SCHIZOPHRENIA 🤪

Question 1

A01for introduction to SCZ
what symptoms needed for DSM V & ICD 10

Answer 1

• Diagnosed by DSM 5 or ICD 10
  -DSM V -one +tive symptom & 2 -tive
• ICD 10: two or more -tive symptoms

Question 2

what are positive and negative symptoms and give example

Answer 2

Positive symptoms:
-additional symptoms
-Hallucinations. - Delusions

Negative symptoms
-Involves loss of usual abilities
- avolition: loss of goal behv/ lazy
- speech poverty - reduced quality of speech

Question 3

give and issue of diagnosing scz
poor validity

Answer 3

cheniaux et al argues scz likely to be diagnosed with ICD 10 than DSM V
- found one clinician diagnosed 24/100 patients with scz
- the other diagnosed 10/100
scz is either over or under diagnosed using ICD 10

Question 4

Another limitation of SCZ
CO MORBIDITY

Answer 4

-presence of one or more condition at same time when diagnosing scz
-buckley et al found that half patients who were diagnosed with scz also had diagnosis of depression, PTSD
- Affects the validity of

Question 5

A01 for biological explanation of scz

Answer 5

-Several genes are involved which increases an individual’s vulnerability to get scz
-dopamine hypothesis
-dopamine is NTs however works differently for SCZ ppls

TOO MUCH DOPAMINE
-lead to scz
-excess dopamine on brocca area -> speech poverty

research
psychologist measured activity levels in mental stratium in SCZ patients
Found lower levels of activity than control group
The lower the activity higher positive symptoms

Question 6

negative of biological approach to SCZ

Answer 6

Reductionist
-reduces complex behv down to simple explanations
-e.g genes and NTS
-ignores roles of nature and family thought processes

Question 7

Strength of biological approach to scz

Answer 7

Dopamine hypotheses has practical application
-led to development of treatment
-new drugs been developed
-these are more effective than neuroleptics at relieving behv
-therefore psychiatrist can understand role played by NTs

Question 8

A01 for psychological explanations

Answer 8

FAMILY DYSFUNCTION
-double bind theory
-abnormal patterns in family communication
leads to delu

EXPRESSED EMOTION
-the level of negative emotion expressed towards recovering scz patient
-leads to relapse

SCZ MOTHER
-mother cold, rejecting, controlling
-lead to family of secrecy
-distrust leads to paranoid delusions

Question 9

Limitation of psychological explanations
(socially sensitive)

Answer 9

socially sensitive
-blames parents
-there’s lack of research which doesn’t consider impact it has on parents
-economic impact

Question 10

strength of psychological explanation family dysfunction
research support

Answer 10

from read et al
-that difficile fam relo in childhood are associated with increase risk of scz
-69% of patients with scz had history for child abuse
-figure was 59% for men
-family dysfunction makes ppls more vulnerable

Question 11

A01 for biological therapy

Answer 11

TYPICAL ANTIPSYCHOTICS
-chlorprozamine works as antagonist
-blocks dopamine receptors
-dopamine levels increase then reduce
-reduces hallucinations

ATYPICAL ANTIPSYCHOTICS
-Clozapine used when other treatments fails
-potential fatal side affects
-300-400mg a day
-binds on dopamine & serotonin receptors
-improves mood and reduces depression

RISPERIDONE
-without serious side affects
-address negative symptoms
-SA = weight gain diabetes

Question 12

Biological therapy
Strength of drug therapy

Answer 12

-evidence to support effectiveness
-psychologist reviewed studies comparing CHLORPROMAZINE to placebo group
-found ppts on CLRZNE showed reduced symptoms
-also had lower relapse rate

Question 13

One limitation of drug therapy
(side affects)

Answer 13

-typical antipsychotic have SA
-e.g Tardive Dyskinesia
-RS shows 30% of patient taking this medication have Td
-which is irreversible 75% of time
-Antipsychotics can cause serious harm

Question 14

A01 For CBT for SCZ

Answer 14

-identifies irrational thoughts replaces them with realistic ones
-normalises experiences

[ how it works ]
-pts asked to travel back symptoms
-asked to recognise their own delusional thinking
-chanllenegs pts interpretation of events

2 strategies which are coping srats
1) cognitive strategy- distraction -positive self talk

2)behavioural strategy - relaxation techniques
increasing social contact

Question 15

Strength of CBT To treat scz
(rs support effectiveness)

Answer 15

pts who had cbt suffer from fewer hallucinations & recover to greater degree
-than those who recieve only antipsychotic drugs
-Drury et al found a 25-50% reduction in recovery time for pts given combination of drugs and therapy

Question 16

Limitation of CBT for scz
low evidence

Answer 16

is the wide range of techniques and symptoms used in studies
- Cbt techniques and scz symptoms vary widely from one case to another
-psychologist points out that different studies involve use of different cbt techniqes
-hard to say how effective cbt is for person with scz

Question 17

A01 for management of scz
TKN economy

Answer 17

Token economy
-based on operant conditioning
-reinforces desirable behv
-token is a secondary reinforcer & are swapped for what patient wants (primary reinforcer)
-allyon trialled token economy in female scz ward
- found average ppts doing daily chores rose from 5-42

there are 3 categories of institutionalised behv
- PERSONAL CARE -SOCIAL BEHV - Condition related behv

• these behvs modified with token economy system
• modifying these behvs improved quality of life

Question 18

Strength of token economy for SCZ

Answer 18

Research support for effectiveness
-Glowacki et al identified 7 studies& examined effectiveness of token economy
-All studies showed reduction in negative symptoms & decline in unwanted behvs

Question 19

One limitation of token economy
(power of control)

Answer 19

-professionals have power to control behv of pts
-imposing institutions norms on pts which can be problematic if behvs haven’t been identified
-e.g someone who like waking up late may have freedom restricted
-ppl experiencing difficulties would be treated worse

Question 20

A01 for Interactionist approach

Answer 20

IA acknowledges that there are biological, psychological and societal factors in development of scz

[Diathesis stress model]
-states that both a vulnerability to scz and a environmental stress trigger (scz mother )are necessary to develop disorder

-original disthesis stress model was entirely genetic
—Meehl said if a person does not have schizo gene then no amount of stress will lead to scz

Question 21

One limitation of of interactionist approach ( diathesis stress)

Answer 21

-Too simplistic
-argues scz is due to single gene
-Ripke found 108 separate genetic variations were associated with increased risk of inheriting scz
-Multiple genes increased vulnerability
-Vulnerability can be due to early trauma
-Childhood sexual trauma was a vulnerability factor

Question 22

Strength of interactionist app
research support for diathesis stress

Answer 22

Evidence supporting role of both vulnerability and stress in development of scz
-Tieneri investigated genetic vulnerability and parenting style
-