PSY240: - L16

Lecture §

• What is the most important issue with diagnostic with Schizophrenia?
  • Subjectivity: Relies on a person’s presenting symptoms
  • Reliable diagnostic ≠ Valid diagnostic
  • Strategies to improve?
    • Endophenotypes: biological or behavioural predispositions that makes a disorder more likely
    • Examples
      • Processing Speed: slowness writing symbols paired with numbers ($71-75\%$)
      • Sensory Gating: Impaired ability to filter out redundant information ($63-80\%$)
      • Verbal Memory: Impaired learning and recall of words and stories ($62-75\%$)
      • Dichotic Listening: Impaired ability to attend to one message and ignore another ($50-71\%$)
      • Phnemic Word Fluency: Reduced ability to generate words rapidly ($53-64\%$)
      • Continuous Performance Test: Slow and inaccurate detection of specified letters ($52-62\%$)
• Etiology Theories related to Schizophrenia
  • Psycho-social models
    • Carl Jung: collective unconscious (similar delusion contexts)
    • Social Drift: explain the connection of schizophrenia with poverty rates
    • Meehl’s Theory
      • Schizogene -> cognitive slippage -> aversive drift -> schizotype
  • Diathesis Stress Model
    • Inherited/fetal injury -> “switches” in the brain turned on by stress
    • Biological vulnerability inherited or acquired early in life
  • Biological factors
    • Genetic contribution
      • Fraternal twins & first degree relative $6-17\%$
      • Identical twins: $48\%$
      • Exposure to flu in utero
    • Brain related
      • Reduced grey matter volume (slower processing)
      • Activation of left temporal lobe: hallucination\
      • Amygdala & hippocampus
    • Dopamine Hypothesis
      • Dopamine dysregulation promote psychotic symptoms
      • Blocking dopamine receptors are effective in treating schizophrenia
• Treatment for schizophrenia
  • Antipsychotic medication
    • Promethazzine (anti nausea)
    • Chlorpromazine (used for mood disorders mania agitation)
      • 1st generation
      • Lots of side effects (motor dysfunctions, weight gain)
    • Risperidone & Olanzapine (symtom control with fewer side effects)
    • Ativan: anti-anxiety medication
  • Psychotherapy
    • Emotional disturbance
    • Psychotic symptoms
    • Social Disabilities
    • Risk of relapse
  • Cognitive
    • Promote independence
    • Stresses reduction
    • Function disability control
  • Family therapy
    • Involvement of family
    • Sense of family members
    • Deinstitutionalization