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- Schizophreniao Residual type Absence of key symptoms: organized thoughts, no delusions or hallucinations But they have evidence of the disorder: blunted emotionally, lacking motivation,withdrawn, isolated  negative symptomso What causes it? Primarily a brain disorder Unusual because no signs of it until later in life (adulthood) Genetic contributions Anatomical abnormalities Glial cells and dopamine are involved (dopamine antagonist reduces schizophrenia)o Genes Genetic risk of schizophrenia if a family member has it Especially in identical twins (~45%) Fraternal twin (~12%) Sibling (~10%) Lower than bipolar disordero Environmental factors Stress (can be early on) “schizovirus”- a virus that increases the risk of a child developing schizophrenia if the pregnant mother has it Latesplitting monozygotic twins have a higher chance of correlation than earlysplitting monozygotic twins Adopted children in “healthy” vs. disturbed families- Healthy: none  psychotic- Disturbed: some did become psychotic Urban environment  higher risk of schizophrenia (perhaps more stressful, noisy, etc., perhaps higher risk of schizovirus) Higher risk of schizophrenia if born in late winter/early springo Dopamine Some sort of dysfunction We don’t know what causes what (gene  dopamine dysfunction or other way around?) A dopamine antagonist blocks the receptoro The ventricle story Looking at brain structure: larger ventricles in monozygotic twins that have schizophrenia (less tissue)o Video on woman talking about schizophrenia & the brain Marian Krauss, schizophrenic Firefighter in the navy Then started having paranoid delusions They think early damage to brain may cause schizophrenia - The frontal lobe and the hippocampus are abnormal- Comparing experiences to the past, doesn’t function correctly in schizophrenics- An abnormal hippocampus may cause disorder in the frontal lobe- Tested this by damaging the hippocampi of ratso Similar results as in humans Different from bipolar disorder  people with schizophrenia feel like their brainis disintegrating- Lose memory based framework- Seem like they’re a different persono Hippocampus Perhaps the neurons are disorganized The way they link things together (with disorganized thought) is differento Sensory overload- e.g. hearing an orchestra that’s not thereo Schizophrenogenic mothers The type of mothering may cause schizophrenia conditioning psychotic thinking This is probably not realo Cause of relapse Expressed emotion (EE)- schizophrenics have a hard time processing high levels of expressed emotion from family members This predicts a relapse of schizophrenia In a study:- With medication and placebo medication and low EE: low relapse- High EE & low contact w/family: low relapse w/medication & mid w/placebo- High EE & high contact w/family: mid w/meds & high relapse w/placeboo Don’t know exactly what causes schizophrenia but “combined-liability”  diathesis-stress model Potential causes:- Specific genes- General genetic inheritance- Environment- Protective genes- Etc.o Medication treatment that is dramatically effective Haloperidol (Haldol)- cheap, controls hallucinations, sedative effect- Giving a shot- effective if administered once a month (then they aren’t as likely to want to stop medication) Chlorpromazine- a pill- Effective in getting people out of the hospital- Sedated- Control auditory hallucinations Similar symptoms to Parkinson’s disease (ticks, had trouble with motor skills) Tardive dyskinesia- another side effect- ticks, facial spasms, tongue protruding New medication:- Chlorpromazine (old) vs. Clozapine- Positive symptoms drop significantly with Clozapine (vs. a bit w/chlorpromazine)- Negative symptoms also drop with Clozapine (vs. almost not at all w/Chlorpromazine)- Unfortunately doesn’t work for all patients Medication is important and works for many but not all patients with schizophrenia However, family support and other treatments are important too Nothing reduces relapse to 0%, but a combination of treatments reduces the risk of relapse significantly - Meds: 40% relapse- Meds & social skills: 20%- Meds & family therapy: 20%- Meds, social skills & family therapy: nearly 0%o Family therapy for schizophrenia Education- it’s not their fault and they can’t talk their family member “out” of schizophrenia (like their delusions); it’s better to just listen to themo Brain tissue actually deteriorates in people with schizophrenia (though we don’t know what causes what)- Childhood disorderso Note: all of the other disorders can happen in childhood as well but these are diseases specific to childreno Two common ones Autism- Impaired language and social functioning- Recognizable early on (don’t respond the same as other children)- E.g. can’t maintain eye contact- Sometimes limited cognitive abilities, yet sometimes advanced- Restrictive/repetitive behaviorso Some have to wear helmets because they bang their heads against objectso Rocking behavior- Symptomso Verbal and nonverbal communication issueso Routine based; difficulty with transition; tantrums if there is a changeo Play activities are restricted- they only want to do one activity (e.g. only watching and reading about the Titanic)- Asperger’so “high-functioning” autismo Trouble with theory of mind (realizing others have different thoughts than you)o Trouble with social interactions- Biologyo 70-90% concordance in MZ twins  genetico Brain develops fast when young and then very slow when adolescent (unusual) Attention deficit/hyperactivity disorder (ADHD)- “Impaired attention, concentration, hyperactive, impulsive”- Seems biologically based- Have trouble in school- sitting in class and focusing- Trouble with friendship (because of impulsiveness)- More boys than girls diagnosed (11% of boys, 4% of girls)- Increased diagnosis lately- don’t know if there are actually more kids or if we are requiring more attention of children now- 55% concordance in monozygotic twins- Perhaps issue with frontal lobe and limbic systemo Video on autism Children would hit themselves nearly to death They did this because they didn’t know how to communicate their thoughts Created a system of teaching- Progress is reinforced and rewarded (instantly) The earlier this education starts the better

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UW-Madison PSYCH 202 - Schizophrenia

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