Schizophrenia

• Positive Symptoms 


  Additional experiences beyond the ordinary
• Negative symptoms 


  lack of usual abilities
• Example of positive + negative symptoms

  postive - hallucinations + delusions. negative - avolition + speech poverty
• diagnosing Sz 


  Use the DSM- 5
• What does the DSM-5 include

  A - two or more symptoms for at least 2 months B - social or occupational dysfunction C - symptoms for at least 6 months
• symptom overlap


  mental disorders that present themselves in similar ways
• co-morbidity 


  when two or more mental disorders exist in the same person
• common co-morbidity with Sz

  depression - 50% substance abuse - 47%
• Kappa score of Sz

  0.46 for Sz, good score = 0.7
• Copeland 1974


  cultural differences - uk and us psychiatrists given same description 2% uk compared to us 69%
• Reliability for diagnosing Sz

  Results are repeatable
• Test - retest


  clinicians make the same conclusion
• Inter-rater 


  different clinicians making the same conclusion
• Validity for diagnosing Sz

  accurately diagnosing someone with Sz
• Who is more likely to be diagnosed with Sz

  Men - women are better at masking their symptoms
• Schizophrenia runs in the family

  It is polygenic + aetiologically heterogenous (different combinations of genes can cause Sz)
• Gottesman 1991 


  Twin study - identified a strong concordance rate Mz - 48% risk Dz - 17% risk. This shows that genetics are a cause but not absolute
• Original dopamine hypothesis 


  excess levels of dopamine in the sub cortex can cause positive symptoms
• Typical anti-psychotics 


  block dopamine receptors suppressing hallucinations
• side effects of typical anti-psychotics

  blurred vision, increased heart rate, tremors
• Avolition 


  loss of goal orientated behaviour
• psychological explanations

  schizophrenogenic mother, double bind theory, expressed emotion
• 1. Schizophrenogenic mother

  controlling childhood creates tension and leads to distrusts + delusion
• 2. double bind theory

  two conflicting messages
• 3. Expressed emotions

  negative emotional climate that is characterised by family communication, cristism, hostility and emotional over involvement
• Tienari et al 1994 


  Finnish adoption study, studied children from families with Sz. Children from these families are less likely to develop Sz if placed into a good family
• Family intervention

  the aim is to provide support for carers in an attempt to make family life less stressful + reduce rehospitalisation
• Pharaoh et al 2010 


  Revised 53 studies and compared standard care to family therapy. He found that compliance with medication, reduction in relapse + social functioning increased
• dysfunctional metarepresentation 


  disrupts our abilities to reflect on our own thoughts and interpret the behaviour of others
• Dysfunctional central control

  impaired cognitive ability to suppress automatic thoughts leads to deliberate actions being carried out instead
• CBTp

  cognitive behavioural therapy, it is used to treat symptoms that persist despite using anti-psychotics. It involves patients identifying irrational thoughts and trying to change them
• Token economies

  reward systems used to manage the behaviour of patients
• Original diathesis stress model

  it is entirely genetic, the result of a single schizogeny which led to a biologically based schizotype personality
• Diathesis-stress model


  A theoretical framework used in psychology to explain the development of mental disorders. It suggests that a person's vulnerability to mental illness (the "diathesis") interacts with stressful life events to trigger the onset of the disorder.