Clinical Flashcards
Research evidence for the social causation hypothesis
Hem- adversity affects development of sz
Harrison- life in declining inner city areas
Dohrewend- lower social class implicated
What are the 4ds of diagnosis with evidence
Distress salkovstus and hyperchondriac
Danger sibbald and nicotine
Dysfunction remick and depression
Deviance- seto and pedophaelia
What does Jacobson prove with the ICD
Reliable as sz diagnosis is consistent
What does hiller find with icd
Agreement when the systems used to diagnosis psychosis
What did chenaux find
Not reliable as sz diagnosed more with icd and there is also an overlap in symptoms
What did pihlajamaa find
70% consistency with sz diagnosis in Finland
What did jannson find
When using interview and assessments found icd and DSM were most similar
What did Ellason and ross find
More sz symptoms in those with schizoaffective disorder than those with sz itself
Some information about rosenhan
7-52 day stay with an average of 19. There were 8 pseudo patients and they underwent depersonalisation after admission. 71% of the time ignored.
In the second study 193 shown and 41 identified but really zero showing sane and insane can’t be distinguished
What are three pieces of evidence for the individual differences in culture
Translations by Kim and Berros with sz being disease of the disorganised mind in China
Language with Sabin finding people reluctant to see doctor in new culture due to fear of being misunderstood.
Symptoms Malagady found that hearing voices means sz in USA but spirits in Costa Rica
How do anti psychotics work and what is evidence for them
They target the dopamine system reducing the amount by depolarising neurones.
There is atypical which are newer and then typical which only target positive and meltzer found them to be effective for 481 in their cognitive functioning but known as chemical straight jacket and leberman found clozapine to have severe side effects
What did falkai find
There is higher domaine activity in the left amygdala
What did Wong find
That there was higher receptor density in the caudate nucleus of sz patients
Delusions are…
False beliefs e.g. Those of grandeur persecution and reference
Hallucinations are.
False perceptions e.g. Visual auditory and olfactory
What are the 4 stages of CBT
Belief modification
Focusing and reattribution
Normalising
Cognitive therapy
Strengths of cbt in treating sz
Hoffman did a meta analysis and found a correlation with positive symptoms
Chadwick and Lowe 10/12 challenged thoughts and 5/12 rejected them
Issues with cbt and sz treatment
Only looks at positive unlike drugs which consider both and hence is only applicable to some forms of sz
High drop out rate and can be distressing
Information about Carlson
Contemporary study
Used a literature review
Gluatmatergic failure in basil is positive and in the cerebral cortex is negative.
Glutamate deficiency must be linked maybe causing sensitivity to dopamine presence
4 ocd symptoms
Hoarding
Ruminations
Checking
Contamination
Bio explanation for OCD
Faulty neurocircuitry within the ofc in the thalamus and a key part of this is the caudate nucleus which usually halts activity of neurones but in OCD this is overactive causing hyperactive loop
Good and bad about the bio explanation
Menzies found high grey matter and McGuire also found difference when the compulsion was presented
May be a symptom and not a cause and is reductionist
Cognitive explanation for OCD
Self doubt, need for perfection
Gives power to individual and Tolin found more obsessions in the people affected due to their negative beliefs.
Mowrer stated that obsessions actually arise due to negative associations and more descriptive than explanatory
What is used as a biological treatment in OCD
Drugs specifically ssris and they are used if CBT doesn’t work, it increases levels and hence increase the serotonegic pathways meaning feel more in balance
Are they useful
Stanford found worked 40-60 percent of time and soomro found that individuals given this in a randomised trial against placebo performed better
High relapse rates of 17-21% hence meaning not effective and they do not work for all with lots of side effects too
Other treatment for OCD
CBT again but this time focus on checking and contamination with an anxiety clock to test how far exposed. Shows what happens if avoid ritual
Whitall found CBT and stress levels reduced on the y boc scale and as it is evidence based theory reliable
Cordioli not effective for 30% and pots team found setraline to be effective too so used in conjunction instead
Contemporary study in OCD
Massellis
43 people from teaching based hospital in Canada, had OCD and average of 34 years. Variables were clinical demographic or both.
Comp and intrusiveness 0.53
Ob and intrusiveness 0.62
Depression 54%
Individual differences and developmental psychology for clinical
Ind
Treatments and cultures.
Dev
Neurotransmitter dopamine levels and adolescence
Discuss HCPC
Three standards of character health and conduct
And then following provisions Respect Act in best interest Manage power imbalance Stay up to date and regulated Duty of care Confidentiality
