AQA A-Level Psychology: Schizophrenia

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Questions and Answers

Which of the following best illustrates a negative symptom of schizophrenia?

  • Expressing firm beliefs that one is being followed by government agencies despite a lack of evidence.
  • Displaying a marked reduction in speech quantity and content during conversations. (correct)
  • Exhibiting agitated movements and unpredictable behavior.
  • Experiencing vivid hallucinations of people who are not there.

A clinician consistently diagnoses patients with schizophrenia who present with similar symptoms. However, another clinician using a different diagnostic manual often arrives at a different conclusion for the same patients. This scenario primarily illustrates a problem with:

  • Criterion validity. (correct)
  • Co-morbidity.
  • Test-retest reliability.
  • Cultural bias.

In Gottesman's (1991) twin study on schizophrenia, the concordance rate was found to be 48% in monozygotic (MZ) twins. What is the MOST accurate conclusion that can be drawn?

  • MZ twins are no more likely to both have schizophrenia than DZ twins.
  • Schizophrenia is entirely determined by genetic factors.
  • Fraternal twins will always have a lower concordance rate than 48%.
  • Environmental factors play a significant role in the development of schizophrenia. (correct)

A researcher is investigating the dopamine hypothesis and administers a drug that increases dopamine levels in participants. According to the hypothesis, what outcome would be expected in individuals with schizophrenia?

<p>A worsening of positive symptoms such as delusions. (D)</p> Signup and view all the answers

MRI scans of patients with schizophrenia consistently reveal enlarged ventricles compared to healthy controls. What does this neural correlate suggest about the brain structure of individuals with schizophrenia?

<p>Brain tissue loss. (A)</p> Signup and view all the answers

What is the main problem with using only the dopamine hypothesis to explain schizophrenia?

<p>It does not account for other neurotransmitters that may be involved. (D)</p> Signup and view all the answers

What is the MOST significant implication of Rosenhan's (1973) study, 'Sane in Insane Places,' for the diagnosis of schizophrenia?

<p>It showed that diagnostic labels can significantly affect how individuals are perceived and treated. (D)</p> Signup and view all the answers

Why might cultural bias be a significant issue in the diagnosis of schizophrenia?

<p>Clinicians may misinterpret culturally normative behaviors as symptoms of schizophrenia. (D)</p> Signup and view all the answers

A patient is diagnosed with both schizophrenia and severe depression. This situation exemplifies which issue in the classification of schizophrenia?

<p>Co-morbidity (D)</p> Signup and view all the answers

Which of the following examples BEST illustrates disorganized speech, a positive symptom of schizophrenia?

<p>A person who frequently shifts topics in conversation in an incoherent manner. (A)</p> Signup and view all the answers

Longenecker et al. (2010) found that men are more often diagnosed with schizophrenia than women. What is the MOST likely reason for this finding?

<p>Clinicians may have gender biases that influence their diagnoses. (A)</p> Signup and view all the answers

A researcher aims to assess the test-retest reliability of a new diagnostic tool for schizophrenia. What procedure would BEST address this goal?

<p>Administering the tool to the same patients at two different points in time to see if the diagnoses are consistent. (B)</p> Signup and view all the answers

Ripke et al. (2014) identified 108 genetic variations linked to schizophrenia. What conclusion can be drawn from this research?

<p>There are a large number of genes that each contribute a small amount to the risk of developing schizophrenia. (C)</p> Signup and view all the answers

Curran et al. (2004) found that dopamine agonists worsen symptoms. How does this evidence support the dopamine hypothesis?

<p>It supports the idea that excessive dopamine activity is associated with schizophrenia. (D)</p> Signup and view all the answers

Lindstroem et al. (1999) found that schizophrenic patients produce more dopamine than controls. What is a limitation of this finding?

<p>The increased dopamine could be the effect rather than the cause. (A)</p> Signup and view all the answers

Flashcards

Hallucinations

Sensory experiences that occur without external stimuli, such as hearing voices or seeing things that aren't there.

Delusions

Strongly held false beliefs that persist despite contradictory evidence, such as paranoia or believing one is being persecuted.

Disorganized Speech

Disjointed and incoherent speech patterns, making it difficult to follow the speaker's train of thought.

Disorganized Behavior

Bizarre, unpredictable, or inappropriate movements and postures, that can manifest of unusual behaviour.

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Avolition

A lack of motivation and goal-directed behavior, making it difficult to start or complete tasks.

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Speech Poverty (Alogia)

Limited speech output and a lack of fluency in conversation.

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Affective Flattening

A lack of emotional expression, appearing as a flat or blunted affect.

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Anhedonia

A loss of pleasure in activities that are normally enjoyable.

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Test-retest reliability

The consistency of a diagnosis over time. A patient should receive the same diagnosis if assessed repeatedly.

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Inter-rater reliability

The extent to which different clinicians agree on a diagnosis when assessing the same patient.

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Criterion validity

Whether different diagnostic systems (e.g., DSM and ICD) lead to the same diagnosis for a patient.

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Co-morbidity

The co-occurrence of schizophrenia with other disorders, making classification difficult.

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Symptom Overlap

Symptoms of schizophrenia that also appear in other mental illnesses, affecting the accuracy of diagnosis.

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Cultural Bias in Diagnosis

The idea that diagnosis may be influenced by cultural factors or clinician bias.

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Gender Bias in Diagnosis

The idea that diagnosis may be influenced by gender-related factors or clinician bias.

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Study Notes

  • Schizophrenia is a severe mental disorder affecting thought, perception, emotion, and behavior.
  • The AQA A-Level Psychology specification addresses schizophrenia through classification, explanations, and treatments.

Classification of Schizophrenia

  • Schizophrenia symptoms are categorized as positive (excess/distorted functions) and negative (reduced functions).

Positive Symptoms

  • Involve excess or distortions of normal functions.
  • Hallucinations: Sensory experiences occurring without external stimuli.
  • Delusions: Strongly held false beliefs despite contradictory evidence.
  • Disorganized Speech: Incoherent or disjointed speech patterns.
  • Disorganized or Catatonic Behavior: Bizarre, unpredictable, or inappropriate movements and postures.

Negative Symptoms

  • Represent a reduction or loss of normal functions.
  • Avolition: Lack of motivation and goal-directed behavior.
  • Speech Poverty (Alogia): Limited speech output and lack of fluency.
  • Affective Flattening: Reduction in emotional expression.
  • Anhedonia: Loss of pleasure in normally enjoyable activities.

Issues in Diagnosis and Classification

Reliability

  • Refers to the consistency of a diagnosis.
  • Test-retest reliability: Diagnoses should be consistent over time.
  • Inter-rater reliability: Different clinicians should agree on the same diagnosis.
  • Cheniaux et al. (2009) found differing diagnoses by psychiatrists using DSM and ICD, which questions reliability.

Validity

  • Concerns whether a diagnosis is accurate.
  • Criterion validity: Different diagnostic systems should yield the same diagnosis, but they frequently do not.
  • Co-morbidity: Schizophrenia's co-occurrence with other disorders complicates classification.
  • Symptom Overlap: Overlapping symptoms with conditions like bipolar disorder affect diagnostic validity.
  • Rosenhan’s (1973) Study: The "Sane in insane places" study highlighted issues with psychiatric diagnosis validity.

Cultural Bias

  • Cochrane (1977) found higher rates of diagnosis among Afro-Caribbean individuals in the UK, potentially due to clinician bias.

Gender Bias

  • Longenecker et al. (2010) indicated that men are more frequently diagnosed with schizophrenia than women do, possibly due to variances in coping mechanisms.

Biological Explanations for Schizophrenia

Genetic Basis

  • Schizophrenia has a significant hereditary component supported by twin, family, and adoption studies.
  • Gottesman (1991) found 48% concordance in MZ twins versus 17% in DZ twins.
  • Ripke et al. (2014) identified 108 genetic variations linked to schizophrenia.
  • Strong empirical support exists from twin and family studies.
  • Concordance rates aren't 100%, so environmental factors likely contribute.
  • Separating nature and nurture effects is challenging, as twins often share environments.

Dopamine Hypothesis

  • Suggests excess dopamine activity causes schizophrenia, especially in areas linked to emotion and cognition.
  • Hyperdopaminergia in the Subcortex: High dopamine levels may cause hallucinations and speech disorganization.
  • Hypodopaminergia in the Cortex: Low dopamine in the prefrontal cortex is linked to negative symptoms.
  • Curran et al. (2004): Dopamine agonists worsen schizophrenia symptoms.
  • Lindstroem et al. (1999): Schizophrenic patients produce more dopamine than controls.
  • Drug studies support dopamine's role
  • Glutamate may also be involved, according to newer research
  • Dopamine imbalances might be an effect rather than a cause.

Neural Correlates

  • Links brain structure abnormalities to schizophrenia
  • Enlarged Ventricles: Enlarged ventricles in schizophrenia patients, as shown by MRI scans, indicate brain tissue loss.

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