Understanding Schizophrenia: Symptoms and Explanations

Positive Symptoms of Schizophrenia

Two of the following:

Delusions, which are bizarre beliefs that seem real to the schizophrenic;

Hallucinations which are unreal perceptions of the environment that are auditory, visual, olfactory or tactile; Disorganised Speech which can be 'word salad', where speech is incomprehensible or 'derailment', in which an individual slips between topics; Disorganised/ Catatonic Behaviour which is an inability or lack of motivation to initiate or complete tasks.

Negative Symptoms of Schizophrenia

Two of the following: Speech Poverty (Alogia) is the lessening of speech fluency and productivity; Avolition is the reduction of interests and desires, as well as an inability to initiate and persist in goal-directed behaviour; Affective Flattening is a reduction in the range and intensity of emotional expression- including facial expression; Anhedonia is an inability to experience pleasure.

Reliability

This refers to the consistency of a measure, as in the same data should be produced by a measurement if it is taken on successive occasions.

Validity

This refers to the accuracy of a measurement- whether or not an observed effect is genuine.

Neural Correlates

These are changes in neuronal events and mechanisms that result in the characteristic symptoms of a disorder, which in the case of schizophrenia may be damaged connections between the hippocampus and the prefrontal cortex.

Dopamine Hypothesis

When the neurotransmitter dopamine is in excess in regions of the brain, positive symptoms of schizophrenia can be observed.

Double Bind Theory

Refers to receiving contradictory information from a family member, such as being told they love them whilst sneering at them.

Expressed Emotions

This refers to a family style in which there may be overinvolvement in a child's life, and a poor style of communication.

High EE Environment and Schizophrenia

This suggests that receiving contradictory information (being told 'I love you' by a sneering person), renders an individual unable to respond to future information, causing cognitive symptoms of schizophrenia.

Cognitive Approach to Hallucinations

Explains that hallucinations may arise from cognitive processes that misinterpret sensory information.

Hallucination

Hallucinating individuals experience hypervigilance due to an excessive focus on auditory stimuli, such individuals find it hard to distinguish between imagery and sensory based perception.

Cognitive Approach to Delusions

This explanation suggests that during the formation of delusions, patients have their interpretations of their experiences controlled by inadequate processing of information.

Atypical Antipsychotics

Atypical antipsychotics carry a lower risk of extrapyramidal side effects and are believed to, unlike typical antipsychotics, have an impact of reducing negative symptoms as well as positive ones.

Advantages of Atypical Antipsychotics

These are also suitable for treatment resistant patients.

Mechanism of Atypical Antipsychotics

Atypical antipsychotics do not only block D2 receptors, but have a stronger affinity for serotonin receptors, and a lower affinity for D2 receptors, which is believed to reduce the risk of side effects.

How Antipsychotics Work

Antipsychotics are dopamine antagonists which are substances that decrease the activity of dopamine, by blocking receptors so that dopamine cannot stimulate them.

Drug Therapies vs Other Therapies

They are effective, cheap, and require less effort on the part of the patients, increasing the chances of them persisting in the treatment.

Token Economy

This is a form of therapy in which desirable behaviours are encouraged by the use of reinforcements. Rewards are given in exchange for tokens earned when desirable behaviours are performed.

Ethics of Token Economy

For token economy to work, psychiatrists have to be in control over food and other things that act as primary reinforcers.

Patient Rights and Token Economy

In order for patients to have access to these things, they have to exchange tokens given to them by the psychiatrists, which contradicts the notion that all humans have the right to things like privacy and food without having to earn them.

Interactionist Approach to Schizophrenia

This is a compromise explanation that suggests schizophrenia develops in individuals who have a genetic vulnerability (diathesis), following an activating event (stress).

Symptom Overlap

This refers to the fact that some symptoms may not be unique to one disorder, but rather shared amongst many disorders.

Example of Symptom Overlap

An example of this is social anhedonia, which is common between both schizophrenia and depression.

Comorbidity

This refers to the extent to which two or more conditions occur simultaneously in a patient, like schizophrenia and depression.