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Psychology P3 > Schizophrenia > Flashcards

Schizophrenia Flashcards

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1
Q

Classification

A

What schizophrenia is
+ positive symptoms
- negative symptoms

Differs depending of classification system used
DSM5
ICD11

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2
Q

positive symptoms of schizophrenia

A

hallucinations - unusual extra-sensory experiences, hearing voices, seeing things

delusions - believing things that aren’t true, paranoia, believing they’re important

jumbled speech

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3
Q

negative symptoms of schizophrenia

A

speech poverty - reduced amount or quality of speech

avolition - lack of drive and motivation to achieve goals

lack of emotion

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4
Q

what is the DSM?

A

list of mental health disorders which helps diagnosis
needs at least one positive symptom

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5
Q

Reliability and Validity

A

Reliability - not consistent
- Gender bias
Longenecker - men 50% more likely then women
- Culture bias
Escobar - American Americans more likely
Swartz - African Americans 2.4x more likely
Cheniaux - more likely diagnosed with ICD than DCM, not consistent
+ Osorio
.97 inter rated reliability in diagnosis, is reliable

Validity - not accurate
- Symptom overlap - diagnose as wrong disorder
- Cheniaux - more likely diagnosed with ICD than DCM, not consistent so not all diagnoses accurate

Diagnosis inconsistent - not everyone diagnosed that should be, treatments less effective
Diagnosis not accurate - wrong condition, treatments less helpful

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6
Q

what is comorbidity?

A

having 2 or more conditions at once

harder to diagnose
reduces validity - may be another issue
reduces reliability - others Amy diagnose as another issue

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7
Q

biological explanations for SZ

A

genetic
neurotransmitters (dopamine hypothesis)
neural correlates

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8
Q

genetic explanation for SZ

A

inherited in genes and runs in families
polygenic - multiple candidate genes found, increase someones likelihood

Gottesman
MZ - 48%
DZ - 17%
concordance rates for SZ

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9
Q

evaluation of genetic explanation

A

+ Gottesman (48% DZ and 17% MZ)
shows there is some genetic influence

+ Tienari - children adopted from SZ mothers more likely to developed SZ than control group
shows genetic factors more influential than environment

  • concordance rates not 100%, must involve other factors
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10
Q

the dopamine hypothesis (neurotransmitters)

A

SZ caused by high levels of dopamine transmission

drugs work by blocking the receptors for dopamine so less is transmitted

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11
Q

evaluation of dopamine hypothesis

A

+ drugs that block dopamine are effective, suggests it must be caused by high levels
Thornley et al - typical antipsychotics more effective than placebo

+ drugs that increase dopamine levels are shown to cause SZ symptoms

+ real world application, effective drug treatments

  • drugs only help positive symptoms, doesn’t explain negative ones
  • correlation doesn’t mean causation
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12
Q

neural correlates in SZ

A

structural abnormalities in brains linked with SZ

Johnstone et al - SZ patients found to have enlarged ventricles

  • however non SZ patients can have it
  • correlation doesn’t mean causation
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13
Q

psychological explanations for SZ

A

family dysfunction
cognitive explanations

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14
Q

outline family dysfunction explanation

A

family issues of conflict, criticism and communication issues caused SZ

schizophregenic mother - mother who is cold and controlling
- leads to stress and distrust

double bind communication - faulty communications means child receives mixed messages
- causes delusions and speech poverty

expressed emotions - living with high ee has high levels of criticism and is hostile
- links to relapse in patents

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15
Q

evaluation for family dysfunction

A

+ Read et al - 69% female patties received abuse in childhood, show family experiences have influence

+ real world application, lead to family therapy
Pharaoh et al - family therapy reduces readmission

  • research is retrospective, may have distorted memories especially with SZ
  • reductionist, evidence for biological explanations, Gottesman
  • blames family
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16
Q

outline cognitive explanation

A

caused by dysfunctional thought processing
leads to delusions and speech impairments

lack of central control - unable to suppress automatic responses
- leads to disorganised speech

lack of metarepresentation - ability to reflect on own actions
- leads to hallucinations and delusions

17
Q

evaluation of cognitive explanations

A

+ Stirling et al - SZ patients performed poorly on cognitive tasks, shows they process information differently

+ real world application. led to effective CBT for SZ
NICE - reviewed treatments, CBT effective at reducing rehospitalisation

  • evidence for biological explanation, Gottesman
  • faulty thought processing may be used by neural correlates or neurotransmitters, a symptom not a cause
18
Q

psychological treatments for SZ

A

family therapy
CBT

19
Q

CBT for schizophrenia

A

based on identifying and changing faulty cognitions

uses basis of CBT and Ellis’ ABC model to determine cause and consequences to be changed

reality test and challenge hallucinations and delusions

gives them an explanation for their symptoms which can reduces distress

20
Q

evaluation of CBTp

A

+ NICE review of treatments, CBT effective in reducing rehospitalisation
most effective with CBT and drugs

+ no side effects, unlike drugs

  • doesn’t address cause just helps symptoms
  • evidence for biological explanations, biological treatments better?
  • more expensive and time consuming than drug therapies
21
Q

outline family therapy

A

therapy with whole family not just individual
aims to reduce conflict and ee in households, which can reduce relapse rates

22
Q

evaluation of family therapy

A

+ Pharaoh et al - reduced readmission after family therapy, effective

+ no side effects

  • doesn’t treat cause, only symptoms
  • evidence for biological explanations, biological treatments better?
23
Q

diathesis stress model

A

combines biological and psychological factors

suggests those more biologically vulnerable may be more likely to develop it when exposed to environmental stressors

biological vulnerability + environmental stressor
leads to schizophrenia

24
Q

outline biological treatments for SZ

A

drug therapies

antipsychotic drugs work to reduce dopamine levels by blocking receptors to stop transmission

sides effects include dizziness and blurred vision, agranulocytosis

typical :
older
more side effects
only treat + symptoms
effects dopamine

atypical:
neweer
fewer side effects
treats + and - symptoms
effects dopamine and serotonin

25
Q

evaluation of drug therapy (biological)

A

+ Thornley et al - typical drugs more effective than placebo, effective

+ cheaper and easier than therapy
+ can be used alongside therapy
Tarrier most effective with CBT and drugs

  • still has side effects, dry mouth dizziness, although fewer with atypical
    stops people taking it, less effective
  • ethical issues, doesn’t help patients just control behaviour
26
Q

token economies in SZ

A

behavioural treatment bassoon operant conditioning, used to manage SZ

uses positive reinforcement to reward desirable behaviour

tokens can be earn and exhacnged for rewards

27
Q

evaluation of token economies

A

+ Dickerson et al, shows use of token economies is effective

+ helps people in institutions

  • lacks ecological validity, doesn’t apply to real world, behaviour may stop when not rewarded
  • unethical, most ill patients less able to participate so don’t get helped, not always effective, desert actually treat cause
28
Q

Read et al

A

retrospective study of SZ patients

69% female patients experienced abuse in childhood, shows experiences influence SZ

supports psychological - family explanations

29
Q

Thornley et al

A

meta analysis shows atypical more effecting than placebo

supports birlgicsl treatments and causes (dopamine hypothesis)

30
Q

Cheniaux et al

A

disagreement in diagnosis of same 100 patients
more likely to be diagnoses with ICD than DSM

shows diagnosis is not reliable or valid

31
Q

NICE review of treatments

A

CBT, drugs and family therapy effective

supports interactionist and all treatments

32
Q

Tarrier

A

CBT and drugs most effective when used together

33
Q

Gottesman

A

48% identical
17% non identical
concordance rates for SZ

supports genetic explanation
limitation of psychological explanations and treatments

34
Q

Outline Interactionist approach

A

Caused by biological, psychological and environmental factors

Diathesis stress model combines the effect of internal vulnerability and external triggers

Vulnerabilities- genetic and childhood trauma effecting brain development
Triggers - negative psychological experiences eg stress, drugs

Explanation has developed - previously a single gene, now polygenic

Treated with a combination of treatments, psychological therapy and drugs

35
Q

Evaluate Interactionist approach

A

Explanation
Tienari - biological
Read - experiences
Tienari - adopted children of schizophrenics, more likely to develop it when adopted into household of high ee, shows combination of genetics and environment

Treatments
Tarrier - combined treatments, drugs and CBT most effective when used together
NICE - reviewed all treatments, all effective

  • ignores some factors such as neutrotransmitters

Psychology P3 (4 decks)

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