Lecture Notes: Schizophrenia in Clinical Psychology

Overview

• This lecture covers schizophrenia, a psychotic disorder.
• Lecture structured around three key sections: Diagnostic Criteria, Explanations, Treatment and Management.
• Diagnostic tools discussed: ICD-11 and DSM-5.

Diagnostic Criteria

• Diagnostic criteria focus on guidelines for disorder diagnosis.
• Schizophrenia falls under psychotic disorders, characterized by a break from reality.
• Symptoms categorized into Positive and Negative:
  • Positive Symptoms (additional behaviors):
    • Hallucinations: Sensory experiences without real stimuli.
    • Delusions: Persistent false beliefs not based on reality.
    • Thought Disorder: Disorganized thinking and speech.
    • Experiences of influence/control: Belief that one's actions are controlled by external forces.
  • Negative Symptoms (absence of normal behaviors):
    • Avolition: Lack of motivation.
    • Flat Affect: Lack of emotional expression.
    • Impaired Cognitive Function: Reduced attention/memory.
    • Catatonia: Lack of movement or speech.
• Duration: Symptoms must persist for at least a month not due to drugs/other disorders.

Example Study: Case of a Child

• Case study of a 10-year-old boy with early-onset schizophrenia.
• Symptoms: Auditory hallucinations, social withdrawal, aggression.
• Treatment involved medication to manage symptoms.

Types of Delusions

• Bizarre Delusions: Impossible beliefs (e.g., alien abductions).
• Non-bizarre Delusions: Highly unlikely but possible beliefs (e.g., infidelity).
• Types of Delusions in syllabus:
  • Persecutory: Belief others wish to harm them.
  • Grandiose: Belief in one's special powers or status.
  • Reference: Belief that events/objects imply personal significance.

Key Study: VR Symptom Assessment by Freeman (2003)

• Use of VR to assess symptoms of persecutory ideation.
• Conducted on non-clinical participants in a VR library setting.
• Findings showed correlations between anxiety, interpersonal sensitivity, and persecutory ideation.
• Positive opinions of avatars were prevalent, but some showed persecutory thoughts.

Explanations for Schizophrenia

Biological Explanations

• Genetic Explanation: Familial, twin, and adoption studies show genetic links.
• Biochemical Explanation (Dopamine Hypothesis):
  • High dopamine levels linked to positive symptoms.
  • Low levels in specific brain areas linked to negative symptoms.

Psychological Explanation

• Cognitive Explanation (Frith, 1992):
  • Abnormal self-monitoring leading to misinterpretation of internal thoughts as external voices.
  • Low theory of mind linked to negative symptoms.

Treatment and Management

Biological Treatments

• Antipsychotic Drugs:
  • Typical (first-generation) and Atypical (second-generation) target dopamine levels.
  • Issues include side effects and treatment resistance.
• Electroconvulsive Therapy (ECT):
  • Last resort option, involves inducing seizures via electrical currents.

Psychological Treatment

• Cognitive Behavioral Therapy (CBT):
  • Aimed at altering thoughts to reduce symptoms.
  • Shows long-term effectiveness over befriending in randomized control trials.

Evaluation and Conclusion

• Importance of understanding both biological and psychological factors.
• Recognize individual differences in response to treatments.
• Study highlights need for holistic approach in treatment and management.

This lecture provides a comprehensive overview of schizophrenia, diagnosis criteria, explanations, and treatment methods, underscoring the need for a balanced understanding of both biological and psychological factors in addressing this complex disorder.