Schizophrenia

Question 1

what is the difference between classification and diagnosis?

Answer 1

• classification is organising symptoms into categories based on which symptoms cluster together in sufferers
• diagnosis - deciding whether someone has a particular mental illness using the classifications

Question 2

what are positive and negative symptoms?

Answer 2

• positive symptoms are atypical symptoms experienced in addition to normal experience
• negative symptoms are atypical experiences that represent the loss of usual experience

Question 3

examples of positive symptoms

Answer 3

• hallucinations - disturbances of perception in any of the senses
• delusions - irrational beliefs that have no basis in reality
• speech disorganisation - jumping from topic to topic in conversation

Question 4

what are the types of delusions?

Answer 4

• delusions of control - the belief that their body is under external control
• delusions of persecution - the belief that others want to harm, threaten or manipulate you

Question 5

examples of negative symptoms

Answer 5

• Avolition - reduction, difficulty or inability to start and continue with goal - directed behaviour
• speech poverty - reduction in the amount and quality of speech

Question 6

differences between ICD-10 and DSM-5

Answer 6

ICD-10:
- two or more negative symptoms
- or one positive symptom

DSM-5:
- two positive symptoms for at least 6 months

Question 7

what is criterion validity?

Answer 7

the extent to which different classification systems produces the same diagnosis in the same patient

Question 8

What does co-morbidity mean?

Answer 8

the occurrence of two or more disorders or conditions together

Question 9

Issues with reliability and validity of classification and diagnosis

Answer 9

• symptom overlap
• co-morbidity
• gender/cultural bias

Question 10

what is the concordance rate for schizophrenia?

Answer 10

58%

Question 11

how many gene variations did Ripke et al 2014 find?

Answer 11

108 separate variations

Question 12

what does neural correlates mean?

Answer 12

measurements of the structure/function of the brain that occur in conjunction with the characteristic symptoms of SZ

Question 13

what is central control dysfunction

Answer 13

the inability to suppress automatic responses while performing deliberate actions

Question 14

what is meta representation dysfunction?

Answer 14

the inability to identify your thoughts and actions as being your own by paying attention to them

Question 15

what is double-bind theory?

Answer 15

• a child receives mixed messages from their parent and feels unable to do the right thing
• this leaves the child with an understanding of the world which as confusing
• this could be reflected in symptoms such as disorganised thinking and paranoid delusions

Question 16

what is expressed emotion?

Answer 16

• the level of emotion, in particular negative emotion, expressed towards a patient by their carer including:
• exaggerated overinvolvement
• criticism and control
• hostility

Question 17

evaluation of family dysfunction

Answer 17

• research support from Tienari (2004)
• poor communication may not have causality

Question 18

Evaluation of CBT for schizophrenia

Answer 18

• research support for effectiveness (NICE review 2014) Counter: most studies have been conducted whilst patients are also being treated with antipsychotics - difficult to look at its effectiveness on its own
• Thomas (2015) - different studies have involved different CBT techniques and a range of patient symptoms

Question 19

what are the features of family therapy

Answer 19

Psychoeducation:
- the family is educated on SZ and the particular diagnosis to understand the difficulties a patient faces
- the patient is asked to discuss their experience with the family - they are the expert

Improve Communication:
- family members learn more constructive ways of communicating with a focus on the positive rather than the negative
- reduce double-bind comments and high expressed emotion

Reduce conflict:
- work to reduce anger and guilt
- reduce the stress of caring for the patient
- done by helping family members with their care/life balance

Practical coping skills:
- developing coping skills to manage the everyday difficulties arising from having SZ in the family

Taught to recognise the signs of relapse:
- can then respond rapidly to reduce severity

Question 20

how long does family therapy last for?

Answer 20

3-12 months with sessions every 2-4 weeks