Psychology/Schizophrenia

Question 1

What do Typical Antipsychotics do?

Answer 1

Bind but don’t stimulate receptors

Question 2

What do Atypical Antipsychotics do?

Answer 2

Block dopamine and serotonin receptors

Question 3

What are 3 evaluation point for Typical Antipsychotics?

Answer 3

1. Unethical
2. They work - Laucht
3. Extrapyramidal side effects

Question 4

What are some key advantages of Atypical Antipsychotics

Answer 4

1. Patients more likely to use them
2. More suitable for patients
3. Fewer side affects - particularly extrapyramidal symptoms
4. Possible affects include: Weight gain/ diabetes/ blood clots/ strokes

Question 5

What did Laucht do with Typical Antipsychotics?

Answer 5

He did meta analysis of 65 studies. There were 6000 patients and some were taken off medication and given harmless placebo. 12 months later 64% in placebo condition relapsed and only 27% in treatment condition

Question 6

Are Atypical Antipsychotics better than Typical Antipsychotics?

Answer 6

Crossley did meta analysis on 15 studies. he found there was no difference in efficiency however Signiant difference in symptoms

Question 7

What is a general evaluation of the two drugs?

Answer 7

-Side effects of both
-Temporary treatment
-Schooler found that there was a 75% report of symptom reduction however relapse rates as high as 55%

Question 8

What is the process of CBT?

Answer 8

Assessment
Normalisation
Critical analysis

Question 9

How many sessions of CBT do most people acquire?

Answer 9

8-20 spread over 6-12 months

Question 10

What did Sensky et al do in terms of CBT?

Answer 10

His aim was to compare CBT with non-specific befriending interventions for patients with Sz. He carried out a randomized controlled design where patients were allocated to two groups; A cognitive behavioural therapy group and a non-specific befriending group. Both interventions were delivered by two experienced nurses who received regular supervision. Patients were assessed by blind raters. In the befriending condition the Ps had the same time allocation at the same intervals as patients in the CBT condition. The therapists were empathetic and non-directive and there was no attempt at therapy.

Question 11

What were the findings of Sensky et als experiment?

Answer 11

1. Both resulted in significant reductions in positive and negative symptoms and depression.
2. After treatment there was no significant difference between conditions
3. After the nine month assessment, it was found that the cognitive behavioural therapy was more effective and showed greater improvement in all elements

Question 12

What is the conclusion of Sensky et al in the essence of CBT?

Answer 12

1. CBT is effective in treating negative as well as positive symptoms in Sz patients resistant to standard antipsychotic drugs
2. Its efficiency was sustained for at least 9 months - effective in teaching patients to cope with symptoms

Question 13

Evaluation of CBT

Answer 13

+ improves symptoms, recovery and relapse dates
+ No side effects
+ Puts Ps in charge of their own treatment by teaching self help strategies
- Not very rational to teach participants to look at life through a rose glass
- Expensive and time consuming

Question 14

What is the diathesis stress model?

Answer 14

The DS model sees Sz as an interaction between biology and psychology

Question 15

What does the discordance rate between MZ twins indicate?

Answer 15

That Stress has to play a factor as genetics cant be the only explanation

Question 16

What is a neural cause of Sz?

Answer 16

Brain damage from birth or pregnancy

Question 17

What is the double bind theory?

Answer 17

Bateson believed that Sz is a consequence of abnormal patterns in family communication. In a double bind situation a person is given mutually contradictory signals by another person. this places them in an impossible situation causing internal conflict.

Question 18

What did Read do?

Answer 18

He reviewed 42 studies and concluded that 69% of female inpatients and 59% of male inpatients had experienced sexual abuse in their childhood

Question 19

What is expressed emotion?

Answer 19

EE is characterised by criticism, hostility, and emotional overinvolvement. communication patterns in families with high EE levels are usually filled with high levels of negative verbal exchange

Question 20

What is research support for Family Therapy?

Answer 20

Leff compared family therapy with routine outpatient care. He found that at 9 months 50% relapse rate for those in routine care and 8% for those doing FT. After 2 years it was 75% relapse rate for those in routine care and 50% for those doing FT

Question 21

Evaluation of FT

Answer 21

1. Reduces relapse rates
2. Good for younger patients
3. Is it appropriate

Question 22

What did Gottesman experiment in the biological explanations of Sz?

Answer 22

Gottesman did meta analysis on 40 studies that had investigated family history of Sz. He found that the more DNA that an individual shares with a patient of Sz the more likely that individual was going to develop the disorder. He found that children with Sz parents have a 46% concordance rate, children with a single Sz parent had a condordance rate of 13% and 9% if the child had a sibling with Sz

Question 23

What were Tienaris findings?

Answer 23

He found that 6.7% of children with a Sz mother had been diagnosed themselves and 2% of adopted children with a non-Sz mother developed the disorder.

Question 24

What were Gottesmans findings in Twins Studies?

Answer 24

Mz twins share 100% DNA and Dz twins share 50% so therefore if Mz twins have a higher concordance rate then it suggests that Genes are a significant factor of the development of Sz. Gottesman carried out a meta-analysis and reviewed 40 studies that had investigated family history of Sz. He found concordance rates of 48% for Mz twins and 14% for Dz twins.

Question 25

What are the problems with twin studies?

Answer 25

If Mz twins share 100% genetic material, and the concordance rates for the development of Sz are 48% then this suggests that Genetics cant offer a complete explanation for Sz

Question 26

What is a negative evaluation point for Twin Studies?

Answer 26

Twins are very rare in the general population and so is Sz therefore it limits Gottesmans findings there go making it less valid

Question 27

What does the Dopamine hypothesis suggest?

Answer 27

That having to many neurotransmitter dopamine in certain regions of your brain could lead to the development of positive symptoms of Sz. It is thought that this is due to abnormally high levels of D2 receptors on the receiving neuron, this results to more dopamine binding and therefore more neurons firing.

Question 28

How can you tackle the Dopamine Hypothesis?

Answer 28

Antipsychotics block the activity of dopamine in the brain. By reducing the activity in the neural pathways in the brain that use dopamine in the neurotransmitter you eliminate symptoms this cause.

Question 29

What are two evaluation points of the dopamine hypothesis?

Answer 29

1. Evidence from treatment - All drugs tested were significantly more effective than placebo according to Leucht meta analysis of 212 studies
2. Inconclusive evidence - Amphetamines affect other neurotransmitters other than dopamine

Question 30

What was the revised dopamine hypothesis?

Answer 30

Davis and Kahn proposed that positive symptoms are due to an excess dopamine in sub cortical areas of the brain and negative symptoms arise from deficient levels of dopamine in the prefrontal cortex

Question 31

What is token economy?

Answer 31

therapy used on patients who are institutionalised and helps them manage their impulses/ behaviour

Question 32

What is the process of token economy?

Answer 32

Identify desirable behaviours i.e. getting dressed
Tokens are offered immediately after patient engages
Tokens can then be transferred for a range of preferred items

Question 33

What research did Paul and Lentz carry out when using Token economy for Sz patients

Answer 33

Used TE with long-term Sz patients. Ps developed social and work related skills. They became better at self care and symptoms were reduced. After 4.5 years, 95% of patients in the token economy half had been released compared to the 45% who had received no treatment

Question 34

What is one problem with using token economy with Sz patient?

Answer 34

Good behaviour quickly reduces when rewards go away which makes it hard to transfer those good behaviours in the real life world.

Question 35

What are all the symptoms you are expected to know?

Answer 35

Hallucinations, delusions, avolition and speech poverty

Question 36

If two doctors agree an a diagnosis of Sz we would say it has

Answer 36

Inter-rater reliability

Question 37

What measurement did Beck find in agreement of doctors diagnosis?

Answer 37

Concordance rate - 50%

Question 38

A problem with validity is when it is diagnosed with other symptoms. What is the name of this problem, plus the most common two MH issues to be diagnosed with Sz?

Answer 38

Comorbidity, Depression 50%, Drug abuse 47%

Question 39

Why do we worry that Sz may not be a distinct disorder? Give two examples of similarities with bipolar

Answer 39

Symptom Overlap, Shares Hallucinations and Delusions

Question 40

What are 3 evaluation points of the classification of Sz

Answer 40

1. Culture bias
2. Gender bias
3. Invalid - Co-morbity system overlap

Question 41

What are 3 evaluation points for the biological explanation of Sz?

Answer 41

1. Gottesman found a 48% MZ twins and 17% in DZ twins
   2.Tienari found Children of SZ mothers who had been adopted of healthy famalies had 6% chance eand Children in dysfunctional families had just under 40% chance
2. A diathesis-stess approach to explaining Sz is more liekly to be valid than biology alone. However, an environmental stressor has to be present to trigger the disorder

Question 42

Whats expressed emotion?

Answer 42

is a measure of the family environment that is based on how the relatives of a psychiatric patient spontaneously talk about the patient

Question 43

Whats the double-bind theory?

Answer 43

Due to mixed messages, feels unable to do the correct thing. Disorganised thinking and paranoia

Question 44

What symptoms are typical and atypical drugs for?

Answer 44

Typical - Positive
Atypical - Negative

Question 45

What are two evaluation points of Drug therapies?

Answer 45

1. Cheap
2. only supress symptoms and do not treat the underlying problem

Question 46

What are two psychological treatments for Sz?

Answer 46

1. Token economies
2. Family therapy

Question 47

What are two evaluation points of family therapy and Token economy?

Answer 47

FT-50% relapsed in regulatr outpatient care, only 8% relapsed in FT
TE-Dickerson found in 13 studies that TE can effectively improve the adaptive behaviour of people with Sz.
Doesnt directly treat symptoms of Sz; they only attempt to manage the negative symptoms

Question 48

What does the interactionist approach suggest about the development of Sz?

Answer 48

That Sz is due to the combined effects and interaction of biological/psychological factors and treatment is effective when combining bio/cog therapies