Schizophrenia Flashcards
What percentage of people affected by schizophrenia also have a substance abuse problems
50%
Define schizophrenia
A mental disorder characterised by withdrawal from reality
What are positive and what are negative symptoms
- Positive symptoms= Present in schizophrenic people but not in normal functioning people
- Negative symptoms= Present in normal functioning people but not in schizophrenic people
What are the positive and negative symptoms
Positive symptoms:
- Hallucinations= Sensory experiences that aren’t actually there
- Delusions= An irrational belief
Negative symptoms:
- Avolition= Lack of motivation
- Speech poverty= Don’t talk a lot, if they do it’s monotone
The two psychological explanations for schizophrenia
1) Family dysfunction
2) Cognitive explanations / Dysfunctional thought processing
2 AO1 points for family dysfunction
1) The characteristics of the schizophrenogenic mother which are:
- High levels of interpersonal conflict
- Difficulty communicating
- Excessively critical and controlling
2) The effect on the child which is:
It causes the child to be in a ‘double bind’ state, which is a state of confusion. Causing the child to be withdrawn, little speech or interaction
1 AO3 mark, Kavanagh (1992) study on effects of a dysfunctional family
Method, results, conclusion
Method= Meta-analysis of 26 previous studies, measuring relapse rates of schizophrenics who returned to families
Results= -48% rate of relapse when returning to dysfunctional family
- 21% rate of relapse when returning to healthy family
Conclusion= Supporting theory, that household environment impacts rate of schizophrenia
2 more AO3 points for dysfunctional family
- Only evidence for negative symptoms, therefore not a comprehensive theory as it doesn’t explain causation for all symptoms
- Therapies focussed on family dynamics, are successful in reducing relapses, Supports theory that environment impacts rate of schizophrenia
Cognitive explanations / dysfunctional thought processes
There are two types of thought processing involved according to Frith et al:
Metarepresentation
Central control
What is metarepresentation
The ability to represent thoughts, concepts and experiences in the mind
What does Frith state about metarepresentation which helps explain positive symptoms such as hallucinations and delusions
Frith states that failure in metarepresentation leads to an inability to distinguish between speech heard externally and internal thoughts
- Helps to explain positive symptoms such as hallucinations
What is central control
The cognitive ability to suppress some thoughts while we perform other actions instead
What test can measure your central control
The stroop test
Stirling (2006) study on cognitive explanations
Method, results, conclusion
Method= Performance of schizophrenia patients on the stroop test was compared with healthy central controls. (Test to measure a persons central control). DV is how quick they can do it
Results= Schizophrenic people take longer
Conclusion= Schizophrenics have no central control, therefore Supports theory
2 more AO3 points for cognitive explanations
- Describing the cognitive deficits explains the symptoms, but doesn’t explain what causes the cognitive dysfunctions, therefore not a comprehensive theory
- If occurrence is so common in schizophrenics, there could be possible patterns of cognitive deficit, therefore can use the stroop test as a diagnostic tool
Biological treatments
Do antipsychotic drugs cure schizophrenia
They don’t cure schizophrenia but they lessen the symptoms
What are the two types of drugs for treating schizophrenia
Typical and Atypical
Describe typical antipsychotics
- Developed In 1950’s
- Inhibitory action on the dopamine system (decreases chance of adjacent cell producing an electrical impulse)
- Reduce positive symptoms
- Many side effects
Describe atypical antipsychotics
- Developed In 1990’s
- Act on both the serotonin and dopamine systems (excitatory and inhibitory)
- Reduce both positive and negative symptoms
- Fewer side effects
Thornley(2003) study on typical antipsychotics
Method, results, conclusion
Method= -Meta-analysis on studies comparing effects of chlorpromazine with a placebo
Results= Chlorpromazine resulted in better functioning, reduced symptom severity and lower relapse rates
Conclusion= Typical antipsychotics are effective
Davis (1989) study on antipsychotics
Method, results, conclusion
Method= Compared antipsychotics with placebos
Results= - 70% of cases improved with antipsychotic use
- 25% improved with placebo
Conclusion= Antipsychotic use is effective
2 statistics that can help in AO1 about treatment
- Less than 3% of schizophrenics live permanently in hospital in the UK, most live a normal life. This shows treatment is effective enough to allow individuals to live independently
- Relapse rate for treated schizophrenics is 40% in the first year. This shows people stop taking medications, due to side effects
What are the 3 Psychological treatments for schizophrenia
- Cognitive Behavioural Therapy (CBT)
- Family therapy
- Token economies
Cognitive behavioural therapy
2 AO1 points
- Aims to change the maladaptive thinking and distorted perceptions of schizophrenia
- Antipsychotic medication taken prior CBT so psychotic thoughts are less severe
- Therapist challenges the delusional thoughts
- Techniques are developed to help patient cope with their hallucinations and delusions:
- Distractions (turn radio up to not hear hallucinations)
- Rationalising (asking for evidence/challenge irrational thoughts)
- Increasing social activity (Homework)
- Relaxation techniques (Decrease stress when diagnosed)
- Relapse recognition (Knowing the hallucinations and delusions to know if they come back)
Tarrier (2000) study for cognitive behavioural therapy (CBT)
3 conditions for it
Participants receiver either of the conditions to reduce schizophrenia symptoms:
1) Antipsychotics and CBT
2) Just antipsychotics
3) Counselling
Results for Tarrier’s study on CBT
Results = - 1/3 of patients in condition 1 achieved a reduction in positive symptoms
- 15% of patients in condition 1 were free of all positive symptoms
- These numbers were lower in both other conditions
- However, 2 years later they were similar in all groups again
Conclusion= Condition 1 is an effective treatment, but not long lasting
Evaluation for CBT
- Rathod study suggests successful CBT depends on relationship between therapist and patient. Therefore validity is questioned
- CBT helps patient ignore hallucinations instead of reducing them. Therefore, ignoring symptoms isn’t really a treatment
Family therapy
2 AO1 points
- About the cause of a schizophrenogenic mother
- Therapy involves not just the individual but relatives as well
Aims for this treatment like:
- Form alliance with family members
- Reduce levels of expressed emotion and stress
- Improve communication within family
- Help reach balance between caring and living life
Left (1985) study on family therapy
Method, results, conclusion
Method= Looked at schizophrenics with families high in expressed emotion.
- Comparing 2 treatments: Therapy and family therapy
Results= Relapse rate was significantly less for family therapy than normal therapy (individual), however symptoms began again after 2 years
Conclusion= Family Therapy is effective in short-term. Not long lasting
AO3 points for family therapy
- Schizophrenia commission (2003) states that Family Therapy is cheaper than standard care by around £1,000 per patient, every 3 years. Meaning there’s less relapse in family therapy
- Not all people are in contact with their family. Meaning not everyone can benefit from family therapy
Token economies as treatment for schizophrenia
AO1 points
- Uses operant conditioning to reinforce positive behaviours with tokens
- Token economies are aimed at reducing negative symptoms of schizophrenia
Ayllon and Azrin study for token economies
Method, results, conclusion
Method= Implemented a token economies system in a hospital for schizophrenic patients
Results= Average Number of chores completed rose from 5 to 42
Conclusion= Token economy is treating negative symptoms (avolition mainly)
2 AO3 points for token economies as treatment
- A token economy can only be implemented in a hospital, therefore not comprehensive
- If patient is not paid immediately, the treatment will not work, therefore cannot be used/generalised in outside settings
Interactionist explanations and treatments
What is a Interactionist theory in terms of schizophrenia
Schizophrenia is seen as developing through 2 interacting factors
- Not just having one cause
What’s a diathesis
A genetic disposition (genetic vulnerability)
What does the diathesis model suggest
Schizophrenia is caused by an underlying genetic vulnerability (diathesis) and the environment an individual lives in (stress)
According to the diathesis model, when are you most likely to develop schizophrenia
When you have High diathesis (a gene) and High stress (environment you live in)
Study for Diathesis
Method, results, conclusion
Method(3 conditions): 1) Antipsychotocs and CBT
2) Just antipsychotics
3) Counselling
Results= 1/3 of patients in condition 1 achieved reduction in positive symptoms
Conclusion= Supports DS theory, as it targets both genetic and environment, which turns out to be most effective
AO3 point for interactionist explanation and treatment
- Combined Therapy is expensive in short term, in the long term it saves money due to reduction of relapse
- A study (Walker 1997) suggests there’s higher levels of cortisol in schizophrenics than non-sufferers causing the high levels of stress. However, no cause and effect as don’t know whether stress causes schizophrenia or schizophrenia causes stress
