Schizophrenia

• What are the symptoms required for a schizophrenia diagnosis according to DSM-5?

  • Two of the following symptoms for at least a month:
  • Positive symptoms (e.g., hallucinations, delusions)
  • Negative symptoms (e.g., avolition, speech poverty)
• What are positive symptoms of schizophrenia?

  Experiences additional to normal experiences
• What are examples of hallucinations?

  Seeing distortions or hearing voices
• What are delusions in schizophrenia?

  Rational beliefs about oneself or the world
• What are negative symptoms of schizophrenia?

  Loss of normal experiences and abilities
• What does avolition refer to?

  Lack of purposeful work or energy
• What is speech poverty in schizophrenia?

  Brief verbal communication style
• How can speech be classified as a positive symptom?

  If it is excessively disorganized
• What are the reliability and validity issues in diagnosing schizophrenia?

  • Inter-rater reliability: agreement between doctors
  • Test-retest reliability: consistency over time
  • Validity: questions about the disorder's existence and symptoms
• What did Back (1963) find about concordance rates in schizophrenia diagnoses?

  54% concordance rate among doctors
• What does low inter-rater reliability suggest?

  Many people may be diagnosed incorrectly
• What is comorbidity in schizophrenia?

  Diagnosis with other disorders
• What are the comorbidity rates found by Bley (2009) for schizophrenia and depression?

  50%
• What is the gender bias in diagnosing schizophrenia?

  Women's experiences are often underdiagnosed
• What does culture bias refer to in schizophrenia diagnosis?

  Higher diagnosis rates in African-Caribbean individuals
• What did Loring and Powell (1988) find about psychiatrist biases?

  Overdiagnosis of black clients and underdiagnosis of females
• What are the biological explanations for schizophrenia?

  • Genetic explanation: polygenetic disorder
  • Neurotransmitter imbalance: dopamine hypothesis
  • Structural brain abnormalities: enlarged ventricles
• What is the concordance rate for schizophrenia in identical twins?

  48%
• What does the dopamine hypothesis suggest?

  Symptoms are due to dopamine imbalance
• What are the effects of hyperdopaminergia?

  Leads to auditory hallucinations
• What are the effects of hypodopaminergia?

  Linked to negative symptoms like avolition
• What did Gotsman (1991) find about concordance rates?

  Higher rates in identical twins
• What did Tari (2004) find about children of schizophrenic mothers?

  Higher rates in dysfunctional families
• What are the biological treatments for schizophrenia?

  • Antipsychotics: typical and atypical
  • Typical: reduce positive symptoms, severe side effects
  • Atypical: address negative symptoms, fewer side effects
• What are typical antipsychotics used for?

  To treat positive symptoms of schizophrenia
• What are the side effects of typical antipsychotics?

  Dry mouth, constipation, and confusion
• What do atypical antipsychotics target?

  Both positive and negative symptoms
• What did Lashette find about drug treatments?

  More effective than placebo treatments
• What did Bagnor find about atypical antipsychotics?

  More effective than typical antipsychotics
• What are the psychological treatments for schizophrenia?

  • Cognitive Behavioral Therapy (CBT)
  • Family therapy
  • Token economies
• What is the goal of cognitive behavioral therapy for schizophrenia?

  To challenge irrational beliefs and thoughts
• What does family therapy aim to improve?

  The home situation of the person with schizophrenia
• What are token economies designed for?

  To manage behavior in a hospital setting
• What did Sensy find about patients resistant to drug treatments?

  Reduction in symptoms with CBT
• What are the practical issues with family therapy?

  Length of therapy and patient dropouts
• What did Dickerson find about token economies?

  They can improve adaptive behavior
• What is the interactionist approach to schizophrenia?

  • Combines biological and psychological factors
  • Diathesis-stress model: genetic vulnerability + environmental trigger
  • Effective treatment combines therapies
• What does the diathesis-stress model suggest?

  Disorder arises from genetic and environmental factors
• What did Gotsman find about genetic factors in schizophrenia?

  Concordance rates suggest genetic influence
• What did Tanari find about children of schizophrenic mothers?

  Higher rates in dysfunctional families