Schizophrenia

Question 1

What is family dysfunction?

Answer 1

Any abnormal family process that can cause schizophrenia. The two main forms of family dysfunction are double bind statements and expressed emotion

Question 2

What is double bind theory?

Answer 2

Created by Bateson et al in 1956, double bind theory outlines how contradictory messages can lead to schizophrenia. An example of a double bound scenario would be a mother telling their child that they love them, while refusing to hug them

Question 3

What is expressed emotion?

Answer 3

Expressed emotion is a communication style which involves criticism, hostility and emotional over-involvement

Question 4

Family dysfunction explanation of schizophrenia AO3

Answer 4

Berger (1965) - schizophrenics could recall more double bind statements from parents than non-schizophrenics

Hogarty (1991) - used this explanation to develop family therapy treatment for schizophrenia

Ethical issues - blaming families for their child’s disability is not constructive, nor is it typically fair

Question 5

What are the symptoms of schizophrenia?

Answer 5

Positive symptoms (cognitive biases) - abnormal mental functioning shown by schizophrenics on top of standard functioning e.g. hallucinations, delusions, etc

Negative symptoms (cognitive deficits) - abnormal mental functioning shown by schizophrenics which takes away from their standard functioning, such as anxiety, depression, inability to maintain hygiene, etc

Question 6

What are the main treatments for schizophrenia?

Answer 6

• Antipsychotics
• Family therapy
• Token economies
• Cognitive behavioural therapy

Question 7

What are the two forms of antipsychotics?

Answer 7

Typical antipsychotics (gen 1)

• Chlorpromazine and Haloperidol
• Blocks D2 dopamine receptors (blocks all dopamine)
• Reduces the effect of positive symptoms

Atypical antipsychotics (gen2)

• Clozapine and Risperidone
• Targets D2 dopamine receptors in the limbic system only (does not target them in the brain)
• Reduces the effects of negative symptoms

Question 8

Antipsychotics AO3

Answer 8

• Has improved the quality of life for patients since the 1950’s
• Highly effective and are cheap to produce
• Does not cure the patient, just reduces symptoms
• Kahn et al (2008) - found that antipsychotics were only effective for a year
• Ethical issues - used for sedating patients for the benefit of carers rather than the patient (HRA abuse)
• Severe side effects - can lead to diseases such as tardive dyskinesia

Question 9

Outline how family therapy works

Answer 9

Family therapy aims to reduce the levels of stress and expressed emotion within a family with a schizophrenic member. The family have their issues analysed and are then taught about more about schizophrenia, alongside receiving communication skills training. This enables them to provide better quality care for their schizophrenic family member

Pharoah - identified that family therapy works by helping carers achieve a good care/life balance.

Question 10

Family therapy AO3

Answer 10

• Anderson et al (1991) - the relapse rate of patients who undertook family therapy was only 20%. Compared to the 40% relapse rate of patients who has antipsychotics
• Reducing relapses is cost effective for hospitals
• Lobban et al (2013) - found that families found caring for their schizophrenic relative was much easier after going through family therapy
• Time inefficient (requires many sessions)

Question 11

Outline how a token economy works

Answer 11

Token economies aim to manage schizophrenia by rewarding good behaviour. Tokens are rewarded upon good behaviour, such as maintaining good hygiene. These tokens can then be spent on rewards, such as sweets, leisure time, cigarettes, etc

Question 12

Token economies AO3

Answer 12

• Paul & Lentz (1997) - found that token economies are very cost effective, as patients try their hardest to behave and not cause damage to anything
• Kazdin et al - token economies only work in a regulated environment such as a hospital or mental institute. As a result, Kazdin found that behaviour shown within the token economy is not maintained once the patient returns home
• Ethical concern - token economies entail that the patients are treated like an animal which get treats upon good behaviour. Which is very dehumanising

Question 13

Outline how cognitive behavioural therapy works

Answer 13

Patients are taught to recognise when they are displaying dysfunctional behaviour. And are taught to avoid it

Tanier (1987) found that schizophrenics could identify schizophrenic triggers, and reduce the effect they had on their behaviour with a 73% success rate

Question 14

Cognitive behavioural therapy AO3

Answer 14

• NICE 2014 - found that CBT does not reduce schizophrenic relapses or hospital admissions
• Tanier (1987) - proved CBT successfully reduces the effects 73% of schizophrenic triggers
• Time inefficient - requires months of sessions to have an effect on the patient
• Does not cure the patient - CBT only teaches the patient how to act like they are not schizophrenic

Question 15

What is the Interactionist approach?

Answer 15

The interactionist approach outlines how there are multiple factors which can cause schizophrenia, and not one sole cause (biological, environmental, psychological, etc)

Question 16

What does the diathesis stress model outline about the causes of schizophrenia

Answer 16

The diathesis stress model outlines how there are people who are born susceptible to schizophrenia, and that they can develop schizophrenia as a result of an extremely stressful event

Question 17

Diathesis stress model AO3

Answer 17

Zubin & Spring - found that a person susceptible to schizophrenia will not develop it if they live a stress free lifestyle

Holistic - acknowledges that different people will have different triggers which cause their schizophrenia

Vasos (2012) - living in the city makes you twice as likely to develop schizophrenia

Toyokawa et al (2011) - urban living = stress, which will cause schizophrenia