Schizophrenia

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  • Schizophrenia
    • Diagnosis and Classification
      • DSM-5 requires one +ve symptom must be present
      • ICD-10 requires two or more -ve symptoms needed for dignosis
      • Positive and Negative Symptoms
      • Low Validity
        • Cheniaux's Study
      • Low Reliability
      • Gender and Cultural bias
      • Co-morbidity and Symptom Overlap
    • Biological Explanations
      • Genetic - Gottesman and Ripke
        • Mz twins - 50% shared risk. Dz twins - 17% shared risk. Siblings - 9% shared risk
        • Ripke - 108 candidate genes
      • Dopamine hypothesis
        • Hyperdopaminergia - high dopamine levels in subcortex
        • Hypodopaminergia - low dopamine levels in pre-frontal cortex.
      • Neural Correlates - Avolition + ventral striatum. Hallucinations + superior temporal gyrus
    • Psychological Explations
      • Family dysfunction
        • Fromm-Reichmann's Schizophrenogenic mothers are cold and rejecting
        • Double bind theory - conflicting family dysfunction
          • Bateson
        • Expressed emotions
          • Criticisms may lead to relapse in patients
      • Cognitive Explanations
        • dysfunctional thought processing
        • Metarepresentation leads to hallucinations
        • Dysfunction of central control leads to speech poverty
    • Biological theories: Drug theory
      • typical antipsychotics
        • Dopamine antagonists - reduce action of dopamine and reduces symptoms such as hallucinations and chlorpromazine - calms patients when anxious
      • Atypical antipsychotics
        • Targets dopamine and serotonin - clozapine and risperidone
    • Psychological therapies for Sz
      • CBT - identifies and change irrational thoughts and helps patients understand their symptoms
      • Family therapies - reduce EE in family and improve family function
      • Token economy - reinforce behaviours (operant conditioning)
    • Interactionists approach
      • Diathesis-stress model: vulnerability + trigger = Sz
        • Stress is anything that triggers Sz
      • Meehl's model - the schizogene but now has been rejected
      • Diathesis doesn't need to be genetic - psychological trauma affecting brain
      • Antipsychotics medication and CBT

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