Complete Schizophrenia Revision Notes

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Schizophrenia Revision Notes
Clinical Characteristics of Schizophrenia:
Schizophrenia is characterised by a profound disruption of cognition and emotion, which
affects a person's language, thought, perception and sense of self.
Schneider (1959) identified the first rank symptoms of Schizophrenia. These are now called Type 1
symptoms and are positive symptoms. This means that they add to a person's behaviour. These symptoms
are not observable and rely on a patient's report of them to be identified.
1. Thought disturbances ­ Thought withdrawal, thought insertion and thought broadcasting by an
external force.
2. Hallucinations ­ Auditory hallucinations and command hallucinations, visual hallucinations,
tactile/somatosensory hallucinations.
3. Delusions ­ Grandeur and paranoia.
Slater and Roth identified Type 2 symptoms of schizophrenia. These are negative symptoms which means
that they take something away from a person's behaviour. These symptoms are directly observable and so
do not rely on a subjective report from the patient to be identified. Instead, they rely on the objective
interpretation of the doctor.
1. Thought process disorder ­ Cognitive deficits/dysfunction.
E.g. Selective attention.
Sensory overload.
Attention deficit.
Loose association of thoughts.
Speech Impoverishment "word salad".
Clang associations.
Neologisms.
2. Disturbances of affect. (Emotions and Feelings)
Blunted affect ­ emotional insensitivity.
Inappropriate affect ­ undesirable reactions.
3. Psychomotor disturbances ­ catatonic behaviour and agitated catatonia.
4. Lack of Volition ­ avolition.
Aimless/purposeless behaviour.
Lack of interest and fun/pleasure. ­ This can lead to social disengagement causing the person to
become unsociable.

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Issues Surrounding the Classification and Diagnosis of Schizophrenia:
When diagnosing a mental disorder, there is no objective laboratory test. It is subjective
interpretation by the psychiatrist. The classifications system used by the psychiatrists is only
useful if they agree consistently about a particular diagnosis. An ideal classification system
would be both reliable and valid. The key issues are reliability and validity.
The two most widely used classifications systems for diagnosis of schizophrenia are:
o DSM-IV ­ Published in 1994 by the American Psychiatric Association.…read more

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Two Biological Explanations of Schizophrenia:
There are more than two biological explanations but you only need to know two in great detail.
However, acknowledge that others exist (such as viral infections and the neuroanatomical
explanation) as you can use them for comparison/evaluation.
1. Neurochemical:
The dopamine hypothesis is based on the role of chemical messages between nerve
cells called neurotransmitters.
Early 1950's ­ the anti-schizophrenic effects of chlorpromazine and reserpine (drugs)
were documented and related to their side effects of Parkinson's disease.…read more

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Genetics:
This is based on the idea that the development of the body, including the brain, is
heavily determined by genetics.
It assumes that most behaviours, whether seen as `normal' or not, are considered to
be inherited from the genes or the parents.
This suggests that relatives of people with schizophrenia have a greater chance of
developing schizophrenia themselves due to their genetics.
Twin studies are used to show concordance rates for developing schizophrenia.…read more

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Evaluations:
+ There is a lot of supporting evidence for the theory from multiple sources, all suggesting
that genetics play a key role in causing schizophrenia.
+ The explanation has allowed those with schizophrenic relatives to be tested and treated
early due to the knowledge of a genetic predisposition.
Twins that weren't reared apart may have both developed schizophrenia due to their
shared environment ­ same house, same family etc. We cannot eliminate environmental
factors.…read more

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Biological Treatments of Schizophrenia:
1. Antipsychotic Drugs ­ you need to know this one well!
There are two types ­ traditional antipsychotic drugs and modern antipsychotic drugs.
Traditional Antipsychotic Drugs:
Based on the medical model ­ biochemical theory i.e. dopamine hypothesis.
The first drugs, neuroleptics were first introduced in the early 1950's. They are major
tranquillisers and were originally developed to reduce anxiety in people undergoing
surgery.
These drugs were found to have a calming effect and became the preferred
treatment for schizophrenic patients.…read more

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Side effects:
There are less serious side effects such as a dry mouth, low blood pressure and dizziness, blurred
vision and sexual dysfunction.
More serious and less frequent side effects include acute dystonia (involuntary muscle contractions),
tardive dyskinesia (abnormal muscle movements), akathisia (inability to remain still) and finally,
neuroleptic malignant syndrome that effects 1% of consumers and can lead to a coma and death.
Due to these side effects approximately 50% of patients stop taking the drugs after one year. 75%
after two years.…read more

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Other Biological Treatments ­ you don't need to know a lot about these!
2. ECT ­ Electroconvulsive Therapy
Developed by Cerletti and Bini (1938)
Involves sending an electric impulse to induce a seizure in anesthetized patients for
therapeutic effect.
+ The therapy can be successful at reducing catatonia (a symptom of schizophrenia).
Less effective than antipsychotic drugs.
Not particularly successful in reducing other symptoms of schizophrenia.
Its use has declined since the advent of antipsychotic drugs.…read more

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Two Psychological Explanations of Schizophrenia:
There are more than two psychological explanations but you only need to know two in great
detail. However, acknowledge that others exist (such as family relations and the cognitive
explanation) as you can use them for comparison/evaluation.
1. Psychodynamic
Schizophrenia is a thought process disorder which is characterised by a person's
perceptions, emotions and beliefs. (i.e. "split mind")
The psychodynamic approach assumes that schizophrenia is a result of unconscious
processes caused by the unconscious mind.…read more

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It is deterministic in that in overemphasises how childhood experiences are related to an
adult's behaviour.
Freud's psychodynamic theory = a critique of science itself because we cannot prove that the
unconscious mind physically exists.
2. Behavioural
This explanation argues that apart from a few innate reflexes, behaviour is learned
as a result of a person's interactions with their environment.
Behaviourists believe that all symptoms of schizophrenia can be explained in terms
of classical, operant and social learning processes.…read more

Comments

MrsMacLean

This is really clear and detailed. Thanks 

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