Key Studies and Vocabulary - CLINICAL Flashcards

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1
Q

what is a summative content analysis?

A

A summative content analysis converts the qualitative data to quantitative data by counting how many times specific things are observed in the sources.

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2
Q

What is a literature review?

A

a survey of other studies in the field of interest, (in this case attitudes towards mental health) in order to decide on the categories (types of thing that they are looking for) and coding units (the specific things e.g. keywords that they are going to count) in their study.

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3
Q

when is a tally chart used?

A

A tally chart is used to record the quantitative data - how many times the key words appear in the sources

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4
Q

What studies are important when thinking of summative content analysis?

A

Thornicroft et al. (2013); Perkins and Francis (2012); Crowe and Averett (2015); Salve et al. (2014)

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5
Q

Why is Thornicroft et al. (2013) important to summative content analysis?

A

Thornicroft et al. (2013) conducted a content analysis of Newspaper coverage of mental illness in England 2008-2011. They found that there was a significant increase in the proportion of anti-stigmatising articles between 2008 and 2011. There was no concomitant proportional decrease in stigmatising articles, and the contribution of mixed or neutral elements decreased.

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6
Q

Why is Perkins and Francis (2012) important to summative content analysis?

A

Perkis and Francis (2012) - Conducted a critical review of mental illness in the media and found that there is a tendency for different types of news and information media to present mental illnesses in a way that promotes stigma (e.g., by conflating it with violence and crime) and/or perpetuates myths about mental illness. However they also found some evidence that reporting practices have improved over time.

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7
Q

Why is Crowe and Averett (2015) important to summative content analysis?

A

Crowe and Averett (2015) published a paper on attitudes of mental health professionals towards mental illness

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8
Q

Why is Salve et al. (2014) important to summative content analysis?

A

Salve et al. (2014) had a similar focus to Crowe and Averett, but this time in rural North India. It would be interesting to see if the same keywords (and ideas) arose in their study.

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9
Q

define deviance

A

behaviour does not conform to the social/cultural norms of society; it is seen as odd or unacceptable to others

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10
Q

define distress

A

the person experiences negative feelings as a result or part of their mental ill health, such as great sorrow, fear or despair.

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11
Q

define dysfunction

A

the person is unable to carry out everyday tasks. This may include occupational (work related ) or social dysfunction - affecting their relationships and social life.

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12
Q

define danger

A

the person is behaving in a way that puts themselves and/or others at risk of harm e.g. violent behaviour

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13
Q

define duration

A

(this is a fifth D) this refers to how long the symptoms have been present

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14
Q

define DSM

A

The Diagnostic and Statistical Manual of Mental Disorders

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15
Q

define ICD

A

The International Statistical Classification of Diseases and Related Health Problems

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16
Q

what studies are considered useful when thinking of classification systems of mental disorders?

A

Davis (2009); Rosenhan (1973); Goldstein (1988)

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17
Q

Why is Davis (2009) considered important when considering classification systems of mental disorders?

A

Davis (2009) suggests that using the 4 Ds can help practitioners to see when a condition might need a DSM diagnosis, which may lead to an effective treatment.

Davis (2009) also found evidence to support the validity of DSM as a diagnostic tool because various diagnoses focus on specific Ds.

Davis (2009) has suggested that without including duration, the four Ds are insufficient as a tool for diagnosis.

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18
Q

Why is Rosenhan (1973) considered important when thinking of classification systems of mental disorders?

A

Rosenhan’s (1973) study found that clinicians using DSM were unable to distinguish well, ‘normal’ participants from those with real psychiatric symptoms. This challenged the validity of DSM as a diagnostic tool. This led to important revisions in DSM, leading to a number to updated editions in the light of new evidence

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19
Q

Why is Goldstein (1988) considered important when thinking of classification systems of mental disorders?

A

Goldstein(1988) tested the reliability and validity of diagnosis between the DSM-II and DSM-III. She used the single blind technique, where clinicians carry out the rediagnosis separately, without knowing the previous diagnosis, so they were not affected by bias/expectations. She found that there was evidence of reliability within the DSM-III, i.e. separate clinicians agreed on diagnosis. (They were consistent).

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20
Q

What research methods are used in classification systems of mental disorders?

A
Validity (Construct, Concurrent, Predictive, Convergent)
Reliability
Cross-cultural research
Interviews
Clinical Interviews
Single-blind technique
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21
Q

define symptoms of a mental disorder

A

the behaviours, thoughts and feelings experienced by the patient/client associated with their diagnosis e.g. hallucinations. They may be observable, or may be reported to the clinician by the patient (privately experienced, self-report).

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22
Q

define positive symptoms

A

Symptoms that are found in patients with schizophrenia that are not found in the normal population such as hearing voices (auditory hallucinations)

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23
Q

define negative symptoms

A

the absence or lack of normal levels of functioning such as apathy or avolition, poor self care, lack of speech (also known as poverty of speech or alogia), and the absence or ‘flattening’ of normal emotional responses (also known as flattened affect)

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24
Q

define features of a mental illness

A

facts about the illness, such as age of onset of symptoms; how commonly it occurs in a particular population (prevalence); whether there are gender or culture differences, or groups at higher risk of diagnosis; the course of the illness; subtypes of the illness (in DSM-IV)

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25
Q

What are the features of schizophrenia?

A

Lifetime Prevalence - Schizophrenia is found in any nation at a rate of 1.4 - 4.6 per 1000 people (Jablensky, 2000)

Onset of symptoms of schizophrenia is usually from late adolescence to about +30 years.

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26
Q

What research methods and diagnostic terms are used schizophrenia?

A
Interview
Prevalence
Onset
Systematic research review
Self-report
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27
Q

define cellular disarray

A

Brain tissue samples from the brains of patients with schizophrenia show neurons that appear to be disorganised in the way they are structured/arranged in comparison to normal controls.

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28
Q

define ventricular enlargement and asymmetry

A

The fluid filled spaces in the brain called ‘ventricles’ are enlarged in patients with schizophrenia in comparison to normal controls, and may be more enlarged in one hemisphere than the other.

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29
Q

define hypofrontality

A

Reduced activity in the frontal lobes of the brain, which are involved in higher level cognitive functioning, planning, problem solving and integrating information. This is measured in fMRI scans

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30
Q

define reduced brain weight

A

at post-mortem, the brains of patients with schizophrenia weigh less, on average, than normal controls.

31
Q

define reduced brain volume

A

MRI scans of discordant MZ (identical) twins show reduced brain volume and increased fluid filled spaces in affected twins (with schizophrenia) in comparison to their well twins.

32
Q

What studies are important to consider when thinking about the biological explanations of schizophrenia (structural abnormalities of the brain)?

A

Gazer et al. (2000); Czernanski et al. (2004); Molina et al. (2005); Van Erp et al. (2015)

33
Q

Why is Gazer et al. (2000) important when thinking of biological explanations of schizophrenia (structural abnormalities of the brain)?

A

Gaser et al. (2000) compared the MRI scans of the brains of MZ (identical) twins, and found that the affected twins, with schizophrenia, had enlarged ventricles and reduced brain volume in comparison to the brains of the controls - the unaffected twins.

34
Q

Why is Czernanski et al. (2004) important when thinking of biological explanations of schizophrenia (structural abnormalities of the brain)?

A

Czernanski et al. (2004) reported that neurons from samples from the hippocampus of patients with schizophrenia were disorganised in comparison to samples from normal controls, showing cellular disarray

35
Q

Why is Molina et al. (2005) important when thinking of biological explanations of schizophrenia (structural abnormalities of the brain)?

A

Molina et al. (2005) compared the fMRI scans of patients with schizophrenia and a normal control group. Both at rest and during a card sort task. They found that the patients with schizophrenia had reduced activity in the frontal lobes of the brain during card sort tasks in comparison to the normal control group. This suggests that the patients with schizophrenia had hypofrontality

36
Q

Why is Van Erp et al. (2015) important when thinking of biological explanations of schizophrenia (structural abnormalities of the brain)?

A

Van Erp et al. (2015) conducted a meta-analysis of research into sub-cortical brain abnormalities in patients with schizophrenia and reported that in comparison to controls individuals with schizophrenia have smaller volume in the hippocampus, amygdala, thalamus, nucleus accumbens and intracranial space than controls, and larger pallidum and ventricle volumes.

37
Q

What research methods are used when thinking of biological explanations of schizophrenia (structural abnormalities of the brain)?

A

Meta-analysis
Magnetic resonance imaging (MRI)
Functional MRI - (fMRI)
Computed tomography (CT)

38
Q

define dopamine hypothesis

A

Schizophrenia is caused by excessive activity at synapses that use dopamine as their primary neurotransmitter. This causes abnormal functioning of DA-dependent brain systems, resulting in schizophrenic symptoms

39
Q

define glutamate hypothesis

A

When glutamate activity increases, dopamine activity decreases, so glutamate has an inhibitory effect on dopamine activity. Where is comes to schizophrenia, what was assumed to be the result of excessive dopamine might actually be the result of too little glutamate activity.

40
Q

define chlorpromazine

A

an antipsychotic drug that blocks dopamine receptor sites without activating them.

41
Q

define amphetamines

A

a drug of abuse that increases levels of dopamine in the brain by interrupting dopamine reuptake. The drug causes causes euphoria and psychomotor agitation and prolonged exposure to high doses of the amphetamines can lead to a paranoid, delusional psychotic state, which can be accompanied by hallucinations.
PCP - a drug of abuse, also known as Angel Dust, which can induce symptoms that are almost indistinguishable from those associated with schizophrenia. It is an NMDA glutamate receptor antagonist, meaning that it blocks glutamate receptors without activating them.

42
Q

What studies are important when thinking of the biochemical explanations of schizophrenia (the dopamine hypothesis)?

A

Wise and Stein (1973); Barlow and Durand (1995); Hietala et al. (1994); Laruelle et al. (1996)

43
Q

Why is Wise and Stein important when thinking of the biochemical explanations of schizophrenia (the dopamine hypothesis)?

A

Wise & Stein (1973) found that schizophrenia patients who died in accidents showed abnormally low levels of Dopamine Beta Hydroxylase (DBH) in the brain fluid. DBH is an enzyme whose function is to break down the neurotransmitter Dopamine after release

44
Q

Why is Barlow and Durand (1995) important when thinking of the biochemical explanation of schizophrenia (the dopamine hypothesis)?

A

Barlow & Durand (1995) report that chlorpromazine is effective in reducing schizophrenic symptoms in about 60% of cases. It appears to have the most impact on the positive symptoms hallucinations, delusions) and treated patients may still suffer from severe negative symptoms.

45
Q

Why is Hietala et al. (1994) important when thinking of the biochemical explanation of schizophrenia (the dopamine hypothesis)?

A

Hietala et al. (1994) found an increase in DA in patients with schizophrenia (not in remission) compared to controls, using PET scanning.

46
Q

Why is Laruelle et al. (1996) important when thinking of the biochemical explanation of schizophrenia (the dopamine hypothesis)?

A

Laruelle et al. (1996) found that patients with schizophrenia release more DA in response to being given amphetamines, in comparison to controls, measured by PET and SPECT scanning.

47
Q

What studies are considered important when thinking of the biochemical explanations of schizophrenia (the glutamate hypothesis)?

A

Javitt and Zukin (1991); Malhotra et al. (1997); Hu et al. (2014)

48
Q

Why is Javitt and Zukin (1991) important when thinking of the biochemical explanation of schizophrenia (the glutamate hypothesis)?

A

Javitt & Zukin (1991) found that drugs such as PCP or ketamine block activity of NMDA glutamate receptors. Taken in sufficient doses, they cause psychological changes that mimic the positive, negative and cognitive symptoms of schizophrenia.

49
Q

Why is Malhotra et al. (1997) important when thinking of the biochemical explanation of schizophrenia (the glutamate hypothesis)?

A

Malhotra et al., (1997), found that if schizophrenia patients are given PCP or ketamine the result is a marked increase in their symptoms that lasts for some time.

50
Q

Why is Hu et al. (2014) important when thinking of the biochemical explanation of schizophrenia (the glutamate hypothesis)?

A

Hu et al., (2014) reported that post-mortem studies comparing brain tissue of schizophrenia patients with controls have found structural differences in areas related to glutamate including (1) reduced volume of parts of the dorsolateral prefrontal cortex, (2) reduced dentritic branching and (3) reduced volume of glutamate receptors in the schizophrenia patients.

51
Q

What research methods are used when considering the biochemical explanation of schizophrenia?

A
Meta-analysis
Research review
Magnetic resonance imaging (MRI)
SPECT
PET
Post-mortem studies
52
Q

define source monitoring

A

the ability to distinguish between self-generated thoughts and externally presented stimuli.

53
Q

define subvocalisation

A

tiny but detectable movements that adults make with their speech muscles when they are ‘talking to themselves’ - their thoughts or ‘inner voice’

54
Q

define schemas

A

information from past experiences that are stored in our long term memories, which help us to make predictions about the future and make sense of our experiences.

55
Q

define JTC bias

A

the jump to conclusions bias is the much replicated finding that patients with schizophrenia reach decisions with less information than normal controls (see Garety et al (1991)

56
Q

What studies are considered important when considering the cognitive explanations of schizophrenia?

A

Bentall & Slade (1985); Johns et al. (2001); Blakemore et al. (2000); Gould, (1948) and McGuigan, (1966); Garety et al., (1991)

57
Q

Why is Bentall and Slade (1985) important when considering the cognitive explanations of schizophrenia?

A

Bentall & Slade (1985) observed that people who hear voices, when asked to detect an externally presented voice against a background of white noise, have an abnormal response bias, leading them to say a voice is present on trials when it is not

58
Q

Why is Johns et al. (2001) important when considering the cognitive explanations of schizophrenia?

A

Johns et al. (2001) found that hallucinating patients are especially likely to mistake their own voice, after it had been electronically distorted, for speech by someone else.

59
Q

Why is Blakemore et al. (2000) important when considering the cognitive explanations of schizophrenia?

A

Blakemore et al. (2000) who found that voice-hearing psychotic patients had a greater ability to tickle themselves than non-psychotic patients.

60
Q

Why is Garety et al., (1991) important when considering the cognitive explanations of schizophrenia?

A

Garety et al., (1991) presented deluded patients and controls with two jars containing red and white beads. The jars were taken away, the participants were presented with a sequence of beads and were asked, once they had obtained sufficient information, to decide which jar the beads had come from. Deluded patients requested less information before reaching a decisio

61
Q

Why is Gould, (1948) and McGuigan, (1966) important when considering the cognitive explanations of schizophrenia?

A

It has been known for many years that subvocalisation is evident when patients experience voices (e.g. Gould, 1948; McGuigan, 1966) which suggests that auditory-verbal hallucinations occur when inner speech is misattributed to an external source.

62
Q

define typical antipsychotic drugs

A
  • these alleviate symptoms of Schizophrenia by blocking dopamine receptors.
63
Q

define Phenothiazines (PTZs)

A

are a family of typical anti-psychotic drugs including Chlorpromazine (CPZ). They can be taken as a pill or via injection and are effective at the synapse within 48 hours. The drugs may take weeks to be effective however they do reduce symptoms of schizophrenia in around 60% of patients. They are less effective at controlling negative symptoms than positive symptoms and have some unpleasant side effects, including dry mouth, constipation, drowsiness and sleep dysfunction, and extrapyramidal side- effects (EPSE)

64
Q

what are ESPSE?

A

tremors and rigidity.

65
Q

define Tardive dyskinesia

A

one of the most severe, and irreversible side effects of typical antipsychotic drugs. It is a neurological disorder that causes painful muscle spasms, including uncontrollable facial movements such as grimacing. These distressing side effects persist after the medication is discontinued.

66
Q

define Atypical Antipsychotics (AAPs)

A

newer antipsychotic drugs that have fewer side-effects and are more effective in alleviating both positive and negative symptoms. Although AAPs have fewer side-effects than PTZs, they do have some serious side-effects for some patients, including blood disorders and diabetes. A treatment of last resort, they are useful for treatment resistant patients or patients for whom the side-effects are intolerable.

67
Q

what studies are important to consider when thinking about antipsychotic drugs as treatments for schizophrenia?

A

Awad & Voruganti, 1999; Meltzer et al. (2014); Meltzer (1999); Bilder et al., (2002); DeNayer et al., (2003); Hartling et al. (2012)

68
Q

How is Awad & Voruganti 1999 important to consider when thinking of antipsychotic drugs as treatments for schizophrenia?

A

AAPs benefit 85% of patients with schizophrenia, compared with 65% given PTZ

69
Q

Why is Meltzer (1999) important when thinking of antispychotic drugs as treatments for schizophrenia?

A

Meltzer (1999) found that a third of patients who had shown no improvement with PTZ responded well to clozapine. AAPs treat the negative symptoms as well as positive symptoms (Remington & Kapur, 2000).

70
Q

Why is Meltzer (2014) important when thinking of antipsychotic drugs as treatments for schizophrenia?

A

Meltzer et al. (2014) who used 481 patients with schizophrenia. The patients were put in 3 conditions: (1) receiving one of four new trial drugs; (2) receiving a typical antipsychotic (haloperidol); (3) receiving a placebo. After 6 weeks, patients taking haloperidol and two of the trial drugs had reduced symptoms. Patients taking the placebo and two of the other trial drugs were still the same. This shows that antipsychotics do better than placebos and really do reduce symptoms.

71
Q

Why is Bilder et al. (2002) important when considering antispsychotics as treatment for schizophrenia?

A

Bilder et al., (2002) found that newer (atypical) drugs (e.g. clozapine) were as effective as typical drugs for positive symptoms; better for negative symptoms.

72
Q

Why is DeNayer et al. (2003) important when considering antipsychotics as treatment for schizophrenia?

A

DeNayer et al., (2003) found atypical drugs were more effective with treatment-resistant patients

73
Q

Why is Hartling et al. (2012) important when considering antipsychotics as treatment for schizophrenia?

A

Hartling et al. (2012) conducted a review and meta-analysis of 114 RCT studies, to look at the effectiveness of typical and atypical antipsychotic drugs. They found that there were few differences in effectiveness for core symptoms, but Haloperidol (a typical antipsychotic), had a benefit over olanzapine (an AAP) for improving positive symptoms.

74
Q

Why is Hartling et al. (2012) and Guo et al. (2011) important when considering antipsychotics as treatment for schizophrenia?

A

Hartling et al. (2012), and Guo et al., (2011) found a higher risk of EPS for patients taking chlorpromazine, compared to those taking AAPs.