schizophrenia

Question 1

What is schizophrenia ?

Answer 1

SZ is a mental illness where contact and insight with reality is impaired and is an example of psychosis.

Question 2

Positive symptoms are an excess/distortion of normal functions
What are the positive symptoms of schizophrenia?

Answer 2

Hallucinations
Delusions
Psychomotor disturbances such as pulling hair and rocking
Disordered thinking

Question 3

Negative symptoms are the loss of normal functions and are usually harder to treat
What are the negative symptoms of SZ?

Answer 3

Affective flattening: Loss of emotive language and facial expressions
Alogia: Speech poverty, lack of words
Avoliation: Lack of motivation for everyday activities and becoming apathetic

Question 4

What are some additional social and occupational dysfunctions that come with SZ?

Answer 4

Loss of ability to make friends, being unable to work and appearing lazy and unmotivated..

Question 5

How would you diagnose SZ?

Answer 5

The use of the DSM and ICD which classify SZ when the supposed sufferer shows two symptoms and other social + occupational dysfunction for a month straight.

Question 6

What does the psychological explanation of SZ propose?

Answer 6

The psychological explanation of SZ proposes that mental disorders arise from unresolved conflicts during childhood and are manifestations of imbalances between the ID, EGO and SUPEREGO.

Question 7

How does the psychological explanation of SZ propose that SZ can be recovered from?

Answer 7

Disorders can be resolved when coming intro terms with the repressed ideas and conflicts.

Question 8

What does the family dysfunction explanation of SZ propose? What are some features of schizophrenic parents?

Answer 8

The family dysfunction explanation proposes that maladaptive relationships and bad patterns of communications are a source of stress and can influence the development of schizophrenia.

These parents are called schizophrenic parents who have high levels of interpersonal conflict, difficulty communicating and are critical of their children.

Question 9

How can he imbalance of the psychological personalities explain SZ?

What symptoms can this explain?

Answer 9

SZ is believed to be the result of regressing to the pre-ego stage where the ID is control which is the hedonistic part of our personality where we are unaware of wrongs and right and do not have a real awareness of the world. The individual will regress to a primitive state.

This can explain delusions.

Question 10

Who proposed the idea of a schizophrenogenic mother and what characteristic will she have?

Answer 10

Reichman, who agreed with Freud that disordered families were the cause of SZ, 1948 believed that schizophrenogenic mothers influence the development of schizophrenia.
They are rejecting, but over protective, dominant, cold and moralistic.

Question 11

How do Waring and Ricks contradict Reichmanns beliefs?

Answer 11

Waring and Ricks found that mothers of schizophrenics were anxious, shy and withdrawn which do not match with the characteristics proposed by Reichmann and additionally they believed that there was no clear difference between mothers of SZ and mothers of non-SZ which questions the cause and effect.

Question 12

What is the double bind theory?

Answer 12

The double bind theory proposed by Bateson et al suggests that children who frequently receive contradictory messages from their parents and more likely to develop SZ as this prevents the development of a regular structure of reality and lead to symptoms such as affective flattening.

Question 13

What is the expressed emotion (EE) explanation of SZ?

Answer 13

This theory suggests that a high level of expressed emotions. which could be the over involvement of family and critical talking of SZ, increase the relapse rates of schizophrenics due to stress.

Question 14

What did Kalafi and Torabi find out regarding EE in Iran?

Answer 14

Kalafi and Torabi found that in Iran, where families have a high prevalence of EE, are one of the main reasons for relapse rates due to stress which can trigger an SZ episode.

Question 15

Evaluate the family dysfunction explanation of SZ

Answer 15

+ Has positive implications, Hogarty developed a family therapy aimed to reduced the levels of expressed emotions within families and reduce family conflicts which have found to lower relapse rates.
+Berger found that Sz’s reported higher levels of double blind statements during their childhood than healthy induviudals

=Cause and effect is questionable, suggested by Warings and Ricks that there is no real difference between the mothers of SZ and non SZ
=Heavy blame placed on mothers, social implications
=Does not consider the biological explanation of SZ which may not be able to be controlled by the treatment of family problems

Question 16

What does the cognitive explanation suggest about SZ?

Answer 16

The cognitive explanation suggests that maladaptive behaviour is the result of faulty/irrational thinking regarding a situation rather than the problem itself and you can recover from it by becoming rational and positive in your thinking.

Question 17

Frith et al identified two dysfunctions involved in cognitive thought process to explain SZ symptoms. what is meta representation and what does it cause when disturbed?

Answer 17

Meta representation is the cognitive ability to reflect on ones own thoughts and behaviours to interpret their own actions and that of others.

Dysfunction in meta representation would disrupt our ability to recognise our own actions and percieve our actions being carried out by someone else rather than ourselves.

This can explain hallucinations of voice and delusions

Question 18

Frith et al identified two dysfunctions involved in SZ, what is central control and what does it cause when disturbed?

Answer 18

Central control is the cognitive ability to suppress automatic responses while be preform deliberate actions.

Dysfunction in the central control can lead to disorganised speech and disordered thinking as you are unable to suppress automatic thoughts and speech and one thing is triggered by another.

Question 19

What did Helmsly propose ? ( Cognitive theory )

Answer 19

Helmsly proposed the cognitive theory of SZ and stated that perception and memory combine regularly in healthy individuals however fail to do so in SZ sufferers.

SZ breaks down the connection between the two and therefore individuals with SZ are unable to [predict what will happen next as their schemas are not in tact and will be more likely to pay to unimportant aspects of the environment.

Question 20

Evaluate the cognitive approach

Answer 20

+ Has led to the development of useful cognitive behavioural therapy which has been found useful in managing schizophrenic symptoms such as delusions
+ Supported by Bowie and Harvey as they discovered that cognitive impairments such as lack of attention and working memory are present throughout the course of SZ

= Cause and effect comes into question
= Reductionist approach as it does not consider the biological aspect
= Cannot explain positive symptoms such as affective flattening

Question 21

What does the genetic explanation suggest about SZ?

Answer 21

The genetic explanation suggests that SZ is transmitted through hereditary means, and that Sz is a polygenic illness (cause through multiple genes)

Question 22

How does Gottesman 1991 support the genetic explanation of SZ?

Answer 22

Gottesman discovered through meta analysis of 40 twin studies that the concordance rate of SZ in MZ twins is about 48% while in DZ it is 17%. Suggests that there is a genetic component involved.

Question 23

How can CBT be used to treat SZ?

Answer 23

Cognitive behavioural therapy aims to treat SZ by using the principles of the cognitive explanation by challenging maladaptive thoughts through reality testing and identifying irrational thoughts and considering other possibilities.

For example by asking, It is possibility, but there could be other explanations, how do you know it is the mafia?

Provides a psychological explanation for their symptoms such as their delusions and hallucinations

Question 24

What is personal therapy and what techniques do they use?

Answer 24

Personal therapy is a CBT approach therapy that involves only the patient and therapist who will recommend techniques to improve SZ symptoms .

For example, distractions from intrusive thoughts, increasing or decreasing social activity to improve low mood, relaxation techniques etc..

Question 25

What is family therapy?

Answer 25

Family therapy is a psychotherapy which aims to reduce tensions and improve communications within families which will lower levels of expressed emotions and therefore relapse rates and additionally give insight to families on how to deal with Sz symptoms

Question 26

What are some techniques Fiona Pharoh recommend to treat SZ via family therapy? What are some positives of these techniques? What is important during family therapy?

Answer 26

+ Reduce the stress for taking care of a SZ patient
+ Reduce anger and guilt
+ Help manage caring for a SZ while balancing their own lives
+ Improve their critical beliefs towards SZ

These techniques reduce stress and increase a patients compliance with medicine and lower relapse rates

Openness is an important factor in family therapy and essential for treatment

Question 27

How can token economics be used to treat someone with SZ?

Answer 27

Token economics is a treatment baed on the principles of operant conditions
When a positive behaviour is shown, they will be rewarded with a token which can be exchanged later on which can help treat negative symptoms such as maladaptive behaviour.
They do not punish undesirable behaviour

Question 28

Evaluate CBT as a treatment for SZ

Answer 28

+ Supports the case for combined treatment as it works very effectively when paired with drug therapy
Tarrier found that compared to drug therapy in isolation, schizophrenics had a large reduction in symptoms when paired with CBT

=Not suitable for all patients as not all SZ sufferers will be willing to engage with CBT, also it is a long process and may have a high drop out rate due to an SZ episode
= Trower et al reported that CBT does not actually get rid of SZ and its symptoms but only reframe them as less of a threat

Question 29

Evaluate family therapy as a treatment for CBT

Answer 29

+ Has positive economic implications as therapy decreases relapse rates, less need to go back to psych wards and additionally parents can go to work as they are more likely to be able to manage their lives and the SZ symptoms
+ Useful for sufferers that lack insights of their illness as family members can inform the therapist their problems

=Effectiveness treatment is dependent on the openness of the family as they may be reluctant to share sensitive information
=Does not consider all individual differences

Question 30

Evaluate token economics as a treatment for SZ

Answer 30

+ Facilities are more stable as the environment is therapeutic meaning staff and patient injuries decrease
+ Flexible source of treatment as it can be used to target and stamp in any positive type of improvement behaviours and meet different individual requirements based on what rewards they will exchange the tokens for

=Does not punish undesirable behaviour and good behaviour becomes dependent on the rewards, what will happen once the reward is not present in regular society
=Can be seen as dehumanising

Question 31

What are the two types of drugs used to treat antipsychotics?

Answer 31

The drugs typical antipsychotics and atypical antipsychotics are used to treat SZ and reduce symptoms and live normal lives

Question 32

What is clorpromazine? How does it work?

Answer 32

Clorpromazine is a typical antipsychotic which are generally used to treat positive symptoms of SZ such as hallucinations and delusions

It works antagonistically against the dopamine system by blocking dopamine receptors in the synapse, the level will initially increase and then be destroyed in the synapse

Question 33

What are the side effects of clorpromazine?

Answer 33

Clorpromazine is an affective sedative which affects other neurotransmitter systems such as the serotonergic mechanisms

Side effects include a dry mouth, constipation and Hill 1986 found that 30% develop tardive dyskinesia which causes uncontrollable muscle movement and could become permanent

Question 34

Evaluate the use of typical antipsychotics in treating SZ

Answer 34

+ Davidson et al found that typical antipsychotics side effects can lead to patients not wanting to take their medicine resulting in a relapse of symptoms

=Has led to enormous improvements on how patients were treated as out of 300,000 SZ sufferers in institutions, after the development of drug therapy, only 3% were permanent residents

Question 35

What is the aetiology fallacy?

Answer 35

This suggests that although drugs can treat psychotic symptoms, it does not necessarily mean that disorders are caused by biological factors.

Question 36

What are atypical antipsychotics?

Answer 36

Atypical antipsychotics are second generation antipsychotics that work similarly to first generation antipsychotics ( attach to dopamine receptors to prevent its excess release ).

Question 37

What is clozapine and how does it work? What side effects can it pose?

Answer 37

Clozapine is an atypical antipsychotic and is more effective than typical antipsychotics as it can work on serotonin and glutamate receptors which improve mood and depression to improve cognitive functioning in the brain .

Although it produces less side effects than typical antipsychotics, it still has some side effects such as causing agranulocytosis which effects the blood and increase risks of strokes and cardiac death

Question 38

Evaluate drug therapy as a whole

Answer 38

+ Production of atypical/ second generation antipsychotics led to less symptoms and shows how science is rapidly developing more effective treatments for SZ
+ Cheap and easy to use and is flexible by combining with CBT for the most effective treatment
+Positive economic implications by returning people into society and work

=Bad side effects can make people not want to take them, more relapse rates, if too much taken it can lead to very bad heath
=Dependent on the sufferers ability to take the drugs, may miss it due to a psychotic episode which can have very bad effects
e.g Davidson et al

Question 39

What is the diathesis stress model of SZ?

Answer 39

The diathesis stress model proposes that both a venerability to SZ and a stress trigger are necessary for the development of SZ

Question 40

What did Meehls model suggest about the interactionist approach to Sz?

Answer 40

Meehel suggested that the disposition to SZ was entirely genetic and caused by a schizogene which made the person more vunrable to stress and therefore more likely to develop SZ
Without the gene it is impossible to get SZ no matter how much stress

Question 41

How is meehls model challeneged?

Answer 41

Recent research has found that Sz is a polygenic disease and cannot be determined by a singular gene as that is reductionist and also a disposition to Sz could also appear in the form of psychological factors such as trauma

Question 42

What did Hogarty et al find about the interactionist approach to treatments?

Answer 42

Hogarty et al assessed 103 Sz paitents from high EE families recieving various treatments and found that those who had a combined treatment of both CBT and drug therapy had no relapse rates in the first year..

However!

A follow up study suggested that tis only delays relapse rather than prevent it

Question 43

Evaluate the interactionist approach to SZ

Answer 43

+It is a holistic approach which combines all aspects meaning that less detail is missed when considering what can cause Sz, more reliable
+ Led to the most effective treatment of Sz, proposed by hogarty et al who found 0% relapse rates in the first year
+ does not attempt to simplify human behaviour

=A follow up study showed that it only delayed relapse rates not stop them suggesting that although combining all approaches are good, there still needs to be more research conducted on what is causing SZ
+ Cultural and gender differences