AQA Psychology - Schizophrenia

What is schizophrenia characterised by?

profound disruption of cognition and emotion, loss of contact with reality

What percentage of the population is affected by SZ?

1%

Which term is defined as an excess of normal functioning?

positive symptoms

Which term is defined as a loss of normal functions?

negative symptoms

Name at least two examples of positive symptoms?

delusions, hallucinations, disorganised thinking and speech

Which term is defined as bizarre beliefs that make sense to patients with schizophrenia but not to others?

delusions

Which term is defined as bizarre, unreal perceptions of the environment that can be auditory, visual, olfactory or tactile?

hallucinations

Which type of delusion are paranoid in nature, involve beliefs that they are being followed or spied on?

(delusions of) persecution

Which type of delusion involves inflated and exaggerated beliefs about their power and importance?

(delusion of) grandeur

What are some types of disorganised speech?

neologisms, word salad, clang

What is the term used when SZ patients use newly-created words whose meanings are unknown to others?

neologisms

What is the term used to describe disorganised speech in which words or phrases are used in confusing and unintelligible mixtures that are semantically non-sense?

word salad

Which type of disorganised speech involve SZ patients choosing words based on their sounds to speak instead of their meanings?

clang

What are the two main negative symptoms in SZ patients?

poverty of speech (alogia) and avolition

Which negative symptom is characterised a reduction in the amount and quality of speech?

poverty of speech/alogia

How is alogia displayed?

fewer words produce, difficulty spontaneously producing words

What is a reduction of interests and desires and an inability to initiate and persist in goal-directed behaviour?

avolition

How can poor social functioning be distinct from avolition?

avolition must involve reduction in self-initiated involvement in activities that are available to the patient

According to DSM-V, how long should two or more symptoms persist on before they are diagnose with SZ?

at least 6 months

What are some issues with regards to the validity of classification and diagnoses of SZ?

gender bias, symptom overlap, comorbidity

What does validity refers to?

accuracy (of diagnosis)

Which other disorders have symptoms that may overlap with SZ?

depression, bipolar disorder, dissociative identity disorder (DID)

Why is symptom overlap an issue with validity?

difficult to distinguish SZ from related disorders

What is the extent to which two (or more) conditions co-occur?

comorbidity

What are some disorders that are comorbid with SZ?

depression, anxiety, substance abuse

Why is comorbidity a problem for the validity of SZ diagnoses?

difficult in separating out disorders/difficulty advising treatments

Who provided evidence for gender bias?

Loring and Powell (1998)

In Loring and Powell research, what percentage of the psychiatrists gave a diagnosis of SZ when the case was classed as 'male' and when the case was classed as 'female', respectively?

56% and 20% (respectively)

Was gender bias more evident among male or female psychiastrists?

male psychiatrists

Who did research into symptoms overlap in SZ diagnoses?

Ellason and Ross (1995)

In Ellason and Ross' research, which symptom was found to have symptoms overlap with SZ?

dissociative identity disorder (DID)

Who provided evidence for comorbidity issues between SZ with depression and substance abuse?

Buckley et al (2009)

What percentage of comorbidity was found between SZ and depression and substance abuse, respectively, in Buckley's study?

50% and 47%

What does reliability refers to?

consistency

How is reliability measured?

inter-observer/rater reliability or test-retest reliability

Measuring reliability by seeing whether two independent assessors using the same classification system give the same diagnosis is which way of measuring reliability?

inter-rater reliability

Measuring reliability by seeing whether diagnostic tests are consistent on different occasions is which way of measuring reliability?

test-retest reliability

What is the type of bias when psychiatrists are influenced by taught values and expectations when diagnosing patients?

cultural bias

Where did evidence for cultural bias come from?

Copeland (1971)

When given a description of a patient and asked for a diagnosis, what percentage of American psychiatrist and what percentage of British psychiatrist diagnosed them with SZ, respectively in Copeland's study?

69% (Americans) and 2% (British)

Who reported that African-Caribbean groups were 8 times more likely to be diagnosed with SZ than white groups in the UK?

Harrison et al (1997)

What is the type of bias that involve misinterpreting cultural differences in behaviour as 'bizarre' called?

ethnocentric bias

What can the cultural differences also represent that can also influence SZ?

environment factors: poorer housing, higher unemployment, social isolation

What is a major consequence of invalid or unreliable diagnosis of SZ?

social stigma

Why are classification systems needed?

provide common language for researchers around the world

What are the biological explanations of schizophrenia?

genetics, the dopamine hypothesis, neural correlates

"The more closely related the family member is to the person with SZ, the greater their chance of developing the disorder." This is the main argument of which explanation?

genetic explanation

Where does evidence for the genetic explanation comes from?

family studies, twin studies and adoption studies

What is the degree to which relatives share the same disorder?

concordance rate

If SZ is genetic then should DZ twins or MZ twins have higher concordance rates for the disorder?

MZ (monozygotic) twins

Who found that 16% of first degree relatives of SZ patients developed SZ compared to 7% in the control?

Varma (1997)

Who developed adoption research to support the role of genes in SZ?

Tienari et al (2004)

What did Tienari et al found to support the genetic explanation?

children whose biological mother had SZ have a higher rate of SZ compared a group of adoptees without any genetic risks

What does the genetic explanation overlook in general?

the role of the environment

Which neurotransmitter is linked to the development of positive symptoms of SZ?

dopamine

What do SZ sufferers have compared to non-SZ people that stimulate more dopamine binding and more neurons firing?

D2 receptors

What can disturbances to dopamine transmission lead to?

problems with attention, perception and thought

What are drugs that stimulate neurons containing dopamine called?

dopamine agonists

What do these drug research (with amphetamine and L-dopa) shows about the relation between dopamine and SZ?

raising levels of dopamine result in symptoms similar to positive symptoms of SZ (hallucinations, delusions)

What practical application does the dopamine hypothesis has?

development of typical antipsychotic drugs (dopamine antagonists)

What happened when dopamine antagonist drugs are used to block D2 receptors?

reduced positive symptoms

What other neurotransmitter can be relevant to the development of SZ?

serotonin

What do atypical antipsychotics do to dopamine receptors

only temporarily block it

Which explanation of SZ links abnormalities within specific brain areas to SZ?

neural correlates

What do SZ patients often have differently, in terms of brain structure?

enlarged ventricles

How do enlarged ventricles affect the brain?

damage to central brain areas and the prefrontal cortex

Who found that enlarged ventricles are associated with only negative symptoms of SZ?

Weyandt (2006)

Why is cause-and-effect unclear in neural correlates explanation?

brain abnormalities could be the result and not the cause of SZ

How is determinism linked to humane?

the blame is put on the sufferer or external factors

How can determinism of an explanation be negative?

they may feel like they have no control and there was nothing they can do

What is the biological explanation be criticised for?

reductionism

What are the two main psychological explanations of SZ?

family dysfunction and cognitive explanations

What do family dysfunction explanations attribute the risk of SZ to?

abnormal/difficulty communication within the family

What are the two sub-explanations for family dysfunction explanations?

double-bind theory and expressed emotions (EE)

Is receiving contradictory/mixed messages, leading to confusion and fear of doing the wrong thing an example of double-bind or expressed emotions?

double-bind

Which positive symptom is the double-bind theory often linked to?

paranoid delusions

Which theory is referred to as the level of emotion expressed towards a SZ sufferer by their family (or carers)

expressed emotions (EE)

How can EE be shown in a dysfunctional family?

verbal criticism, hostility, emotional over-involvement, needless self-sacrifice

Is EE linked more to the course or the cause of SZ?

course

What have high levels of EE in carers been found to lead to?

poorer outcomes and an increased likelihood of relapse

What does Tienari et al adoption study suggest about the course of SZ?

the risk for SZ is increased when the adoptive family is characterised as highly critical

What practical application do family dysfunction theories have?

development of family therapy

According to NICE, what was the relapse rate in a family therapy?

26%

What is a limitation of the family dysfunction explanation?

difficulty of establishing cause-and-effect

What does the cognitive explanation for SZ linked to?

dysfunctional thought processing and the role of thinking

What are the two cognitive explanations for SZ?

egocentric bias and central control

Which positive symptom of SZ is egocentric bias linked to?

delusions

What does egocentric bias mean?

tendency for sufferers to interpret external events as having personal significance to them

What is the ability to suppress automatic responses while performing deliberate actions?

central control

Which SZ symptom is central control linked to?

disorganised speech and thinking

What are some "symptoms" of lack of central control?

derailment, incoherent sentences

Who reviewed studies and found that delusional patients showed various biases in their information processing like jumping to conclusion?

Sarin and Wallin (2004)

Which type of therapy is based on the cognitive explanation of SZ?

cognitive behavioural therapy for pscyhosis (CBTp)

Which was more effective, according to NICE, antipsychotic drug therapy or CBTp?

CBTp

What does CBTp do to patients with SZ?

reduce symptom severity and improve social functioning

What does the psychological explanation fail to take into account?

biological factors (genetics, neurotransmitters, brain abnormalites)

Which is a more holistic that incorporate both the biological and psychological explanations?

interactionist approach

How does the psychological approach being less determinist than the biological explanation have a positive impact?

the sufferer has control over SZ and they can actively work to change/manage the disorder

Which type of antipsychotic drug is chlorpromazine an example of?

typical antipsychotic drugs

Which symptoms do typical anti-psychotic drugs treat?

positive symptoms