Schizophrenia Flashcards

Question

What is Speech Disorganisation?

Answer 1

A more recent view of Speech Poverty, where emphasis is based more on incoherent speech and changing topics mid sentence

Answer 2

(also called apathy) A reduction in, difficulty or inability to start and continue goal-related behaviour - a sharply reduced motivation to carry out a range of activities - can be mistaken for disinterest examples: - sitting alone doing nothing for hours - no longer interested in anything - no longer interested in activities they used to be enthusiastic for

Answer 3

Anderson (1982)

Answer 4

Theorised 3 signs of Avolition

Answer 5

- Poor hygiene or grooming - Lack of persistence in work or education - Lack of energy

Answer 6

Bad - Low criterion validity Chiniaux et al - asked 2 psychologists to independently diagnose 100 patients using DSM and ICD - one diagnosed 26 using DSM, and 44 using ICD - one diagnosed 13 with DSM, and 24 with ICD - This suggests Sz is either over or under diagnosed, according to the diagnostic system, so criterion validity is low - It is easier to see 2 negative symptoms than 1 positive symptom, so it is easier to get a diagnosis with ICD than with DSM - the lack of criterion validity might mean over or under diagnosis - This matters because you are more likely to be diagnosed in Europe, suggesting some people might not be diagnosed when they need treatment, while others might be diagnosed and receive treatment they do not need Bad - Low reliability Chiniaux et al - two researchers arrived at different results despite using the same classification system - suggests the systems are not standardised, and there is no inter-rater reliability - could mean some people are over or under diagnosed Bad - Symptom Overlap - There is a considerable overlap between symptoms of Sz and symptoms of other conditions, such as bipolar disorder - Bipolar disorder also includes positive symptoms and negative symptoms - In terms of classification, this could suggest they might be two variants of a single condition, rather than separate - This could mean difficulty to distinguish and treat the two - This matters because it may mean Sz does not exist as a distinct condition, and is hard to diagnose, so both classification and diagnosis is flawed Bad - Co-morbidity - If co-morbidity occurs a lot of the time, it questions the validity of diagnosis and classification as it might be a single condition - People with Sz are often diagnosed with depression as well - This could mean Sz does not exist as a single condition, which could mean the classification is flawed Bad - Gender Bias - More men are diagnosed than women - This could be suggested by men being more vulnerable from genetics, but it is likely due to females having closer relationships, meaning they can get support - This under-diagnosis could mean women are not receiving the treatment they need Bad - Culture Bias - Some symptoms (especially auditory hallucinations) have different meanings in different cultures e.g. communications with ancestors - British people of African-Carribean origin are up to 9 times as likely to receive a diagnosis as British People - Could suggest discrimination by a culturally-biased diagnostic system

Answer 7

The Genetic Basis of Sz Neural Correlates of Sz

Answer 8

Genetic Basis: - family studies - twin studies - candidate genes Neural Correlates: - the original dopamine hypothesis - the updated dopamine hypothesis - abnormal ventral striatum - abnormal superior temporal gyrus and anterior cingulate gyrus

Answer 9

Sz runs in families and is partly genetic

Answer 10

They indicate the chance of developing Sz based on genetic inheritance

Answer 11

The closer the genetic relationship to someone with Sz, the greater the chance of developing the disorder

Answer 12

Conducted a large scale family and twin study to see the concordance rate of Sz

Answer 13

People with an aunt with Sz had a 2% chance of developing it People with a sibling with Sz had a 9% chance of developing it People with an identical twin with Sz had a 48% chance of developing it

Answer 14

Genotype influences on Sz Phenotype influences on Sz Also suggests genotype has a larger impact than phenotype due to the higher concordance for MZ twins than siblings

Answer 15

Sz is polygenic as it has a number of genes involved The most likely genes involved would be those coding for neurotransmitters such as Dopamine Sz appears to be aetiologically heterogeneous as it may be caused by a different combination of genes

Answer 16

Sz is likely caused by different combinations of genes

Answer 17

Ripke et al

Answer 18

A meta analysis of genome-wide studies of Sz They compared the genetic make-up of 37,000 people with Sz to 113,000 controls

Answer 19

108 separate genetic variations were associated with increased risk of Sz Suggests Sz is aetiologically heterogeneous

Answer 20

Neurotransmitter Dopamine (DA)

Answer 21

It is important in the functioning of several brain systems that are correlated with symptoms of Sz There are 2 hypotheses of how dopamine can cause or increase chances of Sz

Answer 22

Measurements of the structure or function of the brain that correlates with an experience (schizophrenia)

Answer 23

Hyperdopaminergia: - there are high levels of dopamine in the central areas of the brain (sub cortex)

Answer 24

The discovery that drug treatment for Sz caused similar symptoms to Parkinson's Disease Parkinson's Disease is associated with low dopamine levels This suggests there must have been originally high dopamine levels

Answer 25

An excess of dopamine receptors in Broca's area might be associated with speech poverty

Answer 26

Davis et al: Hypodopaminergia: - abnormally low dopamine in the brain's cortex - Suggests perhaps both hyper- and hypo-dopaminergia in different brain regions are involved in Sz - Acknowledges that genes and stress might make some people more sensitive to cortical hypodopaminergia

Answer 27

Low dopamine in the prefrontal cortex (associated with thinking) could explain cognitive problems and negative symptoms

Answer 28

Avolition: - includes loss of motivation - motivation involves anticipation of a reward - anticipation of a reward is associated with Ventral Striatum - suggests abnormality to the Ventral Striatum can cause Sz

Answer 29

Auditory Hallucinations: Allen et al - Brain-scanned patients with auditory hallucinations and compared them to a control group - found the patients with hallucinations had lower activation levels in their Superior Temporal Gyrus and Anterior Cingulate Gyrus - suggests low activity levels here is a neural correlate for auditory hallucinations

Answer 30

Brain scanned patients with auditory hallucinations and compared these to a control group Found patients with auditory hallucinations had lower activity levels in the Anterior Cingulate Gyrus and Superior Temporal Gyrus

Answer 31

Negative: Ventral Striatum (avolition) Positive: Superior Temporal Gyrus Anterior Cingulate Gyrus (auditory hallucinations)

Answer 32

Good - research support for Genetic Vulnerability Gottesman: - 2% aunt, 9% sibling, 48% MZ twin Tienari: - Suggested children of people with Sz are at heightened risk even when adopted by families with no history of Sz - suggests genes must be involved Bad - must be environmental factors Gottesman: - only 48% concordance rate - should be 100% - research has suggested environmental factors can increase the likelihood of Sz: Childhood trauma (people are vulnerable to adult mental health issues) Smoking THC-rich cannabis in teenage years Good - research support for abnormal dopamine functioning in people with Sz (original Dopamine hypothesis) Curran: - dopamine antagonists (amphetamines) increase Dopamine - high DA levels can make Sz symptoms worse, supporting high levels of DA Lindstroem: - chemicals needed to reduce DA are taken up faster in the brains of Sz sufferers, suggesting they produce more

Answer 33

Found Dopamine Antagonists such as amphetamines increase Dopamine levels, and they make Sz symptoms worse This supports the idea that Sz sufferers have high levels of DA

Answer 34

Found chemicals needed to reduce DA are taken up faster in the brains of Sz sufferers This suggests they produce more

Answer 35

Suggested children of people with Sz are still at heightened risk, even if they are adopted by families with no history of Sz Supports genetic influence of Sz

Answer 36

Drug Therapy

Answer 37

Antipsychotics

Answer 38

Can be required short term or long term Can be traditional (typical antipsychotics) or updated (atypical antipsychotics) Some patients need a short course and will have no returning symptoms Others might need them as lifelong treatments

Answer 39

- Been around since 1950s - Can be taken as tablets, syrup or injections - Main one is Chlorpromazine: - Dosage is usually smaller and then gradually increased to a maximum of 400-800mg - Oral doses are up to 1000mg daily

Answer 40

Chlorpromazine

Answer 41

Typical Antipsychotic

Answer 42

They are dopamine antagonists - they reduce the action of the neurotransmitter dopamine - they block dopamine receptors in the synapses of the brain to reduce its action - the dopamine-antagonising effect normalises neurotransmission in key areas of the brain to reduce symptoms such as hallucinations

Answer 43

Hallucinations

Answer 44

400-800mg daily Up to 1000mg

Answer 45

- binds to dopamine receptors in the synapses of the brain to reduce its action - initially builds up dopamine levels and then reduces them - has effective sedative properties so can calm patients with Sz and other conditions

Answer 46

- it is suggested it has an effect on histamine receptors but we are unsure of how this leads to sedation - it can calm patients with Sz and other conditions - used especially on initial admission as patients are anxious - taken in syrup form as it absorbs faster than tablets

Answer 47

- used since the 1970s - their development aimed to maintain/increase effectiveness of suppressing symptoms of psychosis while also minimising side-effects - lots do not work in the same way - we do not know how some of them work - main 2 are Clozapine and Risperidone

Answer 48

Clozapine Risperidone

Answer 49

- Developed in 1960s and trialed in 1970s - Withdrawn in 1970s due to the death of some patients from a blood condition (agranulocytosis) - In 1980s it was found to be more effective than typical antipsychotics so it was used when other treatments failed - Still used today, but patients taking it have regular blood tests - Not available for injection due to deadly side-effects - Daily dosage is typically 300-400mg - Used when patients are thought to be suicidal

Answer 50

- it binds to dopamine receptors to limit the production - it also acts on serotonin and glutamate receptors to improve mood and cognitive functioning, and reduce depression

Answer 51

Trialed - 1960s Released - 1970s Withdrawn - 1970s Re-Released - 1980s

Answer 52

Dopamine Serotonin Glutamate

Answer 53

- developed around 1990 - developed to attempt to be as effective as Clozapine but with less serious side-effects - can be taken in tablet form, syrup form, or as an injection that lasts 2 weeks - a small dose is initially given, but dosage can be up to 12mg, and is usually around 4-8mg per day

Answer 54

It binds to dopamine and serotonin receptors, and binds stronger than Clozapine, so it is more effective in smaller doses

Answer 55

Around 1990

Answer 56

4-8mg up to 12mg

Answer 57

Good: - Syrup absorbs quickly, so it can be used as a sedative Bad: - Takes a while to work (it initially increases dopamine levels) - May produce side-effects like depression, so it could lead to a co-morbidity where anti-depressants are needed as well

Answer 58

Good: - Improves mood as well as regulating symptoms - Can be used when other treatments fail Bad: - Severe side-effects, such as death and Tardive Dyskinesia

Answer 59

Good: - Same effects as Clozapine but without side effects - Fewer side effects - Injections can last 2 weeks Bad: - Can have negative side effects

Answer 60

Depression Generic Typical Antipsychotics: - dizziness - agitation - sleepiness - jaw stiffness - weight gain - itchy skin

Answer 61

- Death - Agranulocytosis (low white blood cells) - Tardive Dyskinesia (involuntary facial movements such as grimacing, blinking and lip-smacking)

Answer 62

Depression Tardive Dyskinesia after long term use

Answer 63

Good - evidence to support effectiveness Typical: - research compared effects of Chlorpromazine to control conditions with placebos - used data from 113 trials with 1,121 participants - found Chlorpromazine was associated with better overall functioning and reduced symptoms Atypical: - research found Clozapine is more effective than typical and other atypical antipsychotics - it is effective in 30-50% of treatment-resistant cases where other antipsychotics have failed - suggests they work Bad - Likelihood of side effects Typical: - dizziness - weight gain - sleepiness - jaw stiffness - agitation - itchy skin Long-term use can lead to Tardive Dyskinesia Atypical: Clozapine can cause death - suggests the treatment is harmful - this could mean patients avoid this treatment, rendering them ineffective Bad - Mechanism Unclear - We do not understand why they work - Our understanding comes from the Dopamine Hypothesis, but this is not a complete understanding of Sz as the new Dopamine Hypothesis suggests some DA levels are too low - If this was the case, antipsychotics should not work - This matters because it could mean the foundation on which the understanding of antipsychotics are based lacks validity, and so they might not be the best treatment option if we are unsure of how they work

Answer 64

2: Family Dysfunction Cognitive Explanations

Answer 65

The Schizophrenogenic Mother Double-bind Theory Expressed Emotion

Answer 66

Dysfunctional Thinking Meta Representation Central Control

Answer 67

The idea that abnormal processes within a family - such as poor communication - are seen as risk-factors for the development and maintenance of Sz There are links between Sz and childhood/adulthood experiences of living in a dysfunctional family

Answer 68

Fromm-Reichmann

Answer 69

Proposed a psychodynamic explanation for Sz based on the accounts she heard from her patients about their childhoods. - many patients spoke about a particular type of parent, and she called this the 'schizophrenogenic mother'

Answer 70

Schizophrenia-causing

Answer 71

They are: - cold - rejecting - controlling They create a family climate characterised by tension and secrecy

Answer 72

The child develops distrust which develops into paranoid delusions, such as delusions of persecution, which then ultimately leads to Sz

Answer 73

Bateson et al

Answer 74

Agreed that family climate is important in developing Sz, but emphasised the role of the communication style within a family. He theorised the Double Bind Theory

Answer 75

The developing child finds themselves trapped in situations where they fear doing the wrong thing, but they receive mixed messages of what the wrong thing is They feel unable to comment on the unfairness of the situation or seek clarification When they 'get it wrong' (which is often), the child is punished by withdrawn of love This leaves them with a confusing and dangerous understanding of the world, which is reflected in symptoms like disorganised thinking and paranoid delusions

Answer 76

The level of emotion (especially negative) that is expressed towards a person with Sz by their carers/family members

Answer 77

- Verbal criticism of the person that can be accompanied by violence - Hostility towards the person, including anger and rejection - Emotional over involvement in their life, including needless self-sacrifice

Answer 78

The high levels of emotion directed towards the individual are a serious source of stress This is an explanation for relapses in people with Sz The stress can also trigger the onset of Sz in a person who is already vulnerable due to genes

Answer 79

The idea that Sz is associated with several types of dysfunctional thought processing (disruption to normal mental processing), and they can be possible explanations for Sz

Answer 80

Disruption to normal thought processing: - Reduced processing in Ventral Striatum --> negative symptoms - Reduced processing of information in Temporal and Cingulate Gyri --> hallucinations The lower than usual level of information processing suggests cognition is likely to be impaired

Answer 81

Frith et al

Answer 82

Identified 2 kinds of Dysfunctional Thought Processes in people with Sz: Metarepresentation Dysfunction Central Control Dysfunction

Answer 83

The cognitive ability to reflect on thoughts and behaviour It allows us insight into our own intentions and goals It allows us to interpret the actions of others

Answer 84

Disruption in our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else

Answer 85

It explains hallucinations of hearing voices and delusions like thought insertion (delusions of control) as people with Sz will not be able to recognise their own thoughts are carried out by themselves

Answer 86

The cognitive ability to suppress automatic responses while we perform deliberate actions

Answer 87

The inability to suppress automatic responses and thoughts triggered by other thoughts

Answer 88

Speech Poverty: - could result from the inability to suppress speech triggered by other thoughts - derailment of thoughts might happen as each word might trigger associations and the person cannot suppress automatic responses to these

Answer 89

Family Dysfunction: Good - Research support Read - indicators of family dysfunction include insecure attachment and exposure to childhood trauma such as abuse - Read reviewed adults with Sz and found they are disproportionately likely to have insecure attachment (especially type C and D) - Reported that 69% of women and 59% of men with Sz have a history of physical and/or sexual abuse - suggests family dysfunction makes people more vulnerable to Sz Bad - Explanations lack support - although there is support for childhood family-based stress associating with adulthood Sz, there is almost no support for traditional theories such as Schizophrenogenic mother and Double Bind theory - this suggests family explanations have not been able to account for the link between childhood trauma and Sz Bad - Socially sensitive - could blame the parents/carers - particularly blames the mother Cognitive Explanations: Good - Research Support Stirling - compared performance on cognitive tasks in 30 people with Sz and a control group of 30 people without Sz - tasks included the Stroop task, where they had to name the font-colours of colour-words, so they had to suppress the tendency to read the words aloud - as predicted by Frith, people with Sz took longer (twice as long on average) to name the font colours - supports the idea of cognitive impairment in Sz Bad - Artificial tasks - low mundane realism Bad - Proximal Explanation - they only explain what is happening now to produce symptoms, rather than what initially caused Sz - could suggest the cognitive explanation is only a partial explanation for Sz as it limits our understanding Bad - Confusion over basis of Sz - cognitive explanation focuses more on Biological origins, and suggests it is a biological condition rather than a psychological condition - suggests there is question over what type of condition Sz is, which could hinder our understanding and ability to provide treatments

Answer 90

Cognitive Behaviour Therapy Family Therapy

Answer 91

Management of Sz: Token Economies

Answer 92

The most common treatment of Sz It aims to deal with thoughts (cognitions), and behaviour It takes place over a period of 5-20 sessions in groups or individually It helps patients identify irrational thoughts and tries to change them It can include arguments and discussions of how likely the beliefs are to be true

Answer 93

It can make sense of how their irrational cognitions (hallucinations/delusions) impact their feelings and behaviour - It can help provide an understanding of where the symptoms come from, which can be helpful for things such as auditory hallucinations as it can reduce fear as they can understand it is them and their faulty thinking, not a demon or alien - It can help people cope better once they understand why they are experiencing their symptoms

Answer 94

Normalisation: Helping people hearing voices by assuring them it is an extension of the ordinary experience of thinking in words Challenging: Using reality testing to examine the likelihood that irrational beliefs from delusions are true

Answer 95

Turkington et al

Answer 96

Described an example of how CBT was used to challenge where a paranoid client's delusions came from

Answer 97

Client has Delusions of Persecution: the mafia are observing me and deciding how to kill me Therapist: you are obviously very frightened, there must be a good reason for this Client: do you think it's the mafia? Therapist: It's a possibility, but there could be other explanations. How do you know that it's the mafia?

Answer 98

- A psychological treatment of Sz that takes place with the families and the identified patient - The identified patient is one member of the dysfunctional family who expresses the family's conflicts - The therapy aims to improve the quality of communication and interaction between family members

Answer 99

Some look at the root cause of the conditions Nowadays, therapists are more concerned with reducing the stress within a family as this can reduce relapse rates

Answer 100

To reduce levels of Expressed Emotion This will reduce stress for the patient so they are less likely to relapse

Answer 101

To identify irrational thoughts and try to change them by challenging them

Answer 102

Pharoah et al

Answer 103

Suggested a range of strategies that are used by family therapists to improve the functioning of a family member with Sz

Answer 104

Reduce Negative Emotions: - reduces Expressed Emotion - especially reduces negative emotions such as guilt - reduces stress, increases compliance and reduces the likelihood of relapse Improve the Family's ability to help: - encourages the family to form therapeutic alliances, including beliefs about Sz

Answer 105

Recude Negative Emotions Improve the Family's Ability to Help

Answer 106

Proposed a model for working with families dealing with Schizophrenia

Answer 107

1) Share basic information and provide emotional support 2) Identify resources, including what each family member can offer 3) Encouraging mutual understanding and creating a safe space for all family members to express their feelings 4) Identifying unhelpful patterns of interaction 5) Learning stress-managing techniques 6) Looking at relapse prevention 7) Maintenance for the future

Answer 108

Someone Identified Elvis In Las Vegas! Rather Funny!

Answer 109

CBT: Good - Evidence for effectiveness Jauhar et al - reviewed 34 studies using CBT with Sz and concluded there is clear evidence for small but significant effects on positive and negative symptoms HOWEVER Bad - Significance was only slight - there is an argument that patients with Sz are likely unfit to participate effectively in CBT Bad - Question of Cure? - CBT improves quality of life for people with Sz, but it does not actually cure them - Sz appears to be largely biological, so we would expect a psychological treatment to only improve their ability to live with Sz - however, studies report significant reduction in severity of positive and negative symptoms, so this suggests it does more than just enhance coping Family Therapy: Good - Evidence of Effectiveness Pharaoh et al - reviewed family therapy and found moderate evidence for reduced hospital readmission - this suggests family therapy improves the quality of life for patients and family Bad - Inconsistent Findings Pharaoh et al - found results of different studies were inconsistent, and there were problems with some of the quality of the studies - this suggests evidence for family therapy is fairly limited Good - Benefits all family members - therapy is beneficial for the identified patient and the families that provide the bulk of the care - a review of evidence concluded these effects are important as families provide the bulk of the care - by strengthening the functioning of a whole family, family therapy lessens the negative impact of Sz on other family members and strengthens the ability for the family to support the member with Sz - this suggests family therapy has wider benefits beyond the obvious positive impact on the identified patient

Answer 110

Token Economies

Answer 111

To make behaviour more socially acceptable by encouraging desirable behaviours through reinforcement

Answer 112

Reward systems used to manage the behaviour of people with Sz, especially those who have developed maladaptive behaviour from spending time in psychiatric hospitals

Answer 113

Allyon and Azrin

Answer 114

They demonstrated a token economy system in a ward of women with Sz diagnoses

Answer 115

(On a ward of women with Sz) They gave a plastic token embossed with 'one gift' to the participants every time they carried out a task such as making their bed or cleaning up The tokens could be swapped for ward privileges, such as being able to watch a film,

Answer 116

The number of tasks carried out increased significantly

Answer 117

Institutionalised behaviours can be tackled with Token Economies. People who spend long times in Institutional psychiatric wards may develop bad hygiene or might stop socialising with others. TE improve the quality of their personal care and social behaviour so they can prepare for life outside the hospital setting, and also improve their quality of life when in one.

Answer 118

Tokens are Secondary Reinforcers - they only have value once the patient learns it can be used to obtain rewards Rewards are Primary Reinforcers - for example, sweets, magazines, films, walks outside etc. Tokens (usually coloured disks) are given immediately when individuals carry out a desired behaviour Target Behaviours are decided, and these can be decided on an individual basis based off their usual behaviour. They are behaviours to look for to reinforce with a Token. The immediate reward for a target behaviour from the token is important as delayed rewards are not as effective

Answer 119

The Tokens

Answer 120

The Rewards

Answer 121

Behaviours to look out for that should be rewarded. They should be decided on an individual basis so that the same level of difficulty/effort is rewarded for each person

Answer 122

It is Behaviour Modification - a behavioural therapy based on Operant Conditioning Tokens are secondary reinforcers as they only have value once they are associated with meaningful rewards Meaningful rewards are primary reinforcers Tokens that can be exchanged for a range of different primary reinforcers are particularly powerful secondary reinforcers (also known as generalised reinforcers) At the start of the TE programme, tokens and primary reinforcers should be administered together to help the association

Answer 123

Operant Conditioning - learning through association

Answer 124

Bad - Ethical Issues - it gives professionals significant power and control over the behaviour of the patients - it imposes their norms and target behaviours onto others, which could be a problem if they are not identified sensitively - restricting the availability of pleasures who don't behave might mean that seriously ill and distressed people have a worse time - there has been legal action from many families who see their relative in token economies, meaning there has been a decline in them - this suggests the benefits of token economies might be outweighed by their impact on personal freedom and reduced quality of life Bad - More Pleasant and Ethical Alternatives Exist - token economies might be helpful for managing Sz, but there are other approaches that do not raise the same ethical issues - a review suggested art therapy might be a good alternative - although there is a small evidence base, it appears to show art therapy is a high-gain, low-risk approach to managing Sz - it is a pleasant experience with no major risks of side effects or ethical abuses - this suggests it might be a good alternative to token economies Bad - Does not reflect the Real World - they are difficult to continue once outside a hospital setting as target behaviours cannot be monitored as closely and tokens cannot be administered immediately - the system of token economies does not reflect the real world, so it could be argued it does not prepare the patient for the real world - this questions the value of token economies to manage behaviour of Sz

Answer 125

An approach that acknowledges the biological, psychological and social factors in the development of Sz

Answer 126

Genetic Vulnerability Neurochemical and Neurological abnormality

Answer 127

Poor family interactions

Answer 128

The Diathesis Stress Model

Answer 129

An explanation of Schizophrenia that suggests there is a Diathesis (vulnerability) that needs a Stressor (trigger) in order for Sz to be developed

Answer 130

A vulnerability to Sz - e.g. through genes

Answer 131

A trigger from a negative experience - stress

Answer 132

Theorised the original Diatheses-Stress Model

Answer 133

Diathesis was entirely genetic, and was the result of a 'Schizogene' (This led to the development of the biologically based Schizotypic Personality) He believed if someone did not have a Schizogene then no amount of stress would lead to Sz However, in the carrier of the gene, chronic stress through childhood and adulthood such as the Schizophrenogenic Mother could result in developing Sz

Answer 134

Many genes each appear to increase Genetic Vulnerability, and there is no single Schizogene Psychological trauma is also now seen as a diathesis rather than a stressor as it was found child abuse and early severe trauma alters the developing brain

Answer 135

Psychological stress (e.g. from parenting) is still considered important Stress now also includes anything that risks triggering Sz,, such as Cannabis use as Cannabis interferes with the dopamine system It was found Cannabis increases the risk of Sz by up to 7 times, however, most don't develop Sz after smoking cannabis, so they must not have a vulnerability

Answer 136

Combines both Biological and Psychological Treatments It usually combines antipsychotic medication with therapies such as CBT In Britain, it is standard to treat people with this combination, but in the US, it is more common to treat biologically without psychological treatment

Answer 137

Turkington et al

Answer 138

Suggested it is possible to believe in the Biological cause of Sz and still practice CBT to relieve the Psychological Symptoms (adopt an interactionist approach)

Answer 139

Good - Evidence for the role of Vulnerability and Triggers Tienari et al - investigated the combination of genetic vulnerability and parenting style in adopted children from 19,000 Finnish Mothers who had been diagnosed with Sz - compared them to a control group of adoptees without a family history of Sz - adoptive mothers had been assessed for child-rearing style, and they found the condition with Sz mothers had high levels of criticism, hostility, and low levels of empathy, and this was associated with development of Sz in the high risk group - this suggests a combination of genetic vulnerability and family stress can lead to risk of Sz Bad - The Original Diathesis Stress model is over-simplistic - the idea of one single schizogeny and a schizophrenic parenting style is over-simplistic - it is now believed vulnerability can be caused by early trauma as well as genetic make-up, and stress can come in many forms - multiple genes increase vulnerability as Sz is polygenic - stress can come in multiple forms, it is not just dysfunctional parenting - it has been shown childhood sexual trauma is a diathesis, and cannabis can be a trigger - this suggests the idea of a biological diathesis and psychological stress is over simple, suggesting the original diathesis-stress model lacks validity Good - Real world support - more people are diagnosed with Sz in urban areas rather than rural areas - this justifies the interactionist approach as it assumes urban living is more stressful, so it acts as a trigger HOWEVER - it could just mean people who suffered abuse (have a diathesis) migrate to cities to get away, and are more likely to be diagnosed there - this could mean there is a question of if there is support for the interactionist approach of Sz

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Schizophrenia Flashcards

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