11. Schizophrenia EQs Flashcards
Explain how symptom overlap might lead to problems with the diagnosis and / or classification of schizophrenia. (2 marks)
- shared symptoms could lead to an incorrect diagnosis (not valid)
- because the person may exhibit a symptom typical of schizophrenia (e.g. delusions) but could instead have another condition with the same symptom (e.g. bipolar disorder).
In the context of schizophrenia, outline what is meant by co-morbidity. (2 marks)
- co-morbidity is where two conditions co-exist in the same individual at the same time
- so a person with schizophrenia might also at the same time be suffering from another condition, e.g. personality disorder, depression, alcoholism
Briefly outline and evaluate one study of validity in relation to diagnosis of schizophrenia. (4 marks)
1,2. rosenhan - some details
3,4. analysis of implications for patients/wider society if diagnosis not valid
Explain why a psychiatrist would want to move a patient from typical to atypical antipsychotics. (4 marks)
- Atypical antipsychotics have been shown to be more effective against negative symptoms
- Typical antipsychotics (such as chlorpromazine) are liable to produce movement side
effects e.g. tardive dyskinesia - They mainly affect dopamine pathways
- Atypical antipsychotics are less liable to produce movement side effects; they have less action on the dopamine system, and instead affect a wide range of neurotransmitter systems
What is the diathesis-stress model of schizophrenia? (1 mark)
Stressful conditions trigger the development of schizophrenia in
people with an underlying predisposition.
Outline a cognitive explanation for schizophrenia and outline one limitation of this explanation. (6 marks)
outline:
* dysfunctional thinking explains symptoms of
schizophrenia
* poor memory function in people with schizophrenia
* people with schizophrenia are poor at understanding their own thinking (metacognition) as
distinct from environmental stimuli
* people with schizophrenia are poor at recognising their own output, eg their own drawings
* central control deficits may explain disordered thinking and language deficits, eg lack of
fluency
limitation:
does not address the underlying cause, so any therapeutic attempts based on the cognitive
explanation might just deal with some symptoms
Evaluate one psychological explanation for schizophrenia. (6 marks)
1,2,3. use of evidence to support/contradict psychological explanation, eg Read et al (2005) link between family history of abuse and schizophrenia;
3,4,5. social explanations, eg family dysfunction can lead to blaming the family, not ethical
Describes neural correlates as an explanation for schizophrenia? (1 mark)
There is a correlation between brain structure and function and symptoms of
schizophrenia.
‘Louise comes from a family with a history of schizophrenia, as both her grandfather and an aunt have been diagnosed with the disorder. Louise’s father
has recently died from cancer and she has just moved out of the family home to start a university course. Although she has always been healthy in the past, she has just begun to experience symptoms of schizophrenia, such as delusions and hallucinations.’
Using your knowledge of schizophrenia, explain why Louise is now showing symptoms of schizophrenia. (4 marks)
Application of the diathesis-stress model as follows:
* genetic vulnerability interacts with stressful life events which trigger schizophrenia
* family background = genetic vulnerability
* losing parent / going to university = stressful events.
Briefly outline family dysfunction as an explanation for schizophrenia. (2 marks)
- Characteristics of dysfunction eg difficulties in communication
- Critical and controlling parents, expressed emotion
- The role of double bind in the development of negative symptoms
- The role of hostility and disapproval in positive symptoms and relapse
- The role of expressed emotion in relapse
Outline family therapy and CBT (6 marks)
Family therapy:
* aim is to reduce anger, frustration and expressed emotion
* therapist meets family members and patient for open, productive discussion
* educates family members about the disorder and what to expect
* encourages the family to develop problem-solving and communication skills to support the patient.
Cognitive behaviour therapy:
* delivery of techniques to identify and manage intrusive or delusional thoughts
* patient is encouraged to develop rational interpretations or alternative perceptions, eg
viewing voices as interesting rather than threatening
* promotes increase in social activity and use of relaxation strategies.
Martine has schizophrenia. She is afraid because she believes that her care workers are trying to hurt her. She hears voices telling her to lock the doors and windows so the care workers cannot get into her house. She thinks about nothing else.
Explain how a cognitive behaviour therapist might treat Martine’s symptoms. (4 marks)
- Martine could be helped to identify her irrational thoughts, eg her belief that care
workers are trying to hurt her - therapist could help Martine understand the voices are not real, explaining how it could be
her own thoughts - Martine could be helped to see the link between her thoughts (that the care workers are
trying to hurt her), her emotion (being afraid) and her behaviour (locking the doors) - therapist could offer Martine alternative interpretations, eg that the care workers are there
to help - therapist could give Martine strategies to counter irrational thoughts, eg self-distraction
strategies to use when the thoughts intrude; positive self-talk strategies.
What is a token economy? (1 mark)
Something neutral that is presented for good behaviour.
