Tuesday, 29 December 2020
Psych Revision Notes
PSYCHOLOGY & ABNORMALIT
• Schizophrenia & psychotic disorder
- Psychosis: loss of insight & touch with reality; individual experiences reality very
differently to others
- Schizophrenia: severe form of psychosis affecting all aspects of thinking, action
and emotion. Spectrum disorder - varies in duration and severit
- Positive and negative symptoms - positive add abnormality to regular function,
negative take away regular function, thus causing abnormalit
- POSITIVE (PSYCHOTIC) SYMPTOMS
- Hallucinations: sensory experiences that don’t exist (eg. Hearing voices, seeing
gures
- Delusions: beliefs not rooted in reality (eg. Delusions of grandeur, paranoia
that people are out to harm and kill you
1. Erotomanic - believing someone is in love with yo
2. Persecutory - believing others are out to harm yo
3. Grandeur - believing you hold a position of more importance than you
actually have (eg. President)
4. Bizarre - illogical & unrealistic beliefs
5. Jealous - believing their partner is cheating on the
- Disorganized thoughts: jumbled thoughts, speech may be incoherent as a resul
- Catatonia: failure to react to the environment; stupor or repetitive movemen
- NEGATIVE SYMPTOMS
- Loss of function: lack of speech and facial expressio
- 3 phases of Schizophrenia:
1. Prodromal: withdrawal, similar to depressio
2. Active: severe positive symptom
3. Residual: cognitive symptoms (eg. Lack of concentration
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, Tuesday, 29 December 2020
- Delusional disorder: characterized by persistent delusions, however all other
behaviour is norma
- Drug-induced psychosis: caused by substance; symptoms only present during
active phase rather than entirety of illness as with schizophrenia (prodromal, active,
residual
- DSM-5 ASSESSMENT
- At least 1 positive & 1 negative symptom present for min. 6 month
- At least 1 month of active phase schizophrenia
- Must be distinguished from related disorder (eg. Cannot be drug induced
psychosis)
- Symptom Assessment - Virtual Reality - Freeman (2008)
-
- CAUSES
- Genetic: Twin Study - Gottesman and Shields (1972
- Focused on genetic inheritance of schizophrenia, lasted 19 year
- Speci c abnormalities of function (eg. Memory impairment) have known
genetic origin. These are called endophenotypes
- Evaluation of ‘nature vs. nurture’ effect by comparing concordance
(prevalence rate) in MZ (100% of DNA) vs. DZ (50% of DNA) twins
- If the rate of schizophrenia is the same with both, the genetic link is ruled ou
- 57 pairs of twins (24 MZ, 33 DZ) - twin type identi ed through blood group &
ngerprint analysis
- Validity of diagnosis double checked with independent judges evaluating the
case
- Schizophrenia concordance higher in MZ (50%) than in DZ (9%
- Concordance in MZ twins higher in correlation with severity, with
concordance in mild cases being much lowe
- EVAL
1. Deterministic - concordance rates can’t be prevente
2. Reductionist - considers only genetic angle to concordance (eg. Not upbringing)
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, Tuesday, 29 December 2020
3. ‘Nature’ side of ‘nature v. Nurture’
4. Low application to everyday life - focused only on cause, not treatment
5. Longitudinal - boosts validity as patterns & trends can be identi ed over tim
- Biochemical: Dopamine Hypothesis - Lindström et al. (1999
- Schizophrenic brains produce more dopamine than others
- Excess dopamine or overactive receptors responsible for some symptoms (eg.
Loss of speech
- Post mortem studies on schizophrenic patients nd that enzymes responsible
for breaking dopamine down are lowe
- Drug trials on schizophrenics v. Non schizophrenics show that dopamine
increases lead to increases in hallucinations and delusion
- Excessive levels of arti cial dopamine used to treat patients with Parkinson’s
disease lead to development of symptoms such as hallucinations
- EVAL.
1. Reductionist - focused on scienti c function alon
2. Deterministic - dopamine automatically leads to positive symptom
3. High application to everyday life - treatment was derived from theor
4. Generalisable - biological function same in all human
- Cognitive: Abnormality of Self Monitoring - Frith (1992
- Frames biological and genetic factors in a cognitive manner, with
schizophrenia being a result of faulty mental processe
- Abnormality of self monitoring is misinterpretation of perception; failure to
recognize symptoms for what they are (eg. Mistaking normal self-talk as outer
speech, leading to hallucinations/mistaking inner belief for logical outside
information, thus leading to delusions
- Impaired theory of mind may lead to at affect as well as paranoia as
individuals have trouble identifying the intentions of others, hence misinterpret
them (negative symptoms
- EVAL
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, Tuesday, 29 December 2020
1. Holistic - considers both biological & genetic factors, framing them in a
cognitive manner
2. Individual exp. - misinterpretation depends on individual experienc
3. Nurture - abnormality of self monitoring can be improved with individual
effort; it is not xed that way (also free-will
- TREATMENTS
- Biochemical (antipsychotics
- Typical (Type A, developed in 50s) & atypical (Type B, developed in 90s)
antipsychotic
- Type A drugs more likely to cause motor control issues, but Type B more likely
to lead to heart disease & obesit
- Treat and relieve psychotic symptoms (eg. By blocking dopamine and
serotonin receptors
- Randomized double placebo control trials used to test effectiveness of
antipsychotics, with 50% showing signi cant improvement in 4-6 weeks, &
30-40% showing partial improvement
- Relapse rates can be high due to non-adherence as a result of side effects; as a
patient’s condition is improving, they’re less prone to take the medication
which has unwanted side effects (eg. Weight gain and motor control issues)
- EVAL.
1. High application to everyday life: easy to administer and effective
2. Ethical issues: side effects are harmful to individual
3. High validity (Double-blind placebo randomized controlled trial; elimination of
bias
4. High generalisability (randomized - elimination of bias
5. Reductionist: focused solely on biological factor
- ECT (electroconvulsive therapy
- Passing electrical currents through the brain to induce a seizure; works by
elimination (rates of schizophrenia in epileptic patients are rare
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Psych Revision Notes
PSYCHOLOGY & ABNORMALIT
• Schizophrenia & psychotic disorder
- Psychosis: loss of insight & touch with reality; individual experiences reality very
differently to others
- Schizophrenia: severe form of psychosis affecting all aspects of thinking, action
and emotion. Spectrum disorder - varies in duration and severit
- Positive and negative symptoms - positive add abnormality to regular function,
negative take away regular function, thus causing abnormalit
- POSITIVE (PSYCHOTIC) SYMPTOMS
- Hallucinations: sensory experiences that don’t exist (eg. Hearing voices, seeing
gures
- Delusions: beliefs not rooted in reality (eg. Delusions of grandeur, paranoia
that people are out to harm and kill you
1. Erotomanic - believing someone is in love with yo
2. Persecutory - believing others are out to harm yo
3. Grandeur - believing you hold a position of more importance than you
actually have (eg. President)
4. Bizarre - illogical & unrealistic beliefs
5. Jealous - believing their partner is cheating on the
- Disorganized thoughts: jumbled thoughts, speech may be incoherent as a resul
- Catatonia: failure to react to the environment; stupor or repetitive movemen
- NEGATIVE SYMPTOMS
- Loss of function: lack of speech and facial expressio
- 3 phases of Schizophrenia:
1. Prodromal: withdrawal, similar to depressio
2. Active: severe positive symptom
3. Residual: cognitive symptoms (eg. Lack of concentration
1
fi )
:
s
s
Y
)
n
:
u
m
u
n
)
y
y
t
t
, Tuesday, 29 December 2020
- Delusional disorder: characterized by persistent delusions, however all other
behaviour is norma
- Drug-induced psychosis: caused by substance; symptoms only present during
active phase rather than entirety of illness as with schizophrenia (prodromal, active,
residual
- DSM-5 ASSESSMENT
- At least 1 positive & 1 negative symptom present for min. 6 month
- At least 1 month of active phase schizophrenia
- Must be distinguished from related disorder (eg. Cannot be drug induced
psychosis)
- Symptom Assessment - Virtual Reality - Freeman (2008)
-
- CAUSES
- Genetic: Twin Study - Gottesman and Shields (1972
- Focused on genetic inheritance of schizophrenia, lasted 19 year
- Speci c abnormalities of function (eg. Memory impairment) have known
genetic origin. These are called endophenotypes
- Evaluation of ‘nature vs. nurture’ effect by comparing concordance
(prevalence rate) in MZ (100% of DNA) vs. DZ (50% of DNA) twins
- If the rate of schizophrenia is the same with both, the genetic link is ruled ou
- 57 pairs of twins (24 MZ, 33 DZ) - twin type identi ed through blood group &
ngerprint analysis
- Validity of diagnosis double checked with independent judges evaluating the
case
- Schizophrenia concordance higher in MZ (50%) than in DZ (9%
- Concordance in MZ twins higher in correlation with severity, with
concordance in mild cases being much lowe
- EVAL
1. Deterministic - concordance rates can’t be prevente
2. Reductionist - considers only genetic angle to concordance (eg. Not upbringing)
2
fi s
fi.
)
:
l
:
r
fi
d
)
:
s
)
s
t
, Tuesday, 29 December 2020
3. ‘Nature’ side of ‘nature v. Nurture’
4. Low application to everyday life - focused only on cause, not treatment
5. Longitudinal - boosts validity as patterns & trends can be identi ed over tim
- Biochemical: Dopamine Hypothesis - Lindström et al. (1999
- Schizophrenic brains produce more dopamine than others
- Excess dopamine or overactive receptors responsible for some symptoms (eg.
Loss of speech
- Post mortem studies on schizophrenic patients nd that enzymes responsible
for breaking dopamine down are lowe
- Drug trials on schizophrenics v. Non schizophrenics show that dopamine
increases lead to increases in hallucinations and delusion
- Excessive levels of arti cial dopamine used to treat patients with Parkinson’s
disease lead to development of symptoms such as hallucinations
- EVAL.
1. Reductionist - focused on scienti c function alon
2. Deterministic - dopamine automatically leads to positive symptom
3. High application to everyday life - treatment was derived from theor
4. Generalisable - biological function same in all human
- Cognitive: Abnormality of Self Monitoring - Frith (1992
- Frames biological and genetic factors in a cognitive manner, with
schizophrenia being a result of faulty mental processe
- Abnormality of self monitoring is misinterpretation of perception; failure to
recognize symptoms for what they are (eg. Mistaking normal self-talk as outer
speech, leading to hallucinations/mistaking inner belief for logical outside
information, thus leading to delusions
- Impaired theory of mind may lead to at affect as well as paranoia as
individuals have trouble identifying the intentions of others, hence misinterpret
them (negative symptoms
- EVAL
3
.
)
fi )
fi
fl)
r
fi e
s
s
’
)
fi
)
s
y
e
, Tuesday, 29 December 2020
1. Holistic - considers both biological & genetic factors, framing them in a
cognitive manner
2. Individual exp. - misinterpretation depends on individual experienc
3. Nurture - abnormality of self monitoring can be improved with individual
effort; it is not xed that way (also free-will
- TREATMENTS
- Biochemical (antipsychotics
- Typical (Type A, developed in 50s) & atypical (Type B, developed in 90s)
antipsychotic
- Type A drugs more likely to cause motor control issues, but Type B more likely
to lead to heart disease & obesit
- Treat and relieve psychotic symptoms (eg. By blocking dopamine and
serotonin receptors
- Randomized double placebo control trials used to test effectiveness of
antipsychotics, with 50% showing signi cant improvement in 4-6 weeks, &
30-40% showing partial improvement
- Relapse rates can be high due to non-adherence as a result of side effects; as a
patient’s condition is improving, they’re less prone to take the medication
which has unwanted side effects (eg. Weight gain and motor control issues)
- EVAL.
1. High application to everyday life: easy to administer and effective
2. Ethical issues: side effects are harmful to individual
3. High validity (Double-blind placebo randomized controlled trial; elimination of
bias
4. High generalisability (randomized - elimination of bias
5. Reductionist: focused solely on biological factor
- ECT (electroconvulsive therapy
- Passing electrical currents through the brain to induce a seizure; works by
elimination (rates of schizophrenia in epileptic patients are rare
4
)
s
:
)
fi
)
y
)
fi s
)
s
)
)
e
