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Psychology Paper 3 > schizophrenia > Flashcards

schizophrenia Flashcards

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1
Q

classification of sz

A

CD-10 and DSM-V cluster symptoms together to identify disorders and distinguish them from each other

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2
Q

positive symptoms

A

hallucinations- unreal or distorted sensory experiences (auditory or visual)

delusions- beliefs with no basis in reality

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3
Q

negative symptoms

A

avolition- loss of or severely reduced motivation that leads to low activity levels

speech poverty- reduced frequency or quality of speech, is often disorganised

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4
Q

symptoms of sz strengths

A

reliability- for diagnosis is .97 for inter rater and .92 for test retest- shows that it is consistently applied

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5
Q

symptoms of sz limitations

A
  • low validity- either under or over diagnosed

-co-morbidity- it is commonly diagnosed with other conditions such as bipolar disorder

-gender bias- men are diagnosed more than women as women are better functioning

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6
Q

family studies

A

people with sz will likely have relatives with the disorder- MZ twins have concordance ates of 48%, DZ twins of 17% and the general population have a 1% rate

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7
Q

candidate genes

A

individual genes that may be associated with increased risk of sz e.g. genes coding for functioning of neurotransmitters including dopamine

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8
Q

mutations

A

parental DNA may mutate because of radiation, viruses etc- explains sz with no family history

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9
Q

original dopamine hypothesis

A

high levels of dopamine (hyperdopaminergia) in subcortical brain areas

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10
Q

updated dopamine hypothesis

A

abnormally low dopamine levels (hypodopaminergia) in brains cortex leads to hyperdopaminergia in subcortical areas

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11
Q

biological explanation strengths

A

genetic- family studies like Gottesman and Tiernan show that biological children of people with sz have a higher risk of developing it

neural- amphetamines increase DA and worsen sz symptoms and antipsychotics reduce DA activity and symptoms

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12
Q

biological explanations limitations

A

genetic- genetic counselling provides and average figure, not true probability of the child developing sz because of the environmental influence

neural- post mortem and live scanning studies have found raised levels of glutamate in several brain regions- several candidate genes involved in production

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13
Q

family dysfunction

A

poor family communication, cold parenting, high expressed emotion

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14
Q

double bind theory

A

a child is confused by mixed messages and punished with love withdrawal

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14
Q

schizophrenogenic mother

A

is cold, rejecting and controlling, creating a family climate of tension and secrecy

Father is passive and uninvolved

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15
Q

expressed emotion

A

high levels of verbal criticism, hostility and emotional overinvolvement

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16
Q

dysfunctional thinking

A

disrupted though processing in ventral striatum and temporal/cingulate gyri

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17
Q

metarepresentation

A

disruption of ability to reflect on own thoughts and behaviour- leads to thinking that own actions and thoughts are someone else’s

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18
Q

central control

A

people with sz tend to have derailment of thoughts because a word triggers associations and the person cannot supress automatic central responses to these

19
Q

psychological explanations strengths

A

-research support- sz patients who have an insecure attachment type are also likely to have suffered abuse- suggests that family dysfunction is likely to make people vulnerable to sz

  • evidence for dysfunctional thinking- Stirling asked sz patients to complete stroop task and it took them longer that control group
20
Q

psychological explanations limitations

A
  • socially sensitive theory as it blames the parents for the child’s condition- especially mother
  • only explains proximal origins of symptoms- only a partial explanation
21
Q

antipsychotics

A

reduce intensity of sz symptoms. especially positive one

22
Q

chlorpromazine (typical)

A

is a dopamine antagonist, blocks dopamine receptors reducing neurotransmitter activity and symptoms

also acts as a sedative and has a calming effect

23
Q

clozapine (atypical)

A

binds to dopamine receptors but also works on serotonin and glutamate. May improve mood and cognitive functioning ( side effect of fatal agranulocytosis)

24
Q

risperidone (atypical)

A

most recent, binds to dopamine receptors more strongly than clozapine does and fewer side effects

25
Q

biological treatments strengths

A
  • Meltzer found that clozapine is more effective than typical antipsychotics- 30-50% success rate in treatment resistant cases
  • evidence for effectiveness- Thornley reviewed drug trials for 1121 patients and found chlorpromazine was associated with better functioning and reduced symptom severity.
26
Q

biological treatments limitations

A
  • side effects of tardive dyskinesia- a movement disorder that causes repetitive movements beyond the person’s control. Can make routine functioning difficult and effects quality of life
  • according to updated dopamine hypothesis, antipsychotics shouldn’t work, so there must be added factors to the success
27
Q

CBT aims

A

to identify and challenge irrational thinking/beliefs including delusions and hallucinations

28
Q

How CBT helps

A

shows clients that delusions and hallucinations affect their feelings and behaviour, reality testing

29
Q

aims of family therapy

A

improve family communication and reduce stress of living as a family

30
Q

how does family therapy help?

A

reduces expressed emotion, improves family ability to help and achieve balance, improve beliefs

31
Q

7 phases of family therapy

A
  1. provide emotional and practical support
  2. identifying resources that members can offer
  3. encouraging mutual understanding
  4. identifying unhelpful interaction patterns
  5. skills training
  6. relapse prevention planning
  7. maintenance for future
32
Q

psychological treatments strengths

A
  • NICE recommends CBT and family therapy as a treatment.

-Jauhar meta analysis found small but significant evidence to show that CBT lessens positive and negative symptoms

-McFarlane found that family therapy was one of the most consistently effective treatments for sz- relapse rates reduced by 50-60%

33
Q

psychological treatments limitation

A

CBT is not a cure, it improves quality of life and enables someone to manage their symptoms.

34
Q

token economies

A

systems of secondary reinforcement used to improve the behaviour of people by systematically rewarding good behaviour

35
Q

how are token economies used for sz

A

tokens are given to individuals immediately after they perform a desired behaviour, they are used to modify personal care to normalise behaviour before leaving institution

36
Q

ayllon and azrin token economies

A

women on a ward were given plastic tokens for tasks that were exchanged for privileges. Popular in institutions in 60s and 70s but use has declined now

37
Q

token economies strength

A

Glowacki identified 7 recent studies which show a reduction in negative symptoms due to token economies

38
Q

token economies limitations

A
  • Ethical issues- gives professionals power over the behaviour of the patient. Could be taking away someone’s freedom to dress/look a certain way
  • once the token economy has been removed, there is no reason to keep up behaviour so no lasting effect
  • Chaing argues that art therapy is an ethical alternative- no side effects and supported by NICE guidelines
39
Q

interactionist approach

A

acknowledges that a range of different factors including biological and psychological are involved in the development of sz

40
Q

old diathesis stress model

A

Meehl- the diathesis was entirely genetic. A schizogene led to a schizotypic personality which is sensitive to stress.

41
Q

modern diathesis stress model

A

D- a range of factors beyond genes, including psychological trauma

S- stress is not just parenting related but anything that may trigger sz

42
Q

interactionist approach to treatment

A

the model combines biological and psychological therapies, most commonly antipsychotics and CBT

43
Q

Interactionist approach strengths

A
  • Tienari- supporting evidence for vulnerability and triggers
  • real world application- combining treatments has the best effect (Tarrier)
44
Q

interactionist approach limitations

A
  • original model is over simplified- there is not one schizogene but many biological and environmental factors which could be a stressor
  • treatment causation fallacy- just because combining treatments is successful doesn’t mean that we can assume that interactionist explanations are correct

Psychology Paper 3 (4 decks)

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