Schizophrenia

Question 1

Mäkinen et al. (2008)

Answer 1

1/3 of schizophrenics suffer from significant negative symptoms.

Question 2

Milev et al. (2005)

Answer 2

The more negative symptoms, the worse the functional outcome for the patient.

Question 3

Sarkar et al. (2010)

Answer 3

Physical, rather than social, anhedonia is a more reliable symptom of schizophrenia.

Question 4

Saha et al. (2005)

Answer 4

0.04% of people have schizophrenia at some point in their lives.

Question 5

Regier et al. (2013)

Answer 5

Diagnoses of schizophrenia only had a kappa (inter-rater reliability) score of 0.46 (not great).

Question 6

Copeland (1971)

Answer 6

US clinicians were much more likely to diagnose schizophrenia than British clinicians.

Question 7

Luhrman et al. (2015)

Answer 7

African and Indian schizophrenics described their voices as playful and helpful whereas US schizophrenics said they were violent and distressing.

Question 8

Broverman et al. (1970)

Answer 8

US clinicians (in 1970) saw ‘healthy behaviour’ as healthy male behaviour and so women are more at risk of diagnosis.

Question 9

Ellason and Ross (1995)

Answer 9

People with dissociative identity disorder (DID) have more schizophrenic symptoms than schizophrenics.

Question 10

Buckley et al. (2009)

Answer 10

50% of schizophrenics also have depression and 47% also have substance abuse.

Question 11

Read (2004)

Answer 11

Most schizophrenics have enough symptoms to be diagnosed as having another illness.

Question 12

Swets et al. (2014)

Answer 12

12% of schizophrenics fit the criteria for OCD and 25% displayed obsessive-compulsive symptoms.

Question 13

Loring and Powell (1988)

Answer 13

Males are more likely to be diagnosed as schizophrenic than women by 36 percentage points.
+
Male psychiatrists are more likely to diagnose the illness than female psychiatrists.

Question 14

Weber et al. (2009)

Answer 14

Patients diagnosed with a psychiatric disorder are less likely to receive adequate medical care and so schizophrenics often had a host of physical illnesses.

Question 15

Rosenhan (1973)

Answer 15

Fake patient study: hospital staff cannot spot healthy people
+
When they look for actors who aren’t there, the think that ill people are pretending.

Question 16

Malmburg et al. (1998)

Answer 16

Gender affects prognosis for schizophrenia.

Question 17

Harrison et al. (2001)

Answer 17

Psycho-social factors (social skills, academic achievement etc.) affected prognosis for schizophrenia.

Question 18

Whaley et al. (2001)

Answer 18

Kappa score for schizophrenic diagnosis as low as 0.11.

Question 19

Mojtabi and Nicholson (1995)

Answer 19

Bizarre delusions are the central point of schizophrenia but when asked what were ‘bizarre’ and ‘non-bizarre’ delusions, senior US clinicians produced a kappa score of only 0.40.

Question 20

Barnes (2004)

Answer 20

Ethnic culture hypothesis: schizophrenics from ethnic minorities experience less distress because they have supportive and protective social structures in their ethnic minority cultures.

Question 21

Brekke and Barrio (1997)

Answer 21

Schizophrenics from ethnic majority groups are more symptomatic than those from ethnic minority groups.

Question 22

Gottesman (1991)

Answer 22

Child Concordance rates:
2 schizophrenic parents: 46%
1 schizophrenic parent: 13%
1 schizophrenic sibling: 9%

Question 23

Joseph (2004)

Answer 23

Concordance rate for MZ twins was 40.4% and 7.4% for DZ twins.

Question 24

Tienari et al. (2000)

Answer 24

6.7% of adopted children who had schizophrenic biological mothers developed schizophrenia compared to 2% of the control.

Question 25

Grilly (2002)

Answer 25

Giving L-dopa to individuals with Parkinson's disease (to raise dopamine) caused them to exhibit schizophrenic symptoms.

Question 26

Davis and Kahn (1991)

Answer 26

Positive symptoms of schizophrenia are cause by excess dopamine whilst negative symptoms are caused by a dopamine deficit.

Question 27

Patel et al. (2010)

Answer 27

Schizophrenics have lower levels of dopamine in their dorsolateral prefrontal cortex.

Question 28

Wang and Deutch (2008)

Answer 28

Reducing dopamine in the prefrontal cortex of rats results in cognitive impairment.

Question 29

Kringlen (1987)

Answer 29

"Because the adoptive parents evidently received information about the child's biological parents, one might wonder who would adopt such a child".

Question 30

Leucht et al. (2013)

Answer 30

Antipsychotics were more effective than placebo in reducing positive and negative symptoms of schizophrenia.

Question 31

Moncrieff (2009)

Answer 31

Stimulants like cocaine and amphetamine can induce schizophrenic episodes. + Post-mortem examinations have not supported the dopamine hypothesis.

Question 32

Noll (2009)

Answer 32

Antipsychotics don't work for 1/3 of patients and so the dopamine hypothesis doesn't explain it all. + A low EE family reduces a schizophrenics dependence on medication.

Question 33

Bateson (1956)

Answer 33

Double Bind Theory.

Question 34

Kuipers et al. (1983)

Answer 34

High EE relatives talk more and listen less than low EE relatives.

Question 35

Linszen et al. (1997)

Answer 35

A patient returning to a high EE family is 4 times more likely to relapse than a patient returning to a low EE one.

Question 36

Beck and Rector (2005)

Answer 36

Patients are unwilling or unable to consider that their delusions are wrong.

Question 37

Aleman (2001)

Answer 37

Schizophrenics find it difficult to distinguish between imaginary and sensory-based perception.

Question 38

Baker and Morrison (1998)

Answer 38

Hallucinating schizophrenics are more likely than non-hallucinating schizophrenics to misattribute self-generated auditory experience to an external source.

Question 39

Tienari et al. (1994)

Answer 39

Children of schizophrenic biological mothers only developed the illness if they were adopted into 'disturbed' families.

Question 40

Berger (1965)

Answer 40

Schizophrenics report having received more double bind statements from mothers than non-schizophrenics.

Question 41

Liem (1974)

Answer 41

Found no evidence to support double bind statements coming from mothers of schizophrenics.

Question 42

Hall and Levin (1980)

Answer 42

Found no difference in verbal and non-verbal communication for houses that produced schizophrenic and those that produced normal children.

Question 43

Altorfer et al. (1998)

Answer 43

1/4 of patients showed no physiological response to stressful comments from relatives.

Question 44

Lebell et al. (1993)

Answer 44

People perceive high EE comments differently, when they are not perceived as negative the likelihood of schizophrenia is reduced.

Question 45

Sarin and Wallin (2014)

Answer 45

Positive symptoms of schizophrenia are down to faulty cognition.

Question 46

Howes and Murray (2014)

Answer 46

Vulnerability factors combine with environmental factors to trigger abnormality in the dopaminergic systems (which causes the symptoms).

Question 47

Kapur et al. (2000)

Answer 47

Between 60 and 75% of D₂ receptors in the mesolimbic dopamine pathway need to be blocked for typical antipsychotic drugs to work.

Question 48

Leucht et al. (2012)

Answer 48

Antipsychotics are much better than placebo.

Question 49

Crossley et al. (2010)

Answer 49

No significant differences in efficacy between typical and atypical antipsychotics but they had different side effects. Typical antipsychotics = extrapyramidal side effects. Atypical antipsychotics = weight gain.

Question 50

Ross and Read (2004)

Answer 50

Prescription of medication reinforces the view that 'I am ill', and so patients will not look for other ways to improve their lives and conditions.

Question 51

Read and Haslam (2004)

Answer 51

The public think that social/environmental factors are the cause of schizophrenia rather than biological factors.

Question 52

NICE (2014)

Answer 52

UK health organisation: In combination with antipsychotics, CBTp was more effective at reducing symptom severity and improving functioning.

Question 53

Addington and Addington (2005)

Answer 53

In the initial phases of schizophrenia, self-reflection in CBTp is inappropriate. After stabilisation with antipsychotics, groups sessions is most effective at this stage.

Question 54

Haddock et al. (2013)

Answer 54

Only 7% of participants had been offered CBTp.

Question 55

Freeman et al. (2013)

Answer 55

Of the minority of schizophrenics who are offered CBTp, few accept treatment and attend sessions.

Question 56

Jüni et al. (2001)

Answer 56

Studies to test effectiveness of CBTp against drug therapy are very weak methodologically.

Question 57

Wykes et al. (2008)

Answer 57

The more sound the study was methodologically, the less effective CBTp appeared to be.

Question 58

Juahar et al. (2014)

Answer 58

CBTp had only a 'small' therapeutic effect on schizophrenics. In blind studies, CBTp had no effect.

Question 59

Taylor and Perera (2015)

Answer 59

Because of such sketchy evidence, there have been mixed recommendations in the UK for CBTp.

Question 60

SIGN (2013)

Answer 60

Scottish health organisation: recommended drug therapy rather than CBTp.

Question 61

Garety et al. (2008)

Answer 61

Relapse rates for recipients of family therapy were 25% whereas for standard care this was 50%. However having a carer was just as effective.

Question 62

Pharoah et al. (2010)

Answer 62

Family therapy boosted compliance with mediation and social functioning as well as reducing relapse rates although there was a lack of blinding in studies. + Main reason for overall effectiveness was increased compliance with medication.

Question 63

Wu et al. (2006)

Answer 63

Studies coming from China, about family therapy, falsely stated that random allocation had been used.

Question 64

NCCMH (2009)

Answer 64

NICE review of family therapies: they save money for hospitals because relapse rates are so low.

Question 65

Lobban et al. (2013)

Answer 65

60% of family interventions had at least one positive effect but methodology in family therapy studies is poor.

Question 66

Ayllon and Azrin (1968)

Answer 66

Used token economy on female schizophrenia ward and found that the number of desirable behaviours sharply increased.

Question 67

Sran and Borrero (2010)

Answer 67

Token economies work best when tokens can be exchanged for a wide variety of behaviours.

Question 68

Kazdin (1977)

Answer 68

Token economies work best when there is little time between token receipt and token exchange.

Question 69

Dickerson et al. (2005)

Answer 69

Token economies were effective at increasing the adaptive behaviours of schizophrenics.

Question 70

Comer (2013)

Answer 70

Studies of token economies are uncontrolled as all the patients take part in the scheme. An increase in staff attention may account for the change in behaviour.

Question 71

Corrigan (1991)

Answer 71

Token economy is very difficult to maintain outside of a clinical setting.

Question 72

McMonagle and Sultana (2000)

Answer 72

If proper research could be carried out, we would know whether or not token economy worked. It is only really practiced in developing countries.

Question 73

Varese et al. (2012)

Answer 73

Children who experienced severe trauma before the age of 16 were 3 times more likely to develop schizophrenia.

Question 74

Vassos et al. (2012)

Answer 74

People living in an urban environment are 2 times more likely to develop schizophrenia than those in rural settings.

Question 75

Tienari et al. (2004)

Answer 75

High-genetic-risk adoptees are far more likely to develop schizophrenia if they are raised in families judged as functioning poorly (using the Oulu Family Rating Scale, or OPAS).

Question 76

Verdoux et al. (1998)

Answer 76

Those who experienced obstetric (lack of oxygen) birth complications were 4 times more likely to develop schizophrenia.

Question 77

Romans-Clarkson et al. (1990)

Answer 77

Found no difference in mental health between urbanites and ruralists.

Question 78

Paykel et al. (2000)

Answer 78

The difference in probability of schizophrenia between urban and rural environments are actually down to socio-economic factors.

Question 79

Hammen (1992)

Answer 79

Poor coping methods for stress constructed in childhood will make someone's life more stressful, increasing the risk of mental illness.

Question 80

Børglum et al. (2014)

Answer 80

Pregnant women infected with cytomegalovirus was more likely to have a child with schizophrenia, but only if both she and the child had a certain gene defect.