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Psychology paper 3 > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

Positive symptoms of schizophrenia (2)

A
  1. Hallucinations (additional sensory experiences)
  2. Delusions (irrational beliefs of the world)
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2
Q

Negative symptoms of schizophrenia (2)

A
  1. Avolition (lack of purposeful, willed behaviour i.e personal hygiene)
  2. Speech poverty (lack of quality/quantity of speech)
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3
Q

Problems with classification/diagnosis of schizophrenia

A
  1. Cultural bias
  2. Comorbidity/symptom overlap
  3. Labelling/stereotyping
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4
Q

Loring and Powell (1988) - gender bias study

A
  • 290 M/F psychiatrists given two patient reports
  • If two patients describe as N/A or male, 56% diagnosis
  • If described as female, 20% diagnosis
  • Discrepancy not present for female psychiatrists
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5
Q

Buckly (2009) - comorbidity rates study

A
  • 50% with depression
  • 47% with drug abuse
  • 23% with OCD
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6
Q

Barnes (2004) - cultural bias

A
  • Found that African Americans were more likely to be diagnosed (hearing voices, hallucinations etc)
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7
Q

Gottesman (1991) - twin concordance study (3)

A
  • 48% MZ
  • 17% DZ
  • Compared to 1% for general population
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8
Q

Tienari (2004) - adopted children of SZ mothers

A
  • 5.8% diagnosis when adopted to healthy families
  • 36.8% when adopted to dysfunctional families
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9
Q

Think about what causes negative and positive symptons

What is the revised dopamine hypothesis?

A

Negative symptoms - deficit of dopamine in prefrontal cortex
Postive symptoms - excess dopamine in prefrontal cortex

The orignal hypothesis only uses the excess dompamine receptors theory

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10
Q

What are neural correlates?

A

Variations in neural structure and biochemistry which are correlated with SZ

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11
Q

Johnstone (1976) - ventricles study

A

Those with larger than average ventricles had increased risk of SZ

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12
Q

What are the 3 biological explanations for schizophrenia?

A
  • Genetic
  • Dopamine hypothesis
  • Neural correlates/brain structure
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13
Q

What is the double bind theory?

A

When a child receives mixed messages on the verbal and non-verbal levels, they develop an incoherent version of reality

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14
Q

What is the expressed emotions theory?

A

SZ is more likely when a patients family exhibits;
1. Exaggerated involvement
2. Criticism/hostility to individual

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15
Q

Butzlaff and Hooley (1998) - EE study

A
  • Meta-analysis of 27 studies
  • Relapse is significantly more likely with families which express EE
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16
Q

What is Frith’s cognitive theory of SZ? (3)

A
  • Identified two types of dysfunctional thought processing
  • Central control is faulty, unable to repress automatic urges
  • Faults in meta-representation can create a feeling that ones actions are being controlled externally
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17
Q

Frith (1992) - SZ PET scans (3)

A
  • 30 SZ patients
  • Found reduced blood flow to the prefrontal cortex (avolition/suppression of urges)
  • Increased activity in the temporal lobe (memory retrieval)
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18
Q

3 negative evaluations of the cognitive explanations for SZ

A
  • Reductionist
  • Lacks causal relationship
  • Places blame on individual
19
Q

What are the 3 psychological explanations for schizophrenia?

A
  • Expressed emotion
  • Double bind theory
  • Frith’s cognitive theory
20
Q

Typical antipsychotics (chlorpromazine)

A
  • Bind to dopamine receptors and prevent firing (inhibitory)
  • Long lasting effects
21
Q

Atypical antipsychotics (clozapine)

A
  • Bind to dopamine receptors and prevent firing (inhibitory)
  • Rapidly disassociate to allow normal transmission
22
Q

Leucht et al (2012) - placebo vs relapse

A
  • Meta-analysis of 65 studies
  • Placebo = 64% relapse in 12 months
  • 27% relapse for antipsychotics
23
Q

Side effects of typical antipsychotics (3)

A
  • Tarkive dyskinesia
  • Lethargy
  • Dry mouth
24
Q

Side effects of atypical antipsychotics (3)

A
  • Agranulocytosis
  • Weight gain
  • Cardiovascular problems
25
Q

Crossley et al (2010) - atypical vs typical antipsychotics

A
  • Meta-analysis of 15 studies
  • No difference in effect on symptoms
  • Has different side effects however
26
Q

Positive evaluations of drug therapies (2)

A
  • Cheaper/better for economy
  • Prevents institutionalisation, allows for patient autonomy
27
Q

Psychological ways of treating SZ (3)

A
  • CBTp
  • Token economy
  • Family therapy
28
Q

How does CBTp work? (3)

A
  • Encouraged to find root causes of symptoms
  • Irrational thoughts challenged
  • Via ABCDE framework
29
Q

How does family therapy work? (3)

A
  • Lower levels of EE
  • Restructure family beliefs on SZ
  • Lower relapse
30
Q

NICE 2015 review - CBTp effectiveness

A

Found that compared with medication alone, rehospitalisation rates reduced after 18 months with CBTp

31
Q

Haddock et al (2013) - CBTp availability

A
  • 187 SZ patients
  • Only 13 offered CBTp
32
Q

Freeman et al (2013) - CBTp refusal

A
  • Found significant number of patients refusing/failing to attend therapy
33
Q

Lobban et al (2013) - family therapy effectiveness

A
  • 50 family therapy studies
  • Found 60% significant positive impact
34
Q

How does token economy work for treating SZ? (3)

A
  • Target behaviours identified
  • Tokens rewarded for exhibiting these behaviours
  • Able to exchange tokens for rewards
35
Q

Dickerson et al (2005) - token economy effectiveness

A
  • 13 studies of token economies
  • 11 reported beneficial effects
36
Q

Issues of the token economy (2)

A
  • Ethical issues
  • Do not treat symptoms of SZ
37
Q

Which 2 studies support the interactionist approach?

A
  • Gottesman (1991) - MZ twins only 48% concordance
  • Tienari (2004) - 5.8% vs 36.8% of adopted children
38
Q

Tarrier (1998) - interactionist approach support

A
  • Drug vs drug + CBT conditions
  • Patients in combined conditions had significant improvement in the severity/number of symptoms
39
Q

2 negative evaluations of the interactionist approach (2)

A
  • Mechanism which links stressor and biological response is not understood
  • Certain birth complications can increase the risk of schizophrenia (Verdoux et al 1998)
40
Q

What is the schizophrenogenic mother theory?

A
  • Mother is cold, rejecting and controlling
  • Creates family climate of tension and secrecy
  • Leads to distrust and paranoid delusions
41
Q

Stirling (2006) - Central control evaluation point

A
  • 30 SZ and 18 controls given Stroop test
  • SZ individuals took twice as long to name the ink colour
  • Suggest faulty central control
42
Q

Key studies for this topic (biological)

A
  • Gottesman (1991) - twin concordance
  • Tienari (2004) - adopted children of SZ mothers
  • Johnstone (1976) - ventricles study
  • Firth (1992) - SZ PET scans
43
Q

Key studies for this topic (misc)

A
  • Loring and Powell (1988) - gender bias
  • Buckly (2009) - comorbidity
  • Barnes (2004) - cultural bias
  • Butzlaff and Hooley (1998) - EE study

Psychology paper 3 (4 decks)

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