Psychology A-Level AQA > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

what is schizophrenia?

A

a chronic, debilitating psychotic disorder involving a break with reality

NOT A MUTLIPLE PERSONALITY!!

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2
Q

what is schizophrenia characterised by?

A
  • periods of loss of touch with reality
  • persistent disturbances of thought, behaviour, appearance and speech
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3
Q

what percentage of people with schizophrenia have only 1 episode and a full remission?

A

7-15%

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4
Q

when is the typical onset of schizophrenia for male and females?

A

generally late adolescence

male: 18-25
female: 25-35

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5
Q

what is the lifetime prevalence of schizophrenia??

A

1%

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6
Q

who is more likely to suffer schizophrenia, men or women?

A

men

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7
Q

is schizophrenia hereditary?

A

yes
(only 1% have no relatives with the disorder)

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8
Q

in the DSM-V, how many positive/negative symptoms must be present for diagnosis?

A

1 or more positive symptoms

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9
Q

in the ICD, how many positive/negative symptoms must be present for diagnosis?

A

2 or more negative symptoms

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10
Q

what is the definition of positive symptoms in schizophrenia?

A

an excess of normal functions which represent a change in thoughts or behaviour

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11
Q

what are the 4 positive symptoms that characterise schizophrenia?

A
  • hallucinations
  • delusions
  • disorganised speech
  • catatonic / disorganised behaviour
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12
Q

what are hallucinations?

A

auditory / visual, e.g. voices (often critical or unfriendly), seeing / smelling / taste/ feel things that aren’t there

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13
Q

what are delusions?

explain the 2 types of delusions.

A

unshakeable beliefs in something that is very unlikely, bizarre or obviously not true

  • paranoid delusions: believing someone is trying to mislead, manipulate, hurt or kill them
  • delusions of grandeur: believes they have some imaginary power / authority, e.g. mission from God or secret agent
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14
Q

what is disorganised speech?

A

speaking in a completely incomprehensible way, e.g. topic changes quickly, no connection between sentences

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15
Q

what is catatonic / disorganised behaviour?

A

behaving in a way that seems inappropriate / strange to the norms of society. Abnormal motor activities, loss of motor skills or hyperactive motor activity

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16
Q

what is the definition of negative symptoms in schizophrenia?

A

appear to reflect a diminution or loss of normal functioning

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17
Q

what are the 4 negative symptoms?

A
  • affective flattening
  • anhedonia
  • avolition
  • alogia (speech poverty)
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18
Q

what is affective flattening?

A

reduction in range and intensity of emotional expression, e.g. facial, voice tone, eye contact and body language

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19
Q

what is anhedonia?

explain the 2 types of anhedonia.

A

loss of interest or pleasure in (almost) / all activities / lack of reactivity to normal pleasurable stimuli

  • physical anhedonia: inability to experience physical pleasures, e.g. food, body contact, etc.
  • social anhedonia: inability to experience pleasure from interpersonal situations, e.g. interactions with others
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20
Q

what is avoliton?

A

reduction of interests and desires as well as inability to initiate and persist in goal-directed behaviour, e.g. sitting at home for hours each day doing nothing
- distinct from poor social function / disinterest

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21
Q

what is alogia?

A

(speech poverty) - lessening of speech fluency and productivity - reflects slowing / blocked thoughts

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22
Q

what are the 4 issues in diagnosis?

A
  • culture
  • gender
  • system overlap
  • co-morbidity
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23
Q

what was Copeland’s study (1971)?

what does it suggest?

A

CULTURE
- sent description of schizophrenic patient to 134 US active clinicians, 194 to UK.
- 69% in US gave diagnosis, only 2% gave diagnosis

shows private healthcare can make a difference - if you’re paying, you often expect a result

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24
Q

what was Luhrmann’s study (2015)?

what does it suggest?

A

CULTURE
- interviewed 60 diagnosed schizophrenic patients - 20 each from Ghana, India and USA
- ppts from Ghana and India reported only positive (e.g. playful) voices, while ppts from US reported only hateful and violent voices

suggests negative voices are not inevitable with schizophrenia

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25
Schizophrenia is more common in African-American / American-Caribbean populations. What could this suggest?
CULTURE greater genetic vulnerability, psychological factors, minority groupings or misdiagnosis?
26
what did Davison and Neale (1994)?
CULTURE in Asian cultures, experiencing emotional turmoil is praised and rewarded if they show no emotion
27
what was Broverman et al.'s study (1970)? what did it show?
GENDER - gave sex-role stereotyping questionnaire consisting of 122 bipolar items to 79 active clinicians. They had to choose 1 out of 3 options for each question: healthy, mature socially competent adult: a) unspecified sex, b) man, c) woman. - behaviours and characteristics judged for unspecified sex had high similarity to 'man' (ideal standard of health) shows that women are perceived as being less mentally healthy
28
what did Ellason and Ross (1995) point out?
SYSTEM OVERLAP people with DID have more schizophrenia symptoms than people diagnosed with schizophrenia - affects validity of diagnosis (e.g. hallucinations, social anhedonia) also overlap with OCD - e.g. repetitive actions to relieve anxiety
29
what is co-morbidity?
the extent to which 2 or more conditions occur at the same time, e.g. depression, anxiety, bipolar disorder
30
what did Buckley et al. (2009) find?
CO-MORBIDITY co-morbidity of schizophrenia with: - depression = ~50% - substance abuse = 47%
31
What did Swets et al. (2014) find?
CO-MORBIDITY (meta-analysis) - 12% of schizophrenic patients also fulfilled diagnostic criteria for OCD;~25% showed OCD symptoms
32
# key study who carried out the "Being Sane in Insane Places" study?
Rosenhan (1973)
33
# key study what was the hypothesis of Rosenhan's study?
that psychiatrists cannot reliably tell the difference between people who are sane and those who are insane
34
# key study what was the procedure of Rosenhan's study?
- 12 hospitals in 5 different states in US (new and old) - 8 ppts - field experiment - only symptom: "I'm hearing a voice saying single words like 'hollow', 'thud', 'empty' (not related to any disorder)
35
# key study what were the findings of Rosenhan's study?
- when admitted to hospital, all except 1 diagnosed with schizophrenia - individuals stayed in institutions for 7-52 days
36
# key study what was Rosenhan's follow-up study?
- told the same hospitals they should expect more people to try and get admitted - 41 patients suspected as fakes, 19 diagnosed by 2 staff members - Rosenhan sent no-one at all!
37
# key study what did Rosenhan's study (1973) highlight?
the unreliability of diagnosis (however, was conducted over 50 years ago - since, manuals have been improved and diagnostic practice is very different. The DSM-V and ICD have been brought more in line with each other)
38
what is the diathesis-stress relationship of schz?
when a person is genetically vulnerable to the disorder, and if they have significant psychological stressors present in their life, they are more at risk of developing the disorder
39
what are the 3 types of studies used for biological expo of schz?
- twin - family - adoption
40
what is the lifetime risk of developing schz?
MZ = 48% DZ = 17% (Gottseman, 1991) this reinforces the diathesis-stress model of schz
41
what did Joseph (2004) do and find?
did a meta-analysis of data from before 2001 and calculated a concordance rate of: MZ = 40.4% DZ = 7.4%
42
what have family studies established?
schizophrenia is more common among biological relatives. The closer the degree of genetic relatedness, the higher the risk
43
what are adoption studies used for?
to disentangle genetic and environmental influences for individuals who share both these factors individuals who have been reared apart (e.g. with only one or no factor/s present) are used
44
what did Tienari et al. (2000) find?
all children raised by non-schizophrenic parents: out of 164 adoptees whose biological mother was schizophrenic, 6.7% were also given a diagnosis out of 197 control adoptees whose biological parents were not schizophrenic, 2% were diagnosed
45
what is the biological (neurochemical) explanation of schz?
the dopamine hypothesis
46
what does the dopamine hypothesis say?
excess amount of dopamine in the prefrontal cortex, causing the DZ receptors in that area of the brain to be overactive, leading to the person having positive symptoms
47
what can reduce schz symptoms?
drugs which block dopamine
48
what is dopamine?
- a neurotransmitter that helps control the brain's rewards and pleasure centres - dopamine helps regulate movement and emotional responses - enables us to not only see rewards, but to take action to move towards them - dopamine deficiency: presence of certain kind of dopamine receptor is also associated with sensation-seeking
49
what is an agonist?
a chemical that binds to a receptor and activates it to produce a biological response
50
what is an antagonist?
a chemical that blocks the action of the agonist and an inverse agonist causes an action opposite to that of the agonist
51
what is amphetamine?
an agonist - increases dopamine level
52
how was amphetamine used in a study?
- given to Parkinson's patients (who have significantly less dopamine) - their movement became normal - dopamine was then too high - led to hallucinations (schz symptoms)
53
what is phenothiazine?
an antagonist - decreases dopamine level
54
how was phenothiazine used in a study?
- given to schizophrenic patients - hallucinations decreased
55
what does the revised dopamine hypothesis say?
- an excess of dopamine in the mesolimbic pathway leads to positive symptoms - a deficit of dopamine in the mesocortical pathway leads to negative symptoms (Brisch et al. 2014)`
56
what are neural correlates?
measurements of the structure or function of the brain that correlate with an experience/behaviour, in this case schizophrenia. Both positive and negative symptoms have neural correlates.
57
what is the psychological explanation for schz?
family dysfunction
58
what is the schizophrenogenic mother theory? (Fromm-Reichmann)
- cold rejecting, controlling - family climate of tension and secrecy - creates weak ego (mediator) - results in 'ego defence mechanisms' to protect person form stress: repression, regression, projection, denial. - these are seen as schz symptoms
59
what is the double-bind theory? (Bateson et al. 1956)
- a person is given mutually contradictory signals by another person (often the mother) - causes internal conflict - develop an incoherent construction of reality - schz symptoms represent an attempt to escape from the double-bind (e.g. flattened affect and withdrawal) - e.g. mother says "I love you" to child whilst turning away in disgust - psychiatrist R.D. Lang: "schz is a reasonable response to an insane world"
60
what is the expressed emotion theory? (Brown, 1972)
- a family communication style of talking about patient in a critical and hostile manner - increases patient's stress levels beyond their coping mechanisms - spend their life not knowing how o deal with stress from their impaired coping mechanisms - triggers schz episodes
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