Genetic Explanations of Schizophrenia

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Questions and Answers

What do family studies suggest about the development of schizophrenia?

  • Genetic relatedness has no impact on risk.
  • More distant relatives have a higher likelihood of developing the disorder.
  • Schizophrenia is solely caused by environmental factors.
  • Closer genetic relationships increase the likelihood of developing schizophrenia. (correct)

What was the concordance rate for dizygotic twins in Gottesman & Shields' study?

  • 42%
  • 9% (correct)
  • 79%
  • 15%

Which type of study allows researchers to separate genetic influence from environmental influence?

  • Adoption studies (correct)
  • Family studies
  • Twin studies
  • Genetic linkage studies

What did Hilker et al. conclude about heritability in their twin study?

<p>Heritability of schizophrenia was 79%. (D)</p> Signup and view all the answers

In the context of genetic linkage, how is schizophrenia categorized?

<p>Polygenic disorder (C)</p> Signup and view all the answers

What percentage of adoptees with a biological mother who has schizophrenia develop the disorder?

<p>6.7% (B)</p> Signup and view all the answers

What impact do problems during cell division have in relation to schizophrenia?

<p>They might lead to a printing error in the genetic information. (D)</p> Signup and view all the answers

Which of the following factors is NOT associated with the genetic explanation of schizophrenia?

<p>Environmental stressors (D)</p> Signup and view all the answers

What was the primary aim of the study conducted by Sensky et al. (2000)?

<p>To analyze the difference between CBT and a befriending intervention for schizophrenia. (C)</p> Signup and view all the answers

Which of the following was a key feature of the CBT sessions in Sensky et al.'s study?

<p>Engaging clients in discussions about their disorder and coping strategies. (A)</p> Signup and view all the answers

What improvement did the CBT group demonstrate at the 9-month follow-up assessment?

<p>Continued improvement in both positive and negative symptoms. (B)</p> Signup and view all the answers

What kind of assessment scales were used in Sensky et al.'s study?

<p>Standardized and validated assessment scales. (A)</p> Signup and view all the answers

In the context of CBT for schizophrenia, what is an essential component of stress management?

<p>Developing coping skills and identifying early warning signs. (B)</p> Signup and view all the answers

What challenge does CBT face according to the evaluation of its use for schizophrenia?

<p>The client must be present and put in consistent effort. (D)</p> Signup and view all the answers

What symptom changes were observed immediately after the treatment period for both groups in the study?

<p>Significant reduction in both positive and negative symptoms. (C)</p> Signup and view all the answers

How did CBT help clients deal with the effects of stigmatization linked to their diagnosis?

<p>By helping them identify stressors and strengthening their sense of self. (C)</p> Signup and view all the answers

What psychological issue was observed in Cathy concerning the presence of Steve Martin?

<p>Delusions of being stalked (A)</p> Signup and view all the answers

What medication did Cathy find effective in alleviating her symptoms after years of struggle?

<p>Risperdal (C)</p> Signup and view all the answers

What was Cathy’s reaction to the side effects of the medication Haldol?

<p>She disliked it due to muscle stiffness (C)</p> Signup and view all the answers

Which neurotransmitter's receptors were targeted by typical antipsychotics developed in the 1950s?

<p>Dopamine (B)</p> Signup and view all the answers

How did Cathy describe the psychiatric care she received over the long term?

<p>Only managed her symptoms weekly (B)</p> Signup and view all the answers

Which antipsychotic medication did Cathy take that caused her to gain high cholesterol?

<p>Risperdal (D)</p> Signup and view all the answers

What was one of the major concerns Cathy had regarding her social interactions while taking Risperdal?

<p>Exacerbated difficulties with empathy (C)</p> Signup and view all the answers

In psychological terms, the beliefs held by individuals with schizophrenia that are resistant to counter-evidence are often referred to as what?

<p>Delusions (C)</p> Signup and view all the answers

What treatment approach focuses on the biochemical aspects of schizophrenia?

<p>Medication management (A)</p> Signup and view all the answers

What role do check-ups play in the management of antipsychotic medication?

<p>To monitor symptoms and potential side effects (D)</p> Signup and view all the answers

What is a common side effect associated with taking atypical antipsychotics?

<p>Weight gain (C)</p> Signup and view all the answers

What was Cathy’s primary emotional state that worsened her situation during college?

<p>Depression (C)</p> Signup and view all the answers

What cognitive error is commonly exhibited by individuals with schizophrenia regarding new information?

<p>Inability to update beliefs (A)</p> Signup and view all the answers

What perspective challenges the reductionist view in understanding schizophrenia?

<p>Holistic perspective (C)</p> Signup and view all the answers

What role does the COMT gene play in the development of schizophrenia?

<p>Its deletion increases the risk of developing schizophrenia. (B)</p> Signup and view all the answers

What is primarily associated with the symptoms of schizophrenia according to the dopamine hypothesis?

<p>Excessive production of dopamine. (D)</p> Signup and view all the answers

Which region of the brain is mentioned as being linked to language impairment due to excess dopamine?

<p>Broca’s region (C)</p> Signup and view all the answers

What does the term 'nature reductionism' refer to in relation to genetic explanations of schizophrenia?

<p>Simplifying complex behaviors to single genetic causes. (B)</p> Signup and view all the answers

What was the key finding from Lindstrom et al.'s drug trials regarding L-DOPA and schizophrenia?

<p>L-DOPA administration increases hallucinations and delusions. (C)</p> Signup and view all the answers

What symptom is most likely linked to excessive dopamine activity in the striatum according to the dopamine hypothesis?

<p>Hallucinations (B)</p> Signup and view all the answers

What cognitive error involves the inability to discern between one’s own thoughts and external auditory stimuli?

<p>Errors in self-monitoring (B)</p> Signup and view all the answers

How does impaired Theory of Mind (ToM) affect individuals with schizophrenia?

<p>It leads to a misinterpretation of neutral intentions as hostile. (C)</p> Signup and view all the answers

What is one major drawback of reductionist views in explaining schizophrenia?

<p>They fail to recognize the complex interplay of multiple factors. (D)</p> Signup and view all the answers

Which group of neurotransmitters does the DISC1 gene primarily interact with?

<p>GABA and glutamate (C)</p> Signup and view all the answers

Which type of studies provided evidence supporting the dopamine hypothesis through the examination of deceased individuals?

<p>Postmortem studies (C)</p> Signup and view all the answers

What condition is characterized by an unusually low level of dopamine and linked to motor function issues?

<p>Parkinson’s disease (B)</p> Signup and view all the answers

What type of symptoms are linked to decreased dopamine activity in the prefrontal cortex in schizophrenia?

<p>Negative symptoms (B)</p> Signup and view all the answers

Which cognitive error suggests that individuals with schizophrenia struggle with processing their own thoughts and messages?

<p>Errors in self-monitoring (D)</p> Signup and view all the answers

Which of the following is a biological explanation for symptoms in schizophrenia according to the dopamine hypothesis?

<p>Excessive dopamine activity (C)</p> Signup and view all the answers

What is a primary advantage of atypical antipsychotics compared to typical antipsychotics?

<p>They dissociate quickly from receptors, allowing normal dopamine transmission. (A)</p> Signup and view all the answers

What percentage of individuals taking antipsychotic medication show no improvement?

<p>10% (A)</p> Signup and view all the answers

Which of the following is a common side effect of ECT?

<p>Temporary memory loss. (C)</p> Signup and view all the answers

What is the typical frequency of ECT sessions during a treatment course?

<p>Twice a week. (C)</p> Signup and view all the answers

One of the criticisms of ECT is its potential effect on which body system?

<p>Cardiovascular system. (B)</p> Signup and view all the answers

What role do longitudinal studies play in evaluating the biochemical treatment for schizophrenia?

<p>They help in understanding long-term outcomes of treatment. (D)</p> Signup and view all the answers

What is a potential disadvantage of antipsychotic medication that can impact adherence?

<p>Side effects leading to unpleasant experiences. (C)</p> Signup and view all the answers

During the initial phase of CBT, what is an important process therapists engage in with the client?

<p>Building a therapeutic alliance. (C)</p> Signup and view all the answers

Which of the following describes a psychological advantage of CBT for schizophrenia?

<p>It modifies irrational thoughts and beliefs. (B)</p> Signup and view all the answers

What type of schizophrenia symptoms does ECT particularly help treat?

<p>Catatonic symptoms. (D)</p> Signup and view all the answers

What percentage of patients typically show major improvements when taking antipsychotic medication?

<p>50% (D)</p> Signup and view all the answers

Which neurotransmitter is primarily involved in the action of antipsychotic medications?

<p>Dopamine. (D)</p> Signup and view all the answers

What is the main goal of cognitive behavioral therapy (CBT) for individuals with schizophrenia?

<p>To help individuals interpret hallucinations more accurately. (C)</p> Signup and view all the answers

What is the primary function of antipsychotic medications?

<p>To reduce symptoms associated with schizophrenia. (A)</p> Signup and view all the answers

Flashcards

Genetic Predisposition to Schizophrenia

The idea that a person's genetic makeup can contribute to their predisposition to develop schizophrenia. This means that while genes don't directly cause schizophrenia, they can increase the likelihood of developing it.

Family Studies of Schizophrenia

Studies that examine the prevalence of schizophrenia among individuals with different degrees of genetic relatedness to someone diagnosed with the disorder.

Twin Studies of Schizophrenia

Studies that investigate the concordance rate (the percentage of twins both having the disorder) of schizophrenia in monozygotic (identical) and dizygotic (fraternal) twins.

Adoption Studies of Schizophrenia

Studies that analyze the incidence of schizophrenia in adopted individuals compared to their biological and adoptive families.

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Genetic Linkage Analysis

A method used to identify specific genes associated with schizophrenia by examining patterns of inheritance of genetic markers within families.

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Molecular Biology of Schizophrenia

A field of research that explores the role of specific genes and their protein products in the development of schizophrenia.

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Polygenic Nature of Schizophrenia

The theory that schizophrenia is caused by a combination of multiple genes, not just a single gene mutation.

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DNA Replication Errors

Errors in DNA replication that may contribute to schizophrenia. These errors can lead to extra copies or deletions of genes.

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Dopamine Hypothesis

The hypothesis that schizophrenia is caused by an excess of dopamine in the brain.

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Dopamine

A type of neurotransmitter that enables communication between neurons, primarily involved in reward, motivation, and movement.

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Synapse

The space between two neurons where neurotransmitters are released and received.

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COMT Gene Deletion

The genetic explanation of Schizophrenia that suggests that a deletion of the COMT gene increases the risk of developing the disorder.

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DISC1 Gene Variation

The genetic explanation of Schizophrenia that proposes that variations in the DISC1 gene, contributing to GABA regulation, increase susceptibility to the disorder.

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Theory of Mind (ToM)

The ability to understand and interpret the mental states, intentions, and emotions of others.

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Errors in Self-Monitoring

A cognitive error in which individuals with Schizophrenia struggle to distinguish their internal thoughts from external stimuli, leading to auditory hallucinations.

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Impaired Theory of Mind in Schizophrenia

An impairment in Theory of Mind in individuals with schizophrenia, which may contribute to persecutory delusions and paranoia.

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Thinking Errors and Biases in Schizophrenia

A cognitive error where individuals with Schizophrenia may have faulty thinking patterns and biases, contributing to delusions and other symptoms.

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Dopamine Agonists

A type of drug that increases the production and availability of dopamine in the brain.

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Antipsychotic Drugs

A class of medications used to treat schizophrenia, often targeting and blocking dopamine receptors in the brain.

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Parkinson's Disease

A neurological disorder characterized by tremors, rigidity, and slow movement, often caused by a deficiency in dopamine.

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PET Scan (Positron Emission Tomography)

A technique used to image brain activity by detecting changes in blood flow.

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Striatum

A brain region involved in processing rewards, motivation, and movement, often implicated in positive symptoms of schizophrenia.

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Limbic System

A brain region involved in emotion and memory, often implicated in positive symptoms of schizophrenia.

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Preventing relapse through stress management

CBT helps clients develop coping skills to manage stress and identify early signs of relapse.

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Psychoeducation in CBT

Part of CBT involves educating clients and families about schizophrenia, helping them differentiate between real and imagined experiences like auditory hallucinations.

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Strengthening Self-Awareness in CBT

CBT helps clients identify stressors, strengthen their sense of self, and cope with stigma associated with the diagnosis.

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Reconnecting with Interests and Social Activities

CBT provides support to help clients reconnect with their interests, hobbies, and social activities, gradually bringing them back to a fulfilling life.

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Sensky et al. (2000) Study

A research study that compared the effectiveness of CBT with a befriending intervention for schizophrenia.

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Randomized Control Trial Design

Participants in the Sensky et al. (2000) study were randomly assigned to either a CBT group or a befriending group, helping to ensure a fair comparison.

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Assessment Methods in Sensky et al. (2000)

The study measured symptoms using standardized scales both before, during, and after the intervention, allowing researchers to assess the effectiveness of each treatment.

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Results of the Sensky et al. (2000) Study

The study found that while both CBT and befriending interventions showed improvements in symptoms, CBT maintained these improvements for longer, even after the intervention ended.

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Cognitive Explanation of Schizophrenia

Individuals with schizophrenia form rigid beliefs based on insufficient evidence, failing to update them with contradictory information. They resist contradictory information, clinging to their delusions.

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How does the cognitive explanation explain schizophrenia?

The cognitive explanation emphasizes inaccurate information processing and flawed thinking. Individuals with schizophrenia have difficulty interpreting the world around them due to distorted cognitive processes.

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Is the Cognitive Explanation Reductionist?

The cognitive explanation is criticized for reductionism, suggesting the complexity of schizophrenia can be explained solely by faulty thinking, neglecting other factors like biology.

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Does the Cognitive Explanation Account for Individual Differences?

The cognitive explanation acknowledges individual differences. Individuals with schizophrenia may experience different levels of cognitive impairment, influencing their symptoms and responses to treatment.

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What are the key features of the cognitive explanation?

The cognitive explanation highlights faulty information processing and illogical thinking patterns in individuals with schizophrenia.

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Typical Antipsychotics

A type of antipsychotic medication, typically used to treat schizophrenia, that blocks dopamine receptors in the brain, reducing the symptom of delusional thinking.

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Atypical Antipsychotics

A type of antipsychotic medication, typically used to treat schizophrenia, that blocks dopamine and serotonin receptors, reducing the symptoms of schizophrenia. They have fewer side effects than typical antipsychotics

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Cathy's Case: Key Takeaway

Cathy's experience illustrates the potential benefits and drawbacks of antipsychotic medication in treating schizophrenia.

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What are the symptoms Cathy experienced?

Cathy experienced hallucinations (hearing voices), delusions (believing she was being followed by a celebrity), and thought disorganization (throwing a glass and walking on broken pieces).

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What was Cathy's treatment?

Cathy's treatment involved various antipsychotic medications, including Haldol, lithium, Tegretol, Ativan, Halcion and Cogentin. Risperdal emerged as a more effective treatment for Cathy.

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What does Cathy's case tell us about schizophrenia treatment?

Cathy's case demonstrates the importance of addressing individual needs in medication management. This includes considering side effects and long-term impact.

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Biological Explanation of Schizophrenia

The explanation of schizophrenia that focuses on the role of neurotransmitters, brain structure, and genetic factors in its development. This explanation is concerned with understanding the biological underpinnings of the disorder.

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Antipsychotic Medication

Medications used to reduce the severity of psychotic symptoms, such as hallucinations and delusions, in individuals with schizophrenia. They are a cornerstone of schizophrenia treatment.

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Atypical Antipsychotics

A type of antipsychotic medication that targets dopamine and serotonin receptors, resulting in a broader range of effects compared to typical antipsychotics. These are often preferred due to fewer side effects.

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Schizophrenia

A complex mental disorder characterized by disturbances in thinking, perception, emotion, and behavior. Key symptoms include hallucinations, delusions, disorganized thinking, and social withdrawal.

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Side Effects of Typical Antipsychotics

Typical antipsychotics have severe side effects mimicking neurological diseases like Parkinson's, dystonia, dyskinesia, and akathisia.

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Responders to Antipsychotic Treatment

Schizophrenia patients treated with antipsychotics who show 50% major improvement and 30-40% minor improvement.

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Treatment-Resistant Schizophrenia

Schizophrenia patients who show no improvement despite taking antipsychotics.

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Non-Adherence to Medication

Patients stop taking their prescribed antipsychotics.

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Relapse in Schizophrenia

A return of symptoms after a period of improvement.

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Remission in Schizophrenia

Periods when a patient is not experiencing symptoms despite a diagnosis.

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Cognitive Behavioral Therapy (CBT)

A type of talking therapy focusing on challenging negative thoughts and beliefs contributing to problematic behaviors.

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Therapeutic Alliance in CBT

Building a strong bond between the therapist and the client based on trust and rapport.

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Electroconvulsive Therapy (ECT)

A treatment approach that uses brief electric pulses to induce a seizure, believed to be therapeutic.

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Unilateral ECT

Targeting the non-dominant hemisphere of the brain during ECT to minimize the risk of memory loss.

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Side Effects of ECT

ECT can cause temporary memory loss, and in rare cases, more serious neurological damage or death.

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Controversy Surrounding ECT

ECT is a controversial treatment as its effectiveness compared to other therapies is unclear.

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Neurotransmitter Theory of ECT

The electric shock in ECT may affect neurotransmitter activity in the brain.

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ECT Effectiveness for Acute Episodes

ECT may be effective during acute episodes of schizophrenia where quick relief from severe symptoms is needed.

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Study Notes

Genetic Explanations of Schizophrenia

  • Schizophrenia is believed to have a biological predisposition that can develop in late adolescence or early adulthood under extreme stress.
  • Family studies show a higher likelihood of developing schizophrenia in relatives who are more closely related genetically.
  • Twin studies, using data from the Danish Twin Register and the Danish Psychiatric Central Research Register, found a heritability of 79% for schizophrenia, with concordance rates higher for monozygotic (identical) twins than dizygotic (fraternal) twins.
  • Adoption studies comparing adoptees with schizophrenic biological mothers to control groups indicated a higher prevalence of schizophrenia in adoptees with schizophrenic biological mothers.
  • Schizophrenia is a polygenic disorder, meaning multiple genes are involved. These genes are linked to proteins associated with neurotransmitter development, transport, and breakdown.
  • Abnormalities in cell division (duplication or deletion of DNA) can also increase the risk of schizophrenia, referred to as "printing errors."
  • Examples include DiGeorge syndrome, linked to a deletion of the COMT gene, which codes for an enzyme that breaks down dopamine, leading to imbalance, and DISC1, impacting GABA regulation and dopamine activity.

Biochemical Explanations of Schizophrenia: Dopamine Hypothesis

  • The dopamine hypothesis suggests excessive dopamine activity is a contributing factor to schizophrenia.
  • Excess dopamine is linked to positive symptoms (hallucinations, delusions) and specific brain regions (e.g., Broca's area and language impairment).
  • Reduced dopamine activity in other areas (e.g., prefrontal cortex) is associated with negative symptoms (e.g., flattened affect).
  • Drug trials show increased dopamine production leading to schizophrenic-like symptoms, like hallucinations, when given L-DOPA to increase dopamine production.
  • Postmortem studies show a larger number of dopamine receptors in schizophrenic brains, and a deficiency of an enzyme responsible for dopamine breakdown.
  • PET scans indicate that excessive dopamine activity is present in regions like the striatum, limbic system, and cortex, related to positive symptoms, and decreased dopamine activity in the prefrontal cortex linked to negative symptoms.

Psychological (Cognitive) Explanations of Schizophrenia

  • Schizophrenia involves faulty mental processes.
  • Frith's cognitive errors include:
  • Errors in self-monitoring: Difficulty distinguishing internal (thoughts) from external stimuli (voices), explaining auditory hallucinations.
  • Impaired Theory of Mind (ToM): Difficulty understanding others' mental states and intentions, leading to misinterpretations and persecutory delusions. ToM deficits are also linked to negative symptoms.
  • Thinking errors and biases: Unable to update beliefs based on new information, leading to false conclusions, and strong resistance to contradictory evidence.

Treatment and Management of Schizophrenia

  • Case Study of Cathy:*

  • Cathy experienced worsening emotional problems, including hallucinations and delusions related to a male celebrity.

  • This was accompanied by strange behaviors like throwing objects at the wall and disorganized thinking.

  • Her treatment initially involved medication, typically antipsychotics (Haldol and Lithium), but these were associated with significant side effects.

  • Cathy experienced relapses and periods of hospitalization, and various medications were tried, with varying effectiveness, until finding a more suitable one (Risperdal).

  • Risperdal led to improvement but also caused side effects like sleepiness and social interaction problems.

  • Biological Treatments:*

  • Antipsychotic medications: Typically block dopamine or dopamine/serotonin receptors.

  • Typical (1st generation): Primarily block dopamine receptors, effective against positive symptoms, but with severe side effects like Parkinsonian symptoms.

  • Atypical (2nd generation): Block both dopamine and serotonin receptors, more effective against both positive and negative symptoms, with fewer, but still present side effects, including weight gain and sleepiness.

  • Effectiveness is measured through randomized controlled trials (RCTs).

  • Side effects of antipsychotics include extrapyramidal effects (e.g., tremors, rigidity), tardive dyskinesia, weight gain, and other physical issues.

  • Medication adherence is essential to prevent relapse.

  • Electroconvulsive Therapy (ECT):*

  • Utilizes brief electrical pulses to induce seizures.

  • Administered in sessions and is currently often used unilaterally to reduce memory loss risks.

  • Effective for acute episodes and some cases of catatonia, but comes with possible side effects.

  • Cognitive Behavioral Therapy (CBT)*

  • A talking therapy that addresses faulty thoughts and reasoning underlying behaviors related to schizophrenia.

  • Collaborative and goal-directed, helping clients understand their experiences and develop coping strategies, including stress management, psychoeducation, and social reconnection.

  • Research suggests CBT can be helpful in reducing symptoms and improving long-term outcomes. Methods can include things like tracking voice experiences in diaries.

Effectiveness of Therapies

  • RCTs show both CBT and antipsychotics can reduce symptoms.
  • CBT appears to result in sustained symptom reduction after treatment, unlike befriending alone as studied in Senaky et al. (2000).

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