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Psychology > Schizophrenia > Flashcards

Schizophrenia Flashcards

1
Q

Schizophrenia
How many people suffer from it

A

1% of world ppopulation

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2
Q

Schizophrenia
Who is it most commonly diagnosed in

A

Men rather than women

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3
Q

Schizophrenia
Where is it. OST commonly diagnosed

A

In cities rather than the countryside

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4
Q

Schizophrenia
What class is it most commonly diagnosed in

A

Working class rather then middle Class

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5
Q

Schizophrenia
What symptoms interfere with

A

Everyday tasks, many sufferers end up homeless or hospitalised

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6
Q

Schizophrenia
What does it affect

A

Thought processes and Ability to determine reality

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7
Q

Schizophrenia
How does degree of severity vary

A

Some sufferers encounter only one episode some have persistency episodes but live relatively normal lives through taking medication

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8
Q

Schizophrenia
Where does a split occur in schizophrenia for sufferers

A

Between a persons though processes and reality

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9
Q

Symptoms
What is a psychosis

A

Term used to describe a severe mental health problem where the individual loses contact with reality

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10
Q

Symptoms
How were people with schizophrenia dealt with before the 1950a

A

Spent most of lives in psychiatric hospitals

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11
Q

Symptoms
How has it changed from institutionalisation

A

New treatment methods have changed this

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12
Q

Symptoms
What are the symptoms split into

A

Positive and negative symptoms

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13
Q

Symptoms
What are positive symptoms

A

Additional experiences beyond those of ordinary existence and involve displaying behaviours concerning ;loss of touch to reality

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14
Q

Symptoms
How do positive symptoms generally occur

A

In short episodes with normal periods in between

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15
Q

Symptoms
How do positive symptoms respond to mediation

A

Squire well

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16
Q

Symptoms
What are negative symptoms

A

Involve loss of usual ability and experiences involving displaying of behaviours concerning disruptions of normal emotions and actions

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17
Q

Symptoms
How do negative symptoms occur

A

In longer lasting episodes

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18
Q

Symptoms
How do negative symptoms respond to medication

A

Resistant to it

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19
Q

Symptoms
What else may a person also be affected w=by

A

Secondary symptoms or impairments such as depression

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20
Q

Symptoms
What are the two positive symptoms need to know *

A

Delusions
Hallucinations

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21
Q

Symptoms
What are delusions

A

Irrational beliefs which can tale a rampage of forms

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22
Q

Symptoms
What are some common delusions

A

Delusions of grandeur which involve being an important historical political or religious figure such as Jesus
Delusions of being persecuted such as by governments or aliens

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23
Q

Symptoms
How can decisions make a sufferer behave

A

In ways that make sense to them but seem bizarre to others

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24
Q

Symptoms
What do some delusions led to

A

Aggression

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25
Q

Symptoms
What are hallucinations

A

Unusual sensory experiences

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26
Q

Symptoms
What are some hallucinations related to

A

Events in the environment whereas other bear np relationships to what the senses are picking up such as vices heard either taking or commenting on the sufferer

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27
Q

Symptoms
What two negative symptoms do need to know *

A

Speech poverty
Avolition

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28
Q

Symptoms
What is speech poverty

A

Patient uses as few words as possible and individual cannot express themselves effectively

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29
Q

Symptoms
What is avolition

A

Loss of motivation to carry out tasks

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30
Q

Symptoms
What does avoliton result in

A

Lowered activity levels, inability to make decisions,have no enthusiasm may lose interest ion personal hygiene

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31
Q

Classification and diagnosis
What do classification systems do

A

Classify abnormal patterns of thinking behaviour and emotion into mental disorders and give guidance on how to diagnose them

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32
Q

Classification and diagnosis
What are the two widely used systems

A

ICD and DSM

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33
Q

Classification and diagnosis
What is used to classify or diagnosis schizophrenia

A

Doesn’t have single defining characteristic as is a cluster of symptoms some of which appear to be unrelated to

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34
Q

Classification and diagnosis
What are the five main subtypes of schizophrenia

A

Disorganised
Catatonic
Paranoid
Undifferentiated
Residual

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35
Q

Classification and diagnosis
What is disorganised schizophrenia

A

Behaviour is disorganised and not goal directed symptoms include disturbance,absence of emotions,mood swings and social withdrawal often in young adulthood

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36
Q

Classification and diagnosis
What is catatonic schizophrenia

A

If patient has severe motor abnormalities such as unusual gestures or use of body languages

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37
Q

Classification and diagnosis
What is paranoid schizophrenia

A

Involves delusions of various kinds however patient remains emotionally responsive and are more alert, tend to be argumentative
Later onset then other

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38
Q

Classification and diagnosis
What is undifferentiated schizophrenia

A

Show symptoms of schizophrenia but don’t fit into the other types

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39
Q

Classification and diagnosis
What is residual schizophrenia

A

Describes people who have had episode within last 6 months but symptoms not strong enough to be put in other symptoms

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40
Q

Classification and diagnosis
Why is it important to receive a reliable and valid diagnosis

A

Will go on to affects and individuals treatment and quality of life

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41
Q

Classification and diagnosis
What does reliability mean

A

Consistency

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42
Q

Classification and diagnosis
What are the two important types of reliability

A

Test retest reliability
Inter rater reliability

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43
Q

Classification and diagnosis
What is test retest reliability

A

Occurs when a clinician males the same diagnosis on separate occasions from same information

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44
Q

Classification and diagnosis
What is interrater reliability

A

Occurs when different clinicians make identical independent diagnoses of the same patient

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45
Q

Classification and diagnosis
Research for reliability

A

Cheniaux et al

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46
Q

Classification and diagnosis
What did cheniaux et al do

A

Had two psychiatrists diagnose 100patients using both the DSM and ICD criteria

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47
Q

Classification and diagnosis
What did cheniaux et al find

A

Inter rater reliability was poor
One psychiatrist diagnosing 26 patient with schizophrenia according to DSM and 44 to ICD
Other diagnosed 13 according to DSM and 24 to ICD

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48
Q

Classification and diagnosis
Which classification system is regarded as more reliable and why

A

DSM as symptoms outlined for each category is more specific

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49
Q

Classification and diagnosis
What may come from diagnosis based on classification systems

A

Provides practitioners with a common language which may facilitate research and ultimately better understanding and treatment

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50
Q

Classification and diagnosis
What does evidence suggest for reliability

A

Poor reliability but is improving as classification systems have been updated

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51
Q

Classification and diagnosis
What is validity

A

Extent to which we are measuring what we intend to measure

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52
Q

Classification and diagnosis
What are the 4 validity issues to consider

A

Criterion
Reliability
Predictive
Decriptive

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53
Q

Classification and diagnosis
What is criterion validity

A

Where’d ifferent assessment systems arrive at the same diagnosis for the same patient

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54
Q

Classification and diagnosis
How is reliability linked to validity

A

A valid diagnosis must first be reliable although reliability doesnt guarantee validity

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55
Q

Classification and diagnosis
What is predictive validity

A

If diagnosis leads to successful treatment diagnosis is seeen as valid

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56
Q

Classification and diagnosis
What is descriptive validity

A

To be valid patient with schizophrenia should differ in symptoms,protons from patients with other disorders

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57
Q

Classification and diagnosis
Study for validity

A

Rosenhan

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58
Q

Classification and diagnosis
What did rosenhan do

A

8 volunteers who didn’t suffer with mental illness presented themselves to different mental hospitals claiming to jhear voices

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59
Q

Classification and diagnosis
What did rosenhamn find

A

Volunteers took between 7 and 52 days to be released , diagnosed as schizophrenic in remission
Normal behaviour interpreted as signs of schizophrenia
Concluded that the diagnosis of schizophrenia lacks validity as psychiatrists cannot distinguish between real and pseudo patients

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60
Q

Classification and diagnosis
What is the effects of being labelled as schizophrenia

A

Long lasting negative effect on social relationships work prospects self esteem etc which seems unfair when diagnosis seem to have little evidence of validity

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61
Q

Classification and diagnosis
What is co morbidity

A

Phenomenon when two or more conditions occur together

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62
Q

Classification and diagnosis
What does comorbidity create problems with

A

Reliability of diagnosis as may be confusion over which actual disorder is being diagnosed

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63
Q

Classification and diagnosis
What has been reported for schizophrenics with co morbid conditions what what does it suggest

A

Excluded from research and yet form the majority of patients suggests research findings into the cased of schizophrenia can’t be generalised to most sufferers

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64
Q

Classification and diagnosis
What will this have an effect on

A

What treatments patients should receive

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65
Q

Classification and diagnosis
What does conditions occurring together a lot of the time call into question

A

Validity of their diagnosis and classification as may actually be a single condition

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66
Q

Classification and diagnosis
What is symptom overlap

A

When two or more condions share symptoms

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67
Q

Classification and diagnosis
What does symptom overlap call into question

A

Validity of classification two disorders separately

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68
Q

Classification and diagnosis
Wjhayt does schizophrenia have symptom overlap with

A

Other conditions such as bipolar as both involve positive symptoms like delusions and negative symptoms like avolition

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69
Q

Classification and diagnosis
What could misdiagnosis due to symptom over lead to

A

Years of delay in receiving relevant treatment during which time suffering and further degeneration can occur as well as high levels of suicide

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70
Q

Classification and diagnosis
What is gender bias in diagnosis

A

Some disagreement but some argue clinicians misapplied diagnostic criteria to women

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71
Q

Classification and diagnosis
Research for geneder bias

A

Longnecker et al

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72
Q

Classification and diagnosis
What did longenecker et al find

A

Reviewed studied of the prevalence of schizophrenia and concluded that since the 1980s men have been diagnosed with schizophrenia more often them women

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73
Q

Classification and diagnosis
What two reasons may this be

A

Men are genetically vulnerable to develop schizophrenia
Or gender bias

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74
Q

Classification and diagnosis
Why may females be less likely diagnose

A

Female patients typically funtion better then men eg have good family relationships
Better interpersonal functioning may bias practitioners to under diagnose schizophrenia

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75
Q

Classification and diagnosis
What is also true for females

A

Tend to develop schizophrenia on average between 4 and 10 years later than males and females can develop a much later form of post menopausal schizophrenia suggesting there are different types

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76
Q

Classification and diagnosis
What does this question

A

Validity of diagnosis

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77
Q

Classification and diagnosis
What is culture bias in diagnosis

A

Concerns tendency to over diagnose member of other cultures as suffering from schizophrenia

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78
Q

Classification and diagnosis
What os true in Britain for cultura bias

A

Those who are of African American decent are several times more likely to be diagnosed then white peoples

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79
Q

Classification and diagnosis
Why is it not due to genetic vulnerability

A

As rater in Africa and West Indies are not particularly high

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80
Q

Classification and diagnosis
Why may positive symptoms be more acceptable in African cultures

A

Because of cultural beliefs in communication with ancestors as people more ready to acknowledge such experiences

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81
Q

Classification and diagnosis
What does this over diagnosis cast doubt on

A

Validity of diagnosis

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82
Q

Explanations
What threee do need to know

A

Genetic explanation
Dopamine hypothesis
Neural correlates

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83
Q

Genetic explanation
What does this explanation see schizophrenia as

A

Transmitted through hereditary means (DNA or genes passed through family )

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84
Q

Genetic explanation
How is the evidence for a genetic link and why

A

Quite weak evidence because family members also share aspects of their environment as well as genes

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85
Q

Genetic explanation
What are the three key terms

A

Candidate genes
Polygenic
Aetiologically heterogeneous

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86
Q

Genetic explanation
What does candidate genes mean

A

Several genes involved which increase overall vulnerability to developing schizophrenia

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87
Q

Genetic explanation
Example of candidate gene

A

PCM1

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88
Q

Genetic explanation
What does polygenic mean

A

Number of genes each appear to confer a small increased risk of schizophrenia increased risk of schizophrenia with number of genes working in combination

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89
Q

Genetic explanation
What does aetiologically heterogeneous mean

A

Different combinations of factors can lead to the condition

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90
Q

Genetic explanation
How is genetic explaniton researched

A

Twin family and adoption study to assess concordance rates of developing schizophrenia
Gene mapping more recently used looms for genetic material common found among sufferers

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91
Q

Genetic explanation
What have genes associated with increased risk oincluded

A

Genes linking with the functioning of a number of neurotransmitters including dopamine

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92
Q

Genetic explanation AO3
Strength

A

Researcher evidence

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93
Q

Genetic explanation AO3
What is the research evidence

A

Torres et al

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94
Q

Genetic explanation AO3
What did Torrey et al review

A

Evidence from twin studies

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95
Q

Genetic explanation AO3
What did torrey et al find

A

If one MZ twin develops schizophrenia there a 28% chance the other twin will also

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96
Q

Genetic explanation AO3
What does this support

A

Idea that schizophrenia is inherited

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97
Q

Genetic explanation AO3
3 weaknesses

A

Problems with studies
Biological reductionism
Consequences of assuming a genetic cause

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98
Q

Genetic explanation AO3
What is bad for twin studies

A

Whilst suggest a genetic factor in onset of schizophrenia they don’t consider the influence of social class and shared environmental influences

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99
Q

Genetic explanation AO3
Why must other factors be considered

A

No study has found 100% concordance rate between MZ twins so schizophrenia can’t just be cause by genetic

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100
Q

Genetic explanation AO3
What is not consistent for twin studies

A

Heritability estimates

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101
Q

Genetic explanation AO3
What may oversimplifying a complex disorder lead to

A

Loss of validity

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102
Q

Genetic explanation AO3
What does explaining schizophrenia from a genetic basis not include

A

Analysis of social context or cognitive factors which might be implicated in the disorder

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103
Q

Genetic explanation AO3
What does this mean

A

Genetic explanation can only ever form part of an explantion

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104
Q

Genetic explanation AO3
What might this explantion lead to

A

Feeling of family responsibility for the onset of schizophrenia which is unhelpful

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105
Q

Genetic explanation AO3
What could this lead to

A

Very pessimistic outlook on life

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106
Q

Dopamine hypothesis
What is the central idea

A

Neurotransmitter dopamine is liked to onset of the disorder

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107
Q

Dopamine hypothesis
What effect for dopamine generally have

A

Excitatory effect and is associated to sensation of pleasure

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108
Q

Dopamine hypothesis
Why has this theory developed

A

Antipsychotic drugs work by decreasing dopamine activity and these lessening symptoms of schizophrenia

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109
Q

Dopamine hypothesis
What did the original version focus on

A

Hyperdopaminergia

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110
Q

Dopamine hypothesis
Where has hyperdopaminergia been linked to

A

Subcortex

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111
Q

Dopamine hypothesis
What might Hyperdopaminergia be associated with

A

Poverty of speech or auditory hallucination as around Broca’s area

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112
Q

Dopamine hypothesis
What is the most recent version focused on

A

Hypodopaminergia

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113
Q

Dopamine hypothesis
Where has hypodopaminergia been linked to

A

Cortex

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114
Q

Dopamine hypothesis
What may hypodopaminergia in the cortex be responsible for

A

Thinking and decision making so negative symptoms

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115
Q

Dopamine hypothesis
What is the difference between Hyperdopaminergia and hypodopaminergia

A

Hyper is high levels of
Hypo is high levels

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116
Q

Dopamine hypothesis AO3
Strength

A

Research support

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117
Q

Dopamine hypothesis AO3
What is the research support

A

Randrup and munkvad

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118
Q

Dopamine hypothesis AO3
What did randrup and munkvad do

A

Created schizophrenic like behaviour in rats by giving them amphetamines which activate dopamine production
They then reversed the effects by giving them neuroleptic drugs which inhibit the release of serotonin

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119
Q

Dopamine hypothesis AO3
What dos this support

A

Dopamine hypothesis

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120
Q

Dopamine hypothesis AO3
3 limitations

A

Evidence is inconclusive
Oversimplistic
Biological redcutiomism

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121
Q

Dopamine hypothesis AO3
Where is there no consistent difference

A

Between drug free schizophrenics and non sufferers

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122
Q

Dopamine hypothesis AO3
What other neurotransmitters may be implicated

A

Glutamate and serotonin

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123
Q

Dopamine hypothesis AO3
What does dopamine seem to be more associated with and what does this mean

A

Positive symptoms so may only contribute to certain aspects of the disorder or only certain types of schizophrenia

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124
Q

Dopamine hypothesis AO3
What does this mean for the dopamine hypothesis

A

May be accused of being oversimplistic as many other neurotransmitters may also be involved in development of the disorder

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125
Q

Dopamine hypothesis AO3
What may oversimplifying a complex disorder lead to

A

Loss of validity

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126
Q

Dopamine hypothesis AO3
What does explains schizophrenia to a biological basis not include

A

Analysis of social context or cognitive factors which may be implicated in the disorder

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127
Q

Dopamine hypothesis AO3
What’s does this mean

A

Can only ever form part of an explanation

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128
Q

Neural correlates
How does this explain schizophrenia

A

Abnormalities within specific brain ares may be associated with the development of schizophrenia

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129
Q

Neural correlates
Where is evidence for this explantion from

A

Originally only post mortem so but now fMRI scans are used to get a picture of the brain in action through the use of magnetic fields and radio waves

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130
Q

Neural correlates
How can links between functioning of brain be made

A

Comparing functioning of brains of schizophrenics to non sufferers to identify brain areas

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131
Q

Neural correlates
What is an important consideration

A

Whether brain abnormalities found in schizophrenics are caused by genetic factors or are a result of the disorder itself

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132
Q

Neural correlates
What two things have neural correlates

A

Positve and negative symptoms

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133
Q

Neural correlates
What is a neural correlate of negative symptoms

A

Activity in the ventral straitum

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134
Q

Neural correlates
How does activity in ventral straitum relate to avolition

A

Motivation involves anticipation to a reward and the ventral straitum is believed to be involved in this so abnormalities in this are may be involved

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135
Q

Neural correlates
What evidence for negative symptom nearly correlate and what found

A

Juckel et al found lower levels of activity in the ventral straitum in schizophrenic than controls

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136
Q

Neural correlates
What is a neural correlate of Positve symptoms

A

Reduced activity in the superior temporal gyrus and the anterior cingulate gyruas as a neural correlates of auditory hallucination

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137
Q

Neural correlates
What did a reach do for Positve neural correlate

A

Allen et al scanned the brains of patients experiencing auditory hallucinations and compared them to a control group whilst they indentured prerecorded speech as theirs or others

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138
Q

Neural correlates
What Did Allen et al find

A

Low activation levels in the superior temporal gyrus and anterior cingulate gyrus were found in the hallucination group and hallucinogenic group also made more errors then the control group

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139
Q

Neural correlates AO3
1 strength

A

Research evidence

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140
Q

Neural correlates AO3
What eveidne is there

A

Large amount of research linking structure and activity in the brain with having schizophrenia

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141
Q

Neural correlates AO3
What si example for research

A

Juckelet al and Allen et al

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142
Q

Neural correlates AO3
What does a this back up

A

Idea that there is some abnormality in the specific brain areas in schizophrenics

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143
Q

Neural correlates AO3
3 limitations

A

Inconsistency in research findings
Causal correlation problems
Unclear picture

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144
Q

Neural correlates AO3
Example for inconsistency in research findings

A

Some non schizophrenics have enlarged ventricles whilst not all do

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145
Q

Neural correlates AO3
What does consideration need to be given too

A

Environmental factors such as substance abuse and stress levels a which may have a damaging influence upon brain tissue

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146
Q

Neural correlates AO3
Why may studies not be useful in flagging up particular brain systems that arent working normally

A

Evidence leaves some important questions unanswered

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147
Q

Neural correlates AO3]
What is important question about usual activity

A

Does the unusual activity in a region of the brain actually cause the symptom

148
Q

Neural correlates AO3
What is the issue with cause and correlation

A

Perhaps something wrong in the ventral straitum is causing the negative symptoms or it the negative symptoms themselves are resulting in less information passing through the straitum and therefore reduced activity

149
Q

Neural correlates AO3
What could other factors be doing

A

Causing the negative symptoms and the reduce activity

150
Q

Neural correlates AO3
What does this mean

A

The existence of neural correlates tells us relatively little in itself

151
Q

Neural correlates AO3
Who don’t respond to medication who mainly exhibits enlarged ventricles

A

Schizophrenics

152
Q

Neural correlates AO3
What could this mean

A

That it is the effect of suffering from schizophrenia over a long period that leads to physical brain damage rather than brain damage leading to schizophrenia

153
Q

Neural correlates AO3
Why may it be that schizophrenic patients don’t respond to mediation

A

Because structural brain damage doesn’t allow antipsychotic medications to have a therapeutic effect on reducing symptom levels

154
Q

Family dysfunction explanation
What does is think causes or influences the development of schizophrenia

A

Maladaptive relationships and patterns of communications within families as sources pf stress

155
Q

Family dysfunction explanation
What are the three parts

A

Schizophrenogenic mother
Double bind
Expressed emotion

156
Q

Family dysfunction explanation
What approach does the schizophrenogenic use

A

Psychodynamic

157
Q

Family dysfunction explanation
What is the schizophrenogenic mother

A

Cold rejecting and controlling

158
Q

Family dysfunction explanation
What is the dad in the schizophrenogenic mother explanation

A

Often passive

159
Q

Family dysfunction explanation
What is the family climate characterised by in the schizophrenogenic mother

A

Tension and secrecy

160
Q

Family dysfunction explanation
What does tensions and secrec in family lead to

A

Distrust which develops into paranoid delusions and then schizophrenia

161
Q

Family dysfunction explanation
What does the double bind theory emphasis

A

Family climate and role of communication style within a family

162
Q

Family dysfunction explanation
What happens to children in the double bind theory

A

Often places in contradictory situations by parents so fears doing wrong this and unable to seek clarification

163
Q

Family dysfunction explanation
What happens when children get it wrong

A

Punishment is withdrawal of love

164
Q

Family dysfunction explanation
What may his lead to

A

See world as confusing uncertain and dangerous often reflected in symptoms like disorganised thinking and paranoid delusions (negative symptoms symptoms )

165
Q

Family dysfunction explanation
What is expressed emotion

A

Level of emotion in particular negative emotion expressed towards a patient by their carers

166
Q

Family dysfunction explanation
What three elements does expressed emotions contain

A

Verbal criticism of the patient occasionally accompanied by violence
Hostility towards the patient including anger and rejection
Emotional over involvement in the life of the patient including needless self sacrifice

167
Q

Family dysfunction explanation
What are the high levels of expressed emotion towards the patient a source of

A

Serious stress

168
Q

Family dysfunction explanation
What is the double bind theory primarily and explantion for

A

Relapse

169
Q

Family dysfunction explanation
What else may it be a source of stress for

A

Trigger on set of schizophrenia in a vulnerable person

170
Q

Family dysfunction explanation AO3
1 strength

A

Research support

171
Q

Family dysfunction explanation AO3
What is the research support

A

Read et al

172
Q

Family dysfunction explanation AO3
What did read et al do and find

A

Reviewed 46 studies of child abuse and schizophrenia and concluded that 69% of adult women in patients with a diagnosis of schizophrenia had a history of abuse

173
Q

Family dysfunction explanation AO3
What does this support

A

Idea that family dysfunction is linked to the onset of schizophrenia

174
Q

Family dysfunction explanation AO3
3 limitations

A

Lack of evidence and parent blaming isn’t helpful
Problems with cause and 3ffect
Incomplete explanation

175
Q

Family dysfunction explanation AO3
What is there no evidence for

A

Supporting the importance of the schizophrenogenic mother or double bind

176
Q

Family dysfunction explanation AO3
What is the schizophrenogenic mother and double bind theory based on

A

Clinical observations of patients and assessing the personality of the mothers of parents for crazy making characteristics which is not reliable

177
Q

Family dysfunction explanation AO3
What can dysfunctional family explantions lead to

A

Parent blaming

178
Q

Family dysfunction explanation AO3
Why is parent blaming unhelpful

A

Parents have already suffered seeming their child’s decent into schizophrenia and are also likely to bear lifelong responsibility for their care then undergo furhter trauma by receiving blames

179
Q

Family dysfunction explanation AO3
What has this led to

A

Decline of the schizophrenogenic mother and double bind theories

180
Q

Family dysfunction explanation AO3
What are the problems with cause and effect

A

Unsure that the dysfunctional family has caused schizophrenia and it is not the stress on have a schizophrenic in the family which has caused the dysfunction

181
Q

Family dysfunction explanation AO3
What is a key problem with the family dysfunction theory

A

Fails to explain why all children in such families often don’t go on to develop schizophrenia

182
Q

Family dysfunction explanation AO3
What does thus mean

A

Other factors must be involved and family dysfunction is therefore an incomplete explanation

183
Q

Cognitive explanation
What type of explanation is it

A

Psychological

184
Q

Cognitive explanation
What dies this explantion focus on

A

Role of maladaptive thought processes

185
Q

Cognitive explanation
When do cognitive deficits occur

A

Where sufferers experience problems with attention communication and information overload

186
Q

Cognitive explanation
Why may Positve symptoms occur

A

Because of cognitive biases (thinking in irrational ways ) or because of biased information processeing

187
Q

Cognitive explanation
Why may negative symptoms occur

A

Because of cognitive strategies to control the high level of mental stimulation not expressing themselves levels and withdrawing may be a strategy to control the levels of emotion being experienced

188
Q

Cognitive explanation
What two kinds of dysfunctional though processing have been identified whoich could underlie some symptoms

A

Meta representation problems
Central control problems

189
Q

Cognitive explanation
What is meta representation

A

Cognitive ability to reflect on thoughts behaviour and experience
Allows us self awareness and insight into our own intentions, goals and interpretation of others

190
Q

Cognitive explanation
What does dysfunction in meta representation disrupt

A

Ability to recognise our own actions and thoughts as carried out by ourselves rather than someone else

191
Q

Cognitive explanation
What three symptoms can be explained meta representation problems

A

Hearing voices
Delusion of thought insertion
Delusion of being persecuted

192
Q

Cognitive explanation
How can hearing voices be explained by meta representation problems

A

Failure of meta representation means the patient is unable to distinguish speech heard externally from a thought generated in their own mind
Think something and cannot tell accurately whether they or someone else said it

193
Q

Cognitive explanation
How can the delusion of though insertion be explained by meta representation problems

A

Patient believes they thought come from sole one else can be explained in the same way

194
Q

Cognitive explanation
How can the delusion of being persecuted be explained by meta representation problems

A

Could be explained by meta representation failure as we require it to make judgements about others intentions

195
Q

Cognitive explanation
What is the central control

A

Cognitive ability to suppress automatic responses to stimuli while we perform deliberate actions that reflect our wishes or intentions

196
Q

Cognitive explanation
What do we do whenever we want to achieve something

A

Suppress the brain systems responsible for stimulus driven behaviour and activate those responsible for willed behaviour

197
Q

Cognitive explanation
What symptoms can be explained by central control problems

A

Disorganised thinking
Disorganised speech
Derailment
Clanging

198
Q

Cognitive explanation
How can disorganised behaviour be explained by central control problems

A

Result from a failure to regulate willed and stimulus driven behaviour

199
Q

Cognitive explanation
How can disorganised speech be explained by central control problems

A

Could result from the inability to suppress automatic thoughts and speech triggered from other thoughts

200
Q

Cognitive explanation
How can derailment be explained by central control problems

A

Each word triggers associations dn the patient cannot suppress automatic responses to these

201
Q

Cognitive explanation
What is clanging

A

Patient takes one word in a sentence and drifts from the sentence into words associated eg rhyming

202
Q

Cognitive explanation AO3
1 strength

A

Reseach evidence

203
Q

Cognitive explanation AO3
What is there strong support for

A

Idea that information is processed differently in the mind of schizophrenia sufferers

204
Q

Cognitive explanation AO3
What is the research support

A

Stirling et al

205
Q

Cognitive explanation AO3
What did Stirling et al do

A

Compared 30 schizophrenics with 18 controls on a range of cognitive tasks eg stroop test (name ink colour to suppress impulse to read the words

206
Q

Cognitive explanation AO3
What did Stirling et al find

A

Patients took twice as long to name the ink colour as the control group

207
Q

Cognitive explanation AO3
What does this support

A

Theory of central control dysfunction

208
Q

Cognitive explanation AO3
3 limitations

A

Directions of causality
Real life application
Individual blaming

209
Q

Cognitive explanation AO3
What remains unclear

A

What causes what from abnormal cognitions in schizophrenia but remains unclear what causes what

210
Q

Cognitive explanation AO3
What is difficult

A

Conlusion as to whether cognitive factors are a cause or result of the neural correlates seen on schizophrenia

211
Q

Cognitive explanation AO3
What do some studies show for CBT

A

Can be effective in schizophrenia supporting an involvement of cognitive factors in the disorder

212
Q

Cognitive explanation AO3
What does highlighting meta cognition as important indicate therapies will need to concentrate on

A

Improving meta cognitive abilities to be effective

213
Q

Cognitive explanation AO3
What does this mean for the therapy

A

Could be targeted as specific areas of meta cognitive impairment to best suit needs of patient

214
Q

Cognitive explanation AO3
Why is this a strength

A

May increase effectiveness of treatment and allow sufferers to access a more normal life

215
Q

Cognitive explanation AO3
What do cognitive explanations sometimes lead to

A

Blaming the individual and making them actively responsible for their symptoms

216
Q

Cognitive explanation AO3
What does this contrast to

A

Biological explantions which people may feel there less control over

217
Q

Cognitive explanation AO3
Why is this unhelpful

A

Can put even more stress on the sufferer

218
Q

Cognitive behaviour therapy
What is it

A

Main psychological treatment used with schizophrenia

219
Q

Cognitive behaviour therapy
How long does it normally take

A

Between 12 to 20 sessions

220
Q

Cognitive behaviour therapy
What is the main aim

A

To help patients identify irrational thoughts, maladaptive thinking and distorted perceptions and try to change them

221
Q

Cognitive behaviour therapy
What do beliefs expectations and cognitive ideas affect

A

How individuals perceive themselves
How problmeas are approached
How successful people are ion coping and reacting goals

222
Q

Cognitive behaviour therapy
How does it aim to help schizophrenics

A

Help by changing maladaptive thinking and distorted perceptions seen as underpinning the disorder in order to modify hallucinations and delusional Beliefs

223
Q

Cognitive behaviour therapy
How might these be disputed

A

By argument or discussions of how likely the beliefs are to be true
Considerations of less threatening alternate explanations

224
Q

Cognitive behaviour therapy
What are coping strategies used for

A

Dealing with symptoms eg Positve self talk

225
Q

Cognitive behaviour therapy
What is the ABCDE framework for cognitive restructuring

A

A activating event
B beliefs
C consequences
D disputing irrational beliefs
E effect

226
Q

Cognitive behaviour therapy
What are used alongside

A

Antipsychotic drugs

227
Q

Cognitive behaviour therapy AO3
2 strengths

A

Effective treatment
Less side effects

228
Q

Cognitive behaviour therapy AO3
What supports cas3 for double treatment

A

Evidence suggesting that CBT plus antipsychotics is effective in treating schizophrenia then drugs or CBT alone

229
Q

Cognitive behaviour therapy AO3
What does CBT mean for patients

A

Helps to make schizophrenia more manageable and improve quality of life
Can make sense of and challenge some symptoms

230
Q

Cognitive behaviour therapy AO3
What side effects can antipsychotics have

A

Weight gain and blurred visions

231
Q

Cognitive behaviour therapy AO3
Why is no side effects as strength

A

Less impact on constsnt day to day live

232
Q

Cognitive behaviour therapy AO3
2 limitations

A

Expensive
Not sutiable for all patients

233
Q

Cognitive behaviour therapy AO3
Why si the expense an issue for nhs

A

At time of reduced healthcare budgets

234
Q

Cognitive behaviour therapy AO3
Why is expense a limitation for patient

A

May not able able to afford to consistently go

235
Q

Cognitive behaviour therapy AO3
Who may CBT not be suitable for

A

Patients who are too disoriented agitated or paranoid to form trusting alliances with practitioners

236
Q

Cognitive behaviour therapy AO3
What does CBT require

A

Self awareness and willingness to engage with process as positive symptoms lead to lack of awareness and negative symptoms lead to reluctance or inability to engage

237
Q

Cognitive behaviour therapy AO3
Why si this a limitation

A

Not all clients are suited to vigorous confrontations

238
Q

Family therapy
What is it a form of

A

Psychotherapy

239
Q

Family therapy
What is it based on

A

Assumption that family dysfunction can play a role in development of schizophrenia and involves who,e family not just the patient

240
Q

Family therapy
What does it focus on

A

Altering relationships and communication within dysfunctional families to try to lower levels of expressed emotions

241
Q

Family therapy
What does it do to try to lower levels of emotion

A

Improve Positve and negative forms of communication
Increase tolerance levels and decrease criticism levels between family members
Decrease feelings of guilt and responsibility for causing the illness among family members

242
Q

Family therapy
What did pharaoh et al do

A

Identified a range of strategies used by family therapists to improve family functioning where there is a schizophrenic family member

243
Q

Family therapy
What strategies did pharaoh et al identify

A

Forming therapeutic alliance with all family members
Improving ability of family to anticipate and solve problems
Help family members and achieve balance between caring and mainting lives
Reduce stress of caring
Reductions of anger and guilt
Improve families beliefs about behaviour towards schizophrenia

244
Q

Family therapy AO3
2 strengths

A

Family assistance
More cost effective

245
Q

Family therapy AO3
Which patients can it be useful for

A

Patients who lack insight into illness or cannot speak coherently about i

246
Q

Family therapy AO3
How can family members assist here

A

Family members Have lots of useful information and insight into a patients behaviour and moods and can often speak for them

247
Q

Family therapy AO3
Why is this a strength

A

As well as decreasing replace rates and lowering the need for hospitalisation family therapy can educate family members t help mange a patients medication regime

248
Q

Family therapy AO3
Why is this more cost effective

A

Family members help manage a patients medication regime and decreasing need for clinicians to do this

249
Q

Family therapy AO3
What is it cheaper then

A

Other treatments such as CBT

250
Q

Family therapy AO3
Why is cost effectiveness a strength

A

Mean more accessible to more patients and improve for of their quality of life

251
Q

Family therapy AO3
2 limitations

A

Family tension
Not a cure

252
Q

Family therapy AO3
What can be an issue

A

Emphasis on openness can be an issue if members reluctant to share sensitive information
Also may open family tension

253
Q

Family therapy AO3
Why is this a limitation

A

Lowers the effectiveness’s of the treatment s

254
Q

Family therapy AO3
Why can it not be considered a cure

A

Whilst family therapy helps by reducing the stress of living with schizophrenia in a family doesnt cure schizophrenia

255
Q

Family therapy AO3
Why may it not be considered a cure

A

Although coibantion of drug and family therapy is desirable often not possible due to const restraints so other treatment such as drugs may be better if possible

256
Q

Token economies
What are they a form of

A

Behavioural therapy
Behaviour modification

257
Q

Token economies
What is it based on

A

Principles of operant conditioning g

258
Q

Token economies
What is the aim

A

To use reinforcement to encourage desirable behaviour and change behaviour cor the better to improve patients quality of life

259
Q

Token economies
Who si it particularly aimed at

A

Those with negative symptoms who have developed patterns of maladaptive behaviour thought institutionalisation eg bad hygiene

260
Q

Token economies
How is the idea of generalisation in learning theory apoplied

A

Idea that desired behaviour once reinforced in an institution would be generalised to the outside world , intention of treatment that more natural reinforcers will eventually replace the tokens

261
Q

Token economies
What is it more likely for patients

A

To live outside of a hospital setting

262
Q

Token economies
How does it work (long )

A

List of target behaviours to be reinforced drawn up
Patient receives a token immediately after carrying out desired behaviour
Tokens have no value in themselves but can be saved up and swapped for more desirable and tangible rewards

263
Q

Token economies
Why is immediacy of giving the token important

A

To prevent delay discounting, effect of reward is reduced if reward delayed

264
Q

Token economies
What are secondary reinforcers

A

The tokens

265
Q

Token economies
What are primary reinforcers

A

Reward

266
Q

Token economies
What does the rewards have to be for the technique to work

A

Desirable to the patient

267
Q

Token economies AO3
2 strengths

A

Effective treatment
Staff-patient environment

268
Q

Token economies AO3
What has the use of tokens shown

A

Considerable success in psychiatric institutions

269
Q

Token economies AO3
What behaviour have shown improvement

A

Self care and prosocial behaviour

270
Q

Token economies AO3
What does this mean for the patients

A

Makes schizophrenia more manageable and can improve patients quality of life

271
Q

Token economies AO3
Why is this a strength

A

Helps make their behaviour more socially acceptable so they can better reintegrate into society

272
Q

Token economies AO3
What does it mean for staff and patient interaction

A

Becomes more Positve

273
Q

Token economies AO3
What do token economies facilitate

A

A safer more stable therapeutic environment

274
Q

Token economies AO3
Why is this a strength

A

Staff and patient injuries reduce, less staff absenteeism and emergency incidents

275
Q

Token economies AO3
2 limitations

A

Dependency
Ethical issues

276
Q

Token economies AO3
What may token lead to

A

Dependency whereby patients only produce desired behaviour to receive tokens

277
Q

Token economies AO3
What can there be problems with

A

Transferring behaviour to outside world as everyday reinforcement is much more subtle and often delayed

278
Q

Token economies AO3
What may this lead to

A

High re admittance rates

279
Q

Token economies AO3
Why are tokens not a cure

A

May onl change behaviour in the short term as it doesnt address underlying causes

280
Q

Token economies AO3
What can be argued

A

Behaviour is on you changed superficially not the patients actual thin,ing so should not be seen as a treatment in itself

281
Q

Token economies AO3
When does it work best

A

When combine with other treatments such as antipsychotic drugs

282
Q

Token economies AO3
What ethical issues are associated with

A

Differences between patients

283
Q

Token economies AO3
What is true for patients with more old symptoms

A

Have more access to privileges and services (the rewards )

284
Q

Token economies AO3
What is true for those with more severe symptoms

A

Symptoms prevent them from complying with desirable behaviour and miss out on rewatrds

285
Q

Token economies AO3
Why is this a limitation

A

Lead to discrimination and may delay treatment s

286
Q

Drug therapy
When is it used

A

As most common treatments for schizophrenia involves use of antipsychotic drugs

287
Q

Drug therapy
How are antipsychotic taken

A

Can be taken as tablet or syrup or injection

288
Q

Drug therapy
Is the effects long term

A

Can be long or short term
For some symptoms don’t return other need to take them fr life

289
Q

Drug therapy
What are drugs divided into

A

Typical and atypical

290
Q

Drug therapy
What is the example of an typical antipsychotic

A

Chlorpromazine

291
Q

Drug therapy typical antipsychotic
What do typical do

A

Reduce dopamine activity by blocking dopamine receptors at the synapse

292
Q

Drug therapy typical antipsychotic
What symptoms do typical effect

A

Positive like hallucinations and delusion
Also have sedative effect

293
Q

Drug therapy typical antipsychotic
What are typical taken as

A

Tablets syrups or injection

294
Q

Drug therapy typical antipsychotic
How is dosage decided

A

Initial small dose and increased until max of 1000

295
Q

Drug therapy typical antipsychotic
What effect do typical have

A

Major effect by enabling many people with schizophrenia to live relatively normal lives outside mental institutions

296
Q

Drug therapy typical antipsychotic
What neurotransmitter do they work on

A

Dopamine

297
Q

Drug therapy typical antipsychotic
How do they effect the dopamine system

A

Reduce dopamine actives by blocking receptors at the synapse to normalise neurotransmittion in key areas

298
Q

Drug therapy typical antipsychotic
What can these drugs also act as

A

An effective sedative

299
Q

Drug therapy typical antipsychotic
When do patients start to see improvement

A

Symptoms such as hallucination and feelings of agitation tend to recur within a few days and delusion after weeks
Imprpvent after 6 weeks

300
Q

Drug therapy typical antipsychotic
What symptoms are associated

A

Dry mouth unrinatory problems constipation stiff jaw dizziness agitation sleepiness weight gain itchy skin visual disturbance low blood pressure problems with sexual function nasal congestion

301
Q

Drug therapy typical antipsychotic
What can be developed from long term use

A

15% of sufferers develop tardive dyskinesia which causes involuntary and uncontrolled muscles movements especially around the mouth and may be permanent

302
Q

Drug therapy atypical antipsychotic
What is example of an atypical

A

Clozapine

303
Q

Drug therapy atypical antipsychotic
How do atypical work

A

Bind to dopamine receptors and also serotonin and glutamate receptors

304
Q

Drug therapy atypical antipsychotic
Which symptoms do they act on

A

Negative and positive

305
Q

Drug therapy atypical antipsychotic
What is the aim of atypical

A

Suppress the symptoms of psychosis and minimise side effects

306
Q

Drug therapy atypical antipsychotic
When are they used

A

When other treatments failed

307
Q

Drug therapy atypical antipsychotic
What has to be done for patients who are on clozapine

A

Regular blood tests to ensure they’ve not developed agranulocytosis , a blood disorder with reduction of white blood cells

308
Q

Drug therapy atypical antipsychotic
How does daily dose compare to typical

A

Little lower

309
Q

Drug therapy atypical antipsychotic
How do they work

A

Bind to dopamine serotonin and glutamate receptors

310
Q

Drug therapy atypical antipsychotic
How does this reduce negative symptoms

A

Helps improve mood and reduce depression and anxiety
May also improve cognitive functioning

311
Q

Drug therapy atypical antipsychotic
What are dose effects of atypical

A

Weight gain malignant syndrome, life threatening neurological disorder, increased risk of stroke sudden cardiac death blood clots and diabetes

312
Q

Drug therapy AO3
1 strength

A

Effective as a way to reduce symptoms

313
Q

Drug therapy AO3
What is there evidence for

A

Support of idea that both typical and atypical antipsychotics are atleast moderatly effective in tackling symptoms of schizophrenia

314
Q

Drug therapy AO3
3 limitations

A

Side effect
Reliant on dopamine hypothesis
Drug companies

315
Q

Drug therapy AO3
What are the likelyhood of side effects

A

Very high ranging from mild to serious to fatal

316
Q

Drug therapy AO3
What are typical antipsychotics associated with

A

Range of side effects including dizziness agitation sleepiness stiff jaw and weight gain

317
Q

Drug therapy AO3
What can long term use of typical result in

A

Tardive dyskinesia caused by dopamine hypersensitive gives involuntary facial movement eg grimacing

318
Q

Drug therapy AO3
Why are side effects a weakness

A

Impact everyday life and may be worse then the original symptoms

319
Q

Drug therapy AO3
What does the use of antipsychotics depend on

A

Dopamine hypothesis

320
Q

Drug therapy AO3
What is a limitation of the original hypothesis

A

A lot of evidences to show not a complete explantion of schizophrenia

321
Q

Drug therapy AO3
Effect if dopamine in other area

A

Dopamine levels in other areas of the brain other than the subcortex are too low rather then too high

322
Q

Drug therapy AO3
Why is this a weakness

A

Unclear how antipsychotics would help ad they reduce dopamine activity

323
Q

Drug therapy AO3
What is a limitation for drug industry

A

Many within the psychiatric community who see the widespread use of antipsychotics as being fuelled by powerful incfluence of drug companies

324
Q

Drug therapy AO3
Why may drug companies try to push use of antipsychotics

A

To get profits made

325
Q

Drug therapy AO3
What may drug companies do to push use of antipsychotic

A

Skew drug trials to be in favour of the drug
Push ineffective drugs

326
Q

Drug therapy AO3
Why os this a limitation

A

Drug may not actually work

327
Q

Drug therapy AO3
Why os this a limitation

A

Drug may not actually work

328
Q

Interactionist approach
How do they see schizophrenia as developing and treated

A

Several interacting factors including biological and psychological View
View combination of different therapies as the best treatment

329
Q

Interactionist approach
What do bioligxakl factors include

A

Genetic vulnerability and neurological abnormality

330
Q

Interactionist approach
What do psychological factors include

A

Stress from life events and daily hassles including poor quality interactions

331
Q

Interactionist approach
What model do they use to explain the interactionist approach

A

Diathesis stress model

332
Q

Interactionist approach
What does Diathesis mean

A

Vulnerability

333
Q

Interactionist approach
What does stress mean

A

Negative psychological experience

334
Q

Interactionist approach
What does this model say is necessary to develop the condition

A

Botha a vulnerability to schizophrenia and stress trigger

335
Q

Interactionist approach
Who created the original model

A

Meehl

336
Q

Interactionist approach
What was the problem with Meehls original model

A

Oversimplistic

337
Q

Interactionist approach
What did meehl view the Diathesis as

A

Entirely genetic and result of a single schizogene this led to sensitivity to stress

338
Q

Interactionist approach
What did meehl view the stress as

A

Psychological in nature in particular relating to parenting
Eg chronic stress through childhood and adolescence particularly schizophrenogenic mother

339
Q

Interactionist approach
What does the modern model view Diathesis as

A

Many genes identified which slightly increase the vulnerability to developing schizophrenia
Also likely genetic factors are linked with faulty dopaminergic systems and to abnormal functioning of other neurotransmitters
Also may be psychological trauma

340
Q

Interactionist approach
How may psychological trauma lead to an underlying vulnerability

A

Early trauma such as child abuse can later the developing brain

341
Q

Interactionist approach
What is stress according to modern models

A

Anything that risks triggering schizophrenia psychological triggers such as family dysfunction, substance abuse or critical life events

342
Q

Interactionist approach
What substance abuse can act as a trigger

A

Cannabis use as interferes with dopamine system but not everyone develops schizophrenia from it so much have underlying vulnerability

343
Q

Interactionist approach
What does it believe the best treatment is

A

Combining antipsychotic medication and psychological therapies usuallyCBT

344
Q

Interactionist approach
What has to ve adopted to use a combination of treatments

A

The interactionist model eg if adopt a purely biological approach and tell patients there’s no psychological significance to their symptoms it wouldn’t make sense to treat them with CBT

345
Q

Interactionist approach

In Britain what is the view of combining treatment

A

Increasingly standard practice to treat patients with a combination of antipsychotics drugs and CBT

346
Q

Interactionist approach
In USA what is the view of combining treatment

A

Conflict between biological and psychological models so slower adoption of Interactionist approach, drugs without psychological treatment is more common

347
Q

Interactionist approach
What is the typical combination

A

Unusual to treat schizophrenia using psychological therapies alone CBT family therapy and token economy’s often carried out whilst patients takes antipsychotics

348
Q

Interactionist approach
What is the effectiveness of treatments dependent on

A

Factors such as cost relapse rates degree of side effects symptom reduction but research suggest a combination is generally most effective

349
Q

Interactionist approach
What is the combination of treatment used determined by

A

Each patients individual circumstances and needs

350
Q

Interactionist approach
What is generally done for combinging them

A

Antipsychotics given first to reduce symptoms so psychotic al treatment ewill have greater effect

351
Q

Interactionist approach
What is generally done for combinging them

A

Antipsychotics given first to reduce symptoms so psychotic al treatment ewill have greater effect

352
Q

Interactionist approach AO3
2 strengths

A

In line with knowledge of genes
Differential susceptibility

353
Q

Interactionist approach AO3
What do we know about genes

A

Genes cannot determine outcomes on their own they need a particular environment in which to express themselves

354
Q

Interactionist approach AO3
Example of genes not determine own outcomes

A

Genotype and phenotype

355
Q

Interactionist approach AO3
Example of candidate genes

A

PCM1

356
Q

Interactionist approach AO3
What does this mean

A

Therefore Genes that predispose someone to have increased vulnerability to schizophrenia cannot on their own cause the disorder they need particular stressors to be present to trigger the potential f the genes

357
Q

Interactionist approach AO3
Why is this a strength

A

In line with the Diathesis stress model

358
Q

Interactionist approach AO3
What is the differential susceptibityy of the model

A

Includes positive as well as negative environments

359
Q

Interactionist approach AO3
How is the different environments shown

A

An individual may have biological vulnerabilities combined with a stressor leading to schizophrenia however the same individual if exposed to a Positve environment such as a loving family could have better outcomes that reduce the chances of them becoming schizophrenic

360
Q

Interactionist approach AO3
2 limitations

A

Original Diathesis tress model is oversimple
Combination os treatments can be expensive

361
Q

Interactionist approach AO3
What is now known to be oversimplistic

A

Classic model of schizogene and schizophrenic parenting style as the major source of stress

362
Q

Interactionist approach AO3
Why is the Diathesis wrong

A

Multiple genes i crease vulnerability to schizophrenia each having a small effect on its own not a single schizogene
Can be th result of each trauma and genetic make up

363
Q

Interactionist approach AO3
Why is the stress wrong

A

Can come in many forms including but not limited to dysfunctional parenting including biological sources

364
Q

Interactionist approach AO3
Why is this a limitation

A

Therefore an incomplete explanation

365
Q

Interactionist approach AO3
Counter

A

Although co,violation of behavioural and cognitive therapy is effective

366
Q

Interactionist approach AO3
What is the problem.

A

Cost can be an issue

367
Q

Interactionist approach AO3
Why is this a limitation

A

Not all patients will be able to access the full range of the treatment

Psychology (11 decks)

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