Schizophrenia

Question 1

Classification of Sz, Reliability and Validity

Answer 1

Should:
Rosenhan - 7-52 days to release actors (poor validity)
Cheniaux - DSM > ICD + poor inter-rater reliability

Additional:
Aleman - Meta analysis, M 42% more likely diagnosed than F
Cotton - Gender Bias
Cochrane - Cultural differences (Afro-Caribbean)

Question 2

Biological explanations of Sz

Answer 2

Genetic:
Gottesman - MZ 48% > 17% DZ
Tienari - longitudinal study on adoptees. Biological Sz mothers more likely to inherit

Neural:
Popular in 1970s when research by Seeman, Creese, and Snyder showed drugs effective as dopamine receptor antagonists.

Question 3

Family Dysfunction Explanation for Sz

Answer 3

Should:
Bateson - Double bind
Fromm-Reichmann - Schizophrenogenic mother (cold, overprotective, and rejecting).

Additional:
Tienari - Dysfunctional 36.8% vs 5.8% Healthy, rates of Sz.
Brown - High EE families = higher relapse rates…
(However) Rosenfarb - Correlation of higher Sz intensity and EE.

Question 4

Cognitive explanations for Sz

Answer 4

Should:
Christopher Firth - Attention deficit theory/Dysfunctional thought processing.
-> 1. Meta representation (inability to reflect on thoughts/behaviours, feeling like another person).
-> 2. Central control (inability to supress automatic responses).
Stirling - Stroop test; Sz 2x longer than control to state ink colour because of dysfunctional central control.

Question 5

Psychological Treatments for Sz

Answer 5

Should: Tarrier - 20 controlled CBT Trials, found very effective for short-term benefits. Even more w/ drugs.

Additional:
Jauhur - Meta-analysis on CBT, finding ineffective.
Pilling - Meta-analysis on Family Therapy, found reduces relapse.
McMonagle & Sultana - Token economics reduces negative symptoms.

Question 6

Interactionist approach to Sz

Answer 6

Must: Meehl - ‘Schizogene’ activated via stress.

Should:
Tienari - Family dysfunction 36.8% > 5.8%
Xiong - Drugs + Family Therapy lower relapse than just Drugs

Question 7

Typical Antipsychotic e.g.

Answer 7

Chlorpromazine

Question 8

Atypical Antipsychotic e.g.

Answer 8

Clozapine
Risperidone

Studies (like by Bagnall) show more effective than typical.

Question 9

Biological Treatments

Answer 9

Must: David Healy - research bias, exaggerated for money.

Should:
Thronley - meta-analysis Chlorpromazine > placebo.
Bangall - atypical > typical.

Additional: Leiberman - 78% of 1300 quit after 18m due to side effects

Question 10

Symptom overlap and co-morbidity

Answer 10

Ophoff (2011) - Genetic overlap of Sz and bipolar disorder.

Buckley (2009) - Around half of Sz patients also illness with depression or substance abuse.