Managment Of Schizophrenia Flashcards
What is operant conditioning?
Behaviour can be shaped by the use of positive and negative reinforcements.
What is a token economy?
A form of therapy where desirable behaviours are encouraged by the use of selective reinforcements.
Who benefits from token economies?
They are used on those who have developed patterns of maladaptive behaviour through spending long periods of time in psychiatric hospitals.
What does token economy NOT do?
Token economies do not cure schizophrenia but improve the quality of life.
Who conducted a study using token economy in a schizophrenia ward?
Ayllon and Azrin used a token economy in a schizophrenia ward.
What was given for every tidying act in the token economy study?
A gift token was given for every tidying act, later swapped for privileges e.g. films.
When were token economies extensively used?
Token economies were used extensively during the 1960s and 70s.
Why did the use of token economies decline in the UK?
They declined due to a shift towards care in the community.
Are token economies still used today?
Token economies remain a standard approach to managing schizophrenia in many parts of the world.
What is institutionalisation?
Institutionalisation occurs in long-term hospital treatment.
What categories of institutional behaviour did Matson et al identify?
Personal care, condition-related behaviours (e.g. apathy), and social behaviour.
What is the effect of modifying institutional behaviours?
Modifying these behaviours does not cure but does have benefits, such as improved quality of life.
What does modifying behaviours do to patients?
It ‘normalises’ behaviour.
What are tokens in the context of token economy?
Tokens are coloured discs given immediately after a desirable behaviour to act as an immediate reward.
How are target behaviours determined in a token economy?
Target behaviours are decided individually based on the knowledge of the person.
Why are tokens given immediately?
Tokens are given immediately because delayed rewards are less effective.
What negative symptom of schizophrenia can token economy address?
Token economy can address social withdrawal, which may lead to neglect of self-care.
What is a primary reinforcer?
A primary reinforcer is anything that gives pleasure and is directly rewarding, such as food or TV time.
What is a secondary reinforcer?
A secondary reinforcer has no intrinsic value but can be exchanged for a range of different primary reinforcers, having a more powerful effect.
What evidence supports the effectiveness of token economies?
Glowacki et al identified seven high quality studies showing a reduction in negative symptoms and unwanted behaviours in patients with chronic mental health issues.
What time frame did the studies examined by Glowacki et al cover?
The studies examined were published between 1999 and 2013.
What was the setting of the studies that supported token economies?
The studies involved patients living in a hospital setting.
What is the concern regarding the number of studies supporting token economies?
Seven studies is quite a small evidence base to support the effectiveness of a technique.
This raises questions about the reliability of the findings.
What is the file drawer problem?
The file drawer problem leads to a bias towards positive published findings because undesirable results have been ‘filed away’.
This is particularly problematic in reviews with a small number of studies.
