Schizophrenia

Question 1

psychological therapy CBT AO2

Answer 1

Not in isolation Kingdon - 142 unsuitable, combine

Necessary? - comorbidity disorder, triggers, function with symptoms

Tarrier - effective (less pos sympt and hospital time) had lasted after a year…. Drop out rate…

Appropriateness- young, higher IQ, mild schizophrenics who won’t take drugs - can function. Others need a combination

Educational part also used successfully in family therapy, flexible

Question 2

psychological therapy CBT AO1

Answer 2

Cog assumptions
Not cure-> education 
9-12 weeks, trusted therapist
Re-evaluate irrational beliefs eg...
Triggers & coping mech

Question 3

Biological therapy AO1

Answer 3

Typical antipsychotics - dopamine antagonists
Bind to D2 receptors (frontal and temporal lobe)
Do not stimulate
Block dopamine
Reduce activity - relieves pos symptoms (not cure)

...Atypicals 1990s - dopamine and serotonin
Positive and negative symptoms
Mechanism unsure
Rapidly disassociate 
No fluctuation

Question 4

Biological therapies AO2

Answer 4

Effectiveness Typicals - Davis (19% relapse compared to 55%), yet… Ross and Read & irrelevant improvement

Effectiveness and appropriateness atypicals - effective, costly, long term effects unknown

Appropriateness - side effects: tardive dyskinesia 30% (70%) vs. 5%, weight gain, white blood cells - case by case basis

Complacency & preparing for potential relapse use with CBT. Gould

Question 5

Diagnosis - AO1

Answer 5

(What are reliability and validity)
Rosenhan -12 thud hollow
52 days -invalid
2nd imposer detection rate 1 in 5, 42/193.
- unreliable ‘confirmation bias’
DSM (include current classification if ness?)

Question 6

Diagnosis -AO2

Answer 6

Whaley: Inter-rater correlation 0.11, bizarre delusion 50 top psychologists 0.40 correlation
Cultural diffs - Japan, Copeland 63% vs. 2%,
ICD and DSM aligned. >0.50 inter rater reliability
Cog screening tests, Wilks, 0.84

Comorbidity 50% depression, classification entangled
Beutal, Ellason and Ross

Low predictive validity 2000

Come a long way, many diagnosed successfully, progress still being made

Question 7

Biological explanations - AO1 and AO2

because I am not sure which is which and I hope I have enough AO1

Answer 7

Inherited
Gottesman - 48% compared to 17%, and 1%. talk on in fair detail
(Daniels - nature/nurture - 17% vs. 9%) - womb affects biology
Heston. use of adoption studies- 47 + 50, -> 5, (confirmation bias, Rosenhan?)
GWAS - triangulation

Environment - 48% Gottesman. Tienari -> diathesis Stress
reductionist - Dopamine hypothesis D2 receptors, amphetamines, antipsychotics

Overall, -best exp. but should combine

Question 8

Psychological explanation - AO1

EE

Answer 8

Family dysfunction
George Brown 1956 - 156, parents and wives vs. alone and siblings, mum working….
proposed EE - criticism, hostility, emotional over-involvement, warmth, positive comments
high former 3, intense, verbal confrontation
social withdrawal, dependence, frustration and guilt, relapse

Question 9

Psychological explanations - AO2

EE

Answer 9

58% vs. 10% (20%) However challenged aetiology. Liam high EE after disorder begins. Tienari diathesis stress model, EE trigger
No cultural diffs in Brazil (although are in high EE Iran)
Implications - family therapy. Re-education (interviews Brown and Rutter, 75% negative symptoms)
self-report methods - paranoid schizophrenic, yet moving out -> drop in relapse rates (some effect)
not underlying cause, amendable trigger for relapse

Question 10

Family therapy

Answer 10

AO1 - high EE issue. Re-education of family
trusted therapist 9 months to year depending
improve communication, reduce 3 bad things, improve 2 good
teach what to expect, Brown and Rutter interviews…
develop this into AO2 - re-educuation effective (therefore applicable to unknowing, well meaning fams)

only for willing, close families, sometimes separation better instead, effectiveness limited by ppts
effective 10%, 58%

not stand alone , combine (in order to be able to participate?)