Schizophrenia Flashcards
Family Dysfunction defintion
Abnormal family processes ie cold parenting, high EE etc
Scizophrenogenic mother (Psychological explaintion)
When a mother is cold, rejecting and controlling which creates a climate of tension, secrecy and distrust
Schizophrenogenic mother Evaluation
- Subjective, even with their classification only a very small percentage fit into this.
- Hindered understanding of Sz
Roff et al
indicated a relationship between mothering style and schizophrenia development
Double Bind
Psychological Explanation
A child is confused by mixed messages in communication and is punished with love withdrawal
Double Bind evaluation
- Risk factor not causation
- Berger= people with sz reported more DB statements as children
- Levin (1980)= found no difference in patterns of parental communication in families with children with sz and control
Berger et al
Double Bind
Found that people with sz reported a higher number of DB statements in their childhood than control
BUT this is a retrospective self report study, memory may also be affected by medication
Levin (1980)
Expressed emotion
Found no difference in patterns of parental communication in families with children with sz compared to control families
Expressed Emotion (EE) Psychological explation
High levels of verbal criticism, hostility and overinvolvement
Expressed emotion evaluation
- subjective ->How do you measure negative tone?
- Culturally biased
- reciprocal determinism
- Brown = found high EE was a risk factor for relapse
- Tienari et al = children adopted into high EE families are more likely to develop Sz
- Altorfer et al
Brown et al
Found that high EE was a risk factor for sz relapse.
HIgh= 60% relapse
Tienari et al
Children adopted into high EE families were more likely to develop SZ
Altorfer et al
1/4 of patients showed no response to stressful comments from family
Cognitive Explanation for SZ
Definition
States that SZ is characterised by a disturbance in thought attention and perception which results in dysfunctional thought processing.
Firth (1992)
Cognitive explanation
Suggests that people with SZ fail to monitor their thoughts
so inner voice becomes and external force
Stirling et al (2006)
conducted stroop test with 30 patients with sz and 30 control
found patients with sz took twice as long to name the font colour
BUT sample is not representative, as does not reflect the strata 1% of the population
Auditory Selective Attention
Cognitive Explanations
Suggests negative symptoms may be coping strategies to deal with over stimulation
Pickering et al
Auditory selective attention
Proposed that sz may be caused by a breakdown in auditory selective information making interactions difficult. This means they have no choice but to withdraw
Cognitive Explanation Evaluation
STRENTHS
think nature vs nurture
- It is compatible with the biological approach as it suggests that genes are inherited
- cognitive processing deficits can lead to distortions
- Found traumatic event in 2nd trimester of pregnancy can increase chance of sz
Cognitive Explanations Evaluation
WEAKNESS
- Does not give explanation why/what causes cognitive changes ->Although it suggests it may be due to a traumatic event
- If dysfunctional thought processes are said to be the ‘root cause’ it does not explain why people with linked disorders (ie dyslexia) would correlate
Positive Symptoms
Delusions, hallucination, thought disturbances
Negative Symptoms
Avolition, speech poverty, reduced hygiene
Typical Drug Therapy and side effects
Ding to D2 receptors to block action to work on positive symptoms
Short term side effects= shaking, muscle spasms, stiffness (extrapyramidal)
Long term effects= Involuntary movements of face and mouth (tardive dyskinesia)
Atypical Drug Therapy and side effects
Used in the 70s but withdrawn due to deaths, they act on the D2 system and block serotonin receptors to work on both positive and negative symptoms
side effects= weight gain, tiredness, reduced memory, agranulocytosis (low WBC) and NMS (neuroleptic malignant syndrome)
Drug Therapies EVALUATION
Davis et al
Davis= found antipsychotics are more effective than placebo with 75% patient improvement compared to 25% in the control
Lieberman et al
Weakness of Drug therapy
Found 74% of individuals discontinued treatments in first 18 months due to side effects
Aims of Cognitive Bhavioural Therapy for Psychosis (CBTp)
Psychological therapies
Focuses on residual symptoms that persist with antipsychotic meds
Aims= to establish links between thoughts, feelings, actions, and symptoms
= recognise triggers
CBTp Evaluation
- Less side effects but more expensive so not offered by the NHS
- Drury et al= found 25-50% reduction in recovery time with drugs and CBTp
- Kingdon et al= CBTp is not suitable for many as they cannot engage with it
Coping Sttrategy Enhancement (CSE)
Psychological therapies
Tarrier devised specific for Sz with the aims to develp coping strategies
Chadwick (video clips)
Patients with sz delusions said they could predict the future but failed to predict it on 50 video clips
BUT only a case study
Family Therpy
Psychologiccal tratmentd
Based on the idea that family dysfunction causes sz
Aims= to improve positive and negative forms of communication,
increase tolerance,
decrease feelings of guilt and stress,
enhance ability to anticipate and solve problems
There is an emphasis on openessand takes between 3months to 1 year
Mcfarlane et al
Family therapy
A meta analysis found Family therapy reduces symptoms and relapse
Garety et al
Weakness of Family therapy
Found no difference between FT and no therapy so not effective
Pharoah (2009)
Strengths of family therapy
Found evidence that FT reduces hospital readmission
BUT noted inconsistency between studies
Psychological explanations for Sz
Schizophrenogenic mother
Double bind
Expressed emotion
Cognitive explanations for schizophrenia
Distortion of reality
Auditory selective attention
Psychological therapies
CBTp
Coping strategy enhancement (CSE)
Family therapy
