schizophrenia Flashcards

Question

briefly explain how biological explanations could be applied to MOM schiz? (5)

Answer 1

1. schizos produce excessive amounts of dopamine 2. to reduce suffering and symptoms like hallucinations and delusions - lower dopamine levels 3. antipsychotics work by binding to but not stimulating the receptors preventing dopamine from gaining access 4. dopamine levels reduce - can cause side effects 5. new atypical antipsychotics bind to receptors but rapidly dissociate - allows for some transmission and side effects are lessened

Answer 2

1. englarged ventricles 2. cortical atrophy 3. reversed cerebral asymmetry

Answer 3

cavities that produce and transport cerebrospinal fluid

Answer 4

- Andreasen studied MRI scans of individuals with or wothout schiz and found that those with schiz had ventricles that were 20-50% larger than the others - connections between neurons gets disrupted as ventricles enlarge whcih can lead to a lack of chemical stability in the brain - leads to abnormal functioning

Answer 5

the loss of neurons in the cerebral cortex. it affects the cognitive functions of that area

Answer 6

- Vita et al ised CAT scans to assess 143 indivudals with schiz and 45 without - found that 33% of those with schiz showed moderate to severe atrophy - as the volume of the brain decreases, cerebrospinal fluid replaces brain matter and puts pressure on the ventricles whcih enlarges them

Answer 7

in many schizos the right hemisphere is larger than the left which is reversed in non schizo brains. as language function is located on the left hemisphere, the reversed asymmetry may account for some of the symptoms such as alogia

Answer 8

- findings from the studies are highly reliable - McCarley et al suggested that the presence of enlarged ventricles is the most reliable finding in research using brain scans - Flashman and Green have confirmed the link between schiz and cortical atrophy - McCarley et al also suggested that factors like age, sex and severity of symptoms can all have an influence on the observed brain abnormalities - suggests that either structural abnormalities are only evident in some schizos or that we need to acknowledge more subtle differences when assessing these abnormalities

Answer 9

- the structural abnormalities can be found in individuals suffering from other conditions than schiz - Roy et al noted that people diagnosed with bipolar disorder and schizoaffective disorder also have enlarged ventricles - similarly, these abnormalities are not found in all schizos - this weaknes the validity and suggests that we need to consider other factors that may account for the illness

Answer 10

cognitive explanation schizophrenogenic mother

Answer 11

internal mental processes if one or all of these are faulty

Answer 12

cognition memory language perception attention

Answer 13

developing a sense of what other are thinking to help to form our response

Answer 14

hallucinations

Answer 15

that they can be onset by a variety of triggers including stress, lack of sleep and certain drugs. the people that have migraine and vision problems but no other symptoms of schiz do not recieve a diagnosis. those experiencing hallucinations may appraise these voices inappropriately whcih elicits behaviours like social withdrawal

Answer 16

we have an 'inner voice' and we use it to think. he argues that schizos can't monitor their own thoughts, misattributing them to the outside world, so when a person hears voices it's just their inner speech being misinterpreted

Answer 17

he found that schizos have reduced activity in those parts of the brain involved in monitoring speech other research used PET scans and found an under-activity in the frontal lobe of schizos which is linked to self-monitoring

Answer 18

Beck's cognitive triad the future the self the world

Answer 19

believe they have nothing valuable to say loss of self confidence - nobody likes them negative thoughts = unemotional negative view of self leads to tics (nervous). depression = lack of movement

Answer 20

preconscious filters

Answer 21

all the informatio from our environment enters our preconscious where thought occurs without awareness. the information that our brain interprets as the most pertinenet enters the conscious mind and the rest is filtered out

Answer 22

that the attentional filters that inhibit most of the sensory information from making it into our conscious are defective. so things that are usually filtered out as irrevelant are now more significant than they really are

Answer 23

abnormalities in those areas of the brain that uses dopamine, especially the prefrontal cortex. research shows schizos have reduced blood flow to these areas during certain cogntive tasks

Answer 24

hallucinations, delusions and disorganized speech the inability to properly focus causes schizophrenics to give the impression of disordered thought

Answer 25

that schizos have attentional bias towards stimuli of a threatening and emotional nature, particularly stimuli associated with violence and pain. they are also more leikly to percieve stimuli as threatening when it isn't paranoid delusions

Answer 26

- research evidence - Barch et al compared performance on a stroop test between schizos and non schizos - those with schiz were slower and made more mistakes - this is evidence that they can't filter the information as effectively - suggests that evidence has been produced to support Frith's idea that the attentional filters of schizos are defective

Answer 27

question validity of the use of stroop test to measure cognitive abilities as it's difficult for everyone

Answer 28

- reductionist - Frith proposed there the faulty operation of cognitive mechanisms is due to impairment within the frontal cortex and posterior areas of the brain - despite this, it's almost impossible to imagine that schiz will come down to mere functioning of a few brain circuits

Answer 29

- only accounts for the cognitive based symptoms - fails to account for origins of cognitive deficits that result in schiz - this explantion can only explain proximal causes not distal causes - suggests that we should be cautious about claims made by this approach as a single explanation for schiz

Answer 30

- needs to be considered in a more holistic way - Howes and Murray proposed that genes or other factors in early life combined with difficult life events or social stressors provokes the realease of dopamine - this causes problems with cognitive processing especially hallucinations and delusions - the individula gets caught in a cycle due to stress and it prompts the release of more dopamine - demonstrates that this explanantion if insufficient alone but can be used in conjunction with other theories

Answer 31

- a major symptom of schiz is seen in the disordered thinking of an individual, possibly cause by faulty information processing recieved from the environment - the purpose of CBT is to help an idividual help and organise their disordered thoughts in a more rational way - CBT helps them to realise that their disordered thinking is likely the cause of their illness - CBT sessions are collabrative between the client and the therapist over a number of sessions using disputing techniques to challenge their perception - they also work on relapse preventing strategies where early warning signs of relapse are identified and plans can be developed

Answer 32

stress or trauma id is overly dominant = creation of alternate realities/delusions

Answer 33

a number of studies suggested that the mother-child relationship was disordered in cases where the child was schizophrenic

Answer 34

- that the trigger for schiz came from mothers who were overly dominant in the home and dominant in their interactions with the schizo child - however while being controlling and overprotective, they were also cold and distant - the overprotection stifles the child's development and leaves the child feeling emotionally insecure

Answer 35

- explanatory power that Freud's theories have - provides explanation as to why schizos lose touch with reality and he argues that schizo is a regression to an infant like state - links with many of the symptoms - due to a wide range of symptoms it's unable to account for all cases - suggests that Freud may have some insight into the reason as to why schiz develops but may at best only be able to offer a partial explanation

Answer 36

- concepts are out of date and widely discredited by today's psychologists - in not being able to verify the existence of concepts like the id, ego and the superego or defence mechanisms, it becomes almost impossible to trust in and accept a psychodynamic approach - so if the concepts of Freud's theory of schiz is founded on no basis, it reduces the validity of the whole explanation

Answer 37

dysfunctional families sociocultural factors

Answer 38

double bind theory expressed emotion

Answer 39

Bateson conflicting messages - if a child is repeatedly exposed to social interactions with 2 conflicting messages and the child doesn't get an opportunity to ignore them or respond to them they may develop schizophrenia e.g. parent asks how your day was whilst on their phone

Answer 40

non verbal cues - body language, tone of voice, facial expression words may not match paralanguage shown by parent so the child is getting 2 contradicting messages and whatever their actions, they can't win

Answer 41

delusions - false beliefs through hidden meanings avolition - avoid social interactions for emotional safety flatness of affect - learned not to demonstrate emotion

Answer 42

Brown - investigated 156 men with schiz after being discharged from hospital; found that those who stay with their partner or wives were more likely to relapse than those in lodgings or with siblings - fund a relationship between the amount of expressed emotion within a household and the likelihood of relapse

Answer 43

critical comments hostility emotional over involvement

Answer 44

making comments which are critical of a persons behaviour, appearance or anything about them e.g. 'you're always so negative' ; 'why can't you be more like ____'

Answer 45

being too invested or involved in another persons life to the point where emotions become enmeshed e.g always asking how they are; excessive blame/praise; asking too personal questions

Answer 46

being openly rude and unkind - showing distaste or dislike e.g 'you're stupid' ; 'I hate you'

Answer 47

- supportive evidence - Vaughn and Leff offered support for the role of EE in relapse rates - found 53% of those with schiz who had high EE relapsed within 9 months; 12% of those with low EE relapsed - however, McCreadie and Philips failed to find higher 6 and 12 month relapse rates among those with schiz living in a high EE home - suggests that although EE may be a significant factor in relapse rates it is not the only and doesn't appear to cause the onset of schiz

Answer 48

- findings have been inconclusive in regards to the double bind theory - Liam suggested that the difference found in the parental communications may just be parents adjusting their communication styles to deal with a schiz child - suggests that the communication difficulties that the theory is based on may really be an effect not a cause of schiz

Answer 49

- determining what classes as a double bind statement if very subjective - Ringuette and Kennedy discovered that the so called experts in the theory were no better at identifying double bind statements than the non experts - suggest that due to the fact that we can't define double bind, it also can't be measured of its effect on schiz

Answer 50

- schiz could equally be due to the product of family shared genes as much as communication difficulties - Gottesman et al found that as genetic similarity increased so did the probability of both individuals having schiz - looking at the Diathesis Stress Model - genetics may predispose someone to schiz and family relationships may act as a psychological trigger and cause the onset - suggests that an interactionist biopsychological explanation may be required

Answer 51

- the dysfunctional families explanation suggest the disorder is cause by communication difficulties within the family home - it is suggested that a significant reduction in relapse rates can be achieve through family based interventions rather than working in isolation with the individual with schiz - Pharaoh et al revised 53 randomised controlled trials that concluded that family interventions decreased both frequency of relapse and reduced hospital admissions - family based interventions could include; increase ability of family members to solve and anticipate problems; reduce expressions of anger and guilt; maintain reasonable expectations for how the ill family member should perform

Answer 52

urbanicity social isolation ethnicity and discrimination

Answer 53

findings from their investigation of schizophrenia in Chicago demonstrated there was a higher incidence of schiz in densely population centre of the city rather than the less densely populated suburbs. also found that the highest levels of schiz were in areas of high ethnic conflict and high degree of social mobility

Answer 54

reported findings of a longitudinal study of 5.363 people born in a specific week in March 1949 between ages of 16 and 43. childhood data was gathered and 30 cases were diagnosed with schiz those diagnosed were more likely to show solitary play at ages 4 and 6 and at age 13 were more likely to rate themselves as less socially confident

Answer 55

higher than expected numbers of Afro Caribbean individuals are diagnosed with schiz. they are more likely to be compulsory admitted as opposed to voluntarily admitted to psychiatric hospitals

Answer 56

- can consider social isolation and its links to schiz as a means of tackling and treating the condition - unlike ethnicity, discrimination and urbanicity, interventions can be put in place to help develop social skills of children who are socially isolated in order to reduce risk of schiz - suggests there are practical applications that could reduce the level of suffering experienced by real people

Answer 57

- need to consider cause and effect - unclear whether living in an urban environment leads to a greater risk of schiz or if having schiz means you're more likely to live in an urban area - Pendersen and Mortensen report that those who had a high risk of psychotics disorders reduced the likelihood of developing schiz if they moved to a rural area - implies that we can't say living in an urban environment causes schiz but there is enough research to establish a link

Answer 58

antipsychotics CBT

Answer 59

conventional atypical

Answer 60

blocking the action of dopamine e.g. chlorpromazine - acts as an antagonist - blocks D2 receptors (binds with but doesn't stimulate)

Answer 61

reaction in the mesolimbic pathway which benefits the reduction in positive symptoms

Answer 62

prevent the ability of dopamine from gaining access to and stimulating receptor sites

Answer 63

atypical bind to fewer dopamine D2 receptors and to more D1 and D4 receptors

Answer 64

atypical drugs bind to recsprto sites for only a brief moment of time bind to long enough to relieve symptoms but not long enough to cause side effects seen in conventional drugs e.g. tardive dyskinesia atypical falls off within 24 hours conventional fall off lower than 24 hours

Answer 65

- Cole et al found that 75% of those given a conventional drug were considered to be 'much improved' compared with only 25% of those given placebo - none of the patients given the drug had gotten worse in comparison to 48% of those given placebo

Answer 66

- non compliance of those with chronic schiz - Rettenbacher et al found full compliance with 54.2%, 8.3% partial compliance and 37.5% non compliance of those with schizophrenia - may not be as effective in the real world as they are in clinical studies

Answer 67

- side effects - e.g. tardive dyskinesia and Parkinsons - when first diagnosed, antipsychotics Amy be administered without valid consent meaning they didn't choose the resulting side effects

Answer 68

- risk of violence - may be a threat to themselves or others if they don't follow their drug therapy - NCISH reported 346 homicides in England between 2003 and 2013 by people with a history of schiz - 29% of those had been non adherent with drug treatment a month prior to homicide

Answer 69

help organise disorder thoughts in a rational way. it challenges the clients interpretations of events by asking them to discuss evidence for beliefs

Answer 70

helps deal with positive symptoms like hallucinations and delusions also effective in making the client more self reliant as they challenge their own perceptions

Answer 71

engagement strategies psycho education behavioural skills training relapse prevention strategies

Answer 72

provide the opportunity to talk about potential worries and any symptoms that are of concern to the client. during this stage the therapist will try to develop a rapport which is important if the client has negative previous experience. the client and therapist will discuss any 'natural coping strategies' to help manage symptoms

Answer 73

decatastrophises and normalises the experience of psychotic symptoms, offering alternative explanation s of the clients experience of their symptoms. the client will increase their own understanding of when symptoms may occur

Answer 74

e.g. relaxation, activity scheduling, distraction and problem solving. these are useful in coping with secondary symptoms like anxiety and depression

Answer 75

identify early warning indicators of relapse. these include identifying thought and feelings experienced before becoming unwell

Answer 76

- effective form of treatment - Kuipers et al conducted a study on 60 individuals with schiz who each had a 'positive and distressing symptom that was medication resistant' - randomly allocated to either a CBT plus standard care condition or standard care only condition - after 9 months, 50% of the first group were considered to have improved with only 1 becoming worse; 31% of second group had improved with 3 becoming worse and 1 committing suicide - suggests although CBT plus standard care improvements seemed only marginal it's still significantly better than standard care only

Answer 77

- short term effectiveness - Tarrier et al studied individuals who either received CBT shortly after diagnosis or received standard care - 18 months later the CBT group had the same relapse rates as clients with just standard care - suggests effects of CBT are short lived

Answer 78

- some psychiatrists limit access to CBT - some may not feel that CBT is a viable option for people suffering with schiz - Kingdon and Kirsches reported that 142 individuals who'd been diagnosed in a specific time frame, only 49% had been referred to CBT - suggests that psychiatric prejudice may be limiting the access to CBT in individuals who could benefit from it

Answer 79

- cost effective - Kuipers analysed economic impact of offering CBT to individuals with schiz in addition to antipsychotics - reported that costs involved in delivering CBT were likely to be offset by the reduced utilisation of service cost in the future - suggest that although initially the use of CBT might be more costly, in the longer term the costs are likely to be recouped due to the individuals being less likely to need emergency psychiatric services