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Schizophrenia > Essay ones > Flashcards

Essay ones Flashcards

1
Q

What are the two classifications of mental disorders?

A
  • ICD-10
  • DSM -5
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2
Q

What are the positive symptoms of schizophrenia?

A

Hallucinations
- unusual sensory beliefs which could be related to the environment and can be experienced in relation to any sense
Delusions
- irrational beliefs that can take a range of forms, for example : being involved in big historical events

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3
Q

What are the negative symptoms of schizophrenia?

A

Avolition
- finding it difficult to being or keep up with a goal-directed activity
Speech poverty
- reduction in the amount of quality of speech

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4
Q

What is comorbidity?

A
  • two or more conditions are present in a person at once
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5
Q

What is symptom overlap?

A

two or more conditions share symptoms
- Sz + BPD both share delusion

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6
Q

Genetic basis for schizophrenia

Ripke et al

A
  • Individual genes have been believed to be associated with risk of inheriting schizophrenia
  • since each gene is associated with a small risk, it can be said that schizophrenia is polygenic
  • Further research has proved that there are many factors in causing schizophrenia including many different candidate genes, making it aetiologically heterogenous
  • Ripke et al (2014) looked all the pervious genome-wide studies and found that 108 genes are related in causing schizophrenia
  • some genes also included affecting dopamine
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7
Q

The dopamine hypothesis for schizophrenia

A
  • DA is important in the function of the brain systems
  • Hyperdopaminergia in subcortex : excess DA receptors in broca’s area which is associated with poverty of speech
  • Hypodopmerminergia in the cortex : low levels in DA cause negative symptoms
  • More recent research focuses on abnormal levels of DA and says that both high and low levels can have an affect on schizophrenia symptoms
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8
Q

Biological explanations for Sz AO3 (adoption studies?)

A

P: Supporting evidence from adoption studies
E: Tienari et al (2004) shows that children that are biologically connected to people with Sz are still at high risk even when adopted by non-Sz families. Also, gattsman found that if your aunt had sz you have 2% chance of getting it but if its your identical twin its goes to 48%
A: There is overwhelming evidence for genes making you more vulnerable for being at risk for schizophrenia

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9
Q

Biological explanations AO3

curran et al

A

Evidence for dopamine Curran et al amphetamines increase dopamine and worsen symptoms in people with schizophrenia DOUBLE not all drugs that increase dopamine lead to worse symptoms for example apomorphine

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10
Q

Biological explanations for Sz AO3 (dopamine hypothesis) support from drug therapy

A

P: Support from drug therapy
E: DA is involved in Sz as dopamine agonists increase dopamine-receptor activity and make Sz worse, antipsychotic drugs which block DA reduce symptoms of Sz
A: there is a direct link between Sz and dopamine which increases validity of theory as DA plays a role in Sz

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11
Q

Biological explanations AO3 (dopamine hypothesis) other neurotransmitters

A

P: Other evidences show that other neurotransmitters have a central role such as glutamate
E: Several brain scan studies and post mortem showed that paitents with Sz have high levels of glutanate. Several candidate genes of Sz also are involved in glutamate production
A: evidence for dopamine hypothesis is mixed and equally as strong for other neurotransmitters

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12
Q

Drug therapy AO1 (Chlorpromazine)

A

Chlorpromazine
- typical antipsychotic, dopamine antagonist (block DA receptors and doesn’t allow message to pass
- this reduces hyperdopaminergia which reduces certain positive symptoms
- Atypical drugs were created to reduce the many side effects that come with this

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13
Q

Drug therapy AO1 (risperidone)

A

Risperidone
- developed to avoid a certain blood condition that comes from clozapine
- blocks DA, serotonin and glutamate receptors but stronger on DA
- This makes it more effective in smaller doses and has fewer side effects

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14
Q

Drug therapy AO1 (Clozapine)

A

Clozapine
- Atypical which acts as an antagonist where it blocks DA receptors but also serotonin and glutamate receptors
- effective at improving cognitive functioning and mood
- used when patient doesn’t respond to typical drugs
Risperidone

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15
Q

Drug therapy AO3 ( evidence for effectiveness of antipsychotic drugs/ thornly?)

A

P: Evidence for effectiveness of antipsychotic drugs
E: Thornly (2003) review studies comparing effects of chlorpromazine to control conditions. 13 trials 1121 ptps overall showed better functioning with the drug. Meltzer (2012) clozapine is more effective than typical antipsychotics and effective in 30-50% of treatment resistant cases where anitpsychotic have failed
A: Shows they’re effective at reducing symptoms, it is better to treat as early as possible

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16
Q

Drug therapy AO3 (serious side effects?)

A

P: serious side effects
E: Typical AP, long term effects associated with tardive dyskinesia (Involuntary facial movements) caused by DA super sensitivity. Very serious sone is neuroleptic malignant syndrome - drug blocks DA in hypothalamus, resulting in high temp, delerium and coma
A: Typical AP can do harm as well as good so many may avoid them, making them ineffective

17
Q

Drug therapy AO3 (weakness) unclear mechanism

A

P: Unclear mechanism due to dependence on dopamine hypothesis
E: DA hypothesis is an incomplete explanations as explained by the updated version. DA levels in other parts of the brain are too low rather than too high - antipsychotics shouldn’t work
A: AP may have be the best treatment to opt for and there may be other factors involved in their success

18
Q

Psychological explanations : Schizophrenogenic

A
  • Cold, rejecting, controlling mother which creates a family environment characterized by tension and secrecy
  • Leads to distrust that later develops into paranoid delusions, ultimately Sz
    Issues:
  • Alpha bias as it maximizes the difference between male and female
  • it is socially sensitive that is blaming the parent, in this case, blaming the mother which can create stress for mothers
19
Q

Psychological explanations : Double bind theory

A
  • Child may be trapped in situation where they fear doing the wrong thing
  • get mixed signals from parents as to what is right/wrong
  • they get punished by withdrawal of love
  • Leads them to learn the world is confusing and dangerous which causes disorganized thinking and delusions
    Issues with this:
  • Socially sensitive, blames parent
  • Creates additional stress for parents who already see their children experience Sz
20
Q

Psychological explanations : Expressed emotion

A
  • Level of mainly negative emotion expressed towards a Sz paitent
  • This includes:
  • verbal criticism (sometimes paired with violence)
  • Hostility towards them (anger and rejection)
  • emotional over-involvement in their life
  • stress can trigger onset of sz in someone who is vulnerable
  • Mostly used to describe how increase stress is more likely to lead to relapse
  • attachment type studies suggests that over half of men and women who develop Sz have a history of mental/physical abuse
21
Q

Psychological explanations : cognitive explanations

A

Central control errors
- Inability to suppress automatic thoughts while performing deliberate actions
- Leads to derailment of thought and disorganised speech
Misrepresentation errors
- Misinterpreting our own behaviour as being under another’s control due to error in thinking about our own goals or intentions

22
Q

Psychological explanations A03 (read et al)

A

P: Evidence showing that difficult family relations may increase risk of Sz
E: Read et al (2005) reviewed 46 studies of child abuse and Sz and found that 69% of adult woman patients had a history of verbal, physical and sexual abuse. For men, it was 59%
A: shows a clear link between family dysfunction and increased risk of sz
H: Most of the evidence shares a weakness, they are all based on information about childhood, reported after all the symptoms have occurred so they may havterm-24e forgotten or Sz may have distorted their recall

23
Q

Psychological explanations A03 (weakness: schizophrenogenic mother)

A

P: weak evidence for schizophrenogenic mother
E: Research provided is from clinical observations and early evidence that looked at mothers and gave them “crazy-making” observations.
A: The supporting evidence is weak and may tell us very little about the extent to which childhood and family affect the development of Sz

P: Schizophrenogenic mother leads to parent-blaming
E: After having to see your child descent into Sz and having to bear a life-long responsibility of taking care of them. This theory adds further trauma by “adding salt to the wound”
A: this makes it very hard for a mother to take care of her child and causes her to blame herself for everything

24
Q

Psychological explanations A03 (research support for cognitive explanation)

A

P: Research support for cognitive explanation
E: Stirling found, comparing 30 people in a control to 30 people with a Sz, that those with Sz performed poorly on cognitive tasks like the stroop test (took twice as long)
A: Supports ‘central control errors’ hypothesis
H: fails to explain the actual cause and offers only part of the explanation on what is happening

25
Q

Psychological therapies AO1 (CBT)

A
  • For Sz paitents suffering from delusions & hallucinations
  • helps identify the hallucinations and delusions and make sense of them (reducing anxiety)
  • Hallucinations and delusions are challenged and tries to help develop strategies to deal with them
  • Paitents learn that their beliefs and hallucinations are not based on reality and overall their cognitive thinking improves and they are able to talk themselves through suffering hallucinations
26
Q

Psychological therapies AO1 (Family therapy)

A
  • For Sz patients within families
  • Improves quality of communication and interaction within a family (reduces anxiety of family)
  • Strategies to anticipate and solve problems, reduces anger and guilt and blame. Balances caring for Sz and overall family wellbeing
  • Changes the way families interact overall reducing levels of EE and stress
27
Q

Psychological therapies AO1 (Token economy)

A
  • For patients with Sz displaying maladaptive behaviour in institutions
  • Improves QOL and enable them to eventually leave hospitals
  • Token given desirable behaviors immediately to prevent delay discounting (reduced effect of delayed reward)
  • Tokens are secondary reinforcers based on the principles of operant conditioning
28
Q

Psychological therapies AO3 (strength of CBT / jauner 2014)

A

P: Evidence for effectiveness of CBT
E: - Jauner (2014) reviewed 54 studies of CBT on Sz paitents concluding small but significant effects on symptoms
- Pontillo (2016) found reductions in frequency and severity of hallucinations
A: allows people with Sz to get better and increase overall QOL
H: CBT and symptoms vary from case to case, different studies have involved different CBT techniques with different combiniations for + and - symptoms. Hard to suggest effectiveness for a particular person

29
Q

Psychological therapies AO3 (strength of family therapy?/ Mcfarlane?)

A

P: Evidence of effectiveness of family therapy
E: McFarlane (2016) concluded that family therapy was one of the consistently effective treatments ; relapse rates were reduced by 50%-60%
A: Benefits to the whole family not only the patient as they provide the bulk care so by strengthening the family relations, it’ll provide better care for the patients

30
Q

Psychological therapies AO3 (weakness of ethical concerns?)

A

P: ethical issues with treatments
E: CBT may be seen as controversial as it interferes with freedom of thought
Token economy may be easier for people for milder symptoms and opens up doors for discrimination due to how different people live their lives
A: May lose trust in therapies

31
Q

Interactionist approach AO1

A
  • Meehl (1962) suggests that the diatheses vulnerability is entirely genetic and without a schizogene, no amount of stress can cause Sz
  • However, modern understand suggests that Sz is polygenic and suggests that there are multiple factors that lead to Sz including trauma that can become the stressor
  • Trauma could alter brain structure like child abuse causing the HPA system to be overactive and increase stress
  • Stress includes anything that risk triggering Sz
    -Research suggests that cannabis can be a stressor an increases risk of Sz by 7x
32
Q

Interactionist approach treatment AO1

A
  • Combine drugs and CBT
  • Turkington (2006), possible to believe in biological causes and practice CBT to relieve symptoms
33
Q

Interactionist approach (wider reading)

A

Steve cole
- closeted gay men with HIV die faster than open gay men with HIV
- due to certain genes being expressed as a result of their loneliness or ostracization
- leads to inflammation which speeds up disease

34
Q

Interactionist approach AO3 (real world application / terrier )

A

approach AO3 (strength)
P: Real world application
E: Studies show that combination treatments enhance their effectiveness, tarrier (2004) randomly allocated 315 ptps to either group 1 (CBT + medicine) or group 2 (CBT + medicine) or group 3 (medication only). Group 1 and 2 showed lover symptoms the following trial
A: Suggests a clear practical advantage of the adoption of the interactionist approach in terms of treatment outcomes

35
Q

Interactionist approach AO3 (oversimplified )

A

P: original diathesis model is oversimplified
E: Multiple genes are involved in the influence of Sz whilst stressors can be psychological. They can also be biological as Houston looked at childhood sexual abuse which emerged as the major influence to Sz and cannabis as the major trigger
A: Original diathesis stress model didn’t involve multiple genes which suggested an over simplicity as there are multiple factors both biological and psychological affecting both diathesis and stress, supporting the modern understanding

36
Q

Interactionist approach AO3 (real life studies?)

A

P: real life studies
E: Sz is diagnosed more in urban areas than rural areas which supports the interactionist approach as urban living is more stressful than rural living. The city may be a trigger for Sz
A: Increases validity as it can be found in a real life setting
H: this could just be due to more people being diagnosed in cities or that people with a diathesis for Sz tend to migrate to cities

Schizophrenia (2 decks)

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