Week 9 - Schizophrenia Flashcards
(38 cards)
1
Q
What is schizophrenia?
A
Psychological disorder that involves severely distorted beliefs, perceptions and thought processes
2
Q
What are the five subtypes of schizophrenia?
A
- Paranoid subtype (Delusions centred on ideas of grandiosity or persecution)
- Disorganized subtype (Disorganized speech patterns)
- Catatonic subtype (Non-normal activity of motor system)
- Undifferentiated subtype (Signs not fitting any of the three major subtypes)
- Residual subtype (No longer display traditional symptoms of delusions and hallucinations)
3
Q
Define positive symptoms and describe the positive symptoms of schizophrenia
A
- Definition: Things that shouldn’t be there and are added to a person
Positive Symptoms of Schizophrenia:
- Delusions
- Hallucinations
- Disorganized thought processes, speech and behavior
4
Q
Describe the delusions experienced in schizophrenia
A
- Persecutory delusions (Beliefs about being followed or watched)
- Grandiose delusions (Beliefs about being a famous or special person)
- Delusions of Thought Control
5
Q
Describe the hallucinations experienced in schizophrenia
A
- Distorted perceptions of reality which could affect all five senses
- Most common altered perception is hearing voices or other sounds (auditory perception), followed by visual hallucinations
- The hallucinations may tell the person to perform certain acts or may be frightening
6
Q
Describe the disorganized behaviour experienced in schizophrenia
A
- Disorganized speech: Lack of associations between ideas and events
- Disordered behaviour: Unusual or repetitive behaviours and gestures
(ex. head-banging, finger-flapping, etc.)
7
Q
Describe the catatonia experienced in schizophrenia
A
- Catatonic stupor: Absence of motor behaviors, totally motionless and rigid
- Catatonic excitement: Agitated, fidgety, shouting, swearing or moving rapidly
- Either of the two can last for hours
- Neither a positive nor negative symptom
8
Q
Define negative symptoms and describe the negative symptoms of schizophrenia
A
- Definition: Things that should be there but aren’t there in a person
Negative Symptoms of Schizophrenia:
- Flat affect
- Alogia (reduced speech)
- Avolition (lack of follow through)
9
Q
Describe the flat affect experienced in schizophrenia
A
- Definition: Lack of emotional expression
- Passive with immobile facial expression
- Vocal tone does not change
- Do not respond to events with emotion
- Speech lacks the inflection that communicates mood
10
Q
Is schizophrenia temporary or chronic?
A
- Onset typically occurs during young adulthood
- 25% of those who experience schizophrenia recover completely
- 25% experience recurrent episodes of schizophrenia
- 50% schizophrenia becomes a chronic mental illness, and the ability to function may be severely impaired
11
Q
Explain the genetic factors (family) in schizophrenia
A
- Based on family, twin and adoption studies,
*50% risk for a person whose identical twin has schizophrenia
*If biological parent of an adopted individual had schizophrenia, there is a greater risk to develop schizophrenia - Schizophrenia clusters in certain families -> The more closely related a person is to someone who has schizophrenia, the greater the risk of schizophrenia
12
Q
Explain the genetic factors (chromosomes) in schizophrenia
A
- Chromosomes associated with genes that influence brain development, memory and cognition seem related
- No specific patterns of genetics can be identified as “cause” of schizophrenia but the presence of variations increase susceptibility
- Bipolar disorder and schizophrenia might share genetic origins
13
Q
Explain the social factors in schizophrenia
A
Being raised in a psychologically healthy environment lowers your chances of developing schizophrenia
14
Q
Explain the effect of paternal age on schizophrenia
A
- Age of fathers can increase the rate of mutation; The “manufacturing” of sperms in a man gets less and less accurate as he ages, hence the chances of mutation
- 45-49yo: 2x more likely to develop schizophrenia, compared to fathers younger than 25 years
- 50+ years: 3x more likely to develop schizophrenia, compared to fathers younger than 25 years
15
Q
Explain the biological factors (abnormal brain structures) in schizophrenia
A
- 50% of people with schizophrenia show some type of brain abnormality
- Most consistent finding: Enlargement of the ventricles
- Loss of gray matter tissue and lower overall volume of the brain (Gray matter = cell bodies, White matter = myelinated axons)
16
Q
Describe the default mode network and explain its relation to schizophrenia
A
- Default mode network: Parts of the brain under wakeful rest (ex. the part that is active when you’re zoned out)
- Normally, people would switch between this and executive functioning but for schizophrenics, they tend to stay in the default mode network (difficulty switching between it and the executive functioning)
17
Q
What are the issues with neurotransmitters in schizophrenia?
A
- Activity with dopamine neurons
*Dopamine neurons are overactive in schizophrenia in midbrain areas and underactive in higher cortisol areas - Dopamine Imbalance Hypothesis
*Activations influence other brain areas with dopamine projections - Result in more creative thinking
*Increased dopamine D2 receptor densities in the thalamus resulted in a lower gating threshold and thus increased information flow resulting in more creative thinking - Glutamate linked to psychotic-like symptoms
*Excitatory neurotransmitter, blocking of glutamate receptors in normal individuals leads to psychotic-like symptoms (Glutamate hypothesis)
18
Q
Describe the role of dopamine
A
- Reward and reinforcement (responsible for feelings of euphoria)
- Motor movements (responsible for feelings of euphoria)
- Produced in brainstem, but has projections which affect activation in the cortex (surface of the brain)
19
Q
Explain the Dopamine Imbalance Hypothesis
A
- Leads to both positive and negative symptoms
*Overactivity in midbrain/brainstem -> Hallucinations/delusions
*Underactivity in cortex -> Lack of motivation/flat affect - Changes in dopamine activity results in more creative thinking
*Inability to stop influx of thoughts
*Increased information flow resulting in more creative thinking
20
Q
Antipsychotic Medications: Chlorpromazine (Thorazine)
A
- Discovered in 1945
- Reduces dopamine activity in the brain
- Reduces agitation, hostility, aggression, hallucinations, delusions
- Increases time between hospitalisations
- Does not change negative symptoms and cognitive deficits
*Because these are due to the underactivity of dopamine
*Early drugs only target the overactivity of dopamine
21
Q
Antipsychotic Medications: What are the side effects of Thorazine and other “typical” drugs?
A
- Weight gain
- Tardive dyskenia (movement disorder)
*Involuntary movement of lower face, limbs
*Affects dopamine neurotransmitters
*“typical” -> first generation of antipsychotic drugs
22
Q
Antipsychotic Medications: What is the importance of dopamine?
A
- Imbalance of dopamine activity in the brain
- However, anti-dopamine drugs do not help upwards of 40% of those seeking treatment
- First generation, typical antipsychotics also produce tardive dyskinesia (involuntary motor movements)
- Medications which block dopamine are somewhat effective
- Drugs that increase dopamine cause schizophrenic-like symptoms
- However, typical antipsychotics mainly target positive symptoms like hallucinations and delusions
- Link between dopamine and schizophrenia may be more complicated
23
Q
What are the advantages of atypical medications?
A
- Less likely to cause movement-related dopamine side effects
- More effective in treating the negative symptoms of schizophrenia
- Target the dopamine imbalance, rather than just overactivity
24
Q
What are the disadvantages of atypical medications?
A
- Weight gain, diabetes, cardiac problems
- No greater improvements than with older antipsychotics
25
What are the issues with all antipsychotic medications?
- Does not actually cure schizophrenia
- Unwanted side effects
- "Revolving door" patter of hospitalisation, discharge and rehospitalisation
26
Describe the atypical, second generation antipsychotics for schizophrenia
- Target specific dopamine receptors, not all types of dopamine
- Produces less tardive dyskinesia
- Equal to, or sometimes more, effective than the typical, first generation of antipsychotic medication
27
Psychosocial Interventions: How does family intervention help in schizophrenia?
- Provide practical emotional support to family members
- Provide information about support services
- Help family develop model of schizophrenia
- Modify unhelpful, inaccurate beliefs about schizophrenia
- Enhance positive communications
- Involve everyone in relapse prevention plan
28
Psychosocial Interventions: How does Cognitive Behavioral Therapy help in schizophrenia?
- Importance of individual’s interpretations of psychotic events
- Understand client’s interpretations of past and present events
- Normalize and reduce impact of symptoms
29
Psychosocial Interventions: How does early intervention help in schizophrenia?
- Seek out high-risk individuals
- Develop cognitive skills to increase attention, memory, executive control, and other cognitive processes
30
What are the environmental origins of schizophrenia?
- Direct brain damage or injury details during early development
- Prenatal complications
*Stress, immune responses and starvation during pregnant
31
What is the biopsychosocial model in psychology?
- Models the interactions between genetics (biology, personality, psychology) and environment (social) and their impact on mental health
- Proposed by George Engel, who suggested that mental health should be understood from more than just a biological perspective
32
Explain the biological influences in the biopsychosocial framework
- Biology is important but cannot explain everything; Some clinical disorders do not have reliable biological markers
- ex. Only 50% chance of identical twin developing schizophrenia is other twin has the disorder
33
Explain the psychological factors in the biopsychosocial framework
- Personality approaches
- Learned patterns of behavior
- ex. Schizophrenia might develop through observational learning of parents with disorder
34
Explain the social factors in the biopsychosocial framework
Social upbringing and environmental influences on a person's mental health
35
How is the biopsychosocial framework applied to evaluate mental health?
- Intervention must address all three factors
- Recognize relationships are central to treatment
- Promote self-awareness among clients
- Find out about the patient's history and life circumstances
- Decide which aspects of biological, psychological and social domains are most impactful on client's health
- Provide multidimensional treatment
36
Explain the social factor of the biopsychosocial model of challenge/threat
- Features in the environment which promote stress
- ex. exam, interview, social interactions, etc.
37
Explain the psychological factor of the biopsychosocial model of challenge/threat
- How we interpret the situation
- Evaluate the importance of performance
- Determine if we have the ability to succeed
*If we have confidence in our ability = challenged
*If we have no confidence in our ability = threatened
38
Explain the biological factor of the biopsychosocial model of challenge/threat
- How our body reacts
- Cardiovascular system
*Blood flow (cardiac output)
*Blood pressure (peripheral resistance)
