Schizopherenia

Question 1

What do gottesman and shields mean by term ‘genetic explnaation of schizophrenia’

Answer 1

• Theres a link between schizophrenia and inherited genetic material
• so the closer a persons genetic link is to somone who has been diagnosed (e.g a sibling) the MORE likely that the person can also be diagnosed w/ schizophrenia

Question 2

Describe the cognitive explanation of schizophrenia as outlined by Frith

Answer 2

• Cog explanation states that schizo is caused by faulty info processing
• FRITH stated ppl w schiz have faulty metacognitive processes and diffculty reflecting on thoughts, behaviours and emotions
• May link to TOM + how schizos struugle to understand others and issues w attention and generating self initiatiated actions and problem solving, recognising their own inner speach leading to auditory hallucinations

Question 3

Describe biochemical and electroconvulsive theraphy for schizo

Answer 3

BIOCHEMICAL:
- Chloropromazine + other antipsychotics (atypical) BLOCK dopamine and seratonin receptors in the brain
- Reducing agitation and hostility in patients AFTER 2 weeks reduces positive symptoms

ECT:
- General anaesthsia + a muscle relaxant is given
- ELectrodes placed on scalp and finely controlled electric current through electrodes for very short time
- Causing brief seizure in brain
- Can be done unilaterally or bilaterally

Question 4

Treatment of schizo w/ CBT:

Answer 4

• Comparing CBT w/ non specific befriending interventions for ppt w schizo
• randomized controlled design
• patients allocated to 1 of 2 groups: CBT and non specific befriending control group
• 90 patients, 57 from clinics in newcastle, cleveland and durham and 33 from london
• both interventions delivered by 2 experienced nurses who got regular supervision
  Patients assesed by blindraters at baseline, after treatment (9 months) and a 9 month post treatment follow up eval
• assessed on measures like comprehensive psyhicatric rating scale and scale of assesment of negative symptoms and depression rating scale
• after 9 months no sig diff between 2 groups
• at 9 month follow up, patients who recieved cog theraphy showed greater improvement on all measures
• they had improved while befriending lost some

Question 5

Explain whats meant by ECT as a treatment for schiz

Answer 5

• A person recieves a brief amount of electricity to the brain to induce a seizure
• Patient is anesthetisated and given a sedative
• ELectric current is passed through the head for no longer than a second via electrodes attached to skull
• Seizure last up to 1 minute
• Can be bilaterl across both brain hemispheres OR unilateral across the non dominant hemisphere

Question 6

Describe procedure of Freeman

Answer 6

• A library scnece was used initially but subsequently a 5 minute ride of a london underground train between 2 stations has been developed consistent with continium views of paranoia
• it was show approx 1/3rd of general pop have presecutory ideations abt computer characters
• validating the methodology—-> those higher in trait paranoia experience higher levels of persecutory ideation in VR
• 200 NON clinical members of general pop

Question 7

Describe reliability of Freemans procedure

Answer 7

• Some ppt may show demand characteristics and others may not
• Use of computer generated enviornment increased reliability e.g all ppt were on exact same 4 min journey on same 4 min train ride
• Avatars responded differently to ppt depending on how ppt acted in VR simulation e.g if ppt looked at one of the avatars the avatar would smile at them = so each ppt has diff experience of engaging w/ avatrs which lowers reliability
• Some ppt may respond more to the fact this isnt the natural enviornment due to type of schizo they have whereas other may be unaffected = showing how scenrios can impact ppt in a diff way and LOWER reliability

Question 8

Explain whats meant by schizo

Answer 8

• Schizo is a mental health disorder involving pos and neg symotoms
• pos symtoms include things like visual, auditory hallucinations and delusions
• neg symptoms include speech poverty and flattening of mood

Question 9

Describe genetic explanation of schizo by Gottesman and Shields

Answer 9

• Schizo appears to have a genetic cause as shown by G + S in their stuides of adoption, siblings and twins with schizop
• All adoption studies found an INCREASED incidence of schizo in adopted children with a schizo biological parent
• Biological studies of children w/ schizo showed a much higher percent of schizo
• All twin studies found a higher concordance rate for schizo on MZ than DZ twins
• IN G+S the rate was 58% for identical twins and 12% for non identical twins
• Heavy genetic influence on the onset of schizo

Question 10

Discuss the ethics of using Token Economies as a schizo treatment

Answer 10

1. Use of vulnerable patienst may not be capable of giving informed consent
2. Inability to withdraw from scheme without loss of priveligies
3. PSchological harm as patienst may feel they are being judged aversely for merely suffering with an abnormality over which they have little control
4. Briefing patients can be made fully aware of why they are engaging in the program and how itll help them
5. No deception is being used

Question 11

Describe token economy as treatment of schizo

Answer 11

• Based around operant conditioining
• patients w/ schizo are rewarded w/ tokens for instances of desirable behaviors like making beds, taking meds, self care, engaging socially and attending therapy sessions
• tokens can be exchanged for luxury items like ciggs, TV use, sweets or clothing
• In some cases, tokens can be removed for behaviours considered undesirable like angry outbursts

Question 12

Outline 2 characterstics of schizo

Answer 12

• Pos symtoms= delusions, hallucinations, disorganised speech
• Neg symtoms= flattened efect, avolition, poverty of speech and social withdrawl

Question 13

Teatment of schizo CBT p2

Answer 13

• both interventions delivered by 2 experienced nurses who received regular supervision
• patienst were assesed by blind raters at baselineaft treatment (lasting 9 months) and AGAIN at a 9 month follow up eval.
• Assesed on measures including “Comprehensive Psychiatric Rating Scale, the scale assesemnt for negative symptoms + depression rating scale
• Patients continued to recieve routine care throughout the study
• Patients recieved a mean of 19 individual treatment sessions over 9 months
• Both interventions resulted in signifcant reductions in positive and negative symptoms and depression
• aft treatment there was NO sig diff between 2 groups
• at 9 month follow up eval, ppt who recieved cog theraphy showed greater improvement on all measures
• They had improved while befriending group lost some benefits