Schizophrenia Flashcards
Reliability and Validity: AO1.
Reliability: must be able to reach the same conclusion. Copeland: 69% US and 2% UK psychiatrists diagnosed schizophrenia.
Luhrmann et al: Africans heard more positive voices, US heard more angry voices.
Validity: gender bias, women are perceived as less mentally healthy.
Ellason and Ross: dissociative identity disorder, more schizophrenic symptoms than schizophrenics.
Co-morbidity: 1% with schizophrenia, 2-3% of these develop OCD.
Reliability and Validity: AO3.
Loring and Powell: male - 56% diagnosis, 20% diagnosis when female. Less evident with female psychiatrists.
Co-morbidity may also be with non-psychiatric diagnoses.
Rarely share same symptoms or outcomes.
Whaley: interrater reliability as low as 0.11. Unreliable, subjective symptoms.
Ethnic culture hypothesis: non-minority group more symptomatic than ethnic groups.
Biological Explanations: AO1.
Genetic factors: Gottesman: 2 schizophrenic parents, 46% concordance, 1 schizophrenic parent, 13% concordance, siblings, 9% concordance.
Joseph: monozygotic, 40.4%, dizygotic, 7.4%.
Tienari et al: mothers with schizophrenia 6.7%, control, 2%.
Neural correlates: abnormally high D2 receptors. Amphetamine/L Dopa - dopamine agonists.
Antipsychotics - dopamine antagonists.
Davis and Kahn: positive symptoms, excess of dopamine, subcortical areas. negative symptoms, deficit of dopamine, prefrontal cortex.
Neural imaging, animal studies.
Biological Explanations: AO3.
Common rearing patterns may explain family similarities. Monozygotic twins experience more similar environments.
Adoptees may be selectively placed.
Leucht et al: meta anaalysis of 212 studies, antipsychotics compared with a placebo.
Dopamine agonists also affect other neurotransmitters. Some people have delusions/hallucinations regardless of dopamine levels.
Psychological Explanations: AO1.
Double Bind Theory: Bateson et al: contradictory messages from parents, more likely to develop schizophrenia.
Berger: higher level of double bind statements.
Expressed Emotion: hostile, critical, over-involvement. Talk more, listen less. 4x more likely to cause relapse.
Schizophrogenic mother: conflict, distrust. Did not exist. Delusion: inadequate cognitive process - egocentric bias.
Hallucinations: focus on auditory stimuli.
Psychological Explanations: AO3.
Genetic vulnerability not sufficient.
Liem: patterns of parental communication no different.
Individual differences, vulnerability to expressed emotion.
Biases found in cognition towards hallucinations/delusions.
CBTp applications.
Deals with some aspects but ignores others.
Diathesis-stress model.
Antipsychotics: AO1.
Typical: dopamine antagonists bind to dopamine receptors. Kapur et al: 60-75% of dopamine receptors need to be blocked.
Atypical: lower risk of extrapyramidal side effects. Effect on negative symptoms. Temporary blocking. Stronger affinity for serotonin.
Antipsychotics: AO3.
Leucht et al: meta analysis, 64% of placebo, 27% of antipsychotics had relapsed.
Results in motor side effects, tardive dyskinesia.
Cost-benefit analysis would likely be negative.
Crossley et al: atypical gained more weight, lesss side effects.
No difference in efficacy.
Ross and Read: reinforces the view that something is wrong with them.
Ignores stressors.
Cognitive Behavioural Therapy: AO1.
Assessment/discussion, engagement, ABC model, normalisation, critical collective analysis, alternative explanations.
Traceback symptoms.
Works on distorted beliefs.
Cognitive Behavioural Therapy: AO3.
Effective in reducing rehospitalisation, 18 months. More effective at certain stages of schizophrenia. Relatively unavailable. Only 6.9% offered CBTp. Wykes et al: more rigorous studies, weaker effect of CBTp. Benefits may be overstated.
Family Therapy: AO1.
Pharoah et al: 53 studies, mixed mental state improvement, complied with medication, improvement in general functioning, reduced risk of relapse.
Prioritised where there is a risk of relapse. Works to reduce expressed emotion.
Garety et al: relapse rate of 25%, 50% control.
Family Therapy: AO3.
Effective in improving mental and social functioning. May be due to compliance with medication. Pharoah: random allocation may be problematic. Lack of blinding. Economic benefits. Positive impact on non-schizophrenic family. May not improve outcomes overal..
Token Economy: AO1.
Paired with rewarding stimuli > target behaviours > given tokens > trade tokens for privileges.
Assigned value. Ayilon and Azrin: female schizophrenic patients, improved behaviours.
Dickerson et al: 13 studies, 11 were beneficial.
Token Economy: AO3.
Token economy supported with research. Difficult to assess success. More useful in a hospital circumstance. Ethical concerns. Questionable as to whether it works or not.
Diathesis-Stress Model: AO1.
Tienari et al: hospital records, adoptees reviewed at 12 and 21 years. OPAS scale used to measure adoptive families. 14 developed schizophrenia, 11 from high risk.
Genetic predisposition/biological influences interact with environmental influences.
