Schizophrenia flashcards (Clinical psychology)

Schizophrenia

A group of psychotic disorders affecting thinking, emotions, behaviour and contact with reality.

Psychosis

A major break from reality involving hallucinations and/or delusions.

Simple Schizophrenia

Gradual withdrawal from reality.

Paranoid Schizophrenia

Characterised mainly by delusions and hallucinations.

Catatonic Schizophrenia

Little response to the environment or repetitive movements.

Disorganised Schizophrenia

Disorganised thoughts and speech ("word salad").

Undifferentiated Schizophrenia

Has schizophrenic symptoms but does not fit other categories.

Positive Symptoms

Additional behaviours not normally present (e.g. hallucinations and delusions).

Negative Symptoms

Loss of normal behaviours (e.g. flat affect, withdrawal, reduced speech).

Delusions

Fixed false beliefs that are not based in reality.

Hallucinations

False sensory experiences such as hearing voices.

Flat Affect

Reduced emotional expression.

Delusional Disorder

Persistent delusions lasting at least one month with otherwise normal functioning.

Erotomanic Delusion

Belief that someone is in love with you.

Grandiose Delusion

Belief of having exceptional importance, ability or status.

Jealous Delusion

Belief that a partner is unfaithful.

Persecutory Delusion

Belief that others intend to harm or conspire against you.

Bizarre Delusion

A logically impossible belief.

Non

bizarre Delusion

Freeman (2008) Aim

Investigate the use of virtual reality to assess paranoia and schizophrenia symptoms.

Freeman (2008) Sample

24 UCL volunteers (12 males, 12 females), mean age 26.

Freeman (2008) Procedure

Participants explored a virtual library/train with neutral avatars while wearing VR equipment.

Freeman (2008) Before VR

Completed paranoia and emotional distress questionnaires.

Freeman (2008) After VR

Measured persecutory thinking, symptom ratings and immersion.

Freeman (2008) Results

Higher paranoia questionnaire scores predicted greater persecutory thinking in VR.

Freeman (2008) Results

People with real-life auditory hallucinations also experienced them in VR.

Freeman (2008) Evaluation Strength

Standardised procedure increases reliability.

Freeman (2008) Evaluation Weakness

No clinical population was used.

Freeman (2008) Evaluation Weakness

Artificial environment reduces ecological validity.

Freeman (2008) Evaluation Weakness

Self-report measures may produce response bias

Freeman (2008) Application

Can help identify symptoms, causes and treatment strategies.

Gottesman & Shields (1972) Aim

Investigate the genetic basis of schizophrenia using twins.

Gottesman & Shields (1972) Sample

57 twin pairs (24 MZ, 33 DZ) from Maudsley Hospital.

Gottesman & Shields (1972) Procedure

Interviews, cognitive tests and independent assessment of schizophrenia concordance.

Concordance

Both twins possessing the same disorder or characteristic.

Gottesman & Shields (1972) Results

MZ twins had 50% concordance while DZ twins had 9%.

Gottesman & Shields (1972) Results

Severe schizophrenia increased concordance in the co

Gottesman & Shields (1972) Evaluation Strength

Independent judges reduced researcher bias.

Gottesman & Shields (1972) Evaluation Weakness

Findings generalise only to twins.

Dopamine Hypothesis Evidence

Excess L-dopa in Parkinson's patients can produce schizophrenic symptoms, Schizophrenic patients often have more dopamine receptors, Amphetamines and cocaine increase dopamine and can cause hallucinations

Wise et al. (1974) Finding

Lower dopamine-breaking enzyme levels increase dopamine concentration.

PET Scan

Uses radioactive tracers to identify active brain regions.

High Dopamine Activity

Striatum, limbic system and cortex are linked to positive symptoms.

Low Dopamine Activity

Prefrontal cortex is linked to negative symptoms.

Frith (1992) Explanation

Schizophrenia results from impaired self-monitoring

Frith (1992) Hallucinations

Inner speech is mistaken for an external voice.

Frith (1992) Delusions

Logical explanations are applied to hallucinations.

Alien Control

Belief that externally controlled forces cause one's actions.

Thought Insertion

Belief that thoughts have been placed into one's mind by another source.

Frith (1992) Negative Symptoms

Result from difficulty initiating spontaneous behaviour.

Frith (1992) Evaluation

More holistic because it considers both cognition and biology.

Nature vs Nurture Debate

MZ twins may share environments as well as genes.

Biological Explanation Evaluation

Reductionist because schizophrenia is explained mainly by genes.

Biochemical Explanation Evaluation

Reductionist because it focuses only on dopamine.

Cognitive Explanation Evaluation

More holistic but still largely ignores social factors.

First generation Antipsychotics

Drugs such as chlorpromazine that mainly block dopamine receptors.

Second generation Antipsychotics

Drugs that are equally effective but produce fewer movement disorders.

Antipsychotic Effectiveness

Around 50% show significant improvement after 4-6 weeks

Partial Improvement

Around 30-40% improve partially with medicine

Treatment resistant Schizophrenia

Little or no response to antipsychotic medication.

High Relapse Rate

Patients stop medication after symptoms improve due to side effects.

First generation Side Effects

Weight gain, drowsiness, EPS and tardive dyskinesia

Extrapyramidal Symptoms (EPS)

Drug-induced movement disorders

Tardive Dyskinesia

Involuntary facial and body movements caused by long-term antipsychotic use

Second generation Side Effects

Increased risk of obesity, diabetes and heart disease.

ECT

Electrical stimulation that induces seizures to treat severe psychiatric disorders.

Modern ECT

Uses anaesthesia and muscle relaxants before inducing seizures.

ECT Course

Usually 6-12 sessions given about twice weekly

ECT Best Use

Acute psychosis and catatonic schizophrenia.

ECT Risks

Temporary memory loss, neurological damage and cardiovascular complications.

Paul & Lentz (1977) Aim

Compare token economy with other treatments for schizophrenia.

Paul & Lentz (1977) Sample

84 long-term psychiatric patients.

Milieu Therapy

Therapeutic community encouraging patients to care for one another.

Traditional Hospital Management

Standard psychiatric hospital care.

Token Economy

Appropriate behaviour is rewarded with tokens exchangeable for privileges.

Paul & Lentz (1977) Results

97% of token economy patients lived independently.

Paul & Lentz (1977) Results

71% of milieu therapy patients lived independently.

Paul & Lentz (1977) Results

45% of hospital management patients lived independently.

Token Economy Most Effective For

Reducing catatonic behaviour and social withdrawal.

Token Economy Less Effective For

Hallucinations and delusions.

Token Economy Evaluation Strength

Staff training and manuals increased standardisation.

Token Economy Evaluation Weakness

Difficult to apply outside hospital settings.

Token Economy Ethical Issue

Removing rewards may distress patients.

Sensky et al. (2000) Aim

Investigate CBT for treatment-resistant schizophrenia.

Sensky et al. (2000) Sample

90 treatment-resistant patients from 5 UK clinical services.

Sensky et al. (2000) Design

Randomised controlled trial comparing CBT with befriending.

Befriending Therapy

Discussions about neutral topics such as hobbies and current affairs.

Sensky et al. (2000) Procedure

Patients received approximately 19 CBT or befriending sessions.

Voice Diary

Patients recorded hallucinations to develop coping strategies.

Sensky et al. (2000) Results

Both groups improved initially.

Sensky et al. (2000) Results

CBT showed greater long-term improvement in positive symptoms.

Sensky et al. (2000) Evaluation Strength

Randomised controlled trial increased validity.

Sensky et al. (2000) Evaluation Strength

Blind assessors reduced bias.

Sensky et al. (2000) Evaluation Strength

Large UK sample improved representativeness.

Biochemical Treatment Application

Reduces hospitalisation and improves quality of life.

ECT Application

Used mainly in urgent, severe cases involving catatonia.

Token Economy Application

Requires trained staff and controlled clinical settings.

CBT Application

Particularly useful for treatment-resistant schizophrenia.