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AQA A-Level Psychology (1) > P3 Section C (Schizophrenia) > Flashcards

P3 Section C (Schizophrenia) Flashcards

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1
Q

What are the positive symptoms of schizophrenia

A

The positive symptoms of schizophrenia are hallucinations, delusions, disorganised speech and catatonic behaviour

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2
Q

What are the negative symptoms of schizophrenia

A

The negative symptoms of schizophrenia are speech poverty, avolition, affective flattening and anhedonia

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3
Q

What are hallucinations

A

Hallucinations are bizarre perceptions of the environment and can be olfactory, auditory, visual or tactile

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4
Q

What are delusions

A

Delusions are irrational and bizarre beliefs and can be of persecution (feeling like being watched) and of grandeur (like having superpowers or being a historical figure)

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5
Q

What is disorganised speech

A

Disorganised speech is difficulty organising thoughts so have poor speech

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6
Q

What is catatonic behaviour

A

Catatonic behaviour is inability or unmotivated to complete tasks

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7
Q

What is speech poverty

A

Speech poverty is lower speech fluency/productivity due to slow thoughts

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8
Q

What is avolition

A

Avolition is reduction of interests or desires and inability to initiate or persist goal-directed behaviour

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9
Q

What is affective flattening (lack of)

A

Affective flattening is lack of co-verbal behaviours (gestures when speaking) and reduction in intensity of emotional expression

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10
Q

What is anhedonia

A

Anhedonia is the loss of interests in most activities that would normally be pleasurable and can personal or bodily

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11
Q

What is diagnostic reliability

A

Diagnostic reliability is when a diagnosis is repeatedly given by clinicians

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12
Q

What is test-retest reliability

A

Test-retest reliability is when clinicians reach the same conclusions at two different points in time

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13
Q

What is inter-rater reliability

A

Inter-rater reliability is when two separate clinicians reach the same conclusions

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14
Q

What is Kappa Score

A

Kappa Score is a measure of inter-rater reliability and a score of 1 indicates perfect agreement and a score above 0.7 is considered good

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15
Q

What is Schizophrenia’s kappa score

A

Schizophrenia’s kappa score is 0.46 in DSM-V field trials

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16
Q

What did Copeland find in cultural differences of SZ diagnosis

A

Copeland found in cultural differences of SZ patients that when one description of a patient was given: 69% US psychiatrists gave diagnosis and only 2% UK psychiatrists gave diagnosis

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17
Q

What is symptom overlap

A

Symptom overlap is where symptoms exist in more than one condition which can pose issues of misdiagnosing

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18
Q

What did Ellason and Ross find SZ has symptom overlap with

A

Ellason and Ross found SZ has symptom overlap with dissociative identity disorder and found that DID patients had more symptoms of SZ than those that had been diagnosed with SZ

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19
Q

What is co-morbidity

A

Co-morbidity is the extent to which two or more conditions can co-occur

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20
Q

What did Buckley found in co-morbidity with SZ

A

Buckley found 50% SZ patients have co-morbid depression and 47% have co-morbid substance abuse

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21
Q

How did Ripke support genetic explanation for SZ

A

Ripke supports genetic explanation for SZ as he found in a meta-analysis of 150,000 people, there was 108 candidate genes involved in SZ - showing it is polygenic

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22
Q

How did Gottesman and Shields support genetic explanation for SZ

A

Gottesman and Shields support genetic explanation for SZ as he found there was a 75% concordance rate for severe SZ in MZ twins, compared to 24% for DZ twins - suggesting correlation between degree of genetic sharing and SZ symptoms

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23
Q

How did Tienari support genetic explanation of SZ

A

Tienari supports genetic explanation of SZ as she found in study of 164 Finnish adoptees, 6.7% with a biological mother with SZ also were diagnosed with SZ and only 2% of a control group without a biological mother with SZ were diagnosed with SZ

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24
Q

How does Joseph criticise Gottesman’s findings

A

Joseph criticises Gottesman’s findings by saying that it is the similar environment in which MZ twins share during upbringing which causes the high concordance rate

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25
Q

What is the hormonal explanation for SZ

A

hormonal explanation for SZ is the dopamine hypothesis that excess dopamine neurotransmitters in the brain result in the positive symptoms of SZ

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26
Q

How did Davis and Kahn support hormonal explanation of SZ

A

Davis and Kahn supported hormonal explanation of SZ by theorising the revised dopamine hypothesis which is that positive symptoms are due to excess dopamine in subcortical areas like mesolimbic pathway and added that negative symptoms are due to deficient dopamine in prefrontal cortex

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27
Q

How did Patel support hormonal explanation of SZ

A

Patel supported hormonal explanation of SZ by finding low level of dopamine in dorsolateral cortex in SZ patients compared to a normal control group in PET scans

28
Q

How did Seeman and Kapur support hormonal explanation for SZ

A

Seeman and Kapur supported hormonal explanation for SZ by finding more dopamine receptors in post-mortem examinations of SZ patients compared to a control group - suggesting more dopamine is binding which sends more neural impulses leading to positive symptoms

29
Q

What is a negative of biological explanations of SZ

A

A negative of biological explanations of SZ is that they are biologically deterministic as it blames biochemistry for behaviour which is immoral as it removes any responsibility for a person’s actions

30
Q

How do antispsychotics reduce positive symptoms of SZ

A

antispsychotics reduce positive symptoms of SZ by blocking neural pathways of the brain that use dopamine

31
Q

Why does L-dopa increase positive symptoms of SZ in Parkinson’s disease sufferers

A

L-dopa increases positive symptoms of SZ in Parkinson’s disease sufferers as they take it to increase dopamine

32
Q

How does Leucht support dopamine hypothesis (hormonal explanation) of SZ

A

Leucht supports dopamine hypothesis (hormonal explanation) of SZ as he found in meta analysis of 212 studies, antipsychotic drugs were more effective than a placebo in treating symptoms of SZ by normalising dopamine levels

33
Q

How does Noll criticise dopamine hypothesis (hormonal explanation) of SZ

A

Noll criticises dopamine hypothesis (hormonal explanation) of SZ by finding antipsychotics do not alleviate hallucinations and delusions in 1/3rd people so dopamine therefore can’t be the sole cause of positive symptoms

34
Q

What are the psychological explanations of SZ

A

the psychological explanations of SZ are family dysfunction and cognitive

35
Q

What is family dysfunction explanation of SZ

A

family dysfunction explanation of SZ is that maladaptive relationships and poor communication between family are sources of stress which can cause schizophrenia

36
Q

What is Bateson’s double bind theory

A

Bateson’s double bind theory is the idea that children who are involved in contradictory situations with parents (where a verbal message is given but the opposite behaviour is exhibited) will often display negative symptoms like social withdrawal and the flattening effect in order to escape these double bind situations

37
Q

What is another feature of Bateson’s double bind theory

A

another feature of Bateson’s double bind theory is that SZ patients of high expressed emotion families will often relapse and experience hallucinations and delusions when they return to their families

38
Q

How does Noll support double bind theory

A

Noll supports double bind theory as he argues families with low expressed emotion are generally more supportive and can reduce likelihood of relapse and reduce the use of anti-psychotic medication

39
Q

What is the cognitive explanation of Schizophrenia

A

cognitive explanation of Schizophrenia is that dysfunctional thought processing is particularly evident in those who display positive symptoms

40
Q

How is cognitive explanation for SZ flawed

A

cognitive explanation for SZ flawed as it is impervious to reality testing since patients are unwilling/unable to consider that they might’ve been wrong since they have impaired insight

41
Q

How does Baker and Morrison support cognitive explanation for SZ

A

Baker and Morrison support cognitive explanation for SZ as they suggest those with SZ find it difficult to separate the inner voices within their head and actual external sources

42
Q

What is metarepresentation

A

Metarepresentation is the ability to reflect on our own thoughts and behaviours which allow us to distinguish the actions of others from our own

43
Q

How does dysfunction of metarepresentation lead to SZ

A

dysfunction of metarepresentation leads to SZ as it disrupts our ability to recognise own actions being carried out by ourselves rather than others leading to hallucinations and delusions

44
Q

Con of family dysfunction explanation of SZ

A

Con of family dysfunction explanation is that it leads to blaming the family

45
Q

How does Sarin and Wallin support idea that faulty cognition creates positive symptoms of SZ

A

Sarin and Wallin supports idea that faulty cognition creates positive symptoms of SZ as they found delusional SZ patients would display faulty information processing by jumping to conclusions and failing reality testing

46
Q

how does cognitive therapy support cognitive explanation of SZ

A

cognitive therapy supports cognitive explanation of SZ as evaluating content of delusions and assessing validity of faulty cognitions was found in NICE reviews to be more effective than antipsychotics in reducing symptoms and improving social functioning

47
Q

how do antipsychotics of SZ work

A

antipsychotics of SZ work by reducing dopamine transmission

48
Q

how do typical antipsychotics work

A

typical antipsychotics work by binding to dopamine receptors particularly in the mesolimbic pathway and blocking their action

49
Q

example of typical antipsychotic

A

example of typical antipsychotic is chlorpromazine which eliminate hallucinations and delusions

50
Q

how do atypical antipsychotics work

A

atypical antipsychotics work by blocking dopamine receptors but only temporarily and they rapidly dissociate to allow normal dopamine transmission afterwards

51
Q

example of atypical antipsychotic

A

example of atypical antipsychotic is clozapine which has little affect on the dopamine system which controls movement so reduces side effects of typical antipsychotics

52
Q

what is a problem with typical antipsychotics

A

problem with typical antipsychotics is that Kapur found 60-70% of dopamine receptors in mesolimbic pathway need to be blocked to be effective which will lead to extrapyramidal side effects like tardive dyskinesia (involuntary movement of face and jaw)

53
Q

what is an issue with extrapyramidal side effects and tardive dyskinesia

A

Issue with extrapyramidal side effects is that it can lead to patients giving up their drug course

54
Q

how does Crossley criticise antipsychotics

A

Crossley criticises antipsychotics by finding that there is no difference between reduction of symptoms between typical and atypical, but difference in side effects as atypical caused weight gain and typical leads to extrapyramidal side effects

55
Q

how does CBTp treat SZ patients

A

CBTp treats SZ patients by identifying faulty cognitions and their link to symptoms and then encouraging patients to develop coping strategies and alternative explanations to their faulty beliefs

56
Q

how does Addington criticise CBTp

A

Addington criticise CBTp by saying self-reflection is not appropriate at acute stage (most severe) and so drug therapy should be used first

57
Q

how does CBTp lack availability

A

CBTp lacks availability as only 1 in 10 gain access to the therapy and of those who are offered the therapy, a significant number refuse or do not attend which limits effectiveness further

58
Q

how is CBTp good long-term

A

CBTp is good long-term as it provides skills to cope with symptoms that can be used forever to maintain progress and challenge irrational thoughts

59
Q

how does family therapy treat SZ

A

family therapy treats SZ by educating family of SZ disorder, reducing hypersensitivity to the disorder (as this can be a cause), teaching how to spot when an episode will occur and teaching families that 1/3rd patient symptoms do not dissipate

60
Q

what did Pharoah find about family therapy

A

Pharoah find about family therapy that it would reduce risk of relapse and reduce hospital readmission during treatment and 24 months after and also some cases showed improvement whereas others did not

61
Q

how does family therapy reduce suspicions associated with CBTp

A

family therapy reduce suspicions associated with CBTp as if family are involved in treatment then SZ patients are less likely to have irrational beliefs about treatment

62
Q

how does Varese show environmental impact on SZ

A

Varese show environmental impact on SZ development by finding teenagers who had a traumatic life event before 16 were 3x more likely to develop SZ in later life compared to general population

63
Q

what is token economy

A

token economy is a management of SZ whereby patients are rewarded for positive behaviour (like making the bed) with tokens which can be exchanged for tangible rewards within the institution like TV remote or sweets

64
Q

how is token economy behaviourist

A

token economy is behaviourist as it uses operant conditioning in the form of positive reinforcement to make a person more likely to repeat a desirable behaviour or removing an undesirable behaviour by taking away any reinforcers that maintain it

65
Q

how did Sultana support token economy

A

Sultana supported token economy by a meta-analysis finding token economy would reduce negative symptoms however it was unclear whether these behavioural changes lasted beyond the treatment programme

66
Q

problem with token economy

A

a problem with token economy is that alone, it merely masks the symptoms of schizophrenia with desirable behaviours making it ineffective as the underlying cause is not tackled in any way

67
Q

how does NICE support family therapy treatment

A

NICE supports family therapy treatment by reviewing and finding it provides significant cost savings when combined with standard care as the extra cost of the therapy is offset by the savings from lower re-hospitalisation rates due to lower relapse rate

AQA A-Level Psychology (1) (9 decks)

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