Schizophrenia
- Created by: Pickledwalnuts
- Created on: 13-05-17 12:17
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- Schizophrenia
- Classification of Schizophrenia
- No single defining characteristic, cluster of symptoms
- DSM 5 requires at least 1 positive symptom for diagnosis
- ICD 10 allows 2 or more negative symptoms for diagnosis
- Positive Symptoms
- Additional experiences beyond ordinary existence
- Hallucination: Unusual sensory experiences that can come from any sense
- Delusions: Irrational beliefs, believing one to be someone else or of persecution
- Negative Symptoms
- The loss of usual abilities and experiences
- Speech Poverty: Reduction in amount and quality of speech, delay in verbal responses
- Avolition: Difficulty beginning or continuing goal-directed activity. Poor hygeine, lack of energy, lack of persistence in work or education
- Evaluation of classification
- Inter-rater reliability/ 2 or more make same diagnosis/ Cheniaux found diagnosis of 26 with DSM and 44 with ICD, other found 13 DSM & 24 ICD/ Weakness of diagnosis
- Criterion validity/ Cheniaux shows diagnosis more likely with ICD/ over diagnosed in ICD or under in DSM/ poor validity is weakness
- Co-morbidity is it single condition/ Buckley 50% depression/ if half have depression maybe same condition/ Weakness
- Symptom overlap with other conditions/ bipolar has similar positive and negative symptoms/ under ICD be schizophrenic, under DSM be bipolar/ might not be separate conditions
- Since 80s men diagnosed more/ maybe men more genetically vulnerable/ maybe gender bias as women function better with work and relationships/ unclear if not schizophrenic or just good interpersonal functioning
- African Americans & Afro Carribean more likely to be diagnosed/ Rates in Africa and West Indies not high, must be culture bias/ positive symptoms mor acceptable in african cultures/ Escobar (2012) showed white doctors more likely to diagnose and mistrust black people in diagnosis
- Biological Explanations
- Genetic basis: Runs in families, strong relationship with genetic similarity. Gottesman (1991) familial relationship immediately doubles risk 1% to 2%
- Candidate genes: Believed to be polygenic. Ripke (2014) 108 genetic variations found to increase risk of schizophrenia
- Dopamine Hypothesis: Dopamine belived to be involved
- Hyperdopaminergia in the subcortex: high levels of dopamine in the central areas. Excess in Broca's Area associated with speech poverty or auditory hallucinations
- Hypodopaminergia in the cortex: low levels of dopamine in the pre-frontal cortex (thinking & decision making)
- Neural Correlates: Measuing structure/function that correlate with experience
- Negative Correlation between activity in Ventral Striatum & severity of negative symptoms
- Lower activation levels in Superior Temporal Gyrus & Anterior Cingulate Gyrus correlate to auditory hallucinations
- Genetic basis: Runs in families, strong relationship with genetic similarity. Gottesman (1991) familial relationship immediately doubles risk 1% to 2%
- Psychological Explanations
- Family Dysfunction
- Schizophrenogenic mother: cold, rejecting & controlling, create atmosphere of secrecy
- Paranoid Delusions
- Double-Bind Theory: Child is sent mixed messages & fear doing the wrong thing
- Disorganised thinking, paranoid delusions
- Expressed Emotion: Verbal criticism, hostility & emotional over-involvement, source of stress
- Relapse or onset
- Schizophrenogenic mother: cold, rejecting & controlling, create atmosphere of secrecy
- Cognitive Explanations: disruption to normal thought processes & dysfunctional thought processiong
- Metarepresentation: ability to reflect on thoughts and behaviour
- Disrupt ability to recognise own thoughts as own, hallucinations and delusions
- Central Control: ability to supress automatic responses
- Derailment of thoughts & speech
- Metarepresentation: ability to reflect on thoughts and behaviour
- Family Dysfunction
- Classification of Schizophrenia
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