Schizophrenia

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What is schizophrenia?
A severe mental disorder where the sufferer experiences psychosis
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What is psychosis?
Losing touch with reality
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How is schizophrenia characterised?
By a collection of symptoms (rather than a specific trait)
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What are the 2 major systems for classifying mental disorders?
The DSM-5 and ICD-10
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Give an example of how the DSM-5 and ICD-10 differ in classification of schizophrenia?
The ICD recognises subtypes, the DSM doesn't anymore
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What are positive symptoms?
Experiencing an excess of normal functionings (e.g. Hallucinations + delusions)
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What are hallucinations?
Unusual sensory experiences related to any of the senses (e.g. Auditory). They may also be related to events in the environment
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What are delusions?
Irrational beliefs (aka. Paranoia); sufferer may believe that they are an important historical, religious or political figure/they are being watched or followed/ part of their body is under external control
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What are negative symptoms?
Experiencing a loss of normal functionings (e.g. Avoiltion and speech poverty)
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What is speech poverty?
A reduction in the quality and quantity of speech of a sufferer. This is usually accompanied by a delay in the sufferers verbal feedback in conversations
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What is avolition?
When a sufferer finds it hard to keep up with the steps of a task or to begin it. This is accompanied by a sharp reduction in motivation to carry out tasks
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Identifying signs of avolition?
Poor hygiene, lack of persistence in school/work, lack of energy
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Who are more likely to be diagnosed with schizophrenia?
Men (gender bias) and Afro-carribeans (culture bias)
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What is reliability?
The extent to which the same diagnosis is reached by different assesors
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Why is the diagnosis of SZ poor in inter-rater reliability?
Because Cheniaux found that the 2 psychiatrists reached different diagnosis
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What is validity?
The extent to which we measure what we want to measure?
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How do we assess the validity of SZ?
By using criterion validity, to see if different assessment types arrive at the same diagnosis for the same patient
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Why is SZ poor in validity?
Because SZ was more likely to be diagnosed with the ICD than the DSM. Suggests that the ICD over diagnosis or vice versa
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What is co-morbidity?
When two or more conditions occur together
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What questions arise due to co-morbidity?
Are they separate conditions or the same?
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What did Buckley et al. Find?
50% of SZ sufferers also had depression or substance abuse. 29% PTSD and 23% OCD
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What is symptom overlap?
When the symptoms of two or more conditions overlap
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An example of a condition that SZ overlaps with?
Bipolar (also has pos + neg symptoms), with ICD a patient may be diagnosed as SZ but with DSM with bipolar disorder
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What does symptom overlap (+co-morbidity) call into question?
The validity of the diagnosis and classification of SZ & whether they are two conditions or one
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What is the genetic basis of schizophrenia?
The idea that schizophrenia runs in families/ is inherited
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What did Gottesman find in his family studies?
Genetic similarity increases the risk of both individuals developing sz (concordance rate of 48% in mz twins)
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What are candidate genes?
Individuals genes associated with the risk of inheritance
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Why does SZ appear to be polygenic?
There are a number of genes that cause and increased risk of developing SZ. Several studies have found different candidate genes so different combinations of genes can lead to SZ.
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What did Ripke et al. do?
Studied 37,000 patients and compared the genes in with 113,000 controls
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What did Ripke find?
That there were 108 separated gene combinations that are linked to an increased risk of SZ, this also included genes that code for the functioning of several neurotransmitters (e.g. Dopamine)
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What is dopamine?
An neurotransmitter that has an excitatory effect that is associated with feelings of pleasure
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What is the dopamine hypothesis (DH)?
That SZ patients have neurotransmitters that work differently from the brain of a non-sufferer; particularly dopamine
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Why is dopamine important?
Because it is involved in the functioning of many brain systems that may be implicated in the symptoms of SZ sufferers
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What are the levels of dopamine like in SZ sufferers?
Excessively high or low
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What is hyperdopaminergia?
Original version of the DH that focuses on possible high levels or activity of dopamine in the sub cortex
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What symptoms are linked with an excess of dopamine receptors in the Broca's area?
Auditory hallucinations and poverty of speech
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What is hypodopaminergia?
Recent versions of the DH focused on low levels of dopamine in the prefrontal cortex, linked to negative symptoms (Goldman-Rakic)
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Card 2

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What is psychosis?

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Losing touch with reality

Card 3

Front

How is schizophrenia characterised?

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Card 4

Front

What are the 2 major systems for classifying mental disorders?

Back

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Card 5

Front

Give an example of how the DSM-5 and ICD-10 differ in classification of schizophrenia?

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