Schizophrenia Content

Question 1

What is DSM-5

Answer 1

Way of classifying SZ

- includes one positive symptom being present (delusions, hallucinations or speech disorganisation)

Question 2

What is ICD-10

Answer 2

Classification of SZ

- two or more negative symptoms are needed for diagnosis (avolition and speech poverty)

Question 3

Positive symptoms of SZ

Answer 3

• additional experiences beyond those of ordinary experience
  1. Hallucinations – sensory experiences that have no basis in reality or distorted perceptions of real things, experiences in relation to any sense
  2. Delusions beliefs that have no basis in society – make a person with SZ behave in ways that make sense to them but bizarre to others e.g. Victim of conspiracy

Question 4

Negative symptoms of SZ

Answer 4

• loss of usual abilities and experiences
  1. Avolition – severe loss of motivation to carry out everyday tasks e.g. Work, hobbies and personal care
• results in lower activity levels and unwillingness to carry out goal-directed behaviours
  2. Speech poverty – a reduction in the amount and quality of speech - may include a deal in verbal responses during conversation
• DSM emphasises speech disorganisation and incoherence

Question 5

What are the issues in diagnosis of SZ

Answer 5

Reliability – extent to which the diagnosis of SZ is consistent
Validity - extent to which the diagnosis and classification techniques measure what they are designed to measure what they are designed to
Co-Morbidity - occurrence of two illnesses together which confuses diagnosis and treatment
Symptom Overlap - when two or more conditions share symptoms

Question 6

What is the genetic basis of SZ

Answer 6

• Strong relationship between similarity of family members and likelihood of both developing SZ
• each individual gene confers a small increased risk of SZ – polygenic

Question 7

What is the dopamine hypothesis

Answer 7

• featured in the functioning on the brain systems related to the symptoms of SZ

Hyperdopaminergia – high dopamine in sub cortex associated with hallucinations and poverty of speech
Hypodopaminergia – recent versions have focused on the low levels of dopamine in the prefrontal cortex (responsible for thinking and decision making)

Question 8

What are neural correlates in SZ

Answer 8

• measurements of the structure or function of the brain that correlate with positive or negative symptoms

Ventral Striatum – involved in anticipation of reward causing a loss of motivation in SZ as a result of low activity levels there

Question 9

Name the psychological explanations of SZ

Answer 9

Family dysfunction and cognitive explanations

Question 10

What does family dysfunction include

Answer 10

Schizophrenogenic mothers, double-bind theory and expressed emotion

Question 11

Explain schizophrenogenic mothers

Answer 11

• patients early experiences with those types of mothers
• these mothers are cold, rejecting and controlling and create a family climate of tension and secrecy which causes distrust, paranoid delusions and SZ

Question 12

Explain double-bind theory and who suggested it

Answer 12

Bateson - described how a child may be regularly trapped in situations where they fear doing the wrong thing but receive conflicting messages about what counts as wrong

• cannot express their feelings about unfairness of the situation
• when they ‘get it wrong’ child is punished by withdrawal of love so learn the world is confusing and dangerous
• leads to disorganised thinking and delusions

Question 13

Explain expressed emotions

Answer 13

level of emotion expresses towards the schizophrenogenic patient and includes:
- verbal criticism of the patient
- hostility towards them
- emotional over-involement in their life
high levels of EE cause stress in the patient – primary explanation for relapse

Question 14

What do cognitive explanations include

Answer 14

dysfunctional thought processing
meta-representation
dysfunction of central control

Question 15

Explain dysfunctional thought processing

Answer 15

• lower levels of information processing in some areas of the brain suggest cognition is impaired e.g. reduced processing in ventral striatum is associated with negative symptoms

Question 16

What is dysfunction of central control and who said it?

Answer 16

Frith – cognitive ability to suppress automatic response while performing deliberate actions
- people with SZ experience derailment of thoughts and spoken sentences because each word triggers automatic association they cannot suppress

Question 17

What is the biological therapies for SZ

Answer 17

Drug therapies

Question 18

what are antipsychotic drugs?

Answer 18

most common
pills, injections and syrup
reduce intensity of symptoms

Question 19

What is the name of a Typical Antipsychotic

Answer 19

Chlorazapine

Question 20

outline Chlorazapine

Answer 20

• start at a low dosage and build up to - 400-800mg
• anatagnoist chemicals reduce action of neurotransmitter - blocks dopamine receptors in the brain
  it normalises transmitters in key areas of the brain
  reduces symptoms like hallucinations

Question 21

What is an atypical antipsychotic

Answer 21

Clozapine

Question 22

Outline Clozapine

Answer 22

• newer
• more effective with fewer side effects
• was trialled in 1970s - led to death of patients as it killed blood cells so was withdrawn
• relaunched as more effective with regular blood checks
• 300-450mg