#Clinical Flashcards

Question

Description of Genetic explanation of SZ

Answer 1

1% likelihood however this increases when related to someone with illness 48% - MZ twins Deletion of COMT gene means D not regulated properly deletion of section of C 22 causes digeorge syndorme in which 1/4 have SZ c4 a specific gene. if you have it you have intensified pruning.

Answer 2

tienari-7% of adoptees had biological parent with sz Gottesman- MZ twins 48% concordance rate used alongside NT explanation explains links between family members

Answer 3

reductionist- not just genes concordance rate is not 100% showing environmental factors ignores cognitive weakness of twin studies- not always equal enviroments

Answer 4

``` depressed mood decreased interest or pleasure in most activities weight change sleep pattern changes change in activity fatigue worthlessness suicidal ideation ```

Answer 5

1/5 affected each year 7-12% of population experience it in the year 7% but variation with age more women effected 2:1 but more men commit suicide

Answer 6

Neurotransmitters

Answer 7

imbalance of NT such as serotonin and dopamine low levels of serotonin linked to symptoms such as high anxiety and low mood there may be too much reuptake of serotonin which has functional effect of lowering levels low serotonin effects levels of other monoamines, like noradrenaline and dopamine

Answer 8

Objective and empirical antidepresseants increase monoamine levels and reduce depression symptoms Drevets- found reduced serotonin receptor binding potential in depressed people rosen et al- enzymes involved with breakdown of serotonin higher in depressed people

Answer 9

cause and effect Cognitive explanation difficult to measure blood and urine levels reduces v drugs dont work for everyone Treatment aetiology drugs work but not necessarily the cause Delgrado- monoamine depletion in depressed people didn't make them feel worse

Answer 10

depression is caused by faulty thinking which interprets how they view the world catastrophising, all or nothing thoughts maladaptive thought through learned experience Beck's negative triad- negative thought about oneself, future and the world negative attributes are internal

Answer 11

CBT works suggets that it is credible seligman- shows dogs develop learned helplessness Beck- people with depression had negative viewpoints about themslef

Answer 12

issues with empiricism cause and effect issues reductionist ignores monoamines drugs work suggesting biological underpinning lewishon et al- little evidence to suggest cognitve attitudes present before depression

Answer 13

depression caused by faulty thinking so CBT is a method of changing that 1:1 with therapist 16 weeks roughly identify negative thoughts and disproves them, diaries completed to note down behaviour teaches you ability to get rid of negative thoughts

Answer 14

``` no side effects Hollon- 47% dont relapse after CBT tailored and individual long lasting Williams demonstrates effectiveness of ICBT ```

Answer 15

doesn't include biology- reductionist requires motivation which depressives often lack socially controlling March et al- suggested best to combine treatments Jones - CBT is not as effective as other psychosocial treatments

Answer 16

to investigate whether sane people who admitted themselves to mental hospital would be diagnosed

Answer 17

5 men 3 women, 12 hospitals in 5 states pseudo patienst claimed to hear voices which said 'thud' all gave their own real life stories natural covert observation

Answer 18

100% diagnosis 7 with schizophrenia 7-52 days 19 days was average stay released as schizophrenia in remission 35/118 patients detected they weren't really ill

Answer 19

``` various hospitals- more generalisable standardized procedure ecological validity as in staffs environment low deman characteristics all trained by rosenhan ```

Answer 20

``` validity- can't blame doctors for getting it wrong usa only only 12 hospitals bias on behalf of pseudo patients ethical issues ```

Answer 21

offers guideline for clinical practitioners ie must provide character references must re register and give details about their health so it doesn't disturb their work

Answer 22

good character, health, good standard of conduct, standards of continuing professional development, standards for education, perscribing

Answer 23

1) best interest of service user taken into account 2) confidentiality 3) high standard of personal conduct

Answer 24

data is collected at one period of time like longitudinal they often look at development of something but do this in a different manner instead of one person over time,two groups ie adults and teenagers with sz

Answer 25

cheaper and easier then longitudinal participants more eay to gather as it does not last years more ethical as right to withdrawl is easier to do

Answer 26

less in depth then longitudinal individual differences cause and effect issues with cohort effect(people too similar)

Answer 27

1)disease characterised by disturbance of language and behaviour-theory this is caused by faulty thinking 2)positive symptoms explained by biological however other symptoms can linked to own experience 3)frith- inability to generate willed action inability to monitor willed action inability to monitor intentions of others 4)Helmsley breakdown in relationship between memories and new information

Answer 28

useful for cbt. used alongside biological- helmsley- hippocampus maybe at fault explains negative symtpoms mcguire et al- auditory hallucinations saw reduced activity in part of brain which recognises inner speech frith and done- video game study. sz find it harder to monitor own actions

Answer 29

``` difficult to test descriptive rather than explanative cause and effect reductionist beck- dopamine causes struggle to underdstand information ```

Answer 30

drug treatments for sz are antipsychotics - work by reducing dopamine- adjusted to level required for patient and can be injection, tablet or syrup. drugs block receptors reducing positve symptoms like hallucinations. roughly takes 10 days to work and sometimes several different drugs need to be taken to find the right one.

Answer 31

``` emsley- 84% patients had 50% reduction in symptoms allows functioning into society drugs act relatively quick;y kane- 80% are helped from antipsychotics relapse rates are lower ```

Answer 32

``` low compliance rate- 50% Rosa severe side effects does not help with the negative symptoms - tardive dyskinsea roughly 60% of pateints are not helped drugs don't cure the disorder not instant ```

Answer 33

cbt aims to challenge maladaptive thought. one or two sessions a week. collaboratively work to discuss symptoms. focused upon rationally. operates on the ABC model normalising- destibmatises psychotic experience belief modification- tests hallucinations against reality attributing- looks at auditory hallucinations- gender and age makes it seem like it was pateint

Answer 34

``` collaborative- works with patient tailored to individual needs no side effects can assist in the acute phases in sz. chadwick - 10/12 found lowered belief in their delusions ```

Answer 35

Sensky- found no difference between cbt and bonding BUT this did change after follow up period CBT - distressing when focusing on certain symptoms social control can be seen as an issue difficulties in measuring congnition ( not empirical)

Answer 36

drug treatments are psychoactive- balance NT in the brain. AD increase the levels on monoamines in brain. psychiatrists will monitor dosage and how patient is respondings. SSRIs stop reuptake of serotonin making there more in synapse. MAOIs stop MOA doing its job of breaqking down monoamines

Answer 37

60% improvement in condition compared to those given placebo act relitavely quickly allows a return to normal functioning jarrett et al- showed effectiveness at MAOIs atv treating depression

Answer 38

``` Muller- netherlands study which found that 76% who weren't given drugs did not relapse side effects and poor compliance effects are not instantaneous do not cure the disorder CBT is effective ```

Answer 39

to review relationship between NT on schizophrenia and specific brain areas wanted to test NT to see the effectiveness in drug treatments

Answer 40

32 studies reviewed eg brain scans on studies on rodents, parkinsons patients those in SZ and in remission observed

Answer 41

dopamine hypothesis too simplistic too hard to choose between models of what causes SZ low glutamate dopamine rises serotonin turnover linked clozapine found as highly effective, antidopamingeric and antiserotonergic

Answer 42

``` Sendt et al- dopemine does not explain all negative symptoms broad amount of study types review study gives a broader view brain scans are objective and reliable ethical- not directly due to him useful for drug therapy ```

Answer 43

animal studies not generalisable some studies disagree showing issues with reliability only used 32 studies parkinsons not exactly linked to Sz

Answer 44

to test remote forms of CBT to see if imagination based cognitive bias modification would impact positively on iCBT outcomes

Answer 45

69 patients who were recruited from online applications diagnostic interview from DSM randomised on control group 31 and treatment group 38 measured on tests such as BDI 20 minutes a day of CBT and later iCBT

Answer 46

pre treatment there was no significant difference after the first week there was a treatment group with lower depression scores therapy was evaluated as good easy and logical by participants

Answer 47

internet recruitment from all over Australia right to withdrawl and medication access to everyone other mental disorders excluded to increase reliability participants who could not take part were referred to other services measured through DSM IV high validity

Answer 48

``` participants rated themselves data was collected over three months self report issues EVs all from same location sample was filtered so less representative ```

Answer 49

to see whether CBT was an effective treatment of atypical SZ in a woman

Answer 50

case study of carol 26 years old to start studied for three years for CBT first stage- building rapport with therapist second stage- was understanding how CBT would work Third- undergoing CBT various measurements

Answer 51

carol showed little distress GPI score of one days in hospital drops to 0 goals included starting college course, volunteering and seeing friends

Answer 52

``` longitudinal lots of data gathered qualitative and data triangulation (various methods) useful as it shows CBT effectiveness ```

Answer 53

difficult to repeat un-generalisable because they are so small case studies are naturally occurring

Answer 54

to see how self esteem, support and life events impacted depression

Answer 55

395 working class women with at least one child at home recruited through postal questionnaire and all were between 18-50

Answer 56

``` women were assessed twice a year apart prospective study initially interviewed about self esteem and social support they had assessments done by interview questioned about stressful life events ```

Answer 57

33% had negative evaluation crisis core support does not impact depression having core support but not in a crisis makes people feel let down so they can get depression

Answer 58

large sample very similar group minimises individual differences prospective study no retrospective bias standardised questions can ask follow up questions eliminated women at second stage who turned out to have depression all along

Answer 59

``` sample only includes women sample only includes people from same doctors surgery social desirability demand characteristics semi structured interview ```