Schizophrenia
, Units
Unit 3 Implications in the Real World
2.5hr written exam Exam: 25 May 2021
Section A - Study of Behaviours
- 3 essay questions (25 marks split up)
- No need to study optional topics Answer one question (Either/Or)
- Addiction, Schizophrenia, Criminal behaviour
- Draw on knowledge from AS
Section B - Controversies
- Ethics of research (Benefits to society, negative consequences, ethical guidelines)
- Non-human animals in research (BPS guidelines, therapeutic devices, comparative to humans)
- scientific status (Benefits to science, research methods, changing sciences)
- Sexism (Gender bias, heterosexism, historical and social context, invisibility of women in psychology)
Unit 4 Applied Research Methods
1.5hr exam
Section A - Personal Investigation
- Conduct an investigation study Exam: 28 May 2021
- “Questionnaire study of perceived well-being after exercise”
- Asked questions about how you carried out your study
Section B - Applications to a Novel Scenario
- 30 mark compulsory question
- Short answer scenario based question
Assessment Objectives
A01 - Knowledge and understanding
- ‘Describe.. ”, “Explain.. ” “Some Candidates are over dependant on
A02 - Evaluation Skills text books which results in more generic
- “Evaluate how.. ”, “Apply. .” answers” - Examiners Report
A03 - Analysis and interpretation of scientific information
- “Analyse.. ”, “Discuss”
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A major psychotic disorder that causes a variety of psychological symptoms and is typified as a lack of connection with reality. It is a long
term condition and those with the illness may have symptoms that differ from each other.
Characteristics of Schizophrenia
Positive Symptoms - Symptoms or behaviours that the person is exhibiting in addition to ‘normal’ behaviours; if they
didn’t have schizophrenia they wouldn’t have symptoms. Includes hallucinations, delusions, and disordered thinking
Hallucinations are perception that are unreal, such as auditory hallucinations which consist if hearing sounds or voices, but
can present themselves in any sensory modality.
- Kathryn Lewandowski estimated that 20% Of people with schizophrenia experience tactile hallucinations, whereby they are
perceiving sensations as if someone or something is touching their skin.
Formication is the same for the sensation that resembles small insects, such as spiders on or under the skin. A hallucination
that is so real that, they can not be initially be appreciated as a hallucination.
Seeing distorted facial expressions or occasionally people or animals that aren’t actually there is also common.
Delusions are beliefs that are unreal, often experienced with no evidence to offer in support of the delusion. Commonly held
delusions are of persecutions and grandiosity.
- Delusions of persecution are based on the idea that a person or group want to harm the individual.
- Delusions of grandiosity suggest that the individual is special in some way, such as believing they are powerful or of superior
knowledge, or assuming the identity of a historical figure.
- Referential delusions is where the individual believes that another persons gestures, comments, or environmental cues are
referring to oneself, e.g. a personal messages are being communicated through the TV or radio.
Delusions are deemed bizarre if they are clearly implausible and are not understandable to same-culture peers and do not derive from
ordinary life., for example, that they have had their internal organs removed without any scars to prove so.
Non-bizarre delusions are beliefs that are plausible, for example, that they are under surveillance by the police despite lack of
convincing evidence.
Disordered thinking are feelings/thoughts that have been inserted or withdrawn from the mind. In some cases, the
person believes that their thought are being broadcasted so that others can hear them. Tangential, incoherent, or loosely associated
speech is used as an indicator of thought disorders (wondering from the topic and never returning or providing information.
- Disorganised speech is the result of abnormal thought processes where the individuals has problems organising
their own thoughts, this shows up in their speech, slipping from one topic to another (derailment), even mid-
sentence. In extreme cases, their speech may be so incoherent that is sounds like complete gibberish (word salad)
- Clanging is the grouping of words, usually rhyming, that are based on similar sounds even though they don’t have any
logical reason to be grouped together.
,Negative Symptoms - Symptoms or behaviours that are inhibiting people with schizophrenia from demonstrating
‘normal’ behaviour such as being unable to hold a conversation.
Alogia is the poverty of speech. Individuals will have a decreased amount of speech produced, and even short simple answers can
be a problem, this is thought to reflect slowing or blocked thoughts. I can also be accompanied by a delay in the sufferers verbal
responses during conversation.
Avolition is when the individual seems to be indifferent or unconcerned with the goings on in their surroundings, and show
neither the will nor desire to take part in activities. There is a distinct lack of goal directed behaviour, such as sitting in the house for
hours every day, and can be mistaken for laziness or apathy.
Andreason identified 3 signs of avolition:
- poor hygiene and grooming
- lack of persistence in work or education
- lack of energy
Anhedonia is where the individual does not react appropriately to pleasurable experiences, e.g. sports fan not appearing happy
when their team wins. Their ability to feel pleasure from positive stimuli is decreased or a degradation in the recollection of pleasure
from precious experiences
Flatness of Affect is the reduction in the range and intensity of emotional expression, including facial expressions, voice,
tone, eye contact, and body language. Individuals appear emotionless and may have conversations without the usual vocal intonations or
facial expressions.
Can often be misinterpreted as apathy as individuals will appear careless, not demonstrating the same signals of emotions, such as
when someone tells a joke and they don’t laugh. Speech patterns are very monotonous and pitches do not rise and fall as usual speech
does.
Catanotic Behaviour can range from fast and repetitive useless movements (positive symptoms) to little to no
movement at all;
- energetically pacing
- wandering in circles
- Unexpected gestures
- Loud utterances
Echopraxia is where individuals will mimic the movements of others around them.
However, individuals may:
- Remain immobile for long periods of time
- Remain in seemingly uncomfortable positions, where attempts to move them will be met wit resistance, or
waxy flexibility where limbs can be moved but maintain a rigid and unnatural posture
- May also adopt bizarre postures and facial contortions
Prodromal Symptoms are early symptoms indicating the onset of the disease which occur in the weeks or months
preceding schizophrenia, they are not enough to diagnose the individual with the schizophrenia as they appear in other illnesses (can
only be seen as prodromal symptoms in retrospect)
- Loss of interest in activities
- avoiding company of other/staying away from work or school
- Being irritable/over sensitive
- Generalised anxiety/mild grades of depression
- Lack of interest in personal appearance/hygiene
,A01 - Thorough and accurate A02 - Accurate connection are
description Essay Plan made (Rory and Ronald)
Describe the characteristics of behaviours that lead to the diagnosis of schizophrenia [10]
Ronald has not been feeling the same lately. He told his friend Rory what he has been experiencing. Rory suggests that the behaviours
Ronald is showing could be characteristics of schizophrenia.
Describe the characteristics of schizophrenia that Ronald may have told Rory he was experiencing [15]
Introduction - Describe positive vs negative symptoms
Positive Symptoms - Hallucinations description
- Ronald could be experiencing hallucinations such as formications
- formications description
- Delusions description
- Ronald could be experiencing delusions such as delusions of persecution/grandiosity
- Delusions of persecution/grandiosity description
Negative Symptoms - Ronald may also exhibit negative symptoms which would cause him to have difficulty
demonstrating ‘normal’ behaviour.
- Rory may notice that Ronald is unconcerned with his surroundings
- Avolition description
- Rory may notice that Ronald talks in a monotone voice with little emotion
- Flatness of Affect description
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Neurotransmitters are chemical messages that are responsible for transmitting signals between the nerve cells (neurones) of the
brain. Neurotransmitters such as dopamine are released in the synapse and enable neural messages to be sent from one neurone to
another across the synaptic gap. From the nucleus there is a long extension called an axon, which reaches to an axon terminal. The
axon terminal of one neurone reaches to the dendrites of another neurone. Between the terminal and the dendrites there is a gap
called the synapse. On one side there are receptors of a certain shape prepared to receive the neurotransmitter from another
neurone. If the neurotransmitter fits the receptor, the message is passed on. If not, the message if blocked.
Too much or too little of a neurotransmitter in a synapse affects the message that is sent. Drugs aim to increase or decrease
neurotransmitter levels, as appropriate.
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, Roles of Dopamine
Movement - Dopamine plays an important role in how our brain controls our movement. Therefore, Parkinson’s disease is caused by
the lack of dopamine, or more the death of dopamine neurones, which causes the sufferer to lose the ability to execute smooth and
controlled movements.
Pleasure and Motivation - Dopamine is commonly associated in providing feelings if enjoyment and reinforcement to
motivate us to do certain activities.
Dopamine and Psychosis - Shortage of dopamine as also been strongly associated to psychosis and schizophrenia,
specifically dopamine neurones in the mesolimbic pathway.
The Mesolimbic Pathway is a range of subcortical structures
that are involved in many functions, for example memory formation and arousal.
Structures in the limbic system include amygdala, hippocampus, and hypothalamus.
This is associated with positive schizophrenic symptoms. The Mesolimbic pathway
connects the ventral tegmental (VT) to the nucleus accumbens (NA). The release
of dopamine in this pathway into the NA regulates incentive salience. This pathway
is associated with positive symptoms
The Mesocortical Pathway carries signals
from the VT to the frontal lobe and Is essential for normal cognitive
function and is thought to be involved in cognitive control, motivation, and
emotional response. This pathway is often associated with negative
symptoms and disordered thinking
Schizophrenia is a result of excess dopamine (Snyder). This theory was
proposed after observations of the effects of amphetamines which
enhance the activity of dopamine in the brain. This drug can produce
amphetamine psychosis with symptoms very similar to schizophrenia.
Drugs such as LSD, which are known to increase dopamine activity, also
trigger schizophrenia symptoms in healthy people and exaggerate the
symptoms of those with the disorder
Parkinson’s Disease and Dopamine
Parkinson’s is a degenerative disease in which the cells in the substantia Nigra region of the brain die, causes a reduction in dopamine
levels, in turn affecting the sufferers ability to execute smooth and controlled movements.
Symptoms such as tremors, slowness, and rigidity can be treated with dopamine replacing drugs such as L-Dopa. Carlsson discovered
that giving L-Dopa to animals reduced their Parkinson’s-like symptoms; however, L-Dopa also reduced Parkinson’s-like symptoms in
humans but gave them psychotic symptoms similar to that of schizophrenia.
Possible side effects of antipsychotics (which reduce dopamine levels) include Parkinson’s like symptoms.
When Dopa is taken orally it passes through the blood-brain barrier, and once it has done this it is converted to dopamine.
Lindstroem, PET Scans - administered L-Dopa to 10 patients with schizophrenia and 10 with no diagnosis
L-Dopa taken up quicker with schizophrenic patients
Suggests they were producing more dopamine than the control group
Falkai, Post Mortem - Autopsies found that people with schizophrenia have a larger than usual amount of dopamine receptors, causing
increased dopamine in brain structures. Concluded that dopamine production is abnormal for schizophrenia
JJ Griffith - induced psychosis in non-schizophrenic volunteers by administering dextro-amphetamine (a drug that increases the amount
of dopamine in the brain) and found volunteers demonstrated a sudden onset of paranoid delusions and cold and detached emotional
response.
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