positive symptoms, negative symptoms

hallucinations, delusions

It is an unusual sensory experience. They may be related to the environment. The passing is in E.G seeing facial distortions of the person you are talking to or they may also have nothing to do with the environment at all E.G hearing a voice that belittles and criticises you

They are a rational beliefs, commonly some people may believe they are our famous figure E.G Jesus or Napoleon. it may also focus around being persecuted or controlled E.G the government or aliens.

Speech poverty, apathy

speech can often become disorganised and delayed

people with schizophrenia often struggle with motivation for daily tasks e.g hygiene and work performance

ICD 10, DSM V

need to have two or more negative symptoms for the diagnosis

it requires at least one of the main positive symptoms to be present for the diagnosis

has good reliability, strength of our understanding of diagnosis of schizophrenia is the consistency. A psychiatric diagnosis is seen as reliable when more than one clinican makes the same diagnosis using the same model. Osorio et al (2019) reports high reliability of diagnosis using the DSM V.

Cultural bias, Copeland Found that there was Is low reliability in the agreement between the different countries in their diagnosis. when psychiatrists In the US and England were given the same description of a patient 69% of the US psychiatrists diagnosed schizophrenia, whereas only 2% of English psychiatrists Gave that diagnosis, symptom, overlap limitation with the diagnosis is for example, bipolar disorder and schizophrenia there are delusions during the manic episodes and abolition In the major depressive episodes. Therefore the same patient could be diagnosed with schizophrenia according to the ICD classification system but with bipolar disorder with the DSM 5 which questions? The validity of the diagnosis and whether these two disorders are actually the same disorder?, gender bias According to McGrath et al 2004 men are 1.4 more likely to be diagnosed with schizophrenia than women. This could be due to men having a greater genetic vulnerability to schizophrenia but it could also be due to gender bias in the diagnosis. Women might be able to function better than men because they have better relationship relationships with family and friends than men do. They might be more willing to ask and receive support from their social network, which might the severity of the symptoms therefore leading to under diagnosis of the disorder in women, comorbidity maybe a singular condition. Buckley found that half of schizophrenics have depression/substance abuse. 29% PTSD/23% OCD, Cultural bias African-American/English Caribbean people are seven times more likely to be diagnosed with schizophrenia. Hearing voices more acceptable/white psychiatrist Distressed and overdiagnosed

The genetic theory does not suggest that schizophrenia is a single gene but a polygenic whether there’s a number of jeans which are responsible for the disorder. twin studies MZ twins are predominantly used as they share 100% of the same genes which makes it more reliable when establishing whether there is a link with genetics

He argues that the closer The genetic relationship you are with someone who has schizophrenia the greater chance that the family members will also be diagnosed with the condition. if a family member like a brother or sister has the diagnosis there’s a 9% their sibling would also be diagnosed with it. if one DZ twin that shares 50% of their jeans, there are 17% of the other twin will be diagnosed with schizophrenia. F1 twin which share 100% of their genes has schizophrenia. There is a 48% the other twin will be diagnosed with schizophrenia.

with studies which use a Longitudinal design and following participants forward is that the diagnosis criteria for schizophrenia changes over time. As a consequence it is difficult to compare the same symptoms in parents and their offspring which Can distort the coordinates rates this week the validity of the study as we cannot be sure that accurate comparisons Has been made this limiting the support for the biological explanation

Hyperdopaminergia in the sub-cortex is the dopamine hypothesis. It states that there are high levels of dopamine active in the central areas of the brain E.g expressive levels of dopamine in the Broca’s area which is responsible for speech can explain poverty of speech., Hyperdopaminergia in the cortex is the reversed version and states that there are low levels of dopamine activity in the brains cortex. low levels of dopamine in the prefrontal cortex areas involving thinking and decision-making can explain negative symptoms

Patterns of structure or activity in the brain that occurs in concurrence with an experience (Schizophrenia)

abolition in the loss of motivation the ventral striatum is believed to control this function. Studies have shown and negative correlation with activity levels in the ventral striatum and motivation

PET scans have shown patience experience auditory hallucinations are linked with low activation levels in the temporal lobe

next evidence for the dopamine hypothesis. Yes, dopamine agonists like amphetamines Warsen schizophrenia and cause schizophrenia like symptoms in non-schizophrenic suffers. Antipsychotics reduce levels of dopamine. No Ripke found genes coding for other neurotransmitters like glutamate , The correlation/causation issue. Low levels of activity in VS assume to cause abolition. or Symptoms cause less information to travel to VS. A third Factor could affect both the VS symptoms, Neural correlates Nothing about the origins of the disorder, evidence for genetics acceptability. Gottesman’s Research. Tienari Found children from schizophrenic parents adopted by non-schizophrenic families are still at an increased risk of developing it Meaning that is genetic vulnerability. Ripke’s genome Study shows genetics are involved

They are mothers causing schizophrenia. The messages are called rejecting and controlling and create a family climate of Tension. This leads to distressed and paranoid delusions and schizophrenia.

Bateson et al says places that child in an impossible situation where they can’t act without someway going against their parents apparent requests. this causes internal conflict which can’t be resolved by any cause of action resulting in the individual seeing the world as dangerous and confusing and this gives a rise to symptoms such as distorted thinking and paranoia. Schizophrenic symptoms are the result of an attempt to resolve the impossible situation which the person has been placed.

this expression focuses on the quality of interaction patterns and the nature of the families relationship among the family of the schizophrenic patient. The expressed emotion is considered to be an unhelpful family environment particularly if emotions are expressed on - E.G hostility criticism and rejection, but also involvement and concern. these factors are a source of stress for the individual that can trigger schizophrenia in a person who is predisposed by the genetic make-up. High expressed emotion has also been found to be associated with relapse in schizophrenia patients.

Metarepresentation - ability to reflect on our own thoughts and behaviour. Known as our intentions and goals and the action of others. dysfunction leads to hallucinations and delusions e.g insertion, Central control - suppressing automatic thoughts and doing what’s deliberate. Dysfunction equals disorganised thoughts/speech.

Poor evidence for family based explanations. Weak evidence for the schizophrenogenic mother and double blind theory. Early researchers had locked for crazy making characteristics. Has historically led to parent blaming 1980s shift from hospital care to communal care equals researchers Oversimplified, Strong evidence for family dysfunction as our risk factor, research found that insecure attached children more likely to develop schizophrenia. Read et al Locked at 46 studies. 69% of females had sexual/physical abuse males had 59%. Tienari stresses The genetic Basis adopted children of schizophrenic still had a heightened risk, supporting evidence for cognitive factors. Sterling Made participants do stroop test. 30 schizophrenics and 18 confederates schizophrenic two times longer to do the test. Plus this dysfunctional information processing is affected by the cause and effect conflict.

Typical antipsychotics, atypical antipsychotics

they work by acting as antagonists in the dopamine system and aim to reduce the action of dopamine- they are strongly associated with the dopamine hypothesis. dopamine antagonists works by blocking dopamine receptors in the synapse in the brain reducing the action of dopamine. test the normalises neurotransmitters in key areas of the brain which helps reduces symptoms like hallucinations

The aim of these drugs was to improve effectiveness of drugs in suppressing psychoses such as schizophrenia and also minimise the side-effects. they typically target a range of neurotransmitters, including dopamine and serotonin. this drug was more effective than typical antipsychotics as it reduces depression and anxiety impatience as well as improving cognitive functioning. It also improves mood which is important as up to 50% of people suffering from schizophrenia attempts suicide

as strength of using antipsychotics is the moderate support that their effectiveness. Thornley et al Who locked at studies into chlorpromazine Compared to placebos. He found that in 13 trials with 1121 Participants better overall functioning using chlorpromazine And reduced symptoms severity. The data also suggests relapse rate is lower among those taking chlorpromazine, A weakness of drug treatment is the presence of serious side-effects. Antipsychotics may cause weight gain fatigue itchiness and dizziness. Long time uses can lead to tardive dyskinesia Involuntary facial movements. NMS Is also a condition that can Caused comas or be fatal. Closely regulated the small risk could be a deterrent for many patients., A further weakness of the biological treatment is that it is heavily reliant on explanations from the dopamine hypothesis which is problematic as it is itself contradictory. It is believed that Hyperdopaminergia occurs in the subcortex. however, in other areas it is too low rather than too high. Antipsychotics are dopamine antagonists So it doesn’t explain how it works

Family therapy, Cognitive behavioural therapy, Token economies

It aims to reduce levels of EE. as the therapy is with the families rather than the individual patients aiming to improve communication and interaction in the family. Family therapies try to reduce stress within the family that may contribute to the risk of the patients relapsing, Pharoah et al help anticipate and solve problems. Reduce the stress of caring for the person. Reduce the anger and guilt. Form therapeutic alliances. Aim to reduce hospital readmissions and relapse

helps participants identify irrational thoughts like delusions and hallucinations and challenges them through argument or discussion. , Turkington provided an example of a person thinking the mafia is following them. “ it’s a possibility but there are other explanations. Why do you think this?”

It aims to change maladaptive behaviours developed from living in a hospital for a long time, tokens are given to participants as a form of reinforcement for desirable behaviour E.G brushing hair they are secondary reinforces a primary reinforcer would be the end prize or goal you get from collecting these tokens

there is supportive evidence for these therapies in only moderate. Jauhar locked at 34 studies on CBT and found a small but significant decrease in symptoms. Pharoah noted that despite results being inconsistent found decreased Hospital resubmission. A review of three studies with 100 patients found only one where participants showed symptom improvement. Non-noted about significant behavioural changes, Another problem of these therapies is that they do not actually treat schizophrenia they help a person cope with their symptoms. Cognitive behavioural therapy helps. Participants makes sense of their irrational thoughts and develop healthier ways of thinking. Token economies help a person to reintegrate into society and family therapies make communication better between members of the family. The failure to cause schizophrenia is a weakness of it as a treatment., token economies have ethical issues associated with them. It may mean that Schizophrenic who have moulder symptoms while those were severe symptoms are restricted such as privileges this has led to families of participants taking legal action. Also CBT may also have ethical issues as it may lead to alternating a persons freedom of thoughts and beliefs. Has limited their use as treatment in psychiatric system

It looks at biological psychological and societal factors that could cause schizophrenia

it says that both vulnerability and a stress trigger are needed to develop schizophrenia

Believe that the vulnerability Was entirely genetic caused by a Single schizogene Which led to schizotypic personality characterised by a high variability to stress. He believed stress was always rooted in the family E.G schizophrenogenic mother

diathesis can also be caused by childhood trauma as well as being genetic. Child abuse can affect the HPA making someone more vulnerable to stress. No singular schizogene (Ripke found 108 different genetic variations) not always from family E.G cannabis users due to its interference with brains dopamine system

There is evidence by Tienari On the role of vulnerability and triggers. Adopted children of 19,000 Finnish mothers With schizophrenia. Controlled group with no genetic risk. Child rearing styles of high conflict was only a vulnerability to the schizophrenia Group but not the Controls. genetically vulnerable children are more susceptible to environmental stress triggers. Supports the role of biological (Vulnerability) And family dysfunction(Stress), The original diathesis stress model by Meehl Is too simplistic. Not just parenting style/no single schizogene (Ripke). Vulnerability can also be caused by early trauma as well as genes. Houston found sexual trauma was a vulnerability factor. Overly simple should be overcome with New models, Support for the effectiveness of combinations by Tarrier. participants randomly allocated to ⚫️medication and CBT ⚫️medication and supportive counselling ⚫️medication only Low symptom levels in combination and decreased readmission rates. practical advantage of Interactionism due to the superior treatment options