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Psychology Clinical > Clinical > Flashcards

Clinical Flashcards

1
Q

What are the 4ds of diagnosis?

A

Dysfunction
Distress
Deviance
Danger

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2
Q

What is the 5th d that was added later?

A

Duration

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3
Q

What are the books used to diagnose mental health problems from?

A

DSM and ICD

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4
Q

Where is the DSM used?

A

America as its created by the American associations

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5
Q

What is descriptive validity?

A

2 individuals suffer the same symptoms and should get same diagnosis

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6
Q

What is ateological validity?

A

When 2 individuals have similar diagnosis due to having similar causal factors

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7
Q

What is concurrent validity?

A

When clinician uses more than one method to diagnose, each method came to the same conclusion

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8
Q

How does a reliable diagnosis occur?

A

Through concurrent validity

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9
Q

How is a valid diagnosis drawn?

A

When symptoms shown are the same as the book. If treatment works then the correct diagnosis was given

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10
Q

What is the kappa value?

A

Reliability of diagnosis, level of agreement 0.7

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11
Q

State the findings of Regnier 2013

A

Found PTSD 0.69
Personality disorder 0.75
General anxiety disorder 0.2

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12
Q

What was Regier trying to prove?

A

If the DSM accurately diagnosed people from volume 4 to volume 5

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13
Q

Who proved the validity of the DSM?

A

Cohen 2005

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14
Q

How did Cohen find the DSM to be valid?

A

Had concurrent, predictive and ateological validity

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15
Q

How was concurrent validity proved by Cohen?

A

Interviews
Questionnaire

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16
Q

How was predictive validity shown by Cohen?

A

Children then had learning difficulties

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17
Q

How was ateological validity shown by Cohen?

A

Having similar causal factors

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18
Q

What mental health problem did Cohen study?

A

Conduct disorder

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19
Q

How is the DSM not valid?

A

Individual differences may effect cause of mental disorder

Can’t identify specific causal factors

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20
Q

Outline the ICD

A

11 editions
Published by WHO
Different code for each disorder

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21
Q

What did Ponizovsky show in terms of reliability? Schizophrenia

A

Schizophrenia went from 68% in 1989 using ICD volume 9 to 94.2% in 2002 using ICD 10

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22
Q

Why is the ICD not reliable?

A

Doesn’t account for individual differences

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23
Q

How does the ICD show validity?

A

Predictive validity where the diagnosis was able to predict later struggles

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24
Q

How is validity a weakness for the ICD?

A

Application it needs to be simplified and be more user friendly

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25
Q

What are the 4 symptoms of schizophrenia?

A

Thought insertion
Hallucinations
Delusions
Disorders thinking

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26
Q

When is a diagnosis of schizophrenia given?

A

After 6 months with at least 1 symptom effecting daily function

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27
Q

What other conditions can schizophrenia be confused with?

A

PTSD
depression

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28
Q

What gender gets diagnosed with schizophrenia earlier?

A

Males

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29
Q

Outline Lurmann study

A

Interviewed 60 American, Ghanaian people with schizophrenia

Found 70% Americans extraneous voices were telling then to hurt others
But on 50% Ghanaians.

Ghanaians said positive voices where more powerful with only 20% negative.

10% Americans said voices were family members

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30
Q

What are the 2 assumptions of the dopamine hypothesis of schizophrenia?

A
  1. Excess dopamine at receptors in the mesolithic pathway cause positive symptoms like hallucinations. Hyperdopaminertia
  2. Lack of dopamine in the mesocortical pathway with pre frontal cortex causes a flattened effect. Hypodopaminertia
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31
Q

What are the 2 assumptions of the dopamine hypothesis of schizophrenia?

A
  1. Excess dopamine at receptors in the mesolithic pathway cause positive symptoms like hallucinations. Hyperdopaminertia
  2. Lack of dopamine in the mesocortical pathway with pre frontal cortex causes a flattened effect. Hypodopaminertia
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32
Q

Who conducted the contemporary study for schizophrenia?

A

Carlson

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33
Q

What were the aims of the schizophrenia contemporary study?

A

Show neurotransmitter functioning between Neurones and brain areas

Provide explanation for schizophrenia

Produce new drugs which are more effective

34
Q

What were the findings of the contemporary study for schizophrenia?

A

People with schizophrenia had higher dopamine levels in mesolymbic pathway

Dopamine in high then glutamine is low so the thalamus becomes overactive and the cerebral cortex is starved of activity

35
Q

Outline the evaluation points for carlsons contemporary study for schizophrenia

A

G + range of research and comparisons as well as using animals

R + inter rater, meta analysis identified thematic analysis

A + new more effective drugs can be made

V- range of methods with different aims lacks internal validity
Bias as well as only pick out findings which are relevant

36
Q

What was the aim of Shields experiment?

A

To investigate how far schizophrenia was genetic

37
Q

What was the procedure of Shields experiment?

A

Used secondary data from 1 hospital where a set of twins were diagnosed with schizophrenia

38
Q

What was the sample in Shields experiment?

A

31 males and 31 females aged between 19 and 64

39
Q

What were the 3 results of Shields experiment?

A

High risk of inheriting schizophrenia in identical twins 42% compared to 9% in non identical twins

Schizophrenia may also be caused by environments

40
Q

What causes genes to cause schizophrenia?

A

Mutation or deletion

41
Q

What is digeorges syndrome?

A

When deletion causes 30 to 40 genes to be deleted on chromosome 22

42
Q

What percentage of people with digeorges syndrome develop schizophrenia?

A

25%

43
Q

What does the COMT gene control?

A

The production of COM enzymes which breakdown neurotransmitters leading to an increase in dopamine

44
Q

What does the diathesis model suggest?

A

An individuals probability of developing schizophrenia is higher is you are exposed to stressful situations and childhood trauma

45
Q

What is social causation theory?

A

Schizophrenia is caused by the way people interact with each other and who you are around

46
Q

What is social adversity?

A

When family disfunction and childhood trauma causes symptoms of schizophrenia as needs are not met

47
Q

What is urbanity?

A

Eaton suggested city life is more stressful than rural life as it increases social defeat

48
Q

Name some city stressors

A

Competition
Crowding

49
Q

What is social defeat hypothesis?

A

When exposed to hostility stress increased

50
Q

What did Selton find in social defeat hypothesis?

A

When an invading rat entered another’s home the resident rat attacked the intruder as stress increased. This lead to submission and increased dopamine to end hostility

51
Q

What did Boydell find in people with Schizophrenia risk?

A

1st and 2nd generation immigrants were at more risk of developing disease

52
Q

Why are immigrants at a greater risk of inheriting schizophrenia?

A

Due to prejudice and discrimination and the parental and cultural norms

53
Q

Why are immigrants at a greater risk of inheriting schizophrenia?

A

Due to prejudice and discrimination and the parental and cultural norms

54
Q

What are the 2 types of antipsychotic?

A

Typical and Atypical

55
Q

List some side effects of antipsychotics

A

Weight gain
Blurred vision
Lack of sex drive

56
Q

Outline how typical anyipsychotics work in the synapse

A

Bind to D2 receptors in the mesolymbic pathway. This means less dopamine can enter and more metabolites are present to breakdown neurotransmitters. Less dopamine less symptoms of schizophrenia

57
Q

Outline how Atypical antipsychotics work in the Synapse

A

Binds to the dopamine and serotonin reuptake channels. Therefore dopamine is reduced and glutamate and serotonin increased. Reduces both positive and negative symptoms of schizophrenia

58
Q

Outline Meltzers experiment

A

Studied 481 patients with schizophrenia.

3 groups, no treatment, 4 atypical drugs and an typical group

59
Q

Outline the findings of Meltzer experiment

A

Haloperidol typical drug improved all areas of functioning

2 out of 4 atypical drugs showed improvements

60
Q

What is tardive dyskinesia?

A

Abnormal movements of the face

61
Q

What percentage of people on antipsychotics developed tardive dyskinesia?

A

15%

62
Q

What does publication bias of antipsychotics effectiveness show?

A

Gain for anyone who created or produced drug.

Bias shows drug may not be effective for all

63
Q

What are the effects of antipsychotics on istitutuonalising those with schizophrenia?

A

Enhances protection in society and quality of life for individual

64
Q

What are the effects of antipsychotics on istitutuonalising those with schizophrenia?

A

Enhances protection in society and quality of life for individual

65
Q

What percentage of people had no response to antipsychotic drugs?

A

55%

66
Q

What negative ethical issue may there be with antipsychotic treatments?

A

Takes away the individuals right to choice as they are incapacitated so consent for treatment is given on their behalf

67
Q

What negative ethical issue may there be with antipsychotic treatments?

A

Takes away the individuals right to choice as they are incapacitated so consent for treatment is given on their behalf

68
Q

What does CBT believe symptoms of schizophrenia are caused by?

A

Thoughts,beliefs,perception

69
Q

How does CBT help treat schizophrenia?

A

Delusions create fear and anxiety which lead to isolation

70
Q

Outline how CBT works

A

Identifies stressor to normalise behaviour to prevent relapse

71
Q

How does CBT help individuals with schizophrenia?

A

They are made to feel their symptoms are as a result of theor disorder so are not an outcast

72
Q

Outline how behavioural treatments help schizophrenia patients

A

Make individual create a situation where their delutions are tested to show proof of reality

73
Q

Outline the NICE findings

A

Showed reduction in hospitalisation,
Reduction in amount of time spent in hospital, reduction in severe symptoms

74
Q

Give evidence to show CBT is ineffective

A

Only 2 out of 9 trials showed CBT helped symptoms.

May be relationship formed woth disorder which helps individuals

75
Q

Give evidence to show CBT is effective

A

55% don’t respond to antipsychotics alternative treatment

Skills are life long with no side effects

76
Q

Give evidence to show CBT is effective

A

55% don’t respond to antipsychotics alternative treatment

Skills are life long with no side effects

77
Q

Outline some issues with diagnosis

A

Subjectivity- symptoms may be viewed differently in cultures

Reliability- diagnosis is not consistent between DSM and ICD

Ethnocentric- DSM based on western cultures

Reductionist- simplifies diagnosis into symptoms

Validity- Bias diagnosis, doesn’t account for causal factors so lacks both aeteological and concurrent validity

78
Q

What was the aim of Rosenhans classic study?

A

Can professionals recognise if someone is faking a disorder

79
Q

What was the sample of Rosenhans classic study?

A

Professionals, doctors, staff at 12 hospitals in 5 different states

80
Q

What was the method in Rosenhans classic study?

A

To fake a diagnosis by claiming to hear voices then when in a hospital to act normal

81
Q

What were the results of Rosenhans classic study?

A

11/12 were diagnosed with schizophrenia. 1/12 diagnosed with bipolar

Length of hospital stay 7-52 days

35/118 actual patients thought fake ones were faking it

All discharged with symptoms in remission

82
Q

Give the evaluation points for Rosenhan classic study

A

G+ representative sample as diagnosis consistent but invalid

R+ standardised procedure

A+ created training for professionals

V+ ecological natural setting
- internal may create bias

E- socially sensitive

Psychology Clinical (2 decks)

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