Schizophrenia

    Cards (17)

    • classification and diagnosis
      DSM-5
      • 2 or more symptoms need to be present for at least a month
      ICD-11
      • 2 or more symptoms need to be present for at least 6 months
      both need to include at least 1 positive symptom
    • symptoms
      positive
      • hallucinations
      • delusions - persecution, grandeur, reference, control
      negative
      • avolition
      • speech poverty
    • weakness of diagnosis
      co-morbidity
      • often diagnosed with other disorders
      symptom overlap
      • bipolar also has positive symptoms
    • biological explanation
      genetic
      • polygenic = 108 contributing genes
      neural correlates
      • Juckel et al
      • negative correlation between avolition and increased activity in the ventral striatum (anticipation of pleasure)
      dopamine hypothesis
      • high levels = hyperdopaminergia = hallucinations
      • low levels = hypodopaminergia = negative symptoms
    • biological explanation neurotransmitters
      serotonin
      dopamine
      glutamate = learning, attention, memory
      • low levels in SZ
    • genetic study
      Gottesman
      concordance rates
      • 48% MZ
      • 17% DZ
      • 9% siblings
      Tienari
      • 5.8% healthy family adoptees had SZ
      • 36.8% dysfunctional family adoptees had SZ
    • dopamine hypothesis study
      Leucht
      • meta-analysis of 212 studies
      • drugs that balance dopamine more effective than placebo
    • psychological explanation
      family dysfunction
      • schizophrenogenic mother = stress and secrecy
      • double-bind theory = mixed messages and emotions
      • expressed emotions = exaggerated involvement
      cognitive
      • dysfunctional central control = derailment of thoughts due to inability to suppress automatic responses
      • meta-representation = ability to identify own ideas
    • expressed emotion study
      Butzlaff and Hooley
      • SZ relapse more likely in families with expressed emotion
    • cognitive study
      Stirling
      • SZ patients in Stroop-test took 2x longer to identify colour
      • therefore they have dysfunctional thought processing (faulty central control)
    • biological treatments
      typical antipsychotics
      • less popular
      • older
      • bad side effects such as tardiv dyskinesia
      • only treat positive symptoms
      • block dopamine receptors
      atypical antipsychotics
      • more popular
      • newer
      • avoid severe side effects
      • block dopamine receptors
      • work on other neurotransmitters such as glutamate
      • address al symptoms
    • biological treatments study
      Bagnall
      • review of 232 studies
      • compared typical and atypical effectiveness
      • atypical more effective than typical at treating symptoms
      • less people quit atypical treatment
      • atypical led to less movement-disordered side effects
    • psychological treatments
      CBTp
      • Ellis ABCDE model
      • challenge irrationality
      • reality testing
      family therapy - Pharoah et al
      • educate
      • family-centered
      • techniques learnt
    • psychological treatment study
      Sensky
      • 19 CBTp sessions reduced symptoms of people who resisted drug therapy
      Dickerson
      • reviewed 13 studies
      • found that token economies reduce symptoms and increase adaptive behaviour
    • interactionist approach to explaining and treatment

      diathesis-stress model - Meehl
      • genes and stressor
      combined CBTp and drug therapy
      • CBTp change underlying faulty cognitions
      • drug therapy allows better engagement for severe patients
    • management of SZ
      token economies
      • behaviour modification using operant conditioning
      • tokens = secondary reinforcer
      • achieving targets = reward = positive reinforcement
    • interactionist treatment study
      Tarrier et al
      • 315 patients randomly allocated to 3 conditions
      1. medication and CBT
      2. medication and counselling
      3. control group with medication only
      • combination showed to be more effective and patients displayed less symptoms after the trials