SCHIZOPHRENIA

Disturbances in thinking, speech, perception, emotion and behaviour

Auditory and visual hallucinations, auditory are more common
Sounds and colours might seem off or more vivid
Think situations have some meaning that they don’t, that they have some sinister quality to them
People might appear to be catatonic, or not care about what’s going on around them
Symptoms can appear all at once or gradually over time
Equal in men and women
Delusions - false beliefs, delusions of persecution, delusions of grandeur (like jesus is their special agent)
Schizophrenia can affect emotions
- Blunted affect - manifesting less sadness, joy and anger
- Flat affect - showing almost no emotions at all
- Inappropriate affect - the person's emotional responses are often inappropriate to the situation

Causes
There is a genetic predisposition for schizophrenia
Structural abnormalities in the brain:
Neurodegenerative theory - destruction of neural tissue can cause schizophrenia
- Mild to moderate brain atrophy (general loss or deterioration of neurons in the cerebral cortex and
limbic system)
- The atrophy influences cognitive processes and emotion
- Enlarged ventricles
- Abnormalities in thalamus
- Disordered attention and perception
These structural patterns are more common in those who exhibit the negative-symptom pattern (withdrawal, apathy)
The density of gray matter and how it changes over time is a useful predictor of when someone is at risk of
schizophrenia

Dopamine hypothesis - positive symptoms (hallucinations, delusions) are produced by over-activity of the dopamine
system in areas of the brain that regulate emotional expression, motivated behaviour and cognitive functioning,
schizophrenics have more dopamine receptors on neuron membranes
Antipsychotics reduce dopamine

These two theories (neurodegenerative theory and dopamine hypothesis) can be combined - increasing the quantity
of dopamine can result in the person developing positive symptoms (hallucinations, delusions). Larger
concentrations of dopamine are neurotoxic - neurons are destroyed - results in degeneration of the brain

Possible relationship between food (consuming gluten or fat) and schizophrenia

Psychoanalysis - psychoanalysts viewed schizophrenia as a retreat from unbearable stress and conflict.
Regression - a person retreats to an earlier and more secure (even infantile) stage of psychosocial development. It's a
retreat from an interpersonal world that has become too stressful to handle.
Life stress is a causal factor of schizophrenia

Cognitive theorists - schizophrenics have a defect in the attentional mechanism that filters out irrelevant
stimuli, they become overwhelmed by both internal and external stimuli → thought disorganization
Stressful life events are important in the emergence of schizophrenic behaviour, they interact with biological or
personality vulnerability
A highly vulnerable person may require less life stress
Psychotic people reacted to their stressors with more intense negative emotions - emotional over-reactivity may be a
vulnerability factor
Children are not more likely to develop schizophrenia if raised with a schizophrenic adoptive parent - unlike
antisocial behaviour for example
Individuals must have a biological vulnerability factor in order to be damaged by stressful life events
Children can show symptoms at 2 years old with odd behaviours which might cause an environment where others
treat that person differently - further causes schizophrenia

Hospitalized schizophrenics are more likely to relapse if they return to a home environment that is high in expressed
emotion - high levels of criticism, hostility, over-involvement
- Relapse 48% in families with high expressed emotion, 21% where the family were low in the factor
Families high in expressed emotion did make more negative comments to schizophrenics when they engaged in
strange behaviours, but the schizophrenics in these families also engaged in about 4x as many strange and disruptive
behaviours - what causes what? High expressed emotion can be a cause or a response
Since schizophrenics are overly sensitive to stress, even mildly negative family reactions may trigger underlying
biological vulnerabilities that could lead to relapse

Sociocultural factors - prevalence is higher in lower socio-economic populations.

Social causation hypothesis - attributes the higher prevalence of schizophrenia to the higher levels of stress that low
income people experience
Social drift hypothesis - as people develop schizophrenia, their personal and occupational function deteriorates, so
they drift down the socio-economic ladder into poverty and migrate to economically depressed urban environments

The likelihood of recovery is higher in developing countries than western