PSYA4 - Schizophrenia (complete notes)

Detailed revision notes for the AQA A Schizophrenia topic.

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  • Created on: 04-06-14 15:44
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Positive symptoms:
Hallucinations, usually auditory
Disordered speech and thinking
Negative symptoms:
Affective flattening (lack of emotional expression)
Alogia (poverty of speech)
Avolition (loss of motivation/goaldirected behaviour)
Catatonia / psychomotor disturbances
Subtypes of schizophrenia
Paranoid ­ hallucinations and delusions are predominant symptoms
Catatonic ­ psychomotor abnormality patients may adopt unusual poses or flail uncontrollably
Hebephrenic / Disorganised ­ behaviour is aimless, speech is incoherent
Residual ­ generally getting better but continue to experience negative symptoms positive
symptoms are generally not shown
Undifferentiated ­ does not fit into other categories
Cultural bias
Harrison et al. (1984) found an overdiagnosis of schizophrenia in West Indian psychiatric
patients in Bristol, suggesting that the symptoms of ethnic minority patients may be
misinterpreted. Questions the reliability of diagnosis ­ suggests that patients can display the
same symptoms but receive different diagnoses because of their ethnic background
Copeland et al. established crosscultural differences in classifications ­ found a 69%
diagnosis rate in the US compared with only 2% in the UK ­ suggests that different attitudes
towards mental illness may impact reliability and validity
Cultural differences can create language barriers, meaning professionals across the world may
struggle to make the same diagnosis for a set of symptoms

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Interrater reliability
Whaley (2001) found interrater reliability correlations in the diagnosis of schizophrenia as low
as 0.11.
Motjabi & Nicholson (1995) established a correlation of just 0.4 between 50 psychiatrists in
the US when rating their classifications of bizarre and nonbizarre behaviour ­ suggests that
positive symptoms are not as easy to classify as some may think.
McGorry et al.…read more

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One patient keeping a diary of their experiences was noted by nurses as exhibiting signs of
`obsessive writing behaviour' ­ suggests that once given a diagnosis, almost everything the
individual does is seen as a symptom.
Dopamine is a neurotransmitter which plays a key role in attention and perception.…read more

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Copolov & Crook (2000) ­ neuroimaging research has so far failed to provide convincing
evidence of dopamine activity in the brains of individuals with schizophrenia.
This theory is reductionist ­ it reduces a complex disorder to a relatively simple level of
explanation and neglects all other potential influences (e.g. stress or irrational thought
Only explains schizophrenia from a biological point of view when this is unlikely to be the sole
explanation ­ environmental and cognitive factors are not taken into account.
Nature vs.…read more

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Kendler et al. (1985) found that firstdegree relatives of those with schizophrenia are 18 times
more at risk than the general population.
Kety et al (1962) Copenhagen HighRisk Study ­ Longitudinal family study identified
children of mothers with schizophrenia and control group of children with `healthy' mothers
matched on age, gender, socioeconomic status and urban/rural residence. Found that
schizophrenia was diagnosed in 16.2% of highrisk group compared to 1.9% in lowrisk group,
while schizotypal personality disorder was diagnosed in 18.8% of highrisk group vs.…read more

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The diathesisstress model of schizophrenia suggests that some individuals are born with a genetic
predisposition to develop schizophrenia, but that environmental stress is required to trigger the disorder.
This may explain why not all individuals with a genetic vulnerability (e.g. a close relative with a diagnosis
of schizophrenia) develop the disorder, and why not all individuals who experience severe trauma or
stress develop schizophrenia.
Research support
Tienari et al.…read more

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Cause vs. effect ­ enlarged ventricles may be caused by the use of antipsychotic medication
Lyon et al. (1981) found that as the dose of medication increased, the density of brain tissue
decreased, leading to enlarged ventricles.
States that schizophrenia is a consequence of abnormal patterns in family communication, i.e. the
patient is a `symptom' of a familywide problem (Bateson, 1956).…read more

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Research support
Linszen et al. (1997) ­ high levels of EE are most likely to influence relapse rates a patient
returning to a family with high EE is about four times more likely to relapse than those returning
to families with low EE.
Kalafi & Torabi (1996) found that high prevalence of EE in Iranian culture (overprotective
mothers and rejective fathers) was one of the main causes of schizophrenic relapses.…read more

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COGNITIVE BIASES refer to selective attention, and may explain some behaviours traditionally regarded
as symptoms of schizophrenia. Delusions may be associated with specific biases in reasoning about
and explaining social situations. Auditory hallucinations may occur because schizophrenics may
mistake their `inner voice' for speech from an external source for example, those who view themselves
as powerless may hear voices telling them that they are useless or worthless.…read more

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Helmsley (1993) theorised that schizophrenia is a result of the individual being able to process
information or activate schemas quickly and unconsciously, leading to an inability to focus
attention selectively. This causes them to simply let in too much irrelevant information, meaning
they are inundated by external stimuli which they cannot interpret appropriately this could lead
to symptoms such as delusions.…read more


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