schizophrenia

Question 1

what does the term ‘schizophrenogenic’ mean

Answer 1

schizophrenia causing

Question 2

what is family dysfunction (SZ)

Answer 2

psychologists have tempted to link childhood and adult experiences of living in a dysfunctional family to SZ 
the three explanations
the schizophrenogenic mother
double-bind theory
expressed emotion (EE)

Question 3

the schizophrenogenic mother (key ideas)

Answer 3

• they are cold, rejecting and controlling
• create tension and secrecy
• can lead to distrust, developing into paranoia and delusions

Question 4

double-bind theory (key ideas)

Answer 4

• the communication style in family
• children feel trapped in situations and fearful of wrong doings, making them feel unable to comment on fairness
• children then get punished through withdrawal of love which leave the children confused
• can lead to disorganised thinking

Question 5

expressed emotion (EE / key ideas)

Answer 5

level of (typically) negative emotions towards a patient by a carer

• verbal criticism, accompanied by violence
• hostility towards patient, anger, rejection
• emotional over-involvement in life
• high levels of EE in carer are a serious source of stress and prone to relapses. although they may already be vulnerable due to genetic makeup

Question 6

cognitive explanations (overview)

Answer 6

• focuses on roles of mental processes
• reduced processing in the ventral striatum is associated with negative symptoms
  reduced processing of info in the temporal and cingulate gyri is associated with hallucinations

Question 7

Frith et al (1920)

Answer 7

identified two kinds of dysfunctional thought processing:

• metarepresentations
• central control

Question 8

what is metarepresentations?

Answer 8

• ability to reflect on thoughts and behaviours
• interpret the actions of others
• dysfunction would disrupt our ability to recognise our own actions and thoughts
• explains hallucinations of voices and delusions

Question 9

what is central control?

Answer 9

• ability to suppress the automatic responses whilst preforming deliberate actions instead
• disorganised speech and thought disorder could result from inability to suppress automatic thoughts and speech triggered by other thoughts.

Question 10

drug theory AO1

Answer 10

most common treatment is anti psychotics

two main: typical anti and atypical anti

Question 11

typical antipsychotics (1950s)

Answer 11

worked as a dopamine antagonist: chlorpromazine

Antagonists reduce action of neurotransmitter dopamine
by blocking dopamine receptors in synapses of the brain

this normalises the neurotransmission in keys areas of brain (reducing hallucinations)

chlorpromazine is sedative and is first given to people admitted to hospitals

Question 12

atypical antipsychotics (1970s)

Answer 12

the aim was to improve the effectiveness of drugs in suppressing symptoms and minimising side effects

two types: clozapine and risperidone

Question 13

clozapine AO1

Answer 13

developed 1960s but withdrawn in 1970s due to risk of agranulocytosis

it was then remarketed as it was tougher and more effective than TA (but patients do need regular blood tests)

binds to dopamine receptors and acts on serotonin and glutamate receptors

Question 14

risperidone (1990s) AO1

Answer 14

aim was to produce a drug just as effective as czp but less side effects

small dosage initially given

binds most strongly to dopamine receptors

Question 15

SZ drug therapy AO3 - evidence for effectiveness

Answer 15

research compared effects for chlorpromazine compared with a placebo (experiences were identical) and found that chlorpromazine was associated with better overall functioning and reduced symptom severity (relapse rate also lower). thus effective (30-50% effective in treatment-resistant cases where typical anti’s have failed.

Question 16

Sz drug therapy AO3 - anti psychs depend on dopamine hypothesis

Answer 16

there’s evidence to suggest the hypothesis explanation is incomplete and that dopamine levels in parts of the brain other than the subcortex are too low rather than too high.
thus its not clear how anti psychs help SZ

Question 17

SZ drug therapy AO3 - side effects mild-fatal

Answer 17

these include dizziness, itchy skin, weight gain. long term can result in tar dive dyskinesia (involuntary facial movements eg blinking). worse side effects like neuroplastic malignant syndrome caused by drug blockage in hypothalamus. however, atypical are made to reduce side effects but clozapine still needs regular blood tests for it to be dosed.

Question 18

SZ drug therapy AO3 - the chemical cosh argument

Answer 18

they have been used in hospitals to calm patients and to be made easily cooperative. although being recommended by the national institute of health and clinical excellence, it is sometimes seen as human rights abuse. thus it is unethical (controlling) and takes away individual personality responsibility ( but they may not be able to give consent due to their position psychologically)

Question 19

3 psychological therapies

Answer 19

CBT
family therapy
token economics

Question 20

CBT AO1

Answer 20

based on cognitive and behavioural techniques
aim to deal with thinking (negative thoughts)
5-20 sessions
group / individual
aim to challenge rational thoughts
won’t get rid of symptoms but will help patient cope

Question 21

how CBT helps

Answer 21

help to make sense of how their delusions/ hallucinations impact their feelings

understanding where behaviours come from

offering psychological explanations can reduce anxiety associated with symptoms

imp to know they’re not based on reality

Question 22

family therapy AO1

Answer 22

improve quality of communication and interaction between family members

use double-bind theory and sz mother to recognise if family are the root

Pharoh et al identified strategies to help

1. form alliance w family
2. reduce stress of care giver
3. ability of family to anticipate and solve problems
4. help a family member achieve balance between patient and own life
5. reduce anger and guilt in family

Question 23

token economies AO1

Answer 23

reward system used to manage behaviour of patients- bad hygiene is a risk so modifying these habits improve the patient’s quality of life

tokens: coloured discs given to patients immediately for achieving certain tasks -immediacy is important as it prevents ‘delay discounting’, the reduced effect of a delay reward.
rewards: tokens can be swapped for tangible rewards, based on operant; conditioning. These may be sweets, magazines, services such as room cleaned.