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Clinical psychology > Schizophrenia (pack 2) > Flashcards

Schizophrenia (pack 2) Flashcards

1
Q

What sort of disorder is schizophrenia?

A

A psychotic disorder

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2
Q

What is schizophrenia marked by?

A

remission, where they have no symptoms and relapse, where symptoms reoccur.

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3
Q

What are positive symptoms?

A

strange and bizarre additions to normal behaviour

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4
Q

What are negative symptoms?

A

loss or absence of normal symptoms

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5
Q

What are cognitive symptoms?

A

issues to do with information processing

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6
Q

What are the four positive symptoms for schizophrenia?

A
  1. Delusions
  2. Hallucinations
  3. disorganised thinking/speech
  4. Abnormal motor behaviour/grossly disorganised behaviour OR catatonia
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7
Q

What are delusions?

A

false or bizarre beliefs, even in the face of disconfirming evidence

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8
Q

What are some ways in which delusions are different in other cultures?

A

delusions tend to reflect predominant themes and values of a persons culture
e.g in Ireland a persons religious piety is greatly valued

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9
Q

what is disorganised thinking/speech?

A

there is an underlying problem with conscious thought that affects their language.

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10
Q

What are three negative symptoms?

A

lack of energy and motivation
social withdrawal
flatness of emotion

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11
Q

Why may negative symptoms be more objective?

A

negative symptoms are more directly observable

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12
Q

What are two cognitive symptoms in schizophrenia?

A

difficulties in concentration and paying attention

problems with working memory

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13
Q

What are the 3 features of schizophrenia?

A

Onset, prevalence and prognosis

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14
Q

when is typically the onset for schizophrenia

A

between the late teens and early thirties

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15
Q

When is peak onset for males and females?

A

early to mid twenties = M
late twenties = F

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16
Q

What does prevalence mean?

A

refers to how common a disorder is

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17
Q

What does prognosis mean?

A

The likely course of the disease

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18
Q

What are some general statistics for prognosis?

A

25% of people experience schizophrenic symptoms continually.

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19
Q

What is the average life expectancy for someone with schizophrenia?

A

10 years less than the overall population average

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20
Q

What is the dopamine hypothesis?

A

suggests that schizophrenia can be explained by changes of dopamine functioning in the brain

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21
Q

what are the three explanations within excess dopamine (hyperdopaminergia)
that explains positive symptoms in schizophrenia

A
  1. Low levels of an enzyme that breaks down dopamine (excess within synapses)
  2. presence of excess numbers of dopamine receptors at the synapses
  3. hypersensitivity of certain dopamine receptors
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22
Q

How does dopamine deficiency (hypodopaminerga) explain negative schizophrenia symptoms

A

low levels of dopamine in the mesocortical pathway

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23
Q

What are three strengths of the theory of neurotransmitters as an explanation for schizophrenia?

A
  1. Backed up by evidence from drug treatment: many antipsychotic medications used to treat schizophrenia by blocking dopamine
  2. People given drugs that treat Parkinson’s disease by increasing dopamine production, can experience schizophrenic symptoms, this provides testable evidence that excess dopamine plays a role
  3. the theory explains both positive and negative symptoms
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24
Q

What are three weaknesses of the theory of neurotransmitters as an explanation for schizophrenia?

A
  1. Not all patients with schizophrenia responded to these drugs. For example, Alpert and Friedhoff and found that some patients did not improve at all after taking dopamine antagonists
  2. the theory cannot prove that excess dopamine causes schizophrenia. Instead it may be a symptom
  3. Some anti-psychotic medications are effective, but focus more on serotonin than dopamine.
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25
Q

What should the chances of having schizophrenia be if someone is related to a schizophrenic if genetics are the correct explanation?

A

higher than 1%

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26
Q

what does Hilker suggest is the heritability rate for schizophrenia?

A

79%

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27
Q

How many genes does Wright say may be involved in causing schizophrenia?

A

up to 700

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28
Q

What are the two genes focused on for causing schizophrenia?

A
  1. the COMT gene
  2. the DISC1 gene
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29
Q

What is the link between the COMT gene and schizophrenia and what does the COMT gene do?

A

The COMT gene is deleted
The gene is involved in regulating dopamine levels
(if it is deleted, than high levels of dopamine remain)

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30
Q

What does the DISC-1 gene code for?

A

GABA

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31
Q

What does GABA regulate?

A

glutamate and dopamine

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32
Q

What are the three major types or research that have looked into the role of genetics?

A
  1. family studies
  2. twin studies
  3. adoption studies
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33
Q

What did Gottesman and shields investigate when looking at schizophrenia?

A

investigated whether schizophrenia has a genetic basis by looking at concordance rates between MZ and DZ twins

34
Q

what is the aim of gottesman and shields study?

A

to find out if there is a genetic basis for schizophrenia

35
Q

what was the sample for gottesman and shields?

A

62 schizophrenic patients, half male and half female aged between 19 to 64

36
Q

What are two parts of the procedure in gottesman and shields study?

A
  1. Twins found through fingerprint testing and blood testing
  2. mental health in the twin was measured by hospital notes and questionnaires.
37
Q

What were the results for gottesman and shields?

A

both twins were schizophrenic= 54% for MZ and 18% for DZ

38
Q

what are the conclusions for gottesman and shields?

A

seems to be a genetic component.

not always 100% therefore cannot truly say genetic is the only factor

39
Q

What are three strengths to evaluate genes as an explanation of schizophrenia?

A
  1. Evidence from twin studies suggest that there is a significant genetic factor, some argue that it is at least as great as with illnesses such as diabetes

2.The biological approach to explaining schizophrenia is associated with the medical profession and has scientific status

  1. It has been used to provide families with genetic counselling, allows families to understand risk factors
40
Q

Two weaknesses to evaluate the use of genes as an explanation of schizophrenia?

A
  1. Research methods to establish genetic links have had methodological flaws
    e.g- MZ twins may be treated as more similar than DZ twins
  2. Twin studies don’t take into account the fact that genes may act different in other environments
  3. few researchers believe that genetics are the only factor. Can be argued to be reductionist.
41
Q

What does THOMAS (2010) suggest about the connection between schizophrenia and developmental psychology?

A

suggests that schizophrenia stems from abnormalities in early brain development

42
Q

What is one non-biological explanation for schizophrenia?

A

The social causation hypothesis

43
Q

what is the social causation hypothesis?

A

suggests that schizophrenia can be caused by factors within the environment

44
Q

what are the environmental risk factors according to the social causation hypothesis?

A

if a child grows up in an environment where their physical, intellectual, emotional and social needs are not met, this makes them vulnerable to mental disorders.

45
Q

What are the four environmental factors within the social causation hypothesis?

A
  1. Urbanicity
  2. social isolation
  3. immigration and minority status
  4. family dysfunction and childhood trauma
46
Q

why is urbanicity a factor for social causation?

A

schizophrenia more associated with living in cities than rural communities

47
Q

what does EATON (1974) suggest about urbanicity?

A

city life is more stressful than rural life and that long term exposure can trigger schizophrenia.
the increased population density makes life more competitive

48
Q

What supporting evidence for urbanicity as a cause for schizophrenia comes from meta-analysis and what do they say?

A

VASSOS ET AL (2012)
Risk of schizophrenia 2.37 times higher for urban people than rural people.

49
Q

What does FARRIS (1934) suggest about social isolation for social causation?

A

cultural isolation- cut off from family and friends leads to symptoms (don’t get feedback from others that their thoughts are inappropriate

50
Q

what is the link between immigration and minority status and schizophrenia?

A

due to census data, increased risk for Afro-Caribbean because immigrants have increased stress due to discrimination

51
Q

What did Veiling say about immigration and minority links to schizophrenia

A

used data gathered through self report questionnaires data to suggest that schizophrenia may be a reaction to long-term prejudice.

52
Q

How does POPOVICH suggest childhood trauma links to schizophrenia?

A

childhood trauma may interact with pre-existing risk factors, such as genes, to trigger schizophrenia in vulnerable individuals.

53
Q

What are three strengths to evaluate the social causation hypothesis?

A
  1. helps explains some features of schizophrenia, for example, why black immigrants more likely to be diagnosed rather than white natives

2.useful practical applications- when housing is designed it should reduce overcrowding whilst encouraging neighbourhood cohesion

  1. helps explains how biological factors, such as genes, can interact with environmental to explain causes (supports diathesis-stress model)
54
Q

Three weaknesses to evaluate the social causation hypothesis?

A
  1. difficult to isolate specific environmental factors to see if they cause schizophrenia
  2. it is not a complete explanation, it suggests environmental factors may only trigger schizophrenia in people who are genetically predisposed.

3.supoorting evidence- popovich, veiling ect.

55
Q

What are the 7 HCPC guidelines set out for clinical practitioners?

A
  1. Character
  2. Health
  3. standards of proficiency
  4. standards of conduct, performance and ethics
  5. standards for continuing personal development
  6. standards of education and training
  7. standards for prescribing
56
Q

What are the two possible treatments for schizophrenia?

A
  1. drug treatment
  2. cognitive treatment
57
Q

what are the drugs used for psychotic disorders called?

A

Anti-psychotics

58
Q

what were the first types of anti-psychotic drugs called?

A

typical drugs (phenothiazines)

59
Q

how do phenothiazines work (typical drugs)?

A

blocking the receptors site for the neurotransmitter dopamine.

60
Q

What was a major problem of phenothiazines (typical drugs)?

A

bad symptoms of shaking muscle tremors and jerky movements

61
Q

what are the new drugs called?

A

a-typical (clozapine)

62
Q

How does clozapine work?

A

blocking serotonin receptors

63
Q

what are the side effects of A-typical drugs?

A

weight gain

64
Q

what are three strengths to evaluate drug treatment for schizophrenia?

A
  1. shown to be effective in reducing symptoms (meltzer) found haloperidol gave sig. improvements in all areas compared to placebo
  2. more effective than any other therapy because it reduces symptoms more quickly than psychological therapies.
  3. Drug therapy allows patients to live fairly normal lives. Before 1950s people were removed and put into mental institutions. Rosenhan called them snake pits, patients were catatonic and unreachable
65
Q

what are two weaknesses to evaluate drug therapy?

A
  1. reductionist, ignores social factors
  2. effectiveness, and therefore the usefulness, of drug therapy for schizophrenia is limited as it is palliative rather than curative
  3. ethical issues raised- produces side-effects which can have serious health effects
66
Q

how to cognitive treatments aim to change maladaptive behaviour?

A

by changing the way people think

67
Q

what do therapists do in CBT?

A

challenge thoughts, show they are wrong and eliminate them

68
Q

how are do therapists change the thoughts of the therapist in CBT?

A
  1. Focusing on the present symptoms (not going back to past issues)
  2. looking at how the person thinks about how an event has affected a person
  3. Challenge negative thoughts and reinterpret them to positive ones
  4. the person will feel better and behaviours will change
69
Q

What symptoms of schizophrenia is CBT used to target?

A

difficulties concentrating, problems with memory
and target delusions and hallucinations.

70
Q

what is the aim of CBT?

A

to reduce the stress felt by the patient and allow them to manage and understand their symptoms

71
Q

what three techniques may CBT involve?

A
  1. belief modification- delusional thinking directly targeted
  2. focusing and reattribution- help with auditory hallucinations, aims to show the voices are self-generated and not actually there
  3. normalising the experiences of the person- look at experiences
    rationally, taught to examine the evidence. Psychotic symptoms are made to seem normal and less of a catastrophe, reduces stress.
72
Q

What are three strengths of CBT as a therapy for schizophrenia?

A
  1. patients show an increase in coping skills, and decreased hallucinations and delusions (SENSKY) - found CBT more effective in reducing both positive and negative symptoms
  2. most ethical- empower patients in educating them in self-help strategies
  3. CBT good for people who have not responded to drug therapy (Elizabeth Kuipers)
73
Q

what are three weaknesses of CBT as a therapy for schizophrenia?

A
  1. reductionist- focuses on thoughts but not underlying problems
  2. effectiveness of CBT may be limited- some argue for CBT to be effective the patient must have good problem solving-skills, schizophrenics may not have this skill.
  3. effectiveness is hard to judge- most studies compare CBT to a control treatment and find it superior - use of inadequate control treatment conditions as they are sometimes given by non-experts
74
Q

What is the contemporary study for schizophrenia?

A

Carlsson

75
Q

What is a review article?

A

summarizes previously published studies

76
Q

what were two aims of Carlsson’s review article?

A
  1. provide evidence for and against the dopamine hypothesis
  2. look at specific areas with regard to neurotransmitter interactions
77
Q

what is some of the procedure for Carlsson’s study?

A

literature review, methods and findings of studies to do with neurotransmitter interactions in schizophrenia are analysed
e.g brain scans to investigate psychosis

78
Q

What are three key points from Carlsson’s literature review?

A

1 Carlsson points out that PET scans provide evidence to show that high levels of dopamine are related to psychosis (Breier et al 1997), however there may be interactions with other transmitters such as serotonin.

  1. suggests that low levels of glutamate plays a role. evidence comes from (LODGE et al 1989) which shows PCP can induce psychosis by inhibiting the action of the glutamate
  2. Found an interaction between dopamine and glutamate; reduced levels of glutamate seem to be associated with increased dopamine release
79
Q

What are two conclusions from Carlsson’s study?

A
  1. Glutamate deficiency should be studied to explain schizophrenia
  2. more focus on other neurotransmitters, such as GABA is needed.
80
Q

What are three strengths of Carlsson’s study?

A
  1. supported by another review article (sendt el al)
    which also suggests that glutamate is important when explaining schizophrenia
  2. much of research cited in Carlsson’s study used scientific methods such as PET scans. For example, (Abig- Dargham) uses pet scans to measure dopamine transmission
  3. looked at a wide range of evidence to provide support that glutamate deficiency may be important. Evidence from studies with rodents
81
Q

What are three weaknesses of Carlsson’s study?

A
  1. Some of the research was done on animals and therefore may not generalise to humans. cannot study the role of culture with animals (Luhrmann)
  2. some findings used to scans to investigate neurotransmitter functioning. Stress may affect functioning
  3. because it is a review article, the reliability and validity of secondary data which it analysed is questionable (however all but one of the studies done by C had been peer-reviewed)

Clinical psychology (6 decks)

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