schizophrenia Flashcards
1
Q
strengths of family dysfunction (psychological)
A
- support by adoption studies by tienari. found that adopted children whose biological parents had sz were more likely to become ill than those whose biological parents did not have sz but only when the adopted family was rated disturbed. suggests illness only manifests itself under appropriate environmental conditions
- support for double bind theory in development of sz. berger found people with sz reported a higher recall of double bind statements from their mothers than people without sz
- read reviewed 46 studies of people with sz and found 69% of adult women in-patients with a diagnosis of sz had a history of child abuse, sexual abuse or both. for men it was 59%
2
Q
weaknesses of family dysfunction (psychological)
A
- led to parent blaming. parents have already suffered watching their child descend into a sz episode and are likely to bear life long responsibility for this underwent further trauma by being blamed for the onset
- ignores role of biological factors e.g having more d2 receptors leading to higher levels of dopamine in the synapse causing positive symptoms
3
Q
strengths of cognitive explanation (psychological)
A
- sarin and wallin reviewed research evidence and found support for claim that positive symptoms have origins in faulty cognition. delusional patients show biases in information processing e.g jumping to conclusions. people with hallucinations had impaired self monitoring and heard own thoughts as voices. people with negative symptoms had low expectations in regard to pleasure and success
- success of cognitive therapies such as cbt implies sz has a cognitive basis. in cbt for psychosis (cbtp) patients are encouraged to evaluate content of delusions and how they may test their faulty beliefs. effectiveness demonstrated by NICE review which found consistent evidence that cbt more effective than antipsychotics for reducing symptom severity
4
Q
weaknesses of cognitive explanation (psychological)
A
- deals with only cognitive aspect of disorder. may be more appropriate to use meehls diathesis stress model which takes an interactionist approach
- ignores role of biological factors e.g having more d2 receptors leading to higher levels of dopamine in the synapse causing positive symptoms
5
Q
metarepresentation
A
- ability to reflect on thoughts and behaviour
- insight to own goals and intentions
- dysfunction disrupts ability to recognise own thoughts and actions as our own
- explains hallucinations and delusions
6
Q
central control
A
-ability to suppress automatic responses while we complete deliberate actions
- causes disorganised speech and thought disorder from inability to suppress automatic thoughts and speech triggered by other thoughts
- each word triggers associations causing derailment of thoughts and speech as automatic associations cannot be suppressed
7
Q
strengths of biological treatments
A
- work instantly so patients can become functional in a shorter amount of time, cbt takes many sessions to complete
- support by thornley. compared a control group who took placebos to a group who had chlorpromazine. those who had the antipsychotic had better overall functioning and reduced symptom severity. also had high population validity as over 1000 pp so generalisable
8
Q
weaknesses of biological treatments
A
- continuous use needed to remain free from symptoms. if patient stops taking them, symptoms will return, treats symptoms not underlying cause so do not provide permanent long term solution to sz
- side effects e.g patients who take clozapine have to have regular blood tests to check for agranulocytosis which increases chance of infection. questions whether quality of life and functioning does actually improve with the use of drugs.
9
Q
strength of cbt
A
- bateman effects of cbt on reducing suicidal thoughts as 30-50% of people w. sz attempt suicide at some point. 99 pp split into cbt or no cbt. cbt reduced suicide ideation immediately and after a 9 month follow up
- benthall, cbt most effective for pp having first episode of sz
10
Q
weaknesses of cbt
A
- most research includes patients who recieve combined therapy e.g with antipsychotics so its difficult to isolate the effects of cbt
- takes place weekly for months so is time consuming and expensive and may not be appropriate for someone with maladaptive behaviours
11
Q
strengths of token economies
A
- improves relationship between patient and psychiatrists enabling smooth daily functioning m and patient is more likely to listen to advice
- mcmonagle and sultana reviewed token economy over 15 years and found it effective for reducing negative symptoms
12
Q
weaknesses of token economies
A
- if the patient does re enter society they will not be rewarded for getting out of bed etc so they may stop these desired behaviours and not function properly
- do not get rid of delusions and hallucinations so do no target the cause of sz in any way
13
Q
strength of family therapy
A
- long term benefit as patient is supported outside institution and skills gained by family support the patient after therapy is complete
- anderson found relapse rate for medication is 40%, only 20% for family therapy or social skills training and less than 5% for a combination
14
Q
weaknesses of family therapy
A
- requires all family member to be willing to engage with therapist
- social desirability as accounts given by family may not be accurate. e.g they may want to relieve themselves of the burden so say they are not doing well
15
Q
strength of the interactionist approach
A
- holistic approach so treatments target all aspects of sz such as antipsychotics for hallucinations and token economies for negative symptoms
- tarrier used random allocation of 315 sz patients to medication and cbt/ counselling and cbt/ control. those given combination treatments had less symptoms than control
