Schizophrenia - Paper 3 Flashcards

Question

how does SZ affect different people | diagnosing schizophrenia

Answer 1

* people (cultural/population) * places (ecological) * time (temporal)

Answer 2

* **evidence** - depression has many symptoms which overlap - flat affect , avolition , speech poverty and lack of hygiene * bipolar - delusion , speech disorganisation * **explain** - sometimes the same patient could be diagnosed SZ using one classification and a different one for another * **link** - low external validity

Answer 3

* **explain** - comborbidity means more than one illness or disease occuring in one person at the same time * **buckley** looks at patients and found with SZ and found 50% also had depression , 23% had ocd * **explain** - which diagnosis is causing which symptom * **link** - cant tell what is causing what

Answer 4

* **evidence** - **longenecker** saw that since the 1980s more men than women have been diagnosed , when before there was no difference * **explain** - could be different as social norms have changed and women play a different role in society * women are better at hiding their emotions and less likly to be diagnosed * **link** - lowers population validity

Answer 5

a gene whose chromosmal location is associated with a particular disease or other genotype

Answer 6

our genes carry infomation that gets passed from one generation to the other

Answer 7

brain activity that corresponds with and is neccessary to produce a particular experience

Answer 8

* a neurotransmitter * dopamine plays a role in how we feel pleasure * its a big part of our unique human ability to think and plan

Answer 9

* a number of different combinations of genes wich lead to the illness

Answer 10

* the percent of cases in which both members of a pair have a particular attribute

Answer 11

* a way for people to understand how genetic illnesses can affect them and their family

Answer 12

* phenotype is influenced by one or more gene

Answer 13

* polygenic disorder - **ripeke et al** found 108 genes contribute to SZ * aetiollgically heterogenous - multiple variations of genes * code for dopamine (imbalances)

Answer 14

* MZ twins - 48% * DZ twins - 17% * parents - 6% * siblings - 9% * grandparents - 5%

Answer 15

* all 4 of them devloped sz in their 20s * abusive parents * grandmother had SZ

Answer 16

* look at the impact of nurture on children who are raised by parents who are not their biological parents * as have no biological traits connection between parents and child * if they grow up to share traits of parents than the traits are probs due to nurture * suggests its important but not 100%

Answer 17

* **function** - responsible for speech production * **role in SZ** - to much dopamine in this area may be associated with speech poverty/auditory hallucintation

Answer 18

* **function** - helps people thing logically and organise their thoughts * **role in SZ** - many SZ have lower activity in this area, which could be linked to delusions and disorganised thoughts

Answer 19

* **function** - process infomation recieved from the eyes and the ears * **role in SZ** - sz have the same ativity in these areas when they have hallucinations as a sane people do when they have genuine visual and auditory experiences

Answer 20

* **function** - located deep inside the brain and affects movement and thinking skills * **role in SZ** - research has shown that this is larger in SZ, which could cause motor dysfunction

Answer 21

* **function** - responsible for basic feelings such as fear , lust and hunger * **role in SZ** - smaller in SZ so can link to a loss of emotion (flat affect)

Answer 22

* **function** - responsible for feelings of pleasure and also affects thinking and movement * **role in SZ** - low levels in ceratin areas in the brain area are linked to a loss of pleasure * high levels in brain areas are linked to a postive symptom

Answer 23

* **function** - associated with attributing stimuli to internal and external causes * **role in SZ** - in sz activity levels are lower which can lead to hallucinations and feelings they are in no control of their own body * can tickle themselves

Answer 24

* in sz actvity levels are low, resulting in a loss of motivation (apathy and avolition)

Answer 25

* causation does not equal causation * is it big/small bc of the SZ * or is te SZ bc of it being big/small

Answer 26

1. **nerve impulse travels down the axon in the presynaptic neuron** 2. **impulse reaches the axon terminal of presynaptic neuron** 3. this triggers the realse of neurotransmitters from its vesicles into the synaptic gap 4. neurotransmitter diffuses across synaptic gap 5. neurotransmitter bind to a receptor site on the postsynaptic neuron 6. **this triggers a new impulse in the next neuron, and the process begins again, passing the message on** 7. **process of summation happens where a message either excitation occurs or inhibiton** 8. the neurotransmitter travels back to the presynaptic neuron and is repackged into vesicle (reupatke) | **bold - electrical process** non bold - chemical process

Answer 27

* amphetamines (drug that increase dopamine) produce symptoms which are similar to those expirenced by some with SZ * **randrup et al (1966)** * behaviour similar to that found with SZ was induced in rats by administering amphetamines and the effect was reversed with antipsychotic drugs * **iverson (1979)** * did some post mortem examinations on people with Sz and without * found a higher number of dopamine receptors in people with SZ than a normal individul = supports the idea of overactive dopamine levels in someone in SZ

Answer 28

* part 1 - hyperdopaminergia * part 2 - hypodopaminergia

Answer 29

* the dopamine hypothesis firt assume that **positive symptoms** of SZ come from **hyperdopaminergia** (too much dopamine) in the **subcortex** (central brain areas) * E.G broacas area is for speech production , so excess dopamine in boracs area is thought to lead to the symptom speech disorganisation * negative symptom - to much activation - shuts down - speech poverty

Answer 30

* **negative symptoms** of SZ can be caused by **hypodopaminergia** (low levels of dopamine) in the **cortex** (outside area) * E.G the prefrontal cortex is for **problem solving** so low levels of dpamine in this area is though to lead to the symptoms of disorganisation * therefore both hypo and hyperdopaminergia can cause symptoms of SZ

Answer 31

* biological determinism * reductionism - way to simple * scientific credibility - emperical evidence in brain scans and dna testing * real life application - drugs reduce symptoms

Answer 32

* central role of glutamate * from post mortem and live scanning * was found in many parts of the brain * as well as other genes * may be a more important one than dopamine

Answer 33

* L-dopa is a drug given to patients with parkinson disease * a dopaminse synthesis medication * this means it increase dopamine levels in the brain * this medication can reduce symptoms resembling acute sz in non-psychotic patients

Answer 34

* **typical antipsychotics** - used to treat positve symptoms * chlorpromazine * **atypical antipsychotics** - used to treat postive and negative symptoms * clozapine * risperidone

Answer 35

* blocks dopamine recpetors in the brain reducing the action of dpamine

Answer 36

* clozapine binds to dopamine receptors but also works on serotonin and glutamate * sideaffects are fewer but may be more fatal * risperidone developed in the 1990s, works in the same but also clozapine, fewer side effects

Answer 37

* reduce intensity of symptoms, espically positive ones

Answer 38

* side effcts of typical antipsychotics * uncontrolable movements of the mouth and face and tounge * blinking * puckering, pouting , smacking (mouth) * biting chewing , clenching , mouth open and lateral movements (jaw)

Answer 39

* first generation * since 1950s * works as dopamine antagnosists and include chlorpromazine

Answer 40

* lowers the amount of dopamine * bad side affects * typical - tardive dyskinesia * aytipical - tardive agranuloctosis (reduction in white blood cells

Answer 41

* typical - only affects dopamine and only for postive symptoms * aytpical - affects dopamine and serotonin and for both postive and negative symptoms

Answer 42

* they dont know the exact cause for SZ * they are not treating the cause * can only reduce the effect of the illness

Answer 43

* body gets used to the drug * bodies begin to compensate and chnage * therefore dependancy becomes an issue

Answer 44

* reviewed studies comparing chlorpromazine to a placebo * data from 13 trials with 1121 participants showed chlorpromazine was associated with better overall functioning and reduced symptoms severity and lower relapse rate

Answer 45

* concluded clozapine (atypical) is more effective that typical antipsychotics (it was effecting 30-50% of cases where typical antipsyhcotics had failed * also had less side affects * shows that new ones are better and improving , so more efficent that typical ones

Answer 46

* tardive dyskinesia , tardive agranuloctosis and neuroleptic maligant syndrome (results in high temperature , delirium , coma and can be fatal) * around 1 in 4 people will suffer from this side affect * harmful and traumatic

Answer 47

* is not a cause of SZ * a risk factor - can lead to SZ in people who are already vulnerable (e.g diathesis stress model)

Answer 48

* schizophrenogenic mother * double bind * expressed emotion

Answer 49

* based on freudian principles * the schizophrenogenic mother was proposed as a cause from SZ to emerge in a child * these mothers dont have SZ but have children with it * these mothers are described as rejecting , cold , controlling , moralistic and fearful of intamcy * leads to tension , conflict and secrecy in the family * **leads to paranoid delusions and persecutory delusions**

Answer 50

* confusing parenting style where the parent contradicts themselves and the child gets conflicted messages * E.G the child is punished for what they were asked to do * **love withdrawal** - where the children are punished for their mistkaes by parents saying they dont love them * child devlopes an understanding o the world that is confusing and dangerous * **leads to disorganised thinking, paranoid delusions , speech poverty and social withdrawal and flat affect**

Answer 51

* family communication style * critical comments through both tone and content , occasionally accompanied by violence * hostility towards the patient , including anger and rejection * emotional over involement in the life , including needless self-sacrifice * risk of relapse is high is lots of factors or a vunreable person could devlop sz

Answer 52

* "you can always come to talk to me about your personal life" * "what did you father say about me last night when he was upset" * going through childs phone

Answer 53

* if you do that again i will shout * whish you were never born * dont make me do something i will regret

Answer 54

* cant you do anything right * youre the reason we are all unhappy

Answer 55

* biased * no supporting evidence * soically sensitve * lack creditbility and too subjective * deterministic

Answer 56

* soically sensitve * is it significantly more prevent in SZ families * self report

Answer 57

* socially sensitve * correlations/causation (looking after someone who has SZ can be extremely tiring and emotional)

Answer 58

* **read 2005** - reviewed 46 studies of child abuse and SZ in adult hood and concluded that 69% of adult patients with a diagnosis of SZ had a hisotry of child abuse * **berry et al 2008** - adult with insecure attachment to their primary career are alose more likly to develop SZ

Answer 59

* by the 1980s research concluded that there was no such thing as a schizophrenogenic mother * this is subjective as it was determined by seeing parents for crazy making characteristics * this is unscientific because one criteria for science is to be objective * many sz have been found to have mothers who do not fit this criteria * the theory has been critised for actually hindering progress and understanding of SZ

Answer 60

* **brown** * recovering SZ, discharged from hosptial and follwed up over a 9 month period * interviews with family member conducted to determine the level of expressed emotion * also looked at how many patients relapsed * in the high expressed emotion families = 58% relapse rate * in low expressed emotion families = 10% relapse rate * clear link between expressed emotion and SZ

Answer 61

* **berger** - found that SZ reported higher reall of double bind statements by their mothers than non sz * HOWEVER * **self report** - dont know what is real and what was delusions * not reliable * recall might be affected by disorder * **liem** - found no difference in patterns of parental commincation in families with a SZ child in comparison to normal families

Answer 62

* SZ is characterited by disruption of normal cognitve processing * this has led to cognitive psychologist to explain the disorder as a result of **dysfunctional though processing** * this equals lower than usual levels of processing (possibly cause by biological factors such as neural correlates) suggests that cognition is likly to be imparied

Answer 63

* metarepresentation - christian frith 1992 * central control - christian frith * auditory selective attention

Answer 64

* when we think, we hear thoughts in our head * metarepresentation is reflecting on our own thoughts * suggested that SZ fault to monitor and reflect upon their own thoughts correctly , masattributing them to the outside world = dysfuntion in metarepresntation * when someone has aduotry hallucinations they belive someone is in the external world communicating but its acc their own inner speech being misinterpreted * this is refered to alein control symptoms bc the sufferers feel as if external forces are influencing their thoughts and actions have no personal control

Answer 65

* central control is the ability to suppress automatic repsonses such as thoughts and associations * frith suggests that SZ fail to supress these automatic thoughts * = derailment of thoughts and sentences * = disorganised thinking and speech

Answer 66

* the process by whihc the brain selects whihc sounds to respond to * our brain selects what to ignore and pay attention to * some people have selective attention impairment * this means they experience potentionally overwhelming levels of infomation from the external and inner world * = the negative symtom may occur as SZ have to keep mental stimulaition to a managble level * = its thought catatonic SZ have no choice but to withdraw from the world

Answer 67

* compared 30 sz to 18 control * found that the SZ took twice as long to complete the stroop test * thi suggests they are less able to supress automatic responses while reading * **A03** - this is strength for the cognitve theory as it shows the lack of central control in SZ and is able to explain why SZ have derailment of thoughts and disorganised speech

Answer 68

* the cognitve approach does describe how infomation prosessing is affected by SZ * but it does not provide an explanation of what causes it * = does not offer an understanding about te intial cause * cogntive disturbance might be symptoms of the disorder rather than an explanation

Answer 69

* compatiable with bio expl * genes could be responsible for these dysfunctional thought patterns * there is a link bewteen neurological abnormalities wich cause cogntive difficulties

Answer 70

* if dysfunctional thought processing is said to be the root cause of the disorder then it would follow that childhood diffiuclties in infomation processing (such as dyslexia) would correlate with the later onset of SZ * however there is no scientific evidence to support this link * so there must be other causes/risk factors = fault cogntiion is not a complete explanation by itself

Answer 71

* usally 5-20 sessions * cbt changes thoughts in order to change behaviour * helps patient to identifty irrational thoughts and try to change behaviour * may involve arguments or discussion of how likly the beliefs are to be true * their irrational beliefs are changed

Answer 72

* helps patients to make sense of how delsuions and halluctinations impact their feelings and behaviours * the patient as a scientist method helps the SZ believe what they learn from CBT (that delusions arent real) because they discorved it themselves and werent told * understanding where the symptoms came from - E>G belive the voices and thinking are demons - can see that they arent real which will lower anxiety and make them less scary * this does not cure SZ but helps manage their symptoms

Answer 73

* pateint had delusions that his thinking could influence the future * however the patient failed to predict what would happen in 50 video clips * this provides evidence that his delusions were false which helped relieve symptoms

Answer 74

* reviwed results of 34 studies of CBT and concluded it has a significant but fairly small effect on postive/negaitve symptoms

Answer 75

* need to attend the sessions * need to be able to hold a convo * undertsand own thoughts = cant work for everyone

Answer 76

however what point does this interfere with an individuals freedom of thought

Answer 77

* based on behaviourist principle * **operant conditiong** - postive & vicarious reinforcement makes behaviour more likly * tokens count as a **secondary reinforcer** - enables patient to get a reward * many in psych hospitals when they are there for a long time * to manage maladaptive behaviours of SZ (usaslly bc in hopsital for so long - bad hygiene) * prepares them to live in the outside world * rewards - sweets , cigerattes , walks outside , room cleaned * the tokens remove delay discounting as the token is an immediate secondary reinforcer * still provides postive reinforcement quickly after behaviour has been performed

Answer 78

* (+) - show to be effective in reducing negative symptoms for pople with SZ in a hospital setting * (-) once that person leave the hospital , the methods of token ecomony are lost as they dont have the reinforcement * (-) the rewards are sometimes things that should be free (walks outside) * (+) no side effects like drugs * (-) not fair on more severly SZ patients who find it harder to maintain the good behviours

Answer 79

* research into token economy is weak because studies comparing token economy to standard care are unable to randomly allocate particpates to conditions * **McMonagle and Sultana** * searches the database of studies into token economy vs standard care and found only three studies where patients had been randomly allocated to conditions, and only one showed improvements

Answer 80

* therpay that happens when the patient has been relased from hopsital * the therapists works with the family and patient to devlop strateries to cope better with the mental disorder and its symptoms * normally two therapists work woth the patient and the family within the home * lasts for 3-12 months with sessions every 2-4 weeks * a minimum of 10 sessions

Answer 81

* the aim is to reduce the high level of expressed emotion within the household which could (or is) causing the relapse of SZ * they will help family members balance their tme between helping the SZ and living their own life = rediced anxiety/stress/anger

Answer 82

* psychological treatment help make SZ more manageable and thus improve quality of life * CBT - allows patients to make sense of symptoms * family therapy - redcues stress for family and patients * tocken economy - make behaviour more socially acceptable so they can reintergrate into society * but all of them failt to cure - weakness to all psychologcal treatments

Answer 83

* is an interactionist model which suggests a person may be born with a predisposition towards SZ that is then triggered by a **stresser** * suggests someone needs the diathesis part and stress part to develop SZ * if someone has a genetic vunrabilitiy but has a supportive social environment with no acute stressers , they will not develop the illness * if thye have a very stressful environment but no early predispostion then they wont devlop the illness

Answer 84

* believed diathesis was entirely genetic - the result of a single **schizogene** * this led to the devlopment of a biological based **schizotypic personality**, one characteristic is sensitvity to stress * if a person doesnt have the schizogene then no amount of stress will lead to SZ * however, in carriers of the gene, chronic stress through childhood and adolescence, particulary a schizophrenic mother could result in SZ

Answer 85

* now clear that many candiate genes increase gentic vulnerability * no single schizogene - **ripke** * trauma can become the diathesis rather than the stresser - **ingram and luxton** * **read** - proposed that a neurodevlopmental model in whihc early trauma in early devlopment alters the devloping brain * E.G **the hypothalamic-pituitary-adrenal system (HPA) (FLIGHT OR FIGHT)** becomes over active and the person is more vulnerable to later stress

Answer 86

* orginally stress was seen as psychological in nature - particularly related to parenting * modern defintion of stress included includes anything that risks riggers SZ - CANNABIS * cannabis is a stresser because it increases the risk of SZ by 7 times as it interferes with the dopamine system * however most wont develop SZ from smoking cannabis there must be other vulnerability factors

Answer 87

* **aim** - to examine the effect of genetic vulnerability and parenting style (over 20 years) * **sample** - children dpted from 19,000 SZ finnish mothers (1960s and 70s), control group = adoptees with no genetic risk * **method** - compared child rearing style and rates of SZ in the sample of children (two groups (critism , conflict , low emphathy) (non critical , no conflict , emphatic) * **findings** - a high level of conflict and critism + low levels of emphathy from parenting linked to devlooment of SZ, but in children with genetic risk only

Answer 88

* as we know there is not just one cause of SZ, and that the environment and biology work ectremely close together with SZ * so therefore isnt one best way to treat it

Answer 89

* effectiveness of combination treatment = support for taking an interactionist approach to SZ * BUT * treatment causation fallacy; just because combo treatments are more effective than bio or psych on their own doesnt mean the interactionist approach is correct (just the same as just because drugs work doesnt necessarily mean the disroder is biological in orgin)

Answer 90

* when compare MZ and DZ twins there is not 100% concordance rate with MZ twins but always a higher percentage * there are multiple things playing the role * higher in MZ shows there is a biological factor * environmental is not 100%

Schizophrenia - Paper 3 Flashcards

(114 cards)