Schizophrenia

1. Positive

   Annotations:

   • -Can be affected by cultural differences -Tend to have greater weight when diagnosing  -Hard to measure objectivly
   1. Dellusions

      Annotations:

      • Irrational ideas usually regarding ones self, these are unreal unseen things
   2. Hallucinations

      Annotations:

      • Sensory Deceptions
2. Catatonic
   1. Waxy Flexibility

      Annotations:

      • a patient can be moved into positions and will remain in that position for a long period of time
   2. Catatonia

      Annotations:

      • The repetition of certain movements or guestures in in complex sequences in in simple actins
3. Negative

   Annotations:

   • -Start before the positive ones  -Sometimes start years before diagnosis  -Less affected by cultural differences  -More objectivaly measured
   1. Avolition

      Annotations:

      • Lack of energy or interest in anything-inability to persist
   2. Flat effect

      Annotations:

      • where virtualy no stimmulus evokes an emotional response
   3. Alogia

      Annotations:

      • Negative thought disorder, the inability to convey information properly through speech 
   4. Asociality

      Annotations:

      • Inparement in creating social relationships or social withdrawl
   5. Anhedonia

      Annotations:

      • the inability to experience pleasure 
   6. Grandiose Delusions

      Annotations:

      • When the patient harbors exagorated ideas of their on importance
   7. Ideas of Reference

      Annotations:

      • Constructing a framework of unimportant facts and adding a personal importance
4. Disorganisation
   1. Disorganised speech

      Annotations:

      • Incohearant or loose association of ideas in speech

1. Psychosis

   1. Annotations:

      • Mental health issues where the individuals has lost touch with reality and is not on a continuum with normal mental health
2. Neurosis

   1. Annotations:

      • Mental health issues that fall just outside normal functioning but the individual is in touch with reality and knows that they are sick

1. Dopamine Hypothisis

   Annotations:

   • The brains of schizophrenic patients are more inclined to having more dopamine or having more sensitive receptors to it creating schizophrenic symptoms. 
   1. Roles of Drugs

      Annotations:

      • -Amphetamines and cocaine (agonists) can produce a state that closely resembles paranoid schizophrenia  -Amphetamines increase the level of dopamine in the brain  -If these drugs are given to schizophrenic patients their conditions worsen.
      1. Parkinsons

         Annotations:

         • Cholopromazine (anti-psychotic drug used to treat schizophrenia) reduces the symptoms by blocking the D2 receptors in the brain but also produces side effects resembling symptoms of parkinsons disease. 
   2. Post mordem Evidence

      Annotations:

      • -Autopsies have found that people with schizophrenia have up to 6 times the number of dopamine receptor sites than normal.  -Excess of dopamine receptor sites is functionally the same as having excess levels of dopamine. 
   3. PET scans

      Annotations:

      • -Radioactivity label a chemical called L-dopa -L-dopa taken up quicker with schizophrenic patients  -Suggests they have more  DA receptor sites or that their receptors are hyper sensative. 
   4. Evaluation Points

      Annotations:

      • -It takes seveal weeks for anti-psychotics to lessen the positive symptoms though they begin blocking dopamine receptors immediately.  -It could be that the development of receptors is one part of the brain that may inhibit  the development of another.  -Drugs such chlorpomazine; Only effective at reveiling the positive symptoms of the illness -Not good at explaining the negative symptoms. Therefore suggested that a different type of abnormality such as a brain structure may be implicated  -Chloropomazine makes little to no difference in 30% of patients -There may be other neurotransmitters involved  -Possible that social end enviromental factors trigger the conditions

Annotations:

• Faulty mental proccesing of information-inappropriate perceptions of one self 

1. Cognitive veiw

   Annotations:

   • -Disturbed thinking procceses are the cause rather than the consequences of schizophrenia  -Cognitive psychologists believe that the are almost certainly physiological abnormalities associated with schizophrenia and that lead to cognitive malfunctioning   -Agrees with Biological view that during hallucinations the brains of people with schizophrenia are producing strange and unreal sensations (triggered biologically) 
2. Rational path to madness (Zimbardo 76)

   Annotations:

   • -Schizophrenic patients are turning to family and friends with sensory details  -Friends and Family deny these details  -Patients conclude that family and friends are somehow involved in this and are denying the truth from them  -Evolves into the suffurer rejecting all feedback from the family and friends and feel they are being prosecuted.
3. Cognitive malfunctions

   Annotations:

   • - In a normal there is a mechanism that filters incoming stimuli  -In a schizophrenic brain the mechanism malfunctions and lets in too much stimuli        - Connot focus       - Unable to interpret information correctly        - World is very different  -Most dramatic distortions of perception are hallucinations       - More often auditory (74%)  than visual       - Can be very frightening       
4. The Brain and Schizophrenia
   1. PET scans

      Annotations:

      • Preforntal cortex play a role in speech decision-making and willing action, which are disturbed by schizophrenia.  - Patient is injectected with glucose containing tiny radioactive tracer  -Areas of the brain most active use up the glucose  -Positrons are emitted and are picked up by the scanner -Color 3D 
      1. Firths Model

         Annotations:

         • -Attempts to explain the onset and maintenance of positive symptoms-verbal hallucinations  -People are unable to distinguish between actions that are brought about by external forces and those that are generated from internal thoughts  - a basic failure in self monitoring processes 
         1. Firths Model of Psychosis

            Annotations:

            •  Most symptoms can be explained in terms of 3 cognitive processes.    -Inability to generate willed action -Inability to monitor beliefs and intentions of others  -Inability to monitor willed action   These three processes are all part of a general mechanism  (called mental representation) that allows us to be aware of our goals and our intentions and to understand the beliefs and intentions of others   Faulty operation of this mechanism is due to functional disconnection between frontal areas of the brain concerned with action and more posterior areas of the brain that control perception.    PET scanning is a type of functional  imaging in which glucose metabolism is studied in various brain regions while patients preform cognitive tests.  -Test place demands on the prefrontal cortex so glucose metabolism goes up.  -Firths detected low activation of the PC in schizophrenic patients who also preformed on the cognitive tests. 
         2. Evaluation

            Annotations:

            • -Unable to explain cause of schizophrenia (relies on biological for explaination) -Too deterministic (not all cognitive impairments lead to mental disorders eg:car accidents damage  -Too reductionist  -Can explain development of delusions as we can from biases that affect how can see the world  -Although reasearch is still in infancy  it has been found that some cognitive impairments are genetically linked but there is not enough research to to implicate schizophrenia, therefore difficult to generalise and assess validity

1. Gottensman & Sheilds

   Annotations:

   •                                Twin Study  Procedure -Examined records of 57 schizophenias -40% were determined to be MZ, 60% were DZ -If pair were discordant for schizophrenia, the non-schizophrenic was followed for 13 years to see if it developed later.                                   Results -Concordance rates:  MZ-42% DZ-9%                         What does this suggest?   -There is a genetic link for schizophrenia -Schizophrenia is not entirely genetic since the concordance rate would have to be 100% 
2. Evaluation

   Annotations:

   • -Role of enviromental factors: MZ twins are more likely to live in similar conditions, be treated similarly, and have similar experiences  -Prior to the 1980's it was difficult to distinguish MZ and DZ twin pairs-The greater similarity of identical twins may be the cause of more similar parenting -Shows more genetic link but it fails to give any other explainations for schizophrenia, or whether there are different types of schizophrenia. 

1. Cognitive Behaivoral Therapy

   Annotations:

   • CBT is a hands on hospitalised thearopy in which psychiatrists idetify flast effects and work with the patients to combat this though the use of thins such as muscle relaxation therapy and reattrobution therapy.
2. Behaivoural Therapy

   Annotations:

   • Behaivoural Therapy is based on operant conditioning-learning through reinforcement.  This is done through the reinforcement of rewards in a token economy  in which patients are rewarded for normal functioning.    Paul and Lentz study incorparated this. 

1. Antipsychotic Drugs
   1. Typical

      Annotations:

      • Antipsychotics- newer generation of antipsychotics.
   2. Atypical

      Annotations:

      • Antipsychotics-the first generation of antipsychotics 
2. Electro Convulsive Therapy

   Annotations:

   • ECT works by sending electrical impuleses into the rain triggering miniature seizures in which  a rush of chemical impulses temporarilty alter functions ECT is not considered a first line treatment but may be perscribed in cases of  where other treatments have failed, It is only measurably effective where symptoms of catatonia are present and in terms of treatmentt for drug resistant catatonic schizophrenia