schizophrenia

Question 1

family therapy

Answer 1

-based on idea that family dysfunction can play a role in development of Sz
-due to altering relationships and communication patterns within dysfunctional families
-works by reducing expressed emotion and stress levels which may contribute to patients risk of relapse

Question 2

how does family therapy work

Answer 2

MAIN AIM TO REDUCE LEVELS OF EXPRESSED EMOTIONS/STRESS BY:
-improving families beliefs about and towards Sz
-reducing the stress of caring for a relative with Sz
-decreasing feelings of guilt
-helping family members achieve balance between caring for individual and living their own life

Question 3

what is positive symptoms on Sz

Answer 3

an additional experience beyond those of ordinary existence

Question 4

what is negative symptoms of Sz

Answer 4

a loss of usual abilities and experiences

Question 5

example of positive symptoms of Sz

Answer 5

hallucinations and delusions

Question 6

what are hallucinations

Answer 6

-unusual sensory experiences that have no basis in reality
-can effect any sense eg auditory/visual hallucinations

Question 7

what are delusions

Answer 7

-irrational/false beliefs that have no basis in reality
-e.g delusions of persecution (beliefs you are being harassed by government)
-e.g delusions of control (beliefs that you are being controlled by something external)

Question 8

what is avolition

Answer 8

-severe loss of motivation to carry out everyday tasks
-andreason identified 3 signs of avolition: poor hygiene, lack of persistence in work and lack of energy

Question 9

what is speech poverty

Answer 9

reduction in amount and quality of speech, usually accompanied by a speech delay or lack of fluency

Question 10

diagnosis

Answer 10

-identification of a disorder through symptoms
-e.g hearing voices

Question 11

classification

Answer 11

-criteria that is used to make a diagnosis
-e.g symptom of Sz is hallucinations

Question 12

symptom overlap

Answer 12

-two or more conditions share similar symptoms e.g Sz and depression both involve negative symptoms

Question 13

co-morbidity

Answer 13

-two illnesses occur at the same time e.g Sz and OCD diagnosed at same time as they share similar symptoms
-lead to misdiagnosis

Question 14

genetic theory ao1

Answer 14

-suggests Sz is hereditary and passed on generations through genes
-a person is born with genetic predisposition for Sz
-believed several maladaptive ‘candidate’ genes e.g PCM1 are involved in increasing individual’s vulnerability to Sz
-Gottesman studied 40 twins and found the concordance rate for monozygotic twins was 48% but 17% for dizygotic twins.
-THEREFORE CLOSER THE GENETIC LINK, HIGHER LIKELIHOOD OF DEVELOPING SZ

Question 15

brain structure or function

Answer 15

-enlarged ventricles
-meta analysis by raz and raz found over half of individuals with Sz had enlarged ventricles
-associated with damage to pre frontal cortex which leads to negative symptoms of Sz e.g schizophrenia

Question 16

dopamine hypothesis

Answer 16

-neurotransmitters appear to work differently in the brain of a patient with Sz
-dopamine is widely believed to be involved as individuals with Sz release too much dopamine
-or have large amounts of D2 receptors on post SN

Question 17

hyperdopaminergia in subcortex

Answer 17

-high dopamine activity in central areas of brain e.g broca’s area (responsible for speech production)
-associated with auditory hallucinations

Question 18

hypodominergia in cortex

Answer 18

-low dopamine activity in prefrontal cortex
-associated with negative symptoms of Sz such as avolition

Question 19

biological explanation ao3

Answer 19

-biological determinism
-scientific methods
-alternative explanation (family dysfunction)

Question 20

family dysfunction

Answer 20

-idea that an individual develops Sz because they’ve been raised in a dysfunctional family environment
-dysfunctional in the way they communicate with each other as they have high levels of tension and arguments
-results in risk factors for development and maintenance of Sz

Question 21

schizophrenogenic mother

Answer 21

-idea that Sz is caused by individuals early experience of a schizophrenogenic mother
-a Sz mother is cold, controlling, rejecting and emotionally unresponsive
-builds a family environment based on tension and secrecy
-leads to distrust that later develops into paranoid delusions in Sz

Question 22

double bind communication

Answer 22

-bateson et al argues Sz is due to faulty communication patterns that exist within families
-occurs when parent communicates a verbal message which is not matched with physical behaviour
-child receives mixed messages
-conflicting, confusing forms of communication can lead to development of Sz
-child feels they can’t do the right thing, increasing anxiety, loses motivation leads to negative symptoms of Sz e.g avolition

Question 23

high expressed emotion

Answer 23

-high levels of expressed emotion towards Sz patient such as verbal criticism, hostility e.g anger and rejection and emotional over involvement
-cause stress in patient and can trigger onset Sz
-the stress caused is a primary explanation for relapse in patients with Sz as they’re placed back in a stressful environment causing relapse of positive/negative symptoms

Question 24

family dysfunction ao3

Answer 24

-RTS schizophrenogenic mother conducted by Mednick et al
-RTS double bind communication by Berger (DISCUSSION: retrospective data)
-practical applications: family therapy

Question 25

meta representation

Answer 25

-cognitive ability to reflect on thoughts and behaviour
-allows us to understand our actions and actions of others

Question 26

dysfunction in meta representation

Answer 26

-disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves and others
-could explain auditory hallucinations as individuals can’t understand voices in head
-lead to distress

Question 27

central control

Answer 27

cognitive ability to supress automatic responses whilst performing a deliberate action instead

Question 28

dysfunction in central control

Answer 28

-could explain speech poverty and thought disorder as individual is not able to suppress automatic thoughts and speech triggered by other thoughts/words spoken
-can experience disrupted spoken sentences: derailment

Question 29

cognitive explanation ao3

Answer 29

-RTS conducted by stirling et al
-practical applications: CBT
-alternative exp: biological explanation

Question 30

drug therapy

Answer 30

-most common treatment for Sz
-dosage is dependent on severity on psychosis
-two types: typical and atypical

Question 31

typical antipsychotics

Answer 31

CHLORPROMAZINE
-dopamine antagonists
-reduces dopamine activity in brain
-bind to D2 receptors on post SN, reducing dopamine action
-reduces positive symptoms e.g hallucinations
-can be used as a sedative

Question 32

atypical antipsychotics

Answer 32

CLOZAPINE
-seretonin agonists
-dopamine antagonists
-binds to D2 receptors to reduce positive symptoms
-acts as agonists upon seretonin receptor sites
-reduces negative symptoms such as lack of emotions

Question 33

drug therapy ao3

Answer 33

-require little motivation (unlike CBT)
-negative side effects
-RTS by thornley et al

Question 34

aim of CBT

Answer 34

-aim is to help patients identify irrational/delusional thoughts and change them into more rational ones through empirical disputing

Question 35

CBT process

Answer 35

-once irrational thoughts have been identified e.g… the psychiatrist would challenge the patients thoughts in order to encourage more rational ones
-use of empirical disputing, asking for evidence
-helps patients understand their delusions aren’t real
-offer more rational explanations can reduce patients anxiety and help patients realise their delusions aren’t based in reality
-positive self talk to challenge auditory hallucinations
-teach self distraction strategies

Question 36

CBT ao3

Answer 36

-RTS by jauhar et al
-requires motivation and commitment
-avoids chemical dependence (unlike drug therapy)

Question 37

token economies

Answer 37

-behaviourist approach to manage behaviour of patients with Sz
-mainly used with patients who have developed maladaptive behaviour e.g bad hygiene

Question 38

token economies aim

Answer 38

-change a patients behaviour so they are easier to manage
-patient will have a better quality of life
-thus enabling them to live outside of a hospital setting

Question 39

how do token economies work

Answer 39

-uses skinners operant conditioning principles
-patients receive reinforcements in the form of token after producing a desired behaviour e.g self care
-tokens can later be exchanged for goods or privileges

Question 40

token economies ao3

Answer 40

-RTS by dickerson et al
-ethical issues
-does not actually treat Sz

Question 41

interactionist approach

Answer 41

suggests Sz is developed through a combination of biological, psychological and social factors

Question 42

explaining Sz: diathesis stress model

Answer 42

-meehls original diathesis stress model suggested that diathesis was entirely genetic
-down to a single ‘schizo-gene’
-if you have the gene then stress through childhood e.g Sz mother could lead to Sz
-now believed many genes increase genetic vulnerability to Sz
-believed other factors can be a diathesis such as psychological trauma
-cannabis use causes increased risk of Sz by up to 7 times due to its interference with dopamine system

Question 43

treating Sz: diathesis stress model

Answer 43

-considers bother biological and psychological factors in development of Sz
-therefore compatible with both biological and psychological treatments
-combination of Sz and antipsychotics

Question 44

interactionist approach ao3

Answer 44

-RTS explaining Sz comes from tienari et al
-individual differences
-RTS treating Sz comes from tarrier et al