Schizophrenia Flashcards
What is schizophrenia?
a serious mental health condition that affects how people think, feel and behave
How did Blueler coin the term schizophrenia?
An illness in which the personality loses its unity: a split between the intellect and emotion
How is schizophrenia categorised?
major distubance of thought, emotion and behaviour
What gender is schizophrenia more common in?
men, earlier in life
What is the cause of schizophrenia thought to be?
biological basis, some king of brain dysfunction that is triggered by psychological factors
What are the 4 main symptoms of schizophrenia?
- Hallucinations
- Delusions
- Avolition
- Speech poverty
What are hallucinations?
experiences where a person perceives things that aren’t actually present, involving any of the five senses. This means they might see, hear, smell, taste, or feel things that aren’t really there.
What are the two positive symptoms of schizophernia?
- Hallucinations
- Delusions
What are positive symptoms of schizophrenia?
Additional experiences beyond those of the ordinary experience
What are delusions?
Delusions are irrational beliefs that an individual holds onto strongly, despite evidence to the contrary. These beliefs are not based in reality and can involve false ideas about the world, other people, or themselves
What are the two negative symptoms of schizophrenia?
- Avolition
- Speech poverty
What is avolition?
Avolition is a persistent lack of motivation or energy to complete everyday tasks. It can lead to a loss of initiative, social withdrawal, and poor hygiene due to a reduced drive to engage in normal activities.
What is speech poverty?
Reduction in the amount/quality of speech, or delayed verbal responses during a conversation
What are positive and what are negative symptoms?
positive = added to their lives
negative = reduced
What are the 2 major systems for the classification of mental disorders for diagnosis?
ICD-10 (WHO) and DSM-5
What is required to be diagnosed with schizophrenia according to the ICD-10?
Minimum of one clear POSITIVE symptoms or 2+ negative symptoms present for at least one month
What is required to be diagnosed with schizophrenia according to the DSM-5?
Requires 2 of the 5 symptoms, but at least one symptom must be one of the first three; delusions, hallucinations, disorganised speech, and be present for at least 6 months
What is validity in diagnosis?
the truth/accuracy of diagnosis
What does it mean for a diagnosis to be valid and give an example?
A diagnosis is valid when it accurately reflects the patient’s actual condition.
For example, if both patients are diagnosed with schizophrenia and both truly have schizophrenia, the diagnosis is valid.
What happens when a diagnosis lacks validity?
A diagnosis lacks validity when it does not correctly identify the patient’s actual condition.
What is an example of a diagnosis lacking validity?
For instance, if one patient is diagnosed with schizophrenia, and the other with bipolar disorder, but both actually have schizophrenia, the diagnosis lacks validity.
When is a diagnosis valid?
.
What is the reliability of the diagnosis of schizophrenia?
refers to the consistency of diagnosis over time or between different doctors
When is a diagnosis considered to be reliable?
when different clinicians or repeated assessments give consistent results.
Who conducted studies to investigate the reliability of diagnosis in schizophrenia?
Read
Beck
What did Read (2004) find about the reliability of diagnosing schizophrenia?
found only a 34% concordance rate for test-retest reliability
What did Beck et al (1961) discover about inter-rater reliability?
found an inter-rater reliability of 54% between two psychiatrists.
the psychiatrists agreed on the diagnosis of schizophrenia for only 54% of 154 patients.
How does the DSM (Diagnostic and Statistical Manual) compare to the ICD (International Classification of Diseases) in terms of reliability?
DSM is regarded as more reliable than ICD because the symptoms in each category of the DSM are more specific.
The specificity in DSM leads to more consistent diagnoses.
What did Osorio (2019) report about the reliability of the DSM-5 in diagnosing schizophrenia?
Osorio (2019) reported excellent reliability for diagnosing schizophrenia using the DSM-5.
Inter-rater reliability was 97%, and test-retest reliability was 92%.
What is inter rater reliability?
multiple people make the same measurement, to see how similar their measurements are.
What does Osorio’s (2019) study suggest about the reliability of schizophrenia diagnoses over time?
The study suggests that the reliability of diagnosing schizophrenia has improved over time, particularly with updates to the DSM.
What is a limitation of the criteria for diagnosing mental illness?
does not specify a precise set of symptoms but suggest that some symptoms in each category should be present.
This lack of precision can lead to misdiagnosis.
What was the aim of Rosenhan’s study “On Being Sane in Insane Places”?
The aim was to investigate the reliability of diagnosing mental illness and assess the subjectivity and validity of diagnostic tools.
What was the method used in Rosenhan’s study?
Rosenhan recruited 8 people, all free from illness, who pretended to hear unfamiliar voices (“empty,” “hollow,” and “thud”) to be admitted to psychiatric hospitals.
All were diagnosed with schizophrenia, despite behaving normally once admitted.
What was the outcome for the participants in Rosenhan’s study?
Seven of the eight participants were diagnosed with schizophrenia.
Once admitted, they behaved normally but felt powerless and fearful.
They had difficulty convincing hospital staff that they were sane, and their stays ranged from 7 to 52 days.
How did Rosenhan’s study improve the diagnosis of schizophrenia?
The study highlighted the unreliability of psychiatric diagnoses and helped improve the reliability of diagnosing schizophrenia by showing how diagnostic labels can affect perception.
What was the key finding of Rosenhan’s study?
“Normal” behavior was often interpreted as abnormal.
The study revealed the unreliability of diagnosing mental illness, as patients were perceived according to the labels given to them.
What did Rosenhan test in his study regarding doctors’ diagnoses?
how long it would take for doctors to declare the volunteers as healthy after they had been admitted to the hospital.
What are the 4 issues with schizophrenia diagonsis?
- cultural bias
- gender bias
- co-morbidity
- overlap of symtpoms
What is cultural bias?
Researchers misrepresent the differences between cultures.
How does cultural bias affect the diagnosis of schizophrenia?
Cultural bias can affect the diagnosis of schizophrenia because social norms and cultural beliefs arent taken into account.
When someone assumes that other cultures behave the same as their own, it can lead to misdiagnosis or misinterpretation.
What is ethnocentric bias in the context of diagnosing schizophrenia?
Ethnocentric bias occurs when doctors from one cultural background judge the behaviors of individuals from another culture based on their own cultural norms.
This can lead to a higher likelihood of diagnosing mental disorders in people from different cultures.
How might cultural differences lead to different diagnoses of the same patient?
Two doctors with different cultural backgrounds might give the same patient a different diagnosis based on their own cultural perceptions and norms.
This highlights the impact of cultural bias on diagnosis.
How might African cultural beliefs affect the diagnosis of schizophrenia?
In some African cultures, positive symptoms like hearing voices may be more acceptable due to beliefs regarding communication with ancestors.
British psychologists might over-interpret these behaviours and classify them as symptoms of schizophrenia, showing cultural differences in diagnosis.
How does cultural bias reduce the reliability of a diagnosis?
Cultural bias can reduce the reliability of a diagnosis because the same patient may receive different diagnoses depending on the cultural background of the doctor.
This inconsistency indicates a lack of reliable diagnostic practices across cultures
What is evidence that cultural bias affect schizophrenia diagnosis?
Cochrane conducted a review comparing schizophrenia diagnoses in the Caribbean and Britain.
Afro-Caribbean people were 7 times more likely to be diagnosed with schizophrenia in Britain than in the Caribbean.
What is gender bias in psychology?
When the differences between men and women are misrepresented.
What are the two ways doctors can display gender bias?
- Alpha bias - over-exaggerating differences in men and womens behaviour
- Beta bias - ignore real difference between men and women
How does gender bias reduce the reliability of schizophrenia diagnosis?
Patients with the same symptoms might get different diagnosis depending on their gender
How does gender bias reduce the validity of schizophrenia diagnosis?
If the criteria used to diagnose schizophrenia over or under-exaggerate the differences between men and women, then they won’t correctly identify schizophrenia in all men and women
What is alpha bias?
over-exaggerating differences in men and womens behaviour
What is Beta bias?
ignore real difference between men and women
Who conducted a study to support gender bias affecting the reliability of schizophrenia diagnosis?
Loring and Powell
What method was used in Loring and Powell’s study?
They gave male and female doctors identical descriptions of a patient’s symptoms.
They varied the patient’s gender.
What were the findings of Loring and Powells study?
When the patient was described as female, 20% of doctors diagnosed the patient with schizophrenia.
When the patient was described as male, 56%
of doctors diagnosed the patient with schizophrenia.
This indicates there may be alpha bias in the diagnosis of schizophrenia.
What is comorbidity?
When two or more conditions occur together
What happens when co-morbidity rates are high for two conditions?
the validity of diagnostic/classification may be questioned as they may actually be one condition
Who conducted a study for co-morbidity affecting diagnosis of schizophrenia?
Buckley
What was Buckleys study?
Buckley investigated how many schizophrenic patients had a comorbid mental disorder.
He found that: 50% of patients had depression and schizophrenia, 47% of patients had an addiction and schizophrenia, and 23% of patients had OCD and schizophrenia.
What is symptom overlap?
when he symptoms of schizophrenia considerably overlap with the symptoms of other disorders.
What happens to the validity of diagnosis when Patients might be diagnosed with the wrong disorder?
reduces the validity
How doe genetic alleles increase the risk of developing schizophrenia?
The more genetic risk alleles a person carries, the more likely they are to develop schizophrenia.
What does the genetic explanation say about schizophrenia?
There are multiple gene alleles that increase the risk of developing schizophrenia.
If members of our family have schizophrenia, we are more likely to develop schizophrenia.
The more genetic risk alleles a person has, the more likely they are to develop schizophrenia.
What does the genetic explanation of schizophrenia suggest about family members and the likelihood of developing schizophrenia?
It suggests that if family members have schizophrenia, it is more likely that you will develop schizophrenia due to sharing specific genes associated with the disorder.
What are the rates of developing schizophrenia based on genetic similarity according to Gottesman (1991)?
General population: 1%
Siblings (50% genes shared): 9%
Identical twins (100% genes shared): 46%
What did Tienara (1991) find about adopted children and schizophrenia?
Tienara found that 10% of children born to schizophrenic mothers developed schizophrenia, compared to 1% of children born to non-schizophrenic mothers, supporting the genetic explanation of schizophrenia.
What has research shown about the genetic nature of schizophrenia?
Schizophrenia is polygenic (involves multiple genes) and (different combinations of factors can lead to the condition).
Have candidate genes been identified for schizophrenia?
No single candidate gene has been identified. Schizophrenia is associated with multiple genes, including those involved in dopamine regulation (Dopamine hypothesis).
Who conducted an adoption study to support the biological explanation for schizophrenia?
Tienari
What was tienari’s study?
The experimental group was adopted children whose biological mothers had schizophrenia.
The control group was adopted children whose biological mothers did not have schizophrenia.
What did Tienari find in her adoption study?
Adopted children with biological mothers who have schizophrenia are more likely to develop the disorder than children whose biological mothers don’t have schizophrenia. This suggests that genetics plays an important role in the development of schizophrenia.
What is one assumption made by adoption studies?
Biological parents of children adopted at birth can influence a child’s genes but not their environment.
What did Tienari et al. find in their adoption study on schizophrenia development?
Children of biological parents with schizophrenia were more likely to develop schizophrenia themselves.
What does the neural correlates explanation look at?
the associations between the structure and function of the brain and symptoms of schizophrenia
What does the neural correlates explanation of schizophrenia say the disorder is caused by?
abnormal brain structure - enlarged ventricles
What evidence supports the hypothesis of neural correlates?
Suddath assessed disconcorant twins and found that the twin with schizophrenia had larger ventricles than the twin without schizophrenia
How do enlarged ventricles provide evidence for neural correlates?
Enlarged ventricles in the brain are often found in individuals with schizophrenia. This structural brain abnormality is thought to correlate with the severity of symptoms, such as cognitive dysfunction and psychosis. This suggests that the size of brain structures, like ventricles, may be linked to the neural processes involved in schizophrenia, providing evidence of neural correlates for the condition
What is a limitation of using enlarged ventricles as a hypothesis for the cause of schizophrenia?
The evidence from MRI studies is correlational, meaning that even if two variables (enlarged ventricles and schizophrenia) are linked, it doesn’t prove one causes the other. Additionally, the medication patients take to treat schizophrenia may act as a confounding variable, complicating the interpretation of the results.
What is dopamine?
‘feel good’ neurotransmitter
What does the dopamine hypothesis suggest about schizophrenia?
caused by abnormal brain function, particularly in the mesolimbic system, where dopamine has an excitatory effect. This leads to overactive neurons and higher levels of dopamine in people with schizophrenia.
How does dopamine affect neurons in the mesolimbic system of people with schizophrenia?
In people with schizophrenia, the mesolimbic system has higher levels of dopamine, causing neurons to generate more electrical activity than normal.
What are neurotransmitters and what do they affect?
the brains chemical messengers which affect the rate of firing between neurons
Which part of the brain is affected by dopamine overactivity in schizophrenia?
Neurons are overactive specifically in the mesolimbic system (sub cortex) in people with schizophrenia.
How does neuron overactivity in the mesolimbic system (sub cortex) relate to symptoms of schizophrenia?
causes delusions in people with schizophrenia.
According to the dopamine hypothesis, how do increased levels of dopamine in the mesolimbic pathway affect neurons?
Increased levels of dopamine in the mesolimbic pathway cause neurons to become overactive, which is thought to contribute to the positive symptoms of schizophrenia.
What is hyperdopaminergia?
Hyperdopaminergia refers to having too much dopamine, specifically higher-than-normal levels of dopamine in the subcortex. This excess dopamine can contribute to the positive symptoms of schizophrenia, such as delusions and hallucinations.
What is hypodopaminergia?
too little dopamine - refers to faulty dopamine systems in the brain, particularly lower-than-normal levels of dopamine in the prefrontal cortex.
How does hypodopaminergia contribute to schizophrenia?
Lower levels of dopamine in the prefrontal cortex, as seen in hypodopaminergia, can lead to the negative symptoms of schizophrenia, such as apathy, lack of motivation, and social withdrawal.
What is the first strength of the dopamine hypothesis?
A strength of the dopamine hypothesis is that there is evidence supporting the idea that dopamine causes positive symptoms of schizophrenia, such as hallucinations and delusions.
What is the second strength of the dopamine hypothesis?
A strength of the dopamine hypothesis is that antipsychotic drugs have been shown to reduce psychotic symptoms, supporting the idea that dopamine plays a key role in schizophrenia.
What is the first limitation of the dopamine hypothesis?
A limitation of the dopamine hypothesis is that antipsychotic drugs take several weeks to reduce positive symptoms, despite blocking dopamine receptors almost immediately.
What are the 3 biological explanations of schizophrenia?
- neural correlates
- genetic explanation
- dopamine hypothesis
What are the two biological treatments for schizophrenia?
- typical antipsychotic drugs
- atypical antipsychotic drugs
What effect does antipsychotic medication for schizophrenia have on the brain?
It reduces dopamine levels.
How do antipsychotic drugs work - long answer?
Antipsychotic drugs work by preventing dopamine from binding to post-synaptic receptors. When higher levels of dopamine are released in the mesolimbic system, more dopamine binds to receptors, leading to an influx of positively charged particles into the post-synaptic neuron, causing overactivity. Antipsychotics reduce this overactivity by blocking dopamine from binding to these receptors, thereby calming the mesolimbic system.
What type of schizophrenia symptom do typical antipsychotic drugs prevent?
positive symptoms
What is the main typical antipsychotic drug?
Chlorpromazine - the first frug treatment for schizopehrnia
How do antipsychotic drugs work - short answer?
They block dopamine receptors.
What is Chlorpromazine and when was it introduced?
Chlorpromazine was introduced in the 1950s as the first drug treatment for schizophrenia. It blocks dopamine receptors in the brain to reduce dopamine levels, helping to alleviate symptoms like hallucinations.
How does Chlorpromazine reduce hallucinations in schizophrenia?
Chlorpromazine reduces the frequency and severity of hallucinations by lowering dopamine levels in the brain, which are involved in perception (seeing, hearing, emotions, etc.).
How is Chlorpromazine administered?
Chlorpromazine is taken as a tablet, syrup, or injection, with doses gradually increasing up to 800mg daily.
who conducted a study investigating the use of antipsychotic drugs?
Cole
What did Cole (1964) find in his study on antipsychotic drugs?
Cole (1964) found that 6 weeks of antipsychotic drug treatment led to significant improvement in 75% of schizophrenia cases, compared to only 25% with placebos.
What are the common side effects of typical antipsychotic drugs?
Side effects include dizziness, agitation, sleeplessness, stiff jaw, and weight gain.
What happens if too many dopamine receptors are blocked by antipsychotic drugs?
Blocking too many dopamine receptors can upset muscle control, causing muscle tremors similar to Parkinson’s disease.
How can side effects of typical antipsychotics be managed?
Some side effects can be reduced or eliminated with anti-Parkinsonian drugs. However, long-term use may lead to tardive dyskinesia, which is difficult to eliminate.
What is tardive dyskinesia?
Tardive dyskinesia is a side effect of long-term use of antipsychotic drugs, involving uncontrollable movements, and is difficult to eliminate.
What do typical antipsychotics bind to?
dopamine receptors/ D2 receptors
When were atypical antipsychotic drugs introduced and why?
Atypical antipsychotic drugs were introduced in the 1970s to reduce both positive and negative symptoms of schizophrenia, with clozapine being the most effective and commonly used.
What is the main atypical antipsychotic drug?
Clozapine
What makes antipsychotic drugs “atypical”?
affect various neurotransmitters, not just dopamine. They block D1, D2, D3, and D4 receptors
What is the usual dosage of Clozapine and how is it administered?
Clozapine is taken as a daily dosage of 300-400mg, and it is never administered as an injection.
How do atypical antipsychotic drugs help people who do not respond to typical drugs?
affect the combination and balance of chemicals in the brain, which has proven effective for schizophrenics who have not responded to typical antipsychotic drugs.
What are some common side effects of atypical antipsychotic drugs?
irregular heartbeat, weight gain, excessive salivation, and increased risk of diabetes.
Why do atypical antipsychotic drugs produce a range of side effects?
block a range of neurotransmitters, leading to a variety of side effects. Risperidone, for example, binds well to dopamine and serotonin receptors, leading to fewer side effects.
How do the side effects of atypical antipsychotic drugs compare to typical antipsychotic drugs?
Generally, side effects are less frequent with atypical antipsychotic drugs compared to typical antipsychotic drugs.
What is the first strength of drug therapy in schizophrenia?
An advantage of drug treatment for schizophrenia is that individuals can begin to lead a more normal life.
What is the first limitation of drug therapy in schizophrenia?
A limitation of drug treatment for schizophrenia is that it is not a cure, and its effects are temporary.
What is the second limitation of drug therapy in schizophrenia?
A limitation of both typical and atypical drug treatments for schizophrenia is the presence of significant and undesirable side effects.
What do psychological explanations of schizophrenia focus on?
The family environment and the role of abnormal cognition in the development of schizophrenia
What does the cognitive explanation say about schizophrenia?
Schizophrenia is associated with abnormal information processing affecting cognitive functions
According to the cognitive explanation of schizophrenia, what are the symptoms of schizophrenia are caused by?
Dysfunctional thought processes
What are the two types os dysfunctional thought processes?
- meta representation
- central control
What is meta representation?
meta-representation is a cognitive ability that allows individuals to overview their own thoughts, actions, and goals, as well as interpret those of others.
What does dysfunction of meta representation do?
Dysfunction of meta-representation distorts our ability to recognise thoughts or actions as being carried out by ourselves rather than someone else.
What is central control?
cognitive ability to suppress automatic responses so that we can focus on more purposeful actions. Suppressing thoughts associated with speech and language enables us to concentrate
What does dysfunction of central control do?
Leads to derailment become of form of speech, because each word triggers associations
How do dysfunctional mental processes cause delusions?
Dysfunctional mental processes, such as impaired attention and reasoning, can lead to delusions. Patients may overfocus on irrelevant details and coincidences, making them feel more significant than they are.
Who conducted a study to give support for the cognitive explanations for schizophrenia?
Stirling
How does dysfunctional attention contribute to delusions?
causes patients to overfocus on irrelevant details and coincidences, making them feel more important or meaningful than they actually are.
What is a strength of the cognitive explanation of schizophrenia?
A strength of the cognitive explanation of schizophrenia is that it is supported by evidence showing differences in information processing between patients with schizophrenia and non-schizophrenic individuals.
What is a limitation of the cognitive explanation of schizophrenia?
A limitation of the cognitive explanation of schizophrenia is that it does not establish clear cause and effect between cognitive factors and the disorder.
How can the cognitive explanation be used to treat schizophrenia?
Cognitive behavioural therapy
What is the main aim of CBT?
To challenge patients’ irrational beliefs and thought processes, to make sense of their irrational cognition
What happens in CBT?
Explanation - the patient explains their symptoms
Normalisation - the doctor explains the patients feelings are normal
Challenging - The doctor challenges beliefs and experiences.
Alternative explanations - The patient is asked to develop alternative explanations for beliefs and experiences.
What does CBT do?
CBT corrects the biases in reasoning that the patient displays, such as the jumping to conclusion bias and persecution bias.
Who conducted a study to support CBT treating shcizopehrnia?
Tarrier
What was Tarriers study?
Reviewed 20 trials of CBT with 739 patients and found short term benefits: reduced symptoms, lower relapse rates, faster recovery rates.
What is a strength of CBT treating schizophrenia?
A strength of Cognitive Behavioural Therapy (CBT) as a treatment for schizophrenia is the evidence supporting its effectiveness in reducing symptoms and improving recovery outcomes.
What is a limitation of CBT treating schizophrenia?
A limitation of Cognitive Behavioural Therapy (CBT) for treating schizophrenia is that it relies on the patient’s ability to talk about and have insight into their condition.
In 1950s what was schizophrenia thought to be caused by?
the stress of living in a dysfunctional family
What types of symptoms can be caused by stress as a result of family dysfunction?
Both Positive and Negative Symptoms.
What 3 dysfunctional characteristics for parents of schizophrenics tend to show?
- high levels of conflict (arguments)
- Difficulties in communicating with each other
- Highly critical and controlling their children
What does the family dysfunction explanation for schizophrenia suggest?
Family conflict leads to stress and confusion in individuals, which causes the development of schizophrenia.
What are two types of family conflict that can lead to schizophrenia?
- double bind
- levels of high expressed emotions
What is a double bind?
A risk factor for schizophrenia - when a parent may say one thing but their body language and tone suggests the opposite.
What is an example of double bind?
A mother may ask for a cuddle, but non verbally push the child away by keeping them at arms length
Who introduced the phrase double bind to describe how children are given conflicting messages from parents?
Bateson
Why are individuals more likely to develop schizophrenia if they are exposed to more double bind situations?
may lead to confused understanding of the world which is reflected in disorganised thinking/paranoid delusions
negative reaction of social withdrawal and flat affect to escape double bind situations
According to the family dysfunction explanation, what is a consequence of the stress and confusion caused by double bind situations?
Increased risk of developing schizophrenia.
What are high expressed emotions?
What symptoms are associated with high expressed emotions in families?
What can High expressed emotions in families trigger?
Who conducted a study to support high expressed emotions involvement in schizophrenia?
Brown
A high degree of expressed emotion is when…?
Members of a family speak to each other in negative ways, consistently expressing lots of criticism and complaints about what everyone else is doing.
What was Browns method for investigating high expressed emotions association with schizophrenia?
investigated people recovering from schizophrenia who were discharged from hospital over a 9 month period
What did Brown find from his study?
Found 58% relapse rates for patients returning to families where expressed emotions was high and 10% where expressed emotions were low.
What is the first limitation for family dysfunction?
A limitation of the evidence linking family dysfunction to schizophrenia is the validity of the evidence itself, particularly due to the retrospective nature of much of the research.
What is the second limitation for family dysfunction?
A limitation of the family dysfunction explanation for schizophrenia is that there is no definable cause and effect, and the relationship may be correlational.
What is the third limitation for family dysfunction?
A limitation of the family dysfunction explanation for schizophrenia is the lack of scientific evidence supporting the theory of double binds.
How can psychological therapies linking to family dysfunction explanation be used to treat schizophrenia?
Family therapy
What view is family therapy based on?
that the sufferer is a symptom of issues within the family
What does family therapy aim to do?
change patterns of communication and interaction. tries to reduce the family stress that puts patients at risk of relapse and aims to reduce levels of expressed emotions
Who identified strategies to improve family functioning?
Pharoah
What were Pharoahs strategies to improve family functioning?
- reducing negative emotions and levels of expressed emotions
- improving the family ability to help each other by encouraging family members to improve belief towards schizophrenia
Who conducted a study to support family therapy’s role in treating schizophrenia?
Hogarty
What was Hogarty’s find from his study?
Found that family therapy helps prevent relapse rates in schizophrenia but when combined with social skills training and medications relapse rates us very low:
Medication only: 40%
Medication and SST or family therapy: 20%
Medication and SST and family therapy: 0%
What is the first strength of family therapy?
A strength of family therapy in treating schizophrenia is the evidence supporting its effectiveness in reducing relapse rates.
What is a limitation of family therapy?
A limitation of family therapy for schizophrenia is that its effectiveness may diminish after treatment ends.
What is the second strength of family therapy?
Another strength of family therapy for schizophrenia is its cost-effectiveness in the long term.
What are token economies?
What do token economies do?
They encourage positive behaviour by associating it with a reward.
What do token economies use?
They use operant conditioning to encourage positive behaviour (psoitive reinforcement)
How are token economies used to manage patient behaviour in the hospital?
Patients are given reward tokens when they engage in positive, adaptive behaviour.
Tokens can be exchanged for tangible rewards.
The patient learns to repeat positive, adaptive behaviours through positive reinforcement.
Based on the theory of behaviourism what reinforces are tokens are rewards?
Tokens are secondary reinforcers
Rewards are primary reinforcers
What is token economy useful for?
behavioural management in institutional settings
Who identified three categories of institutional behaviour commonly tackled by means of token economy?
Matson
What were the 3 categories identified by Matson?
- personal care
- condition releated behaviours
- soical behaviour
What can token economies do to someone with schizophrenia?
Improve the personas quality of life within the hospital and normalises the behaviour to make it easier to adapt to community life
Who conducted research into token economies?
Ayllon and Azrin
What did Ayllon and Azrin when look at token economies?
Trialed a token economy system in a ward of women with schizophrenia . Tokens were awarded for tasks such as making a bed or cleaning up and could then be swapped for ward privileges. They found that the number if tasks carried out increased significantly
What is a strength of token economies?
A strength of token economies is that they have ecological validity, as they have been tested in real-life settings.
What is a limitation of token economies?
A limitation of token economies is that they lack validity, as it is often unclear whether the improvements in behaviour are actually due to the token economy.
What is needed for schizophrenia to develop?
A vulnerability and a stress trigger, both must be present as neither cause the condition on its own
What dies diathesis mean?
when someone is predisposed to developing the illness
A person having a diathesis for schizophrenia means that…
they carry biological risk factors that make them more likely to develop schizophrenia.
According to the interactionist explanation what causes schizophrenia?
The biological and psychology factors interact to cause schizophrenia
What does interactionist approach ackowledge?
Acknowledges that there are biological, psychological and societal factors in the development of schizophrenia
Who created the original diathesis stress model>
Meehl
What was Meehls model (the original diathesis stress model)?
That the vulnerability is genetic (schizogene) which then lead to the idea of a schizogenic personality
Therefore if a person did not have the schizogene, no amount of stress will lead to schizophrenia
However from a modern understanding of diathesis, what do we know about schizogenes?
There is no schizogene, instead many genes slightly increase genetic vulnerability
What is the modern understanding of diathesis?
Factors other than genes can act as diathesis
What is the modern definition of stress for the diathesis stress model?
Relates to anything that risks triggering schizophrenia
What factors can trigger schizophrenia?
cannabis (x7) - due to its effect if the dopamine system
What does the diathesis-stress model suggest about schizophrenia?
According to the diathesis-stress model, people with a diathesis (genetic or biological vulnerability) only develop schizophrenia if they experience significant psychological stress in their environment.
How do biological factors relate to schizophrenia in the diathesis-stress model?
Biological factors act as a risk factor, giving people a diathesis (vulnerability) for developing schizophrenia.
How does stress influence the likelihood of developing schizophrenia?
The more stress people experience, the more likely they are to develop schizophrenia.
How does diathesis influence the likelihood of developing schizophrenia?
The greater the diathesis (biological vulnerability), the more likely a person is to develop schizophrenia.
Who provides evidence from an interactionist level for treatment schizophrenia?
Hogarty
What did Hogarty find in his study?
Found that family therapy helps to prevent relapse in schizophrenia but when combined with social skills training and medication, relapse is very low
Medication only = 40%
Medication + SST or FT = 20%
Medication + SST + FT = 0%
What is a strength for the interactionist approach with vulnerability and triggers developing schizophrenia?
A strength of the interactionist approach is that there is strong supporting evidence from adoption and twin studies, demonstrating the role of both genetic vulnerability and environmental triggers in the development of schizophrenia.
What is a limitation for the interactionist approach?
A limitation of the interactionist approach is that Meehl’s original diathesis-stress model is overly simplistic.
What is a strength for vulnerability and triggers develop schizophrenia?
A strength of the interactionist approach to schizophrenia is that it has led to the development of more effective treatment strategies.
