schizophrenia

Question 1

family dysfunction - schizophrenogenic mother

Answer 1

fromm-reichmann 1948 - mother causes sz if cold and rejective - creates family enviroment of tention and secrecy - leads to distrust which develops into paranoid delusions and sz

AO3

• very little evidence - based on personality judgments
• ethics - places blame on parent

Question 2

family dysfunction - double blind theory

Answer 2

bateson et al 1972 - sz develops as a defense mechanism to second guess actions when growing up in an environment where a child is told to do one thing but punished when doing it - leads to a state of anxiety - delusions act as an escape

AO3
+ berger 1965 - sz p’s could recall more instances of double blind statements from mother
- only explains paranoid sz not catatonic
- ethics - blames parents
- only explains grandeur delusions not persicutions

Question 3

family dysfunction -expressed emotions

Answer 3

emotions, normally negative, exprschizophrenogrenic mother -essed towards sz p - includes verbal criticism, hostility anger and rejection and emotional overinvolvment - high levels of emotions are a source of stress - primary cause in relapse
AO3
+ kalafi and torabi 1996 - higher prevelence of ee in iran - correlated to higher relapse rates
+ hegarty et al 1991 - family therapy reduced relapse rates

Question 4

cognitive - dysfunctional thinking

Answer 4

disruption to normal thought processes - reduced processing in the ventral stratum leads to negative symptoms - reduced processing in ventral straitum and cingulate gyri leads to hallucinations
frith et al 1992 - two types of dysfunction - metarepresentation dysfunction , cognitive ability to reflect on thoughts behavior and goals, both own and others, explains delusions and hallusinations - centeral control dysfunction, an inability to suppress automatic responses to thoughts and speech triggers
AO3
+pet scans - shows underactivity on frontal lobe of SZ p
+ sterling et al 2006 - 50 sz p - stroop test - Sz 2x control p - lots of interference in low level processing - only explains positive P’s
- diathesis-stress model - biological pre-disposition to SZ but enviromental trigger required

Question 5

biological treatments - drug therapy

Answer 5

anti-psychic - antagonisitic - dopamine receptors blocked in synaptic cleff
typical - treats positive symptoms - blocks d2 receptors - chlopromazine
atypical - treats both positive and negative symptoms - chlozapine blocks both serotonin and glutamate receptors
AO3
- kasper et al 2000 - 60-70% of receptors must be blocked to be effective - takes a few weeks to build up enough to produce any effects
- side effects
- atypical less effective at blocking receptors - wear off quicker - can block multiple types of receptors
+ cheap and non disruptive
- high relapse rate after treatment ends
- 20-25% experience side effects
- 50% stop treatment within year
+ chlorprozamine most effective - 80-85% show improvment

Question 6

Cognitive behavioral therapy

Answer 6

therapists build repore -> patient explains symptoms -> patterns uncovered -> beliefs challenged -> strategies learned to self challenge dysfunctional beliefs
typically 16 one to one sessions - attacks cause not symptoms
REBT - ellis ABC - activating event -> irrational belief -> emotional consequences - irrational belief challenged and replaced
AO3
+ tacher 2014 - meta analysis - significant impact on both positive and negative symptoms
- ehtics - policing thoughts - position of power

Question 7

family therapies

Answer 7

therapy with all members of Sz P family - reduces anger and guilt - solves missconception - helpful for EE - 10 sessions minimum
AO3
+ reduced relapse rare
- weak evidence

Question 8

token econemy

Answer 8

operant conditioning - rewards desired behaviors - discourages sz behaviors
AO3
- mild p’s get majority of rewards - sever P’s lack rewards
- care not treatment
- little research support
- only effective in structured environment