schizophrenia

Question 1

Describe and explain Gottesman’s study

Answer 1

• large scale family study conducted
• found that the larger the genetic similarity, the higher the risk of developing Sz was - eg identical twins had 48% chance, and 2% if an aunt had it for example.
• positive correlation between genetic similarity and rate of Sz.
• supports the fact that the development of Sz may have something to do with genes.

Question 2

Define candidate genes

Answer 2

a gene that is inherited, that makes one vulnerable to the illness

Question 3

Which kind of genes are likely to be affected to contribute to Sz?

Answer 3

• the genes that code for neurotransmitters like dopamine.

Question 4

Define aetiologically heterogenous

Answer 4

• means that diff combinations of genes are the cause of Sz in diff people.

Question 5

What is the role of mutation in development of Schizophrenia?
name a supporting study.

Answer 5

• mutation caused by radiation, viral infection or poison and still be a genetic contribution to Sz.
• Brown et al shows evidence: positive correlation between paternal age and risk of Sz.

Question 6

What is a neural correlate?

Answer 6

• the variations in neural structures that are corelated with higher risk of SZ

Question 7

What was the original dopamine hypothesis?

Answer 7

• high levels of dopamine in cortical regions = Sz

Question 8

What is the new dopamine hypothesis?

Answer 8

• both high and low levels of dopamine in different brain regions can be the contributor to Sz.
• early experience of stress seem to make some people more sensitive to cortical hypodopaminergic

Question 9

What is a pro and con for genetic factors contributing to the development of Schizophrenia

Answer 9

Pro: Adoption studies show how that biological children were more at risk for development of Sz even if they grew up in an adoptive family
- shows that some people may be more vulnerable to developing Sz because of their genetic makeup.
Con: environmental factors are often not taken into account - and they often do contribute to Sz.
- eg: most people with Sz reported at least one childhood traumatic event, vs around only 1/3 reporting it in a a matched group.
- shows that genetic factors don’t provide a complete explaination to the biological explanations for Sz.

Question 10

Give a pro and con for the evidence of the role of dopamine in SZ.

Answer 10

• pro: DA involved in SZ.
• amphetamines were shown to increase symptoms in people with SZ, whereas antipsychotics were shown to reduce DA, and the symptoms of SZ.
• shows that dopamine is involved in symptoms of SZ.

Con: possible that drugs that increase DA symptoms only MIMIC SZ not actually cause it. This means that it can be difficult to distinguish the them apart, and do not actually cause REAL SZenic symptoms.

Question 11

How is Schizophrenia diagnosed?

Answer 11

• DSM-5 Symptoms: 1 positive symptom must be present
• ICD-10: 2 or more negative symptoms should be present.

Question 12

Define positive symptoms and give and explain 2 examples

Answer 12

• they are symptoms that are additional experience beyond normal existence.
• hallucinations: SENSORY experiences, eg seeing or hearing things that other people don’t
• Delusions: irrational BELIEFS, eg them believing that they are a famous figure or have superpowers etc.

Question 13

Define negative symptoms and give and explain 2 examples

Answer 13

• symptoms that are something that is absent from ordinary existence.
• speech poverty: involves diorganised patterns of speech - eg changing topic mid sentence, saying words that don’t make sense when put together etc.
• Avolition: when someone finds it difficult to keep up with a goal oriented activity, as their motivation + energy is low.

Question 14

What is reliability?

Answer 14

• consistency in results - when multiple physicians reach the same diagnosis for the same individual or eg.

Question 15

What is validity?

Answer 15

• is what we’re trying to assess actually being assesed.
• eg is the method appropriate for your question.

Question 16

Name 3 (family) psychological explanations for SZ

Answer 16

• The schizophrenic mother
• Double bind theory
• Expressed emotion

Question 17

Name 3 cognitive explanations for SZ

Answer 17

• Dysfunctional thinking
• Meta representation dysfunction. (ability to reflect on thoughts and behaviour.
• Central control dysfunction - inability to supress automatic thoughts and speech triggered by other thoughts.

Question 18

Give pros and cons for family based psychological explanations for SZ.

Answer 18

+ can help develop treatments such as family therapy and reduce expressed emotion in families.
-: Very weak explanation - explainations for trauma, but not for mother specifically, making evidence empirical and sexist. (Mothers mostly blamed in this case)
-: socially sensitive to think that family causes Sz- adds on additional stress when families are already dealing with sz symptoms.

Question 19

Name some pros and cons for cognitive explanations for SZ

Answer 19

Pros:
Stroop test evidence: people with Sz took almost twice as long to distinguish between word + colour.
—> shows that cognitive abilities are impacted with SZ.
Cons:
- not a focus on root cause of the conditions - focuses too much on the NOW and is reductionist in terms of involving genes etc. Shows that it only provides a partial explaination for sz.

Question 20

Name types of biological therapy for sz, give examples of each

Answer 20

Typical antipsychotics eg chlorpromazine

Atypical antipsychotics eg clozapine/respridone

Question 21

explain the mechanisms of typical antipsychotics.

Answer 21

• act as dopamine antagonists, so block dopamine receptors, helping reduce positive symptoms like hallucinations.
• also have a sedative effect - so are sometimes used to calm down patients.

Question 22

Explain the mechanism of Atypical antipsychotics

Answer 22

acts on glutamate and serotonin in addition to dopamine.

Question 23

State a difference in the mechanism of risperidone and clozapine.

Answer 23

• Risperidone binds more strongly to dopamine receptors, so is more effective at lower doses than clozapine.

Question 24

Give pros of using antipsychotic drugs for sz.

Answer 24

Pros:
- can allow for engagement in CBT and other talk therapies, which can aid in faster treatment. Shows that antipsychotic drugs can act as a gateway to improve quality of life for people with sz.
- Allowed patients to be treated in their own community instead of in institutions, saving institutions money, and allowing patients to return to work.

Question 25

Give cons of using antipsychotic drugs for sz.

Answer 25

• severe side effects: such as dizziness stiff jaw etc, but may also lead to neuroleptic malignant syndrome - which could block dopamine receptors in the hypothalamus, causing problems with temp regulation.
• Potential of controlling patients for relief of medical staff - so unethical.
• might simply be supressing symptoms instead of treating the underlying cause.
• drugs ALONE may lead to relapse after treatment is over, as symptoms return after drugs are stopped.

Question 26

Describe how CBT can be helpful to a patient that is suffering from sz

Answer 26

• CBT can help challenge delusions, and reality is tested through this.
• patients can be reconvinced of their reality - which may help combat positive symptoms like delusions and hallucinations.

Question 27

Give psychological treatments for Sz

Answer 27

• CBT
• Family therapy
• token economies

Question 28

How might family therapy help Sz patients?

Answer 28

• May reduce negative emotions: familial support
• Improves the family’s ability to help: encouraging alliances to help aid recovery - balance maintained between their own life and caring for the patient.

Question 29

Give 1 pro and 1 con of CBT for sz

Answer 29

Pros:
- meta analysis of 34 studies showed that CBT is effective in reducing both positive and negative symptoms - so research supports the fact that CBT is effective in reducing symptoms.
Cons:
- techniques vary a lot from one patient to the other, so there is no set method in how to treat one patient, which means that it may not work for everyone. shows that CBT may not be a generalisable therapy for sz.

Question 30

Give 1 pro and 1 con for family therapy for Sz.

Answer 30

-: length of treatment - can take up to a year, and during this, patients may drop out, or incidents within the family may happen.
+: helps with rates of relapse - study finding that 75% of pateints who had had standard outpatient care relapsed, whereas 50% of family therapy patients relapsed after 2 years. Shows that readmission rates are lower in family therapy than standard care. (Leff et al)

Question 31

Give the pros and cons for the way Sz is classified

Answer 31

-: symptom overlap and co-morbidity with bipolar depression etc. Suggests that symptoms or definetion of Sz might need to be rethinked, and validity of the Sz diagnosis is likely to be low
-: gender and culture bias: positive symptoms, such as hearing voices may be thought of differently in different cultures - eg in the Caribbean, it might be thought of as ancestors but the the West, be thought as symptoms of Sz. Shows that symptoms aren’t generalisable to everyone. Gender bias shown as women’s symptoms may be interpreted as hysteria.

Question 32

Evaluate both the biological explainations for SZ.

Answer 32

• Biological determinism: this might make suffers feel disempowered when diagnosed.
• Bioloigical reductionism: biological approach tends to ignore environment or psych causes for Sz.
  +-: Diathesis stress model is a better, more holistic approach.

Question 33

Give the pros and cons of using token economies as a treatment for Sz

Answer 33

-: Skinner’s principles may make it a degrading approach.
-: Not effective for people with severe symptoms, as Skinner’s ideas present this as punishing them for being ill.
+: less risky than some therapies, such as drug therapy, so might apply better to patients with milder symptoms and those who cannot engage in drug therapy or CBT.

Question 34

Give the pros and cons of the interactionist approach.

Answer 34

+: more holistic approach to understanding origins of Sz instead of reducing it to a purely biological or psychological explanation
-: the mechanism by which a negative psychological experience actually triggers a biological event leading to symptoms is not fully understood - which reduces confidence in the interactionist approach to Sz.