Psychology B (PSYB) Unit 3 Schizophrenia

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What are the symptoms of schizophrenia required for diagnosis (Criteria A)?
Delusions, hallucinations, disorganized speech, grossly diorganized/catatonic behaviour, and negative sympotoms (e.g. affective flattening etc.)
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What is the definition of a delusion?
Beliefs that do not correspond to reality
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What is the definition of a hallucination
Sensory experiences that don correspond to reality, usually auditory or somatosensory
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What consititutes disorganised speech?
frequent derailment, jumping from one conversation topic to another at random
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What consititutes grossly disorganised/catatonic behaviour?
Periods of waxy immobility
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What is affective flattening?
Lack of emoition
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What is alogia?
Inability/unwillingness to speak
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What is avolition?
Inability/unwillingness to direct own activities
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What are the two types of schizophrenia?
Episodic (Type one) and Chronic (type two)
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What are the characterisitics of type one schizophrenia?
Mainly positive symptims: hallucinations, delusions and catatonia. Occurs in episoddes, with periods of relative normality
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What are the characterisitcs of type two schizphrenia?
Mainly negative symptoms: alogia, avolition and flattened effect. chronic in form with evidence of stead decline over time.
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What are the different subtypes of schizophrenia?
Paranoid, catatonic, diorganised, undifferentiated and residual
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What arre the characteristics of the paranoid subtype?
Preoccupied with one or more delusions or frequent auditory hallucinations. (NO: disorganised speech, catatonic behaviour or flat/inappropriate effect)
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What are the characteristics of the catatonic subtype?
Motor immobility (including waxy flexibility) or stupor, excessive motor activity, excessive negativism/mutism and streaootyped movements echolalia/echpraxia
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What are the characteristics of the disorganised subtype?
Disoraganised speech/behaviour, flat/inappropriate effect (criteria not met for catatonic)
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What are the characteristics of the undifferentiated subtype?
Symptoms that meet criterion A (diagnostic symptoms) but criteria not meant for disorganised, paranoid or catatonic subtypes
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What are the characteristics of the residual subtype?
No delusions, hallucinations disorganised speech/behaviour but continued evidence of disturbance
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What is echolalia?
Meaningless repetition of another person's spoken words as a symptom of psychiatric disorder.
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What is echopraxia?
Involuntary repetition or imitation of the observed movements of another.
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What is negativism?
An apparently motiveless resistance to all instructions or maintenance of a rigid posture against attempts to be moved
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What is mutism?
Unwillingness or refusal to speak
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What are the diagnostic criteria for scshizophrenia?
Social/occupational dysfunction, and symptoms must a occur for a duration of 6 months (includes 1 month of symptoms that meet criteria A and may include residual symptoms)
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What evidence is there to support that there is a genetic factor to schizophrenia?
Prevalence is the same all over the world (doesnt vary with envirnoment), adoption studies (Kety et al)
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What is the Diathesis-Stress Model?
Predispostion (genetically) but environmental trigger/stresser brings about the development of symptoms
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What is the Dopamine (DA) Hypothesis?
Schizophrenia is caussed by excessive activity at the synapses that use DA as their primary neurotransmitter. This causes abnormal function of the DA-dependant brain systems, resulting in schizophrenic symptoms
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What evidence is there to support the DA hypothesis?
Wise & Stein did post mortems on schz. patients who'd been in accidents and found they had low levels of DBH (enzyme that breaks down DA) in the brain, Treating schz. with chlorpromazine (binds to DA receptors preventing their use)
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What are neuroleptics?
Bind to DA receptors without activating them (e.g. chlorpromazine)
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Comment on the effectiveness of typical dtrugs (older drugs used to treat schz.)
(includes neuroleptics) Short term: beneficial effect in 75% of patients (David et al) Long term: beneficial effect in 55%-60% of patients. Most effective on positive symptoms
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Comment on the sife effects of typical drugs
High ris of side effect, including extrapyramidal side effects (EPS), Parkinsons'-type symptoms, postural and motor abnormality
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Comment on effectiveness of atypical drugs (newer drugs used to treat schz.)
(includes clozapine) As effective as typical drugs on positive symptoms, better than typical drugs on negativve symptoms (Bilder et al 2002). More effective with treatment-resistant patients (Denayer et al 2003)
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Comment on the side effects of atypical drugs
Less risk of EPS, but other side effects may occur. e.g. nausea weight gain, irregular heartbeat and excessive salivation. Also rist of dramatic drop in whihte blood cells
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What does the labelling argue about schizophrenia?
Schizophrenia is not a disease but a leared social roles, it is a label applied to ordinary people who have been caught breaking the residual rules of soceity
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What are residual rules?
Rules of society that have not been "written down" or taught. Rules about what we do/dont doo in all sorts of situations (e.g. talking to people who are not there)
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What are the critizims of the rosenham study?
Rosneham study: people given strong medication so this ewould have affected them, study mostly shows it affects how other people treat you, and raised questions about diagnostic tools used for schz.
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What are the problems with the labelling theory?
Developments shows biological influence on schz., trivialises serious mental illness, little evidence that unusual behaviours (norm violations) that are not given a label go away by themselves (transient)
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What is the familly systems/double bind theory?
Schizophrenia is a consequence of abnormal patterns in familly communication. One member becomes "ill" to preotect the stability of the familly system
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What happens in a double binnd system?
A person is given mutually contradictory signals by another person. This places them in an impossible situation causing internal conflict. Schizophrenia symptoms represent an attempt to escape from the double bind
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What ar the problems with the double bind theory?
Familly- based approaches to schz raise ethical issues (e.g. blaming and guilt) Evidence for a causal role for the familly is lacking
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What is expressed emoition?
hostile, critical or overprotective behaviour in a familly unit
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How does expressed emoition support the familly systems theory?
Found that expressed emoition may play a role in relapse of schz. patients, familly therapy used to reduce levels of high expressed emoition in a familly
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How is cognitive therapy (CBT) used to trat schizophrenia?
CBT strategies to challenge and help modify delusionary beliefs in steps: identify delusions, challenge evidence on which delusions are based, design "experiments" to test reality of evidence
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Comment on the effectiveness of CBT to treat schizophrenia
Chadwick & Lowe (1993) significant reduction in delusions in 10 out of 12 patients (However small scale experiment, doesnt show that it works for everyone)
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What are normalising strategies?
Patient is taught to understand the nature of schizophrenic symptoms- helps the patient feel that symptoms are normal and undertandable, and challenges "catastrophising" beliefs about schz.
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Comment on the effectiveness of normalising strategies
Helps 70% of patients although other 30% may deteriorate (Kingdon & Turkington, 1996)
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How does the Psychodyanmic theory use Represssion to explain mental illnesss (schizophrenia)
Repression: traumatic events repressed in childhood source of unconcious anxiety in adulthood. (evidence: multiple personality disorder)
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How does the psychodyamic theory use Sublimation to explain mental illness?
Sumblimation: into somatic symptoms- underlying anxiety symbolically expressed into hysteria. (evience: case study of Anna-O)
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How does the Psychodynamic theory use Regression to explain mental illness?
Regression: irrational ID dominates and there is no ego to make contact with reality. (adulthood depression) (evidence:many studies show parental loss & childhood trauma link with a later mental disorder)
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What are the 3 methods used in psychoanalysis for identifying the unconcious causes of the disorder?
Free association, Dream analysis, Behaviour interpretation
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How is free association used to identify the unconcious causes of the disorder?
Thought associations expressed from client to analyist without inhibition may have clues regarding cause of unconcious anxiety
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How is dream analysis used to identify the unconcious causes of the disorder?
Unravels the symbolism of the manifest content of the dream (what was remembered), the latent context (what it actually meant) may be revealed
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How is behaviour interpretation used to identify the unconcious causes of the disorder?
Slips of the tounge & abnormal behaviour due to unconcious causes
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What are the 3 methods used in psychoanalysis for treating the unconcious causes of the disorder?
Catharsis, transference, insicht
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What is is catharsis?
Discharge of emoition (psychic energy) associated with repressed impulses or traumatic memories brought about improvement
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What is transference?
The process whereby unconcious feelings of love & hate are projected onto rhe analyst. These feelings provide a basis for identifying, accepting and discussing the analysts interpretation of the problem
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What is Insight?
Increased ego control over-revealed unconcious causes should people undergo psychoanalysis
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Comment on the effectiveness of psychoanaylsis
Webster suggested Freud & Breuer may have misdiagnosed patients and those that were supposedly cured (Anna-O) cont. to show symptoms after treatment. Also now, such patients may be diagnosed witth a different disorder
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What are problems with psychoanalysis?
Therapy is expensive & time consuming, ethically can be distressing for patients (all therapies have this problem) client unable to withdraw as refusal may be interpretted as ego defence against hidden truths
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What are the benefits of psychoanalysis?
Having opportunity to talk to someone about your problems alone could have improved patients symptoms
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What were the aims of community care?
To focus on the development of coping, to encourage independence, self-respect and personal dignity. Provides sheltered accomodation and support in the community
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What are some of the problems of community care?
lac of funding, housing and inadequate support leading to social problems, homelessness, relapse and rising rates of suicide. stigma associated with mental illness, risk to patient and soceity
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What is the definition of a delusion?

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Beliefs that do not correspond to reality

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What is the definition of a hallucination

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Card 4

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What consititutes disorganised speech?

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What consititutes grossly disorganised/catatonic behaviour?

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