Psychology schizophrenia

Schizophrenia definition

• Correlation of unrelated symptoms

What are the two classifications of schizophrenia?

Classification of schizophrenia

ICD-10

DSM-5

What is ICD-10

Classification of schizophrenia

• Two or more negative sympotoms for one month or longer ex; avolition and speech poverty
• UK
• Recognises subtypes

What is DSM-5

Classification of schizophrenia

• one positive symptom must be present, for at least one month,(e.g. delusions, hallucinations)
• US

What is a positive symptom

Positive symptoms of schizophrenia, including hallucinations and delusions

• An additional experience beyond those of ordinary existence

• Hallucination= Unusual sensory, no basis in reality, auditory or visual

• Delusions =Irrational false beliefs, no basis in reality, Persecution (harrassed), Control by external e.g. aliens

What are negative sympotoms

• A loss of usual abilities and experiences.

• Avolition loss of motivation to carry out everyday tasks and difficulty to begin or keep up with goal-directed activity, poor hygeince

• Speech poverty, reduction in the amount and quality of speech

What is reliability?

Reliability and validity in diagnosis and classification of schizophrenia

• Reliability refers to consistency.
• This refers to whether we can gain consistent results when classifying and diagnosing Schizophrenia
• Measured by inter-rater reliability

What is validity?

Reliability and validity in diagnosis and classification of schizophrenia

• refers to accuracy
• the extent to which we are measuring what we intend to measure (schizophrenia).

What is the study to Reliability and validity?

Reliability and validity in diagnosis and classification of schizophrenia

• Cheniaux (2009) asked two psychiatrists to diagnose the same 100 patients using the DSM and ICD.
• One psychiatrist diagnosed 26 according to DSM and 44 according to ICD.
• The other diagnosed 13 according to DSM and 24 according to ICD.
• This shows poor inter-rater reliability as one psychiatrist diagnosed almost double the amount than the other psychiatrist.
• Moreover, it demonstrates poor reliability in the classification of schizophrenia as both psychiatrists diagnosed almost double the amount of patients using the ICD than the DSM, which also calls in to question the validity of the diagnosis.

What is system overlap?

Reliability and validity in diagnosis

• This is where two or more conditions share similar symptoms.
• For example, both schizophrenia and depression involve negative symptoms such as avolition.

What is Co-morbidity

Reliability and validity in diagnosis

• This is where two illnesses/conditions occur at the same time.
• Schizophrenia is commonly diagnosed with other conditions such as depression and/or OCD

Evaluation for reliability and validity

Reliability and validity in diagnosis and classification of schizophrenia

• limitation
• ‘Symptom overlap’.
• This is where two or more conditions share similar symptoms.
• For example, both schizophrenia and depression involve negative symptoms such as avolition.
• This questions the validity and reliability of the classification and diagnosis of schizophrenia
• An individual may be diagnosed with the wrong disorder.
• This is an issue as doctors may not be diagnosing schizophrenia correctly,
• therefore individuals may not recieive appropriate treatment.

Evaluation for reliability and validity

Reliability and validity in diagnosis and classification of schizophrenia

• limitation
• Co-morbidity’.
• This is where two illnesses/conditions occur at the same time.
• For example, Buckley et al (2009) concluded that 50% of patients diagnosed with schizophrenia also have a diagnosis of depression and 23% of patients diagnosed with schizophrenia are diagnosed with OCD. T
• his questions the validity and reliability of classification and diagnosis of schizophrenia,
• because they may be better seen as one condition
• doctors may diagnose the wrong condition.

Evaluation for reliability and validity

Reliability and validity in diagnosis and classification of schizophrenia

• limitation
• Gender bias in diagnosis.
• Since the 1980s men have been diagnosed with schizophrenia more often than women.
• This may be because men are more genetically vulnerable to developing schizophrenia than women.
• However, it could be because females with schizophrenia typically function better than men
• being more likely to work and have good family relationships therefore their symptoms may be masked by good interpersonal skills (Cotton et al).
• This questions the validity and reliability
• as women who share similar symptoms as men may not receive the same diagnosis as their symptoms seem mild.

What are the two explanations of schizophrenia?

• biological explanations
• psychological explanations

What are the three features of the biological explanations?

explanations of schizophrenia

• Genetics
• Neural correlates
• Dopamine hypothesis

What is the genetic theory?

Biological explanation of schizophrenia

Explanations of schizophrenia

• SZ hereditary and polygenic
• Predisposition due to maladaptive candidate genes
• PCM1
• Each gene increases the vulnerability

A01 study for genetic theory.

Biological explanation of schizophrenia

Explanations of schizophrenia

• Gottesman (1991) studied 40 twins
• and found that the concordance rate for monozygotic twins was 48% and only 17% for dizygotic twins
• Therefore, the closer the genetic link to somebody with schizophrenia, the more chance of developing schizophrenia.

Genetic theory evaluation

Biological explanation of schizophrenia

Explanation of schizophrenia

• Research to support Tienerry.
• He studied 155 adopted children who had biological mothers with schizophrenia
• found that they had a concordance rate of 10% compared to 1% in adopted children without schizophrenic parents.
• This provides significant support for the role of genetics as an explanation of schizophrenia
• Social Learning Theory's role could not have been a factor as the children were adopted.

What is neural correlates of brain structure?

Biological explanations of schizophrenia

Explanations of schizophrenia.

• Enlarged ventricles
• Raz and Raz compared ventricle size to those with schizophrenia to those of control group.
• Associated with damage to prefrontal (decision making)
• Leads to avolition

Evaluation for neural correlates brain structure

Biological explanations of schizophrenia

Explanations of schizophrenia.

• strength
• Suddath et al
• Research to support
• He used MRI scans to investigate the brain structure of MZ twins in which one twin had schizophrenia
• the schizophrenia twin was found to have larger ventricle
• suggesting enlarged ventricle do play a role in determining the likelihood of schizophrenia developing

What is neural correlates dopamine hypothesis

Biological explanations of schizophrenia

Explanations of schizophrenia.

1. Neurotransmitters work differently in those with SZ

Both neural correlates exist in different regions

• Hyperdopanminergia
• Hypodopaminergia

What is Hyperdopaminergia? Dopmine hypothesis

Biological explanations of schizophrenia

Explanations of schizophrenia.

1. Subcortex
2. High dopamine activity in Broca's area
3. Auditory hallucinations

What is Hypodopaminergia? Dopmine hypothesis

Biological explanations of schizophrenia

Explanations of schizophrenia.

1. Cortex

2. Low dopamine in prefrontal cortex (decisions)

3. Avolition

Overall evaluation of the biological explanation of schizophrenia

Biological explanations of schizophrenia

Explanations of schizophrenia.

• strength
• scientific methods
• based on objective and emperical methods
• such as gene mapping and brain scans which are used to identify specific genes or area of schizophrenia (enlarged ventricles)
• therefore increases the overall internal validity
• thus raising psychology scientific status

Overall evaluation of the biological explanation of schizophrenia

Biological explanations of schizophrenia

Explanations of schizophrenia.

• limitation
• biological determinism
• theory states an individual is controlled by internal factors
• fir example high dopamine (hyperdopaminergia) in the subcortex which causes auditory hallucinations
• neglets the role of free will
• no control over theor schizophrenic behaviour
• families can feel guilty for passing the gene
• limiting the biological explanation of schizophrenia

Overall evaluation of the biological explanation of schizophrenia

Biological explanations of schizophrenia

Explanations of schizophrenia.

• strength
• practical applications
• schizophrenia is caused by an inbalance of dopamine has led to the treatment of drug therapies such as typical and atypical antipsychotics
• effective in treating schizophrenia by balancing levels of dopamine in the patients brain and reducing symptoms such as hallucinations
• important part of applied psychology
• as it helps treat people in the real world

Overall evaluation of the biological explanation of schizophrenia

Biological explanations of schizophrenia

Explanations of schizophrenia.

• limitation
• family dysfunction
• due to faulty coomunciation patterns such as schizophrenic mother
• leads to distruct that later develops into paronoid delucions rather than delucions being due to levels of dopamine
• therefore the biological explanantion of schizophrenia is not the only explanation that can be considered

What are psychological explanation of schizophrenia.

• family dysfunction
• cognitive explanations including dysfunctional thought processing

What is family dysfunction?

Psychological explanations for schizophrenia.

• individual develops schizophrenia because they are raised in a dysfunctional family environment
• They are dysfunctional in the way that they communicate with each other; high levels of tension and arguments

What is family dysfunction broken down into?

Psychological explanations of schizophrenia.

• schizophrenigenic mother
• Double bind communication
• Express emotion

What is schizophrenogenetic mother?

Family dysfunction

Psychological explanations for schizophrenia.

• The mother is cold,controlling,rejecting,emotionally unresponsive
• Builds a family based on tension and secrecy
• leads to distrust and develops to paranoid delusions +

What is expressed emotion?

Family dysfunction

Psychological explanations for schizophrenia.

• High levels of expressed emotion; verbal criticism and occasional violence towards patient
• hostility towards patient
• anger, rejection
• emotional over-involvement in their life
• causes stress to the patient and results in relapse

What is double bind communication?

Family dysfunction

Psychological explanations of schizophrenia

• Verbal not the same as non-verbal
• Confusion = no trust in themselves
• Anxious
• Withdraw from social contact
• Avolition & paranoid delusions