Schizophrenia

Question 1

What is a positive symptom

Answer 1

An additional experience beyond those of ordinary existence

Question 2

What’s a negative symptom

Answer 2

A loss of usual abilities and experiences

Question 3

What are some examples of positive symptoms

Answer 3

Hallucinations- unusual sensory experiences that have no basis in reality , eg auditory or visual hallucinations

Delusions - false beliefs that have no basis in reality , they can make ppl w schizophrenia behave in ways that only make sense to them

Question 4

What are examples of negative symptoms

Answer 4

Avolition - severe loss of motivation to carry out everyday tasks and reaching goals eg lack of persistence in work

Speech poverty - reduction in the amount of quality and speech

Question 5

How does classification of schizophrenia work

Answer 5

2 major systems for classification of schizophrenia: ICD - 11 used in the uk and he must show 2+ negative symptoms for one month or longer. However it also recognises sub types of schizophrenia like paranoid and catatonic schizophrenia

DSM - 5 - used in USA , must show one positive symptom for at least a month. Doesn’t categorise further into subtypes

Question 6

How does reliability and validity correlate to SZ

Answer 6

Reliability refers to whether we can gain consistent results when classifying and diagnosing Sz.
Validity refers to the accuracy, the extent to which we are measuring what we intend to measure.

Question 7

What is the study into reliability ans validity of SZ

Answer 7

Cheniaux asked two psychiatrists to diagnose the same 100 patients using DSM and ICD. One diagnosed 26 according to DSM and 44 according to ICD . The other diagnosed 13 according to DSM and and 24 ICD. Showing poor inter rater reliability and poor reliability in the diagnosis of SZ

Question 8

What’s symptom overlap
Co morbidity

Answer 8

2 or more conditions share similar symptoms
Co morbidity - 2 illnesses occur at the same time

Question 9

What’s a problem , of reliability and validity

Answer 9

:( there’s often symptom overlap where 2 + conditions share similar symptoms, eg both SZ and depression involve neg symptoms like Avolition , weakening the validity and reliability of the classification and diagnosis of sz, dr may then not be diagnosing SZ properly

:( co morbidity where 2 illness occur at same time, in research patients who had SZ also had depression and some other patients who had SZ also had ocd, questioning whether sz is a separate disorder or not and it causes reliability problems bc there may be confusion over which disorder is being diagnosed

Question 10

What are genetic biological explanations for SZ

Answer 10

Genetic states that SZ is hereditary and passed on from one generation to the next through genes which increases a persons vulnerability to developing sz
There are 108 maladaptive candidate genes including PCM1 which increases vulnerability to Sz

Question 11

Neural biological explanations to Sz

Answer 11

-abnormalities within the brain may be associated with the development of Sz
-a correlate of Sz is enlarged ventricles which cause damage to brain areas and this damage is associated with negative symptoms of Sz

Question 12

What’s another correlate to Sz (enlarged ventricles was the first one)

Answer 12

Dopamine hypothesis- the brains neurotransmitters work diff in the brain of a patient w Sz , dopamine is very involved in Sz patient brains
Hyperdopaminergia in sub cortex - high lvls dopamine in Broca’s area associated with auditory hallucinations

Hypodopaminergia in cortex - low lvls dopamine in prefrontal cortex have been associated with negative symptoms like Avolition

Question 13

Biological explanation of Sz Ao3

Answer 13

biological determinism, states theory is controlled by internal factors like high or low lvls of dopamine which can cause auditory hallucinations or Avolition. Neglecting role of free will leaving indivs feel as tho they have no control over their schizophrenic behaviour . Limiting the biological explanation for Sz

A strength is that it has practical applications, the theory states Sz can be caused due to dopamine imbalances which had lead to the treatment of drug therapies to treat these imbalanced lvls and reduce their symptoms of hallucinations and delusions. Increasing the effectiveness of the biological approach to wards Sz

Question 14

What do agonists do and antagonists do

Answer 14

Increase activity of a neurotransmitter at a synapse
Reduce the activity of a neurotransmitter at a synapse

Question 15

Antipsychotic drugs

Answer 15

Are the most common treatment for Sz, some patients can take them temporality whereas some for their whole life

Question 16

What are the 2 types of antipsychotic drugs

Answer 16

Typical - dopamine antagonists eg chlorpromazine. Works by binding to the D2 receptors on the post synaptic neurons in the brain , reducing the action of dopamine , reducing positive symptoms

Question 17

What’s the second type of antipsychotic

Answer 17

Atypical - eg clozapine, clozapine binds to D2 dopamine receptor sites on the post synaptic neuron , reducing positive symptoms. Also acts as agonists upon serotonin receptor sites , reduces neg symptoms of Sz

Question 18

what are psychological explanations for Sz

Answer 18

family disfunction - these explanations state hostility and difficulties in family communications cause stress and tension leading the child to develop Sz

eg a Schizophrenogenic mother is cold and controlling and builds a family climate characterised by tension and secrecy, leading to distrust , which develops into paranoid delusions in Sz

Question 19

what is double blind communication as a pyschological explanation for Sz
COMS UNDER FAMILY DSYFUNCTION

Answer 19

states Sz is due to faulty communication patterns within families. this is where the parents communicate a verbal msg which isnt matched with their non verbal msg so the child recieves mixed msgs. which csn lead to negative symptoms of Sz

Question 20

whats expressed emotion as a psychological explanation for Sz
COMES UNDR FAMILY DSYFUNCTION

Answer 20

high lvls of expressed emotion (like verbal cristism towards the patient) can cause stress in the patient which is a primary explanation for relapse in patients with Sz

Question 21

a03 to psychological explanations to Sz

Answer 21

:) has practical applications as the theory states Sz is caused by faulty family communications leading to the treatment of family therapy . where the therapist meets with the patient to try alter their rs and communication patterns which can help prevent relapse of Sz

-there are alternate explanations for Sz such as the biological explanation that should be considered, stating Sz is due to hyperdopaminergia and its well evidenced

Question 22

another psychological explanation for Sz (asw as family disfunction) is cognitive explanations including dysfunctional thought processing

Answer 22

cognitive explanations focus on the role of internal mental processes, ppl with Sz have a disruption to normal thought processing

Question 23

what is one type of dysfunctional thought processing that could trigger Sz symptpms

Answer 23

metarepresentation is the ability to reflect on thoughts and beh allowing us to understand our actions and other’s actions
dysfunction in metarepresentation disrupts our ability to recognise our own thoughts and actions as being carried out by ourselves or others
-thus explaining hallucinations of voices, as an indiv may think this voice is someone elses rather than their own

Question 24

what is a second type of dysfunctional thought processing that could trigger Sz symptpms

Answer 24

central control- ability to supress automatic responses while we preform deliberate ones instead

-disfunction in c.c explains disorganised speech and thought disorder (+ symp), an indiv cant supress their automatic thoughts and speech triggered by other thoughts.

Question 25

a03 to cognitive dysfunctional thought processing

Answer 25

adv- practical applications, theory states Sz is caused by delusional thoughts has led to CBT , can help Sz patients challenge their delusional thoughts , reducing + symp, making this an important part of applied pysch as it helps to treat ppl in the real world disasv - -there are alternate explanations for Sz such as the biological explanation that should be considered, stating Sz is due to hyperdopaminergia and its well evidenced

Question 26

A03 to drug therapy

Answer 26

adv - good for those with low motivaton bc the patient only takes a tablet to reduce Sz symptoms , unlike CBT which requires motivation to attend daily sessions to challenge delusional thoughts, increasing effectiveness of drug therapy disadv - ethical issues, its believed antipyshcotics are used to calm patients and make it easier for the staff to work with them , rather than for the patients own benefit, some see this as human rights abuse and its questionnable to if severly effected patients can give fully informed consent to medication. drugs can also cause high realpse rates due to patients stopping trestment due to side effects, so arent effective long term

Question 27

Which drugs are known to be more effective than the other

Answer 27

Atypical are more effective against negative symptoms than typical Typical are more common to producing side effects , whereas Atypical aren’t

Question 28

What factors can affect the reliability and validity when it comes to classifying and diagnosing Sz

Answer 28

Symptom overlap and co morbidity culture bias (eg hallucinations may be seen as something spiritual and special in Africa but a straight up Sz symptom in USA)

Question 29

What’s an example of a psychological therapy to treating Sz 1

Answer 29

Family therapy - family dysfunction can play a role in the development of schizophrenia, so altering communication patterns within dysfunctional families should help

Question 30

Family therapy - what’s the aim, what does it involve

Answer 30

to reduce levels of frustration and expressed emotions. 1. Educating family members about schizophrenia, and what they can expect 2. Encouraging the family to develop problem solving and communication skills to support the patient 3) Helping family members achieve a balance between caring for the patient and maintaining their own lives.

Question 31

AO3 family therapy

Answer 31

emphasis is placed on 'openness' this can be an issue as it may cause or reopen family tensions. Some family members may also be reluctant to talk about, or admit, their problems, lowering the effectiveness of family therapy as a treatment for schizophrenia. Adv- Research concluded that family therapy was one of the most effective treatments available for schizophrenia. Relapse rates were found to be reduced by 50-60% in those receiving family therapy. One could further argue that because family therapy reduces relapse rates those patients can boost their productivity and go into work, increasing money to the economy thru taxation .

Question 32

Token economies as used in the management of schizophrenia (not a treatment it can just manage beh)

Answer 32

mainly used with patients who have spent a long time in hospital and have become institutionalised and developed maladaptive behaviour such as poor personal care aim of token economies is to change a patient's behaviour so that they will have a better quality of life in the hospital setting and to enable them to live outside of a hospital setting

Question 33

How does the token economy for managing Sz beh work

Answer 33

-thru operant conditioning principles, patients receive tokens (2nd reinforcers) immediately after producing a desired behaviour such as self-care, tokens can then be later exchanged for goods such as hours watching tv (primary)

Question 34

A03 to token economy

Answer 34

The use of token economies can raise ethical issues. The major issue is that privileges become more available to patients with mild symptoms and less available to those with more severe symptoms of schizophrenia that prevent them from complying with desirable behaviours. This means that the most severely ill patients suffer discrimination. Focus on Behavior, Not Cause – Only manages symptoms rather than addressing the underlying biological causes of schizophrenia. Such as then go into neural explanation

Question 35

CBT as a treatment for Sz

Answer 35

The aim of CBT is to help patients identify irrational/delusional thoughts and change them. 1. Identify and challenge irrational thoughts , therapist will encourage them to come up with a more realistic thought 2. Logical disputing - therapist asks patient do these thoughts make sense to you? Eg why would ur fam try to kill you 3. Positive self talk to challenge auditory hallucinations eg ) my family won’t hurt me I am loved

Question 36

Cbt for Sz

Answer 36

Can be conducted In groups which saves costs ,5-20 sessions

Question 37

AO3 to cbt as treating Sz

Answer 37

Disadv - it requires motivation and commitment from patients to attend sessions, this is something that individuals suffering from negative symptoms of schizophrenia, such as avolition, will find difficult , CBT may only b effective when combined with antipsychotics. the drugs help the patient to motivate themselves to attend the sessions. Therefore, CBT alone may not be an effective treatment for all cases of schizophrenia. Adv-gives indivs control over their beh free will

Question 38

The Interactionist approach…

Answer 38

suggests that schizophrenia is developed due to a combination of biological, psychological and social factors. This is known as the diathesis-stress model.

Question 39

Diathesis stress model

Answer 39

Diathesis = underlying Stress = neg psychological experience that triggers Sz

Question 40

Explain the Diathesis model further and how it’s developed over time meehl 1

Answer 40

The og model says diathesis was entirely genetic. ‘schizogene’ is which made somebody sensitive to stress. if you have the gene, stress through childhood, such as having a schizophrenogenic mother could lead to schizophrenia.

Question 41

However, it is now believed that.. diathesis stress model 2

Answer 41

there is no single schizogene, but that it is many genes that increase generic vulnerability to schizophrenia (108) It is also believed that factors other than genes can be a diathesis such as psychological trauma. Like child abuse WHICH CAN TRIGGER SZ

Question 42

a modern definition of stress is Diathesis stress model 3

Answer 42

It includes anything that risks triggering schizophrenia, cannabis can also increase the risk of developing Sz due to its interference w the dopamine system

Question 43

What does the interactionist model consider

Answer 43

both biological and psychological factors in the development of schizophrenia and therefore is compatible with both biological and psychological treatments for schizophrenia.

Question 44

A03 to the interactionist approach

Answer 44

There’s Supporting Evidence for the Diathesis-Stress Model • researcher tienari et al Studied 19000 Finnish adoptees and found that children with a biological predisposition to schizophrenia (from parents with the disorder) were more likely to develop it, but only it raised in a dysfunctional family environment strengthens the interactions approach. LARGE SAMPLE SIZE Disadv- Oversimplification of the Diathesis-Stress Model: • Early versions of the model assumed a single genetic vulnerability and environmental trigger. However, modern research suggests multiple genes and cumulative stressors may contribute to the onset of schizophrenia, making it more complex. An adv - research by tarrier et al included 315 patients were randomly allocated to treatment conditions. They found that patients given a combined therapy of medication and CBT/counselling had lower symptom levels than a control group with just one treatment (medication). This therefore suggests by adopting an interactionist approach and using both biological and psychological therapies, patient’s schizophrenic symptoms will be treated more effectively. High control over extraneous variables

Question 45

Research into token economy by Dickenson et all

Answer 45

researched the effectiveness of token economy systems in modifying behavior in institutional settings. They found that token economies can improve desired behaviors, but the effects may not always be long-lasting after the reinforcement stops.

Question 46

Exam question! Briefly discuss two limitations of the family dysfunction explanation for schizophrenia. U need to discuss the a03 by counter arguing