give one ✅ and one ❌ of the DA hypothesis
✅ Practical applications in terms of drugs and anti psychotic drugs and are 85% successful ❌ Incomplete as it’s good in treating positive symptoms but not positive ones and the other 15% does not work
45
What are the neural correlations of Schiz?
Brain abnormalities such as Enlarged ventricles - Brain fluid filled activities and cause negative symptoms Blood flow and hippocampus - reduces blood flow in pre frontal cortex Knock on effects - Amygdala reduces in size
46
Give one ✅ and one ❌ of neural correlates in schiz
✅ Scientific and falsifiable MRI and post mortem examinations show scientific and controlled approach ❌ Enlarged ventricles not exclusive to schiz as it can happen in Parkinson’s disorder
47
What are the 2 psychological explanations to schiz?
Family dysfunction Dysfunctional thought processing
48
What is family dysfunction?
Emphasise nurture and maladaptive family relationships
49
What are the 3 factors affecting schiz in the family?
1) Schizophrenia mother - Fromm reichman suggested a domineering and insensitive mother and create vulnerability 2) Double blind hypothesis - conflicted messages (mother tells love son but looks in disgust) 3) Expressed emotion - 4x more likely to relapse and have higher hostility
50
Give one ✅ and one ❌ of the dysfunctional families
✅ Practical applications ✅ Butzlaff and Hooley meta analysis of 26 studies and found high EE families 2x more likely to relapse ❌ Cause and Effect
51
What is the dysfunctional thought processing theory for schiz?
Due to cognitive defecits Have high levels of cognitive processes called meta representation which is the ability to reflect upon thoughts
52
What are the 3 dysfunctions with cognitive ability?
Central motoring system (hallucinations) - thoughts and actions by me Supervisory attention systems (poverty of speech) - generating self initiated actions Insight and egocentric bias (delusions) - Juno’s to false conclusions
53
Give one ✅ and one ❌ of the cognitive explanation
✅ Practically applied ✅ Bentall and his generating of words and animals, those who suffer with schiz did the worst ❌ reductionist theory as it ignores biological factors
54
What are the 4 most popular treatments for schizophrenia?
Typical and atypical drugs CBT Family therapy Token economics
55
What are anti psychotic medication?
Reduce or stabilise the balance of dopamine
56
What are typical AP?S
Haloperidol Reduce dopamine in brain (old style) Approximately 60% of D2 receptors blocker
57
What are atypical AP?
Modulate Levels of serotonin and dopamine in key pathways Clozapine 2 key pathways are Mesombolic Nigrostriatal
58
What action occurs in the mesolimibic pathway?
Involved in emotions and pleasure/ hyperactivity. This reduces positive symptoms (hit and run)
59
What does the nigrostriatal pathway do?
Role in controlling moment, decreasing serotonin allows for natural dopamine to form
60
Give one ✅ and one ❌ of APs
✅ Davis et al meta analysis of 29 studies and found that 55% relapsed when it was Placebo compared to 19% with real drug ❌ Not effective in treating everyone, only helps around 85% of people
61
How is CBT used to treat schiz?
Help patients identify their faulty, delusionary beliefs to construct more rational ways of thinking
62
What are the 2 techniques that CBT uses?
Integrated psychological therapy Coping strategy enhancement
63
What is IPT?
Help identify specifically cognitive deficits and are taught to recognise and respond to social cues and understand communication more accurately
64
What is CSE?
Better ways to manage severity and frequency of their psychotic symptoms, taught coping mechanisms such as sit active thinking and positive self talk
65
Name one ✅ and one ❌ of CBT
✅ Startup et al had 90 schiz patients who relapsed and half was to be given ordinary care whereas other half CBT, 60% improvement in CBT compared to 40% in non ❌ Clinicians find CBT more suitable for younger patients and some patients may think their not even ill
66
What is family therapy?
Schizophrenia mother High EE household Aimed to help family develop constructive practical coping skills, develop co operative relationships
67
Give one ✅ and one ❌ of family therapy
✅ Leff et al had a control group and non control group and found those with family therapy only 14% readjusted compared to 78% ❌ Most effective when used with AP, without AP relapse increased 92%
68
What is the token economy in treating schiz?
Operant conditioning Positive reinforcement Good hygiene and apathy and avolition allows for tokens to be given Token removed if behaviour is bad
69
Give one ✅ and one ❌ of token economy
✅ Token economy allowed for partners to be treated more humanely with more freedom ❌ Noting to cure the illness and only provide token learning, once rewards stop so does the desired behaviour
70
What is the internationalist approach in treating schiz?
Diathesis stress model Nature and nurture alone cannot explain it
71
What is the diathesis stress model?
Inherit a vulnerability to develop a disorder and then interacted with stress/ environment to trigger disorder
72
Name 3 stress factors
Pollution Addiction Trauma
73
What is the interactionist approach to treating schiz?
Uses mostly all of the treatments
74
What does Garrett say in accordance to the interactionist approach?
Used CBT to change patients mind about taking AP
75
Give one ✅ and one ❌ of the interactionist approach
✅ More realistic and incorporates nature and nurture ❌ Does not explain how stress impacts the nervous system to trigger the condition, does not explain how urban living can cause inflation to dopanine

Psychology (4 decks)

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