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13C > Clinical > Flashcards

Clinical Flashcards

1
Q

A neurotransmitter is

A

A chemical which carries messages between nerve cells

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2
Q

Which is the main neurotransmitter linked to Schizophrenia?

A

Dopamine

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3
Q

The orignal hypothesis said the levels of Dopamine in the synpase are…

A

Too high/too much activity at the receptor sites (hyper dopaminergia)

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4
Q

Why does the neurotransmitter level cause problems for people with Schizophrenia

A

There is too much action in the synapse/too many signals/too much activity

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5
Q

Which receptor is usually the one linked to Schizophrenia

A

D2

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6
Q

What is happening in the mesolimbic system?

A

Too much Dopamine (hyperdopaminergia), causes positive symptoms

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7
Q

What is happening in the mesocortical system?

A

Too little Dopamine (hypodopaminergia), causes negative symptoms

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8
Q

What else is tied to Schizophrenia as it controls Dopamine levels

A

Glutamate

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9
Q

What is the effect of this neurotransmitter on Dopamine?

A

Lower levels (hypoglutamatergia) lead to an increase in Dopamine

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10
Q

An increase in which other Neurotransmitter has been linked to both positive and negative symptoms

A

Serotonin

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11
Q

What did Carlsson find?

A

dopamine, glutamate and serotonin are all implicated in the development of schizophrenia showing that neurotransmitters can explain the development of Schizophrenia (but it isn’t just Dopamine)

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12
Q

What did the Liverpool universty study find?

A

found that childhood trauma makes you three times more likely to develop schizophrenia, suggesting that there is a strong relationship between the environment and the development of schizophrenia and it is not just due to neurotransmitters.

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13
Q

What did the Lindstroem study find?

A

found that schizophrenics used L-DOPA faster than the control group, suggesting they were producing more dopamine at a quicker rate, and the excess dopamine can explain how schizophrenia is caused

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14
Q

What did the Depatie & Lal study find?

A

found that giving people drugs that increase their production of dopamine does not create the symptoms of schizophrenia as would be expected if excess dopamine caused it, so it is not the only explanation of the causes of schizophrenia.

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15
Q

What did the Seeman study find?

A

they have a higher number of D2 receptors

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16
Q

Why is this a useful theory?

A

It has lead to drug treatments which work to lower symptoms- suggesting that this theory is credible

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17
Q

What is a problem in suggesting the drugs ‘prove’ this theory correct?

A

The drugs don’t work for everyone and don’t act instantaneously

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18
Q

Which of these is true and suggests the dopamine theory is valid/credible?

A

Amphetamines raise Dopamine levels and causes similar ‘symptoms’ to Schizophrenia

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19
Q

What is an issue with using Amphetamines as evidence?

A

They only cause the positive symptoms so don’t provide a complete explanation

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20
Q

What is a strength of using a biological explanation to describe Schizophrenia?

A

Empirical- you can measure neurotransmitters directly

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21
Q

A weakness of saying neurotransmitters cause schizophrenia is?

A

It has issues with cause and effect as most of the research is correlational

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22
Q

Why might genetics be a better explanation?

A

Genetics provide an underlying cause to explain why the neurotransmitters are different- giving better cause and effect

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23
Q

Why is this theory reductionist?

A

It ignores environmental factors like early childhood expereicnes influencing cognitive processes

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24
Q

Which of the 4Ds show that culture does effect diagnosis?

A

Deviance from social norms

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25
Q

Why is Ethnocentrism an issue?

A

Diagnosis as it downplays and ignores differences between cultures?

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26
Q

Why might the existence usage of the DSM and ICD cause issues for diagnoses across cultures?

A

They have different criteria/illnesses and are used in different countries

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27
Q

What are Dhat and Koro?

A

Culturally bound illnesses which are only found in one culture and so shows culture might effect illness

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28
Q

What is an issue if doctor and patient come from different cultures?

A

Language barriers or not communicating about illness the same way

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29
Q

What did Malgady find?

A

demonstrated there is a difference in the interpretation of hearing voiced between Costa Rican culture where it is interpreted as spirits talking to an individual and the USA where the same phenomenon is interpreted as a symptom of schizophrenia

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30
Q

What did Sato find/say?

A

Clinicians may be unwilling to give culturally sensitive diagnoses e.g. schizophrenia in Japan

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31
Q

What did Lopez find/say?

A

claimed trying to redress cultural bias in DSM by taking cultural beliefs into account can lead to missing some diagnoses as symptoms are dismissed as cultural norms.

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32
Q

What did Kastrup find/say?

A

argues that as not all cultures see the separation of mind and body prevalent in Western society if the patient and clinician do not share an understanding of how problems are described faulty diagnoses are likely to occur

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33
Q

What did Lin find/say?

A

Schizophrenia around the world shares more symptoms than it differs in- its the same mostly (with availability of treatment being the major factor in many differences

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34
Q

What did Banyard find/say?

A

5% population is black but 25% of psychiatric patients- showing a cultural bias

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35
Q

What did Escobar and Vega find/say?

A

The DSM-IV is unsatisfactory in terms of cross cultural applicability because of its strong western bias

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36
Q

What did Chandresa find/say?

A

shows that there are more rates of catatonia 21% in Sri Lanka than in British white people (5%)- though this is mostly due to treatment options.

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37
Q

What did Lee find/say?

A

showed that the DSM was valid in Korea for ADHD as the criteria matched with those diagnosed with the disorder

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38
Q

What did Burham find/say?

A

Mexican born Americans have more auditory hallucinations than American with Mexican origins. White Americans were reported to show more grandiosity in delusions- showing cultural issues in diagnosis

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39
Q

What did Cinerella and Lowenthal find?

A

ethnic group and religious faith had a marked effect on perceptions of mental illness so such factors need to be taken into account during diagnosis

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40
Q

What are the 4Ds

A

Deviance, Danger, Dysfunction and Distress

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41
Q

What does the deviance explanation of abnormality say about abnormality?

A

You are abnormal if you break social norms, agreed ways of behaving

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42
Q

What are the things which might impact social norms

A

Age, Sex, Culture, Context

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43
Q

What is statistical deviance?

A

When a behaviour is infrequent it becomes abnormal, when only a small % of people show a behaviour

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44
Q

What infrequency is suggested to make something deviant?

A

If it as over 2 standard deviations away from the mean

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45
Q

What does the Danger explanation of abnormality say about abnormality?

A

You are abnormal if your behaviour makes you a risk to yourself or others, this is subjective and on a continuum

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46
Q

What does the Dysfunction explanation of abnormality say about abnormality?

A

You are abnormal if you cannot function or live successfully e.g. go to work or have relationships, this is subjective and can be on a continuum

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47
Q

What would someone who has a dysfunction have difficulties doing?

A

Maintaining a job or going to college

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48
Q

What does the Distress explanation of abnormality say about abnormality?

A

You are abnormal if your behaviour makes you upset, this is subjective and on a continuum

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49
Q

Which axis on the DSM-IV took distress, danger and dysfunction into account to make a global decision?

A

5

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50
Q

Which of these is true for all 4 Ds?

A

They are subjective- due to personal interpretation/opinions of the doctor

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51
Q

What did Thomas Szasz say?

A

Deviance is socially controlling due to the myth of mental illness

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52
Q

What is a weakness of statistical deviance?

A

It uses arbritrary cut off of frequency so might not be valid

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53
Q

What is a weakness about frequency being used to diagnose people?

A

Behaviours can be infrequent without indicating abnormality and disorder

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54
Q

Why is Deviance worse then the other definitions?

A

It doesn’t deal with the wellbeing and quality of their lives whereas the others do

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55
Q

Despite being largely reductionist (only looking at social norms and ignoring the other Ds) how could you argue it might be holistic?

A

It looks at many factors like gender etc

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56
Q

What is a problem with using so many factors in Deviance?

A

It lowers the validity of disorder because there are so many possible definitions

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57
Q

What is a problem all of the Ds share?

A

You can be dangerous, distressed etc without it being classed as a disorder i.e. speeding or criminal behaviour

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58
Q

What is the fifth D which these all fail to address?

A

Duration- the length of time you show a certain behaviour is important

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59
Q

Why are the 4 Ds good?

A

They can and have been used to help in the diagnosis/defining of mental health issues

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60
Q

Describe the DSM

A

Has standardised symptoms for each illness, Updated regularly, Only focuses on mental illness, Created by the APA, Contains things like comorbidity, prevelance, differential diagnosis for each illness

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61
Q

What are the sections of the DSM?

A

Section 1 is the introduction, with section 2 having the classification of the main mental health disorders. Within section 3, there is a cultural formulation interview guide to help with diagnosis of the disorder and emerging disorders

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62
Q

Describe the ICD

A

Created by WHO, Is used worldwide, Updated regularly, Features all illnesses not just mental illness, Contains things like incedence, prevalence and mortality for each illness, Is used more commonly around the world

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63
Q

How would you diagnose an illness using the ICD?

A

You would go to the section about mental and behavioural disorders. You would look at the symptoms and criteria under each mental illness and find the relevant one to the patient

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64
Q

What about the diagnostic systems makes diagnosis more reliable?

A

They have standardised symptoms that everyone uses

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65
Q

What about the diagnostic systems makes diagnosis less reliable?

A

Bias in diagnosis (cultural, gender etc) by the doctor

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66
Q

What did Rosenhan find about validity of diagnosis?

A

Diagnosis might not be valid because patients can lie and be given the wrong diagnosis

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67
Q

What did Rosenhan find about reliablity of diagnosis?

A

Diagnosis is reliable because all but one were given the same diagnosis of Schizophrenia when presenting the same symptoms

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68
Q

What did Ford and Widiger find?

A

males and females diagnosed differently with same symptoms (doctor bias)

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69
Q

What did Ward et al find?

A

False diagnosis was caused 32.5% inconsistency with the interpretation of symptoms and 62.5% was due to the inadequacy of the classification system

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70
Q

What did Lee find?

A

Found good concurrent validity between ADHD diagnosis in Korea using DSM criteria

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71
Q

What did Jakobsen et al find?

A

An ICD-10 diagnosis showed 93% sensitivity and 87% predictive value when diagnosing schizophrenia

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72
Q

What did Goldstein find?

A

found that 169 of the 199 patients were rediagnosed with Schizophrenia when DSM was updated

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73
Q

What did Stinchfield find?

A

91% accuracy on diagnosing gambling disorder when using DSM 5

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74
Q

What did Cheniaux find?

A

They found that schizophrenia was more common when using ICD-10 rather than DSM-IV

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75
Q

What did Brown 2001 find?

A

Brown found good-to-excellent reliability for most of the DSM-IV categories. However, they found some boundary problems with certain disorders

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76
Q

What did Nicholls find?

A

ICD 10 was used it was found to be only a 36% agreement for eating disorders

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77
Q

What did Powers find?

A

women who had suffered complex post traumatic disorder also had higher levels of alcohol and substance misuse as predicted by ICD 11, showing that ICD 11 does have good predictive validity

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78
Q

What is a patient factor effecting diagnosis?

A

They may give faulty information due to stigma

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79
Q

What did Kim-Cohen find?

A

found that the DSM has predictive validity for conduct disorders in children (1) as a larger majority of children who had at least three conduct disorder symptoms at five years old according to DSM had at least one educational difficulty two years later

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80
Q

What did Morey find?

A

found that DSM 5 was more reliable than DSM IV in diagnosing borderline personality disorder so diagnosis of mental health disorders should be reliable if DSM V was used

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81
Q

What did Reiger find?

A

DSM 5 had a concordance rate of 0.46 for schizophrenia so might not be reliable

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82
Q

What would it mean if a diagnosis was valid?

A

A patient was given the correct diagnosis of an illness for the one they have

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83
Q

What would it mean if a diagnosis was reliable?

A

You would get the same diagnosis is rediagnosed

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84
Q

What is construct validity?

A

The diagnostic manual is operationalised correctly and has the correct symptoms for each illnes

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85
Q

What is concurrent validity?

A

Two different diagnostic methods e.g. the two manuals agree

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86
Q

What is meant by predictive validity?

A

We can predict the progression of the illness or the effectiveness of the treatment

87
Q

What is inter-rater reliablity?

A

Two different doctors agree on the diagnosis

88
Q

What in intra-rater reliability?

A

If you are rediagnosed again later by the same doctor you get the same diagnosis

89
Q

What is meant by Aeitiological validity?

A

The patient has the correct causal factor for the illness we have diagnosed them with

90
Q

What about the diagnostic systems makes diagnosis more reliable?

A

They have standardised symptoms that everyone uses

91
Q

What is the issue with shared symptoms between illnesses

A

It might make diagnosis less valid if multiple illnesses have the same symptoms as people might be misdiagnosed.

92
Q

Why does the existence of different manuals impact validity of diagnosis?

A

They might have different criteria which raises questions for the concurrent validity

93
Q

What about the diagnostic systems makes diagnosis less reliable?

A

Bias in diagnosis (cultural, gender etc) by the doctor

94
Q

What did Rosenhan find about validity of diagnosis?

A

Diagnosis might not be valid because patients can lie and be given the wrong diagnosis

95
Q

What did Rosenhan find about reliablity of diagnosis?

A

Diagnosis is reliable because all but one were given the same diagnosis of Schizophrenia when presenting the same symptoms

96
Q

What did Ford and Widiger find about validity and reliablity of diagnosis?

A

males and females diagnosed differently with same symptoms (doctor bias)

97
Q

What did Ward et al find about validity and reliablity of diagnosis?

A

False diagnosis was caused 32.5% inconsistency with the interpretation of symptoms and 62.5% was due to the inadequacy of the classification system

98
Q

What did Lee find about validity and reliablity of diagnosis?

A

Found good concurrent validity between ADHD diagnosis in Korea using DSM criteria

99
Q

What did Jakobsen et al find about validity and reliablity of diagnosis?

A

An ICD-10 diagnosis showed 93% sensitivity and 87% predictive value when diagnosing schizophrenia

100
Q

What did Goldstein find about validity and reliablity of diagnosis?

A

found that 169 of the 199 patients were rediagnosed with Schizophrenia when DSM was updated

101
Q

What did Stinchfield find about validity and reliablity of diagnosis?

A

91% accuracy on diagnosing gambling disorder when using DSM 5

102
Q

What did Cheniaux find about validity and reliablity of diagnosis?

A

They found that schizophrenia was more common when using ICD-10 rather than DSM-IV

103
Q

What did Brown 2001 find about validity and reliablity of diagnosis?

A

Brown found good-to-excellent reliability for most of the DSM-IV categories. However, they found some boundary problems with certain disorders

104
Q

What did Nicholls find about validity and reliablity of diagnosis?

A

ICD 10 was used it was found to be only a 36% agreement for eating disorders

105
Q

What did Powers find about validity and reliablity of diagnosis?

A

women who had suffered complex post traumatic disorder also had higher levels of alcohol and substance misuse as predicted by ICD 11, showing that ICD 11 does have good predictive validity

106
Q

What is a patient factor effecting diagnosis?

A

They may give faulty information due to stigma

107
Q

What did Kim-Cohen find about validity and reliablity of diagnosis?

A

found that the DSM has predictive validity for conduct disorders in children (1) as a larger majority of children who had at least three conduct disorder symptoms at five years old according to DSM had at least one educational difficulty two years later

108
Q

What did Morey find about validity and reliablity of diagnosis?

A

found that DSM 5 was more reliable than DSM IV in diagnosing borderline personality disorder so diagnosis of mental health disorders should be reliable if DSM V was used

109
Q

What did Reiger find about validity and reliablity of diagnosis?

A

DSM 5 had a concordance rate of 0.46 for schizophrenia so might not be reliable

110
Q

What did Cooper find about validity of diagnosis?

A

where the same patient was diagnosed with schizophrenia twice in New York two times more than in London

111
Q

What did Andrews find about validity and reliablity of diagnosis?

A

found that DSM IV and ICD had agreement rates for disorders such as depression, therefore it can be said that both systems have concurrent validity.

112
Q

What is the aim of Rosenhan?

A

To investigate if sane people who present themselves to a psychiatric hospital would be diagnosed and treated to test the validity and reliability of diagnosis

113
Q

Who was the main sample being studied in this research?

A

12 hospitals and their staff

114
Q

There was a variety of hospitals from public to private in this study- across how many US states were they spread?

A

5

115
Q

How many pseudopatients were there?

A

8

116
Q

What did the Pseudopatients do?

A

Go to meetings about symptoms they were suffering at hospital

117
Q

What symptoms did they report?

A

Hearing voices saying hollow, thud and empty

118
Q

What was the diagnostic results for the pseudopatients?

A

All but one were diagnosed with Schizophrenia

119
Q

What type of observation is Rosenhan?

A

Covert, Participant, Naturalistic

120
Q

What happened once the pseudopatients were admitted?

A

They acted normally and the voices stopped & kept written notes

121
Q

What questions did the Pseudopatients ask?

A

Whether they could go outside and when they’d be released

122
Q

Only 2 were taken but how many medication pills were given to pseudopatients?

A

2100

123
Q

What was the range of days stayed by the Pseudopatients?

A

7 to 52

124
Q

What was the average number of days before release for the psuedopatients?

A

19

125
Q

When the pseudopatients were released what was the diagnosis given?

A

Schizophrenia in remission

126
Q

What normal behaviours were interpreted as abnormal?

A

Queuing for food and writing in their diaries

127
Q

How much time did they spend with a member of staff each day on average?

A

7 minutes

128
Q

How many real patients voiced concerns about the Pseudopatients?

A

35

129
Q

What happened in Rosenhan study 2?

A

Rosenhan told hospitals he would send more pseudopatients but didn’t send anyone

130
Q

How many pseudopatients were identified as faking by 1 members of staff in Rosenhan 2?

A

39/193

131
Q

How many pseudopatients were identified as faking by 2 members of staff in Rosenhan 2?

A

19/193

132
Q

What is a strength for Rosenhan in terms of generalisablity?

A

It contained a variety of hospitals and staff

133
Q

What is a weakness for Rosenhan in terms of generalisablity?

A

It is ethnocentric as only takes place in the USA

134
Q

Is Rosenhan reliable?

A

Yes as various things like the words given during diagnosis and the instructions were standardised

135
Q

Is Rosenhan high in ecological validity?

A

Yes- it was the staff’s real life environments and working days and so would treat the patients like they would in real life

136
Q

Is Rosenhan high or low in Demand Characteristics?

A

Low- it was a covert observation so the staff didn’t know they were taking part/being studied and so would treat the patients how they really would without changing their behaviour

137
Q

Rosenhan got qualitative data from pseudopatient notes and a strength of this is

A

It is high in depth and detail about the treatment of patients

138
Q

What is a a weakness with the conclusion about diagnosis?

A

The pseudopatients lied about the symptoms the staff had no reason to think they were faking it, as healthy people do not say they hear voices that are not there

139
Q

What is an issue with the way the pseudopatients recorded data in Rosenhan?

A

The findings are qualitative they could have been biased in what they chose to report so there is subjectivity

140
Q

What are the ethical issues with Rosenhan?

A

There was problems with deception because the Pseudopatients lied about their symptoms, This study has issues with protection from harm because the pseudopatients were given medication and it took time away from real patients, There are issues with withdrawal as the staff couldn’t stop taking part and the pseudopatients couldn’t leave, There was problems with informed consent because the staff didn’t know about the research

141
Q

What type of disorder is Schizophrenia

A

Psychotic

142
Q

How many symptoms of Schizophrenia do you need for a diagnosis in DSM V?

A

2/5

143
Q

One of the symptoms of Schizophrenia must be

A

Delusions, hallucinations or disorganised speech

144
Q

What else isn’t a symptom but is needed or a DSMV diagnosis?

A

Social disturbance for 6 months

145
Q

What are Delusions?

A

Beliefs which don’t align with reality i.e. paranoia

146
Q

What are Hallucinations?

A

Hearing (auditory) or seeing (visual) things which are not there

147
Q

What are Disorganised behaviour and catatonia?

A

involve excessive movements, unusual actions, freezing in place, or not responding to instructions or communication

148
Q

What is thought insertion?

A

A belief that ones thoughts are not their own

149
Q

What are Disorganised speech/thought?

A

difficulty concentrating and maintaining a train of thought, which manifests in the way they speak e.g. making up words, incoherence, difficulty in maintaining a train of thought etc

150
Q

What are Negative symptoms?

A

Including blunted effect, alogia, anhedonia etc

151
Q

What is the gender difference in Schizophrenia?

A

More men get Schizophrenia and often they get it at a younger age

152
Q

What is the prognosis for Schizophrenia?

A

About 50% of people with schizophrenia have times where they have the symptoms and times where they do not have the symptoms

153
Q

What is the prevalence of Schizophrenia?

A

0.3-0.7% (often cited as 1%)

154
Q

When does Schizophrenia usually occur in people?

A

between the ages of late adolescence and the mid-thirties, with males having it at a slightly earlier age than females

155
Q

What is significant about those who develop it earlier?

A

People who have psychosis before late adolescence often have a worse prognosis that those who develop it later on, with it being more severe and lasting longer

156
Q

What is the prevalence of Schizophrenia?

A

0.3-0.7% (less than 1%)

157
Q

What happens to your rate of Schizophrenia if you are related to someone and what does this indicate?

A

It increases which indicates it has a genetic component

158
Q

In Gottesman (1991) what are the rates of Schizophrenia if your non-identical twin (DZ) has Schizophrenia?

A

17%

159
Q

In Gottesman (1991) what are the rates of Schizophrenia if your identical twin (MZ) has Schizophrenia?

A

48%

160
Q

Which chromosomes and genes have been linked to Schizophrenia?

A

22 (via Digeorge syndrome),1, 18, 15, 14, 13, 12 . Sherrington suggests chromosome 5

161
Q

The C4-A gene has been linked to Schizophrenia, what is it’s role?

A

It controls neural pruning

162
Q

Why might this change in genes influence Schizophrenia?

A

It 1. Disrputs neural pathways. 2. alters brain sensitivity to chemicals e.g. dopamine and 3. might have been beneficial in creative thinking

163
Q

What was a finding of Kety’s study?

A

The biological family members of those with schizophrenia had a higher rate of schizophrenia than the adopted family, and than the biological family of the control group

164
Q

What did Tiernari et al (2000) study find?

A

That environment was also important, those who had a high risk of schizophrenia but lived in a ‘healthy’ home didn’t develop it but those in a disturbed household did- even many with a lower risk of Schizophrenia

165
Q

What did Gottesman & Shield’s study find?

A

42% of the MZ twins both had a diagnosis of schizophrenia compared to 9% of the DZ twins

166
Q

What did Tamminga and Schulz (1991) study find?

A

research has failed to isolate a single recessive or dominant gene which causes the illness. The disorder may be more complicated than that and may be the expression of many genes which cause it

167
Q

Why is this a better theory than the cognitive and neurotransmitter one?

A

It has a better cause and effect relationship in suggesting that the genes cause the development of schizophrenia later in life

168
Q

What is a problem with this theory?

A

It largely ignores environmental factors such as childhood trauma suggested by the Liverpool study

169
Q

What is the diathesis-stress model?

A

It suggests you need both a genetic predisposition and environmental triggers in order to develop schizophrenia

170
Q

What is an issue of using twin studies when saying that schizophrenia is genetic?

A

The concordance rate is never 100% which suggests that it is not fully genetic

171
Q

What is an issue with twin studies?

A

They assume MZ twins and DZ twins both share their environment equally with their twin which isn’t the case (MZ treated more alike) which means we can’t get cause and effect when looking at genetics vs environment

172
Q

What does the cognitive approach believe causes Schizophrenia

A

A disturbance in language, attention, thought and perception

173
Q

What does the cogntiive approach say causes issues like hallucinations?

A

Sensory overload/inability to filter out irrelevant information from the senses

174
Q

Some cognitive psychologists say that Dopamine is sufficient to explain some symptoms of Schizophrenia- where do other symptoms come from?

A

People attempting to make sense of these e.g. they hear whispering so ask soeone to confirm this, the other person denies it which leads to delusions and then disorganised thinking to make the delusion make sense

175
Q

What did Frith suggest causes hallucinations?

A

thinking inner voice is an external voice

176
Q

What did Frith suggest causes issues with delusions about others?

A

Delusions may be caused by an inability to process social situations appropriately (monitoring behaviour and intention of others), so leading to feelings of persecution

177
Q

What did Helmsley suggest about Schizophrenia?

A

A poor link between memory and perception can lead to disorganised thinking as people will not know what to expect from a situation (this can then lead to things like social withdrawal)

178
Q

What three processes did Frith say causes schizophrenia?

A

Inability to generate action, monitor their own actions and monitor the actions of others

179
Q

What did McGuigan find about cognition and Schizophrenia?

A

immediately before episodes of auditory hallucination were reported, some schizophrenic patients showed activation of the vocal centres, which may suggest that they misinterpret their own inner voice as belonging to someone else

180
Q

What did Sitskoom find about cognition and schizophrenia?

A

relatives of schizophrenics had similar cognitive deficits, but they did not develop schizophrenia, meaning that other factors must also be involved

181
Q

What did Butler find about Schizophrenia and cognition?

A

there is less activity in the frontal lobes of those with schizophrenia, showing they are less likely to monitor information from the senses so disagreeing with the cognitive explanation

182
Q

What did Frith & Done find about Schizophrenia and Cognition?

A

Asked participants to follow a target on a video game with a joystick. Both schizophrenics and non-schizophrenics could do this when they could see the errors they made on the screen, but when the errors were not visible, schizophrenics with delusions did a lot worse than the control group, suggesting that schizophrenics have difficulty monitoring their own actions

183
Q

Why is this theory useful (and possibly therefore credible?)

A

The cognitive explanation has led to cognitive behavioural therapy for schizophrenics, which has some effectiveness suggesting the cause of schizophrenia is cognitive

184
Q

What is an issue with CBT for Schizophrenia?

A

Cognitive behavioural therapy is less effective for symptoms such as lack of emotional expression, suggesting these symptoms may have another cause rather than cognitive.

185
Q

Why would this theory be reductionist?

A

ignores the impact of social class and other environmental factors on the development of schizophrenia so may not fully explain the disorder

186
Q

Why might this be seen as holistic?

A

focuses on both nature, in the form of neurotransmitters and nurture, so it is a more complete explanation than the biological explanation

187
Q

What is a big issue with suggesting cognitive issues are the cause of Schizophrenia?

A

It could be that the sensory overload is due to having schizophrenia, not a cause of it, so reducing the credibility of the explanation

188
Q

What did Carlsson find about Schizophrenia and what does this mean for the cognitive explanation?

A

found that neurotransmitters such as glutamate cause symptoms such as hallucinations, so the
(20)
13
cognitive explanation is not a full explanation of schizophreni

189
Q

What is your key question for clinical?

A

Should we be prescribing medication for depression?

190
Q

What is AO1 for your clinical key question?

A

What depression is and why it is a key issue for society

191
Q

What is AO2 for your clinical key question?

A

How drug treatments for depression work

How CBT works as an alternative treatment

192
Q

What is AO3 for your clinical key question?

A

Evaluation of the effectiveness of drug treatments for depression and whether we should prescribe them or not

193
Q

How much does depression medication cost the NHS per day and why is this a key issue?

A

Around £780,000

Need to ensure it is an effective treatment method

194
Q

What percentage of people in the UK aged 16 or over have shown symptoms of anxiety or depression?

A

19.7%

195
Q

What is the role of the Doctor in drug treatments for depression?

A

Prescribe medication and monitor effectiveness

Adjust dosage if required

Review side effects regularly

196
Q

How is serotonin associated with depression?

A

Low levels = symptoms such as low mood and high anxiety

Also influences other monoamines so low serotonin = low dopamine and low noradrenaline too

197
Q

How do SSRIs work?

A

stop the reuptake of serotonin to the presynaptic bulb which means there will be more in the synapse. This will improve symptoms such as anxiety.

198
Q

How do SNRIs work?

A

stop the reuptake of both serotonin and noradrenaline, improving symptoms such as concentration and low mood.

199
Q

How do MAOIs work?

A

stops MAO from doing its job which means it doesn’t break down the monoamines and their number increases. This improves symptoms such as energy and pleasure.

200
Q

How does CBT work as an alternative to drug treatments?

A

Aims to change maladaptive thoughts associated with depression

201
Q

Why may CBT be a better treatment for depression than drug treatments?

A

No side effects

Longer lasting

202
Q

What did the Royal College of Psychiatry find about antidepressant drugs?

A

50 - 65% of those treated showed improvement compared to only 25-30% on a placebo - suggests drugs are effective for treating depression

203
Q

How does Kuyken conflict drug treatments?

A

Found drugs have a higher relapse rate than CBT (60% vs 47%) suggesting that CBT is longer lasting than drugs so should be used instead

204
Q

Why may a patient stop taking drug treatments?

A

Side effects

Depowering

Take a little while to work so may feel worse before they feel better

205
Q

What was the aim of your clinical practical?

A

To conduct a content analysis on news articles to investigate their attitudes towards mental health

206
Q

What was the sample for your clinical practical?

A

Two news articles - one from the Sun and one from the Guardian

207
Q

Describe the procedure for your clinical practical

A

Read through the 2 articles and coded initial interesting terms about mental illness

Counted up the occurrences of words e.g. ‘stigma’ ‘illness’ and whether they were used positively or negatively

Read through again to create final codes

208
Q

Describe the results for your clinical practical

A

The Guardian used more positive words e.g. 3 occurrences of ‘illness’

The Sun was more negative e.g. 4 occurrences of ‘no stigma’

209
Q

What is a strength of your clinical practical in terms of reliability?

A
  • I could repeat this using the same mental health search terms and review the same/similar articles. This means we could repeat the process using the same standardised procedure e.g. search terms and see if we got reliable results.

*I used another student to provide inter-rater reliability reading the mental health articles - could check if they found the same quantitative data about positive and negative terms related to mental health that I did.

210
Q

What is a strength of using secondary data in your clinical practical?

A

Quick and easy to gather, the articles already exist so ethics are not a concern

211
Q

What is a strength of your clinical practical in terms of validity?

A

I filtered/vetted the articles about mental health I used to make sure they were relevant to the aim. This makes them more valid/representative of the media’s attitude to mental health

212
Q

What is a weakness of your clinical practical in terms of validity?

A

what I see is subjective because different people could interpret the articles comments differently e.g. ‘sickness’ as a positive rather than a negative as it acknowledges mental illness as a ‘real illness’

213
Q

What is a weakness of the sample of your clinical practical?

A

results about attitudes to mental health gathered from this don’t represent the whole British media. (They were also ethnocentric all being from the UK so don’t represent global media)

13C (7 decks)

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