schizophrenia

Question 1

4 psychological explanations

Answer 1

• schizo mother
• double bind theory
• expressed emotions
• cog explanations

Question 2

schizo mother research

-Freida fromm-reichmann

Answer 2

-accounts from clients about childhood identifying if they had a schizo mother (cold rejecting controlling) , leads to distrust = paranoid conclusions

Question 3

double bind research

-Gregory Bateson et al

Answer 3

• emphasised family communication e.g mixed messages of right and wrong + child seeks clarification
• child punished when in wrong (conditional love)
• disorganised thinking = delusions

Question 4

expressed emotion description

Answer 4

• negative emotions e.g verbal criticism, hostility, emotional over-involvement
• can lead to stress, cause schizo relapse e.g trigger genetics

Question 5

cognitive explanation description

Answer 5

-distruprion of normal thought processing usually in ventral striatum and temporal gyri = impaired cognition

Question 6

cog explanation research

-Christopher frith

Answer 6

Identified 2 kinds of dysfunctional thoughts

• metarepresentation = ability to recognise/reflect on own and others actions and thoughts
• central control = ability to suppress automatic responses - lack of this could cause disorganised speech and thought disorder

Question 7

psychological explanations strengths

• support evidence combo whopper
• Stirling et al

Answer 7

• Read et al reviewed 46 studies of child abuse - 69% women + 59% men had schizo - HOWEVER - evidence is taken after symptom development - validity problem as makes recall less accurate
• compared 30 schizo people with 18 control on diff cog tasks - schizo people took twice as long in troop test - - cog theories can explain schizo causes

Question 8

Psychological explanation weakness

Answer 8

• no support evidence for schizo mother or double bind these blame the parents - adds to already having to deal with child schizo - unethical

Question 9

2 types of drug therapies

Answer 9

typical

atypical

Question 10

Typical antipsychotics description

Answer 10

• since 1950s (chlorpromazine)

- strong association with dopamine hypothesis

Question 11

how do typical antipsychotics work?

- specifically chlorpromazine

Answer 11

• act as antagonists by reducing neurotransmitter actions

- dopamine antagonists block dopamine receptors - reduces hallucinations

Question 12

Atypical psychotics description

Answer 12

• since 1970s

- new to improve effectiveness

Question 13

2 types of atypical antipsychotics

Answer 13

• clozapine - binds to dopamine receptors as well as acting on serotonin + glutamate receptors - improves mood and reduce depression
• risperidone - binds more strongly to dopamine than clozapine so more effective and fewer side effects

Question 14

Drug Therapies strengths

-Ben Thornley et al

Answer 14

-reviewed studies comparing chlorpromazine to placebo - 13 trials + 1121 participants - chlorpromazine reduced symptoms and better overall functioning - 512 relapse rate lower

Question 15

Drug Therapies Weaknesses

• Serious Side effects
• David Healy

Answer 15

• typical = dizziness, agitation, sleeplessness, itchy skin etc , typical long term = NMS (high temp, delirium + coma) 0.1% - 2%, Atypical have less side effects but have to have blood tests with clozapine
• problems with evidence for effectiveness -he suggested some successful data had been published multiple times so make look more positive +only asses short term effects - antipsychotics also have calming effect so impact looks better, doesn’t actually reduce psychosis

Question 16

3 psychological therapies

Answer 16

• CBT
• Family Therapy
• Token economies

Question 17

CBT description

Answer 17

• 5-20 sessions
• identify irrational thoughts + change them
• make sense of delusions and hallucinations

Question 18

Family Therapy description

-Fiona Pharaoh et al

Answer 18

• aim to improve family communication + reduce stress
• strategies e.g = therapeutic alliance, caring for schizo relative, improve problem solving ability, reduction of anger + guilt etc

Question 19

Token economies description

Answer 19

• reward systems to manage behaviour

- tokens (secondary reinforcers) given immediately after good behaviour then rewards given later

Question 20

Psychological therapies strengths

• Jauhar et al
• Pharoah et al (combo)
• McMonagle + Sultana

Answer 20

• reviewed 34 CBT studies = significant but small effect on positive + neg symptoms
• reviewed family therapy studies - FT reduced hospital readmissions over a year + improved patient + family life quality - HOWEVER- studies inconsistent + had quality issues = FT evidence fairly weak
• reviewed token economy studies + found only 3 that used random allocation with only 110 patients - non had useful info on behaviour change - lack of support

Question 21

Psychological therapies weaknesses

• improve but don’t cure
• ethical issues

Answer 21

• improves schizo manageability - CBT helps make sense + challenge schizo symptoms - FT reduces stress of living with schizo - TE help socially acceptable behaviour - these things are helpful but shouldn’t be confused with curing schizo - failure to cure schizo in psychological treatments
• TE is contoversial - more services for patients with mild rather than severe symptoms - severe = suffer discrimination + some families have challenged legality of this - reduced TE use in psychiatric systems

Question 22

interactionist approach definition

Answer 22

acknowledges that there are biological, psychological and societal factor in schizo development

Question 23

What does the diathesis stress model suggest?

Answer 23

-vulnerability to it and stress triggers is necessary to schizo development

Question 24

Meehl’s diathesis stress model description

Answer 24

• vulnerability = entirely genetic (a single schizogene)

- no schizogene means no amount of stress can cause schizo to develop

Question 25

The modern understanding of diathesis description

Answer 25

• many genes increase shcizo development not just one

- include genetics, psychological trauma (trauma = diathesis not the stressor)

Question 26

The modern understanding of stress description

Answer 26

-anything that risks triggering schizo

Question 27

Interactionist Model Treatment

-Turkington

Answer 27

• CBT is best for combining antipsychotics and psychological therapies
• (Turkington) CBT can still be used for biological causation of schizo to relieve symptoms HOWEVER can’t ignore psychological causation if CBT is psychological
• Britain uses antipsychotics + CBT but America took longer to adopt interactionist approach therefore only medication more popular in America

Question 28

Interactionist Approach Strengths

• Evidence for role of vulnerability + triggers (Tienari et al)
• Support for effectiveness of combination of treatments (Nicholas Tarrier)

Answer 28

• investigated genetic vulnerability + parenting style, he used children adopted from 19,000 Finnish mothers - adoptive parents assessed for child rearing style - schizo rates compared to control group of adoptees with no genetic risk - child rearing style = low empathy can lead to schizo for genetic risk children - shows both factors included
• 315 schizo people randomly allocated to medication + CBT treatment/ medication + supportive counselling or a control group = combinations = lower symptoms than control - HOWEVER - no difference in hospital readmission rate - practical advantage

Question 29

Interactionist Approach Weakness

• original diathesis-stress is over simple
• lack of diathesis stress model understanding

Answer 29

• multiple genes = increase schizo risk not one schizogene + stress can come in many forms - vulnerability can be from trauma + genetics (Houston et al) = childhood sexual trauma + cannabis was trigger - shows old diathesis = too simple
• strong evidence for underlying vulnerability + stress = schizo - HOWEVER - don’t fully understand mechanisms of how they produce symptoms