SCHIZOPHRENIA
CHARACTERISTICS OF SCHIZOPHRENIA
hallucinations - sensory experiences that may involve seeing and hearing things that do not exist.
delusions - a set of beliefs with no basis in reality at all.
- persecutory : believe they are being followed
- grandiose : believe they have great talents or insights “i'm the chosen one”
- jealous : think they lover is unfaithful
- somatotype : think a body part is malfunctioning
- erotomanic : believes another is in love with them
catatonic behaviour - unusual behavioural and movement disturbance. The person may not react to things, remain rigid
and unmoving in awkward poses or repeat movements.
disorganised thoughts - thoughts that may be mixed up and racing. The person’s speech might be jumbled and
impossible to understand.
negative symptoms - a loss of normal functioning “switching off”.
Types of schizophrenia spectrum disorder:
→ schizotypal (personality) disorder – showing extreme coldness to others, difficulty building/maintaining relationships
→ delusional disorder – normal behaviour with persistent delusions
→ brief psychotic disorder – characterised by sudden and temporary periods of psychotic behaviour, such as delusions,
hallucinations, and confusion. Symptoms can last as little as a day or as long as a month
→ schizoaffective disorder – a combination of schizophrenia symptoms, such as hallucinations or delusions, and mood
disorder symptoms, such as depression or mania.
→ substance/medication-induced – psyc disorder resulting from heavy and long use of alcohol/drugs over many years
→ psychotic disorder due to another medical condition
→ catatonia associated with another mental disorder or condition
SYMPTOM ASSESSMENT USING VIRTUAL REALITY (FREEMAN)
The use of VR could assess how a patient behaves in certain situations, particularly when misinterpreting other people’s
behaviour, and then a treatment can be applied. The VR program is a 5-minute ride on the London underground where
people could ‘check each other out’. In later trials the VR showed those who had hallucinations also experienced them in
the trials, suggesting that VR does help identify symptoms of schizophrenia and related disorders.
strengths weaknesses
- used in a safe environment for patient and public - side effects (dizziness, nausea and headaches)
- shows how patients with schizophrenia actually behave - VR is only as good as the programmer’s ability to write
rather than having them to describe their behaviour (which and appropriate programme
may not be truthful)
- sample was not clinical so may not be applicable to the
- a wide range of situations can be created which can be clinical population which reduces validity of research.
tailored to needs of individual patient
- culture bias as the VR programme is based on western
- higher ecological validity as it was based on real life cultures (travel on London underground)
situations
In order to receive a diagnosis of delusional disorder, the individual must have been experiencing symptoms for one month
or longer. The DSM-5 states that symptoms should be unrelated to physiological effects of substance use, and are not
better explained by another psychological or medical disorder.
, EXPLANATIONS OF SCHIZOPHRENIA
GENETIC (gottesman & shields) - suggests schizophrenia is inherited and results from a biological process driven by the
activity of certain genes, such as for brain structure development and neurotransmitter levels.
There is no one “schizophrenia gene”, however a collection of gene locations have been located that are associated with a
higher risk of developing schizophrenia. This means schizophrenia is thought to be a polygenetic disorder. If schizophrenia
is genetic we’d expect to see the more closely related two people are, if one person has the disorder the more likely the
other person is to have the disorder (concordance rate).
TWIN STUDY (GOTTESMAN & SHIELDS)
Aim was to compare concordance rates in MZ twins and DZ twins by examining 57 pairs of twins (24 MZ, 33 DZ).
→ Gottesman found a concordance rate of 50% for MZ twins and concordance rate of 9% for DZ twins.
→ Concordance was stronger for female twins than male twins and also stronger with more severe schizophrenia.
The MZ concordance rate was significantly lower than 100%. This means that, despite their shared genotype, MZ twins do
not always share schizophrenic symptoms. This suggests genetics is not the only cause of schizophrenia. Genes may
predispose a person towards schizophrenia, but there needs to be an environmental trigger.
strengths weaknesses
- high generalisability as it covers a range of ages, from - reductionist (only takes into account genes) and
teenagers to men and women in their 60s and there’s a deterministic
50/50 mix.
- the procedures are not reliable. Without DNA testing,
- replicating a twin study design carried out by 11 previous assigning zygosity by physical resemblance and
small-scale studies demonstrates reliability. fingerprints is not accurate.
- applications for families with a history of schizophrenia. - hard for them to understand and agree to the research so
no informed consent.
- informed consent as they’re adults
COGNITIVE (frith) - recognises that biological factors contribute in some way to the positive symptoms of schizophrenia.
Frith views schizophrenia as impared self-monitoring. Patients suffering from schizophrenia feel dispossessed from some of
their actions and thoughts due to ‘faulty mental processes’. This reduces the ability to reflect upon thoughts, behaviours and
feelings and affects our sense of awareness. Frith calls this ‘mentalising impairment’ (the ability to attribute mental states
such as thoughts, beliefs and intentions to people).
“schizophrenia is an abnormality of self monitoring”
hallucinations : when patients fail to recognise that hallucinations are just inner speech it leads them to attribute what they
are hearing is from someone else.
delusional thinking : a misinterpretation of perception due to an impared theory of mind which creates problems in
recognising intentions of others leading to social withdrawal, flattening effect etc. Thoughts that are actually self-generated
appear to be coming from an external source, and become incorporated in the individual’s set of beliefs.
lack of action : those that lack action have difficulty generating spontaneous actions, they are better at reacting to external
stimuli to produce a response.
, Cognitive explanation of schizophrenia (frith)
→ tested by asking patients with sz whether items had been read out by patients themselves, experimenters or a computer.
strengths weaknesses
Practical applications - understanding effects of cognitive Does not explain the cause of cognitive deficits and where
deficits has allowed psychologists to initiate new they come from in the first place.
treatments + improve the quality of lives for those with sz
Reductionist: provides an overly simplistic explanation of
Law of parsimony: though there is evidence that this theory sz as to having cognitive deficits.
is too simple according to this law the simpler a theory is
the more likely it is to be correct.
Deterministic: sz is due to faulty thought processing which
Nurture : takes into account past experiences and other may not give the patient free will to act to a situation
environmental factors to explain sz. Nature as it takes into (actions determined by faulty thought processing).
account biological factors.
BIOCHEMICAL (lindström) - brains of schizophrenics produce more dopamine.
Dopamine (neurotransmitter) is a chemical substance that enables communication
between two neurons. In order to allow the nerve impulse to pass between two
cells, it moves across the synapse (a small junction).
If the amount of dopamine is higher than usual, brain areas that “run” on dopamine
may become overactive, causing hallucinations and delusions, etc.
DRUGS PET SCAN
Amphetamines and cocaine increase the level of PET scans use gamma cameras to detect radioactive
dopamine. Large increase in dopamine production is tracers such as glucose which is injected into the blood.
correlated with an increase in the reporting of The traces accumulate in areas of high activity during the
hallucinations and delusions. scan, allowing them to become visible for analysis.
In those with schizophrenia, the effect of these drugs Scan analysis indicates excessive dopamine activity is
worsen their positive symptoms. linked with positive symptoms.
PARKINSONS POST MORTEM STUDIES
It’s treated with a synthetic form of dopamine (L-dopa). If Autopsies can find the number of dopamine receptors in a
their dosage is too high, it creates symptoms identical to person’s brain.
those in people with schizophrenia, like hallucinations.
A person with schizophrenia will have a larger number of
It supports the dopamine hypothesis as an increased dopamine receptors and excessive quantities of enzymes
amount of dopamine causes schizophrenic symptoms. in the brain fluid.
strengths weaknesses
- shows evidence so increased validity and reliability - reductionist
- deterministic
TREATMENT AND MANAGEMENT OF SCHIZOPHRENIA
ELECTRO-CONVULSIVE THERAPY - passing electricity through the brain with the intention of inducing a seizure; the seizure is the
‘treatment’ rather than the electricity.
1) Patients are given muscle relaxants. 2) Electricity applied bilaterally or unilaterally. 3) Patient convulses/has a seizure. 4)
Patient is unconscious, then wakes and recovers. 5) Applied once or twice a week for several weeks (6-12 sessions).
Immediate side effects that may last for an hour are headaches, nausea, muscle ache and soreness, disorientation and
confusion. To reduce memory loss, instead of applying ECT bilaterally (across both brain hemispheres), it is now applied
unilaterally to the non-dominant hemisphere.
CHARACTERISTICS OF SCHIZOPHRENIA
hallucinations - sensory experiences that may involve seeing and hearing things that do not exist.
delusions - a set of beliefs with no basis in reality at all.
- persecutory : believe they are being followed
- grandiose : believe they have great talents or insights “i'm the chosen one”
- jealous : think they lover is unfaithful
- somatotype : think a body part is malfunctioning
- erotomanic : believes another is in love with them
catatonic behaviour - unusual behavioural and movement disturbance. The person may not react to things, remain rigid
and unmoving in awkward poses or repeat movements.
disorganised thoughts - thoughts that may be mixed up and racing. The person’s speech might be jumbled and
impossible to understand.
negative symptoms - a loss of normal functioning “switching off”.
Types of schizophrenia spectrum disorder:
→ schizotypal (personality) disorder – showing extreme coldness to others, difficulty building/maintaining relationships
→ delusional disorder – normal behaviour with persistent delusions
→ brief psychotic disorder – characterised by sudden and temporary periods of psychotic behaviour, such as delusions,
hallucinations, and confusion. Symptoms can last as little as a day or as long as a month
→ schizoaffective disorder – a combination of schizophrenia symptoms, such as hallucinations or delusions, and mood
disorder symptoms, such as depression or mania.
→ substance/medication-induced – psyc disorder resulting from heavy and long use of alcohol/drugs over many years
→ psychotic disorder due to another medical condition
→ catatonia associated with another mental disorder or condition
SYMPTOM ASSESSMENT USING VIRTUAL REALITY (FREEMAN)
The use of VR could assess how a patient behaves in certain situations, particularly when misinterpreting other people’s
behaviour, and then a treatment can be applied. The VR program is a 5-minute ride on the London underground where
people could ‘check each other out’. In later trials the VR showed those who had hallucinations also experienced them in
the trials, suggesting that VR does help identify symptoms of schizophrenia and related disorders.
strengths weaknesses
- used in a safe environment for patient and public - side effects (dizziness, nausea and headaches)
- shows how patients with schizophrenia actually behave - VR is only as good as the programmer’s ability to write
rather than having them to describe their behaviour (which and appropriate programme
may not be truthful)
- sample was not clinical so may not be applicable to the
- a wide range of situations can be created which can be clinical population which reduces validity of research.
tailored to needs of individual patient
- culture bias as the VR programme is based on western
- higher ecological validity as it was based on real life cultures (travel on London underground)
situations
In order to receive a diagnosis of delusional disorder, the individual must have been experiencing symptoms for one month
or longer. The DSM-5 states that symptoms should be unrelated to physiological effects of substance use, and are not
better explained by another psychological or medical disorder.
, EXPLANATIONS OF SCHIZOPHRENIA
GENETIC (gottesman & shields) - suggests schizophrenia is inherited and results from a biological process driven by the
activity of certain genes, such as for brain structure development and neurotransmitter levels.
There is no one “schizophrenia gene”, however a collection of gene locations have been located that are associated with a
higher risk of developing schizophrenia. This means schizophrenia is thought to be a polygenetic disorder. If schizophrenia
is genetic we’d expect to see the more closely related two people are, if one person has the disorder the more likely the
other person is to have the disorder (concordance rate).
TWIN STUDY (GOTTESMAN & SHIELDS)
Aim was to compare concordance rates in MZ twins and DZ twins by examining 57 pairs of twins (24 MZ, 33 DZ).
→ Gottesman found a concordance rate of 50% for MZ twins and concordance rate of 9% for DZ twins.
→ Concordance was stronger for female twins than male twins and also stronger with more severe schizophrenia.
The MZ concordance rate was significantly lower than 100%. This means that, despite their shared genotype, MZ twins do
not always share schizophrenic symptoms. This suggests genetics is not the only cause of schizophrenia. Genes may
predispose a person towards schizophrenia, but there needs to be an environmental trigger.
strengths weaknesses
- high generalisability as it covers a range of ages, from - reductionist (only takes into account genes) and
teenagers to men and women in their 60s and there’s a deterministic
50/50 mix.
- the procedures are not reliable. Without DNA testing,
- replicating a twin study design carried out by 11 previous assigning zygosity by physical resemblance and
small-scale studies demonstrates reliability. fingerprints is not accurate.
- applications for families with a history of schizophrenia. - hard for them to understand and agree to the research so
no informed consent.
- informed consent as they’re adults
COGNITIVE (frith) - recognises that biological factors contribute in some way to the positive symptoms of schizophrenia.
Frith views schizophrenia as impared self-monitoring. Patients suffering from schizophrenia feel dispossessed from some of
their actions and thoughts due to ‘faulty mental processes’. This reduces the ability to reflect upon thoughts, behaviours and
feelings and affects our sense of awareness. Frith calls this ‘mentalising impairment’ (the ability to attribute mental states
such as thoughts, beliefs and intentions to people).
“schizophrenia is an abnormality of self monitoring”
hallucinations : when patients fail to recognise that hallucinations are just inner speech it leads them to attribute what they
are hearing is from someone else.
delusional thinking : a misinterpretation of perception due to an impared theory of mind which creates problems in
recognising intentions of others leading to social withdrawal, flattening effect etc. Thoughts that are actually self-generated
appear to be coming from an external source, and become incorporated in the individual’s set of beliefs.
lack of action : those that lack action have difficulty generating spontaneous actions, they are better at reacting to external
stimuli to produce a response.
, Cognitive explanation of schizophrenia (frith)
→ tested by asking patients with sz whether items had been read out by patients themselves, experimenters or a computer.
strengths weaknesses
Practical applications - understanding effects of cognitive Does not explain the cause of cognitive deficits and where
deficits has allowed psychologists to initiate new they come from in the first place.
treatments + improve the quality of lives for those with sz
Reductionist: provides an overly simplistic explanation of
Law of parsimony: though there is evidence that this theory sz as to having cognitive deficits.
is too simple according to this law the simpler a theory is
the more likely it is to be correct.
Deterministic: sz is due to faulty thought processing which
Nurture : takes into account past experiences and other may not give the patient free will to act to a situation
environmental factors to explain sz. Nature as it takes into (actions determined by faulty thought processing).
account biological factors.
BIOCHEMICAL (lindström) - brains of schizophrenics produce more dopamine.
Dopamine (neurotransmitter) is a chemical substance that enables communication
between two neurons. In order to allow the nerve impulse to pass between two
cells, it moves across the synapse (a small junction).
If the amount of dopamine is higher than usual, brain areas that “run” on dopamine
may become overactive, causing hallucinations and delusions, etc.
DRUGS PET SCAN
Amphetamines and cocaine increase the level of PET scans use gamma cameras to detect radioactive
dopamine. Large increase in dopamine production is tracers such as glucose which is injected into the blood.
correlated with an increase in the reporting of The traces accumulate in areas of high activity during the
hallucinations and delusions. scan, allowing them to become visible for analysis.
In those with schizophrenia, the effect of these drugs Scan analysis indicates excessive dopamine activity is
worsen their positive symptoms. linked with positive symptoms.
PARKINSONS POST MORTEM STUDIES
It’s treated with a synthetic form of dopamine (L-dopa). If Autopsies can find the number of dopamine receptors in a
their dosage is too high, it creates symptoms identical to person’s brain.
those in people with schizophrenia, like hallucinations.
A person with schizophrenia will have a larger number of
It supports the dopamine hypothesis as an increased dopamine receptors and excessive quantities of enzymes
amount of dopamine causes schizophrenic symptoms. in the brain fluid.
strengths weaknesses
- shows evidence so increased validity and reliability - reductionist
- deterministic
TREATMENT AND MANAGEMENT OF SCHIZOPHRENIA
ELECTRO-CONVULSIVE THERAPY - passing electricity through the brain with the intention of inducing a seizure; the seizure is the
‘treatment’ rather than the electricity.
1) Patients are given muscle relaxants. 2) Electricity applied bilaterally or unilaterally. 3) Patient convulses/has a seizure. 4)
Patient is unconscious, then wakes and recovers. 5) Applied once or twice a week for several weeks (6-12 sessions).
Immediate side effects that may last for an hour are headaches, nausea, muscle ache and soreness, disorientation and
confusion. To reduce memory loss, instead of applying ECT bilaterally (across both brain hemispheres), it is now applied
unilaterally to the non-dominant hemisphere.
