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39 Cards in this Set

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what are the different types of schizophrenia?
Catatonic, Paranoid, Disorganized, Behaviour, Undifferentiated, Residual.
What is Catatonic schizophrenia?
(rarely seen with the introduction of medication) Frozen or stunted movements, repetitious copying of speech
what is Paranoid schizophrenia?
highlighted by delusional thought, hallucinations, delusions of grandeur and bizarre communication beliefs
What is Disorganized schizophrenia?
described often as flat,
What is Behaviour schizophrenia?
inappropriate and affecting speech
What is Undifferentiated schizophrenia?
Individuals displaying a range of
symptoms but not fitting into one of the above types
What is Residual schizophrenia?
Used to have the diagnosis but not any more (remission)
How does gender effect schizophrenia?
Equal Gender Distribution
Women - better long-term prognosis
Onset differs between men and women
How does schizophrenia progress?
Schizophrenia Is Generally Chronic
Moderate-to-severe lifelong impairment Life expectancy is slightly less than average
What proportion of psychiatric beds are filled due to schizophrenia?
50%
Give a brief description of schizophrenia?
Severe form psychopathology personalities seem to disintegrate, perception is distorted, emotions blunted, thought bizarre, and
language strange.
What age is it normally diagnosed?
Usually diagnosed in late teens or early twenties.
Whats the prognosis?
About 80% of those expeiencing first episode will have another within 5 years. In a cohort of people with Schizophrenia 10 years later
• 25% recovered • 25% living relatively independently • 25% needing substantial support • 10% suicide
How does Carson, et al., 1988 describe schizophrenia?
Schizophrenia includes a class of psychological disorders that is perhaps the ultimate in psychological breakdown
A diagnosis is made in the presence of?
Delusions - Hallucinations - Thought disorder - Social withdrawal - Lack of coherence - Flat affect - Marked deterioration from normal functioning - Unusual behaviour
List +'ve symptoms?
Hallucinations (mostly auditory)
Delusions (abnormal beliefs held with great conviction)
Disordersofthe experience of thought
List -'ve symptoms?
Loss of: concentration, Attention,SocialSkills, Emotional Expressiveness, Coherence of thinking

With loss of effective social functioning
What +'ve symptoms are considered first ranked symptoms?
auditory hallucinations in the third person
–Loss of the sense of possesssion of thoughts and actions
– Passivity experiences
What is Avolition?
inability to initiate or persist in activities
What is Alogia?
a relative absence of speech
What is Anhedonia?
inability to experience pleasure
What is Flat affect?
little expressed emotion
Describe the server speech disruptions associated with schizophrenia?
• Cognitive slippage-incoherent or illogical speech
• Tangentiality-going off on a tangent • Loose associations or derailment
What was the Rosenham study?
"Being sane in insane places" Reported a noise saying empty, hollow, thud?
What is the genetic theory for schizophrenia?
Twin studies shows increased twin prevalence
Family studies show a family predisposition
Some evidence of physical features (notably enlarged cerebral ventricles)
(Gottesman) Children of two schizophrenic parents and identical twins of a schizophrenic at heightened risk
Adoption studies (Gottesman) show prevalence of schizophrenia 10 x higher in biological relatives and not in adoptive relatives.
Yet monozygotic twins do not have a 100% concordance, and thus other explanations, either penetrance, polygenic models or environmental factors must also play a part.
What are the weaknesses of the genetic model of schizophrenia?
Around 90% of schizophrenic persons do not have a schizophrenic parent (Goldstein, 1987). Only about 10 - 16% of high risk children develop schiz (Goldstein, 1987). High risk children do not necessarily develop schizophrenia, many children develop other types of
psychological disorders instead (Goldstein, 1987)
What is the biological model of schizophrenia?
dopamine hypothesis–associated with the observation of efficacy of dopamine

neurodevelopmental hypothesis
How does the theory of mind (Brune 2005) relate to schizophrenia?
Impaired

Disturbed capacity of relating own intentions to executing behaviour

Disturbed capacity to monitor others intentions
What are the psychoanalytical theories of schizophrenia?
Earlypsychodynamic theories described “schizophrenogenic” mother who was cold and aloof (no substantial evidence)

Problems - what about father? Do all cold and aloof mother’s children develop schizophrenia? (No)
What is the learning theory of schizophrenia?
There is good evidence that stressful life events, such as separation or bereavement, may trigger an episode of schizophrenia

Problems: Correlation not necessarily associated with causation. Mechanisms unknown.

Again not everyone who experiences these life events has schizophrenia.
What is the social learning theory of schizophrenia?
It has been proposed that families “cause” schizophrenia, yet little supportive evidence.

• However family relation ships and dynamics have been shown to play an important part in relapse and preventing further episodes.
What did Bateson, Jackson, Haley & Weakland, 1956 show?
communication pattern that they hypothesised could play a causal role in schizophrenia.

Double binds

Parents give simultaneous messages on more than one level (verbal, facial tone, gesture) which contradict each other -says one thing but acts differently
What are the social factors associated with schizophrenia? What is the problem with them?
Most consistent social factors associated with later onset of schizophrenia is marked social withdrawal and generally poor interpersonal relationships (Goldstein, 1987, Parnas, Schulsinger, Schulsinger, et al., 1982). These social difficulties become particularly noticeable during later childhood and adolescence.

Problem: Such social problems are seen with children who develop other psychological disorders as well. Not everyone with these problems develops schizophrenia
Whats the relationship between expressed emotion and schizophrenia?
Negative emotional climate or high degree of expressed emotion (EE)

The most consistent evidence is that EE modulates relapse (Falloon, 1988): A patient returned to a family with high EE is more likely (76%) to relapse, than low in EE (28%) (Brown, Monck, Carstairs & Wing, 1962; Brown, Birley & Wing, 1972).

The negative emotional climate (eg: hostility and criticism) raises the patient's arousal and stress beyond his or her already impaired coping mechanisms
What are the current ares of research in schizophrenia?
Current studies exploring a combination of communication deviance and issues about expressed emotion

Communication styles which are hostile, cynical, over-involved are associated with higher rate of relapse and re- hospitalisation for diagnosed schizophrenics
What is the criticism against the idea that communication difficulties cause schizophrenia?
Lack of research support to difficult to establish whether communication difficulties are a reaction or a cause
How does social class relate to schizophrenia? Explain this?
It has been noted to occur more commonly in lower social classes.

Explanation:
Socials election where by lower function leads to lower class
Stresses associated with lower class life leads to poor functioning
Evidence for both
How does gender relate to schizophrenia?
In general psychiatric diagnosis, ratio of adult women to men suffering from depression, anxiety and eating disorders range from 6:1 – 5:3. (Bebbington 1996, Ussher 2007)

Only exceptions are Schizophrenia (no clear gender difference) and alcoholism (men dominate).
How do illegal drugs relate to schizophrenia?
Drugs such as ecstasy, LSD speed and cocaine are known to mimic psychotic symptoms in some people

Cannabis has also caused psychotic episodes

Other drugs may trigger episodes