Schizophrenia Flashcards

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1
Q

What is drug therapy

A

The treatment of mental disorders through the use of antipsychotics to reduce the symptoms of the disorder

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2
Q

What are the two types of antipsychotics used in treating schizophrenia

A

Typical and Atypical antipsychotics

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3
Q

What are Atypical antipsychotics

A

Carry a lower risk of extrapyramidal side effects, have a beneficial effect on negative symptoms and cognitive impairment and suitable for treatment resistant patient

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4
Q

What are typical antipsychotics

A

dopamine antagonists in that they bind to but not stimulate dopamine receptors and so reduce the symptoms of schizophrenia (Hallucinations and delusions)

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5
Q

how do antipsychotics work

A

they work by reducing dopaminergenic transmission in areas of the brain associated with schizophrenia

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6
Q

What percentage of receptors must be blocked for the drugs to be effective.

A

Between 60 and 75%

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7
Q

What do a typical antipsychotics show relating to D 2 receptors

A

rapid disociation from D 2 receptors as well as strong affinity for serotonin receptors

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8
Q

What do a typical antipsychotics act as agonist for

A

serotonin

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9
Q

What is the benefit of having them as serotonin agonist

A

Leads to increase dopamine release in prefrontal cortex to reduce negative symptoms and cognitive impairment

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10
Q

What did Leucht et al. find regarding the placebo effect. (Evaluation) (support)

A

Antipsychotics were more effective than placebo of reducing relapse rates

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11
Q

What were the extrapyramidal side effects (Evaluation) (Weakness)

A

Can produce movement problems as typical antipsychotics impact areas of the brain that control motor activity

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12
Q

What are the ethical concerns with using typical antipsychotics (Evaluation) (weakness)

A

Cost benefit analysis maybe negative as well as human rights abuse because of side effects

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13
Q

What are the advantages of a typical of atypical antipsychotics (Evaluation)

A

There are fewer side effects using typical antipsychotics so patients are more likely to continue with the medication

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14
Q

What did Crossley et al. conclude regarding which antipsychotics are better (Evaluation)

A

There is no difference in efficacy but there are different side effects

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15
Q

What are motivational deficits of using antipsychotics (Evaluation)

A

Antipsychotic treatment reinforces the idea that something is wrong and reduces motivation to look for other possible causes

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16
Q

what are the 2 main psychological explanations for schizophrenia

A

family dysfunction and cognitive explanations

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17
Q

What is family dysfunction

A

Family dysfunction is the presence of problems within a family that contribute to relax rates in recovering schizophrenics, including a lack of warmth between parents and child, dysfunctional communication patterns on parental overprotection

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18
Q

What is the double bind theory of family dysfunction

A

The idea that conflicting messages within the family prevent coherent construction of reality, giving rise to schizophrenic symptoms

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19
Q

What is expressed emotion regarding family dysfunction

A

Family communication style is likely to influence relapse rate call stop suggests lower tolerance for intense environmental stimuli

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20
Q

Who had the double bind theory

A

Bateson et al. (1956)

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21
Q

Who performed research on expressed emotion

A

Kuipers et al. (1983)

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22
Q

What did Kuipers et al. (1983) find

A

High EE relatives are likely to talk more and listen less leading to increased relapse rates.

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23
Q

Who conducted research on relapse rates relating to expressed emotion and what were the findings

A

Linzen et al. (1997) found a patient returning to a family with high EE were around four times more likely to relapse than a patient whose family were low in EE

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24
Q

What are the 2 aspects of cognitive explanations to schizophrenia

A

Cognitive explanations of delusions and cognitive explanations of hallucinations

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25
Q

what are cognitive explanations of delusions

A

Egocentric bias leads people to relate irrelevant events to themselves and arrive at false conclusions

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26
Q

What are cognitive explanations of hallucinations

A

Hypervigilance leads to greater expectation to stimuli; a person is therefore likely to attribute these to external source

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27
Q

How can family relationships trigger schizophrenia (Evaluation)

A

Disturbed adoptive families on more likely to trigger schizophrenia in children with genetic vulnerability

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28
Q

Who found supporting evidence for the double bind theory (Evaluation)

A

Berger (1965)

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29
Q

What did Berger (1965) find in his research (Evaluation)

A

Schizophrenics reported a higher recall of double bind statement by their mothers than non schizophrenics

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30
Q

What is negative to the idea of expressed emotion (Evaluation)

A

There are individual differences in vulnerability to EE as not all schizophrenics respond negatively to high levels of EE

31
Q

Who found supporting evidence for the cognitive model of schizophrenia (Evaluation)

A

Sarin and Wallin (2014)

32
Q

What did Sarin and Wallin (2014) find (Evaluation)

A

They found evidence that supports positive symptoms arising from faulty processing

33
Q

How are cognitive explanations for schizophrenia supported by therapies (Evaluation)

A

The success of cognitive based therapies for schizophrenia reinforces the idea that symptoms of schizophrenia have their origin and faulty cognition

34
Q

What is a problem with the cognitive model for schizophrenia (Evaluation)

A

It deals adequately with one aspect of the disorder (cognitive impairment) but fails to deal with other aspects of the disorder (social adversity)

35
Q

What is the integrated model of schizophrenia (Evaluation)

A

The idea that early vulnerabilities sensitised open in systems meaning more dopamine is released in the biased processing results in paranoia/hallucinations

36
Q

What are genetic factors

A

Inherited factors that make certain individuals more likely to develop a behaviour or mental disorder

37
Q

What are the 3 types of studies of genetic factors affecting schizophrenia

A

Family studies, adoption studies and twin studies

38
Q

Who carried out family studies of genetic factors

A

Gohesman

39
Q

What did gohesman find in his family studies

A

Children with two schizophrenic parents had a concordance rate of 46% whereas with one schizophrenic parent concordance rates were 13%. For siblings concordance rate was 9%

40
Q

Who carried out twin studies into genetic factors

A

Joseph (2004)

41
Q

What did Joseph (2004) find in his twin studies

A

Greater concordance between MZ twins compared to DZ twins. 40.4% concordance for MZ twins compared to 7.4% for DZ twins

42
Q

Who carried out adoption studies into schizophrenia

A

Tienari

43
Q

What did tienari find in his adoption studies

A

Of 164 adoptees who’s mothers had schizophrenia 11 (6.7%) were also diagnosed with schizophrenia compared to just 2 of 197 (2%) of adoptees who didn’t have a parent with schizophrenia

44
Q

What is the evaluation point for twin studies

A

MZ twins encounter more similar environments which explains higher concordance rates

45
Q

What is the evaluation point for adoption studies

A

Adoptees may be selectively placed so adoptive parents of children at risk of schizo are not typical

46
Q

What is the dopamine hypothesis

A

An excess of the neurotransmitter dopamine in certain areas of the brain is associated with positive symptoms of schizophrenia

47
Q

What types of drugs increase dopamine

A

Amphetamines

48
Q

What can be a result of using amphetamines

A

Produce schizophrenic symptoms

49
Q

What types of drugs decrease dopamine levels

A

Antipsychotics

50
Q

What is the benefit of using antipsychotics

A

Reduce symptoms

51
Q

What is the revised dopamine hypothesis

A

Includes dopamine underactivity in the prefrontal cortex

52
Q

What provides support for the dopamine hypothesis (Evaluation)

A

Treatments

53
Q

How do treatments provide support for the dopamine hypothesis (Evaluation)

A

Success of usage of antipsychotics to reduce dopamine indicates the cause is an excess of dopamine

54
Q

What are the challenges to the dopamine hypothesis (Evaluation)

A

Antipsychotics don’t decrease symptoms in everyone and some schizophrenics have normal dopamine levels

55
Q

What are neural correlates

A

Changes in neuronal events and mechanisms that result in the characteristic symptoms of a behaviour or mental disorder

56
Q

What is a cause of cognitive symptoms of schizophrenia

A

Impairment in the prefrontal cortex and its connection to other regions of the brain (hippocampus)

57
Q

What did Cannon et al. (2014) find schizophrenics show on the brain

A

Grey matter deficits and enlarged ventricles

58
Q

What did Du et al. (2013) find

A

Reduced myelination of white matter pathways in schizophrenic patients

59
Q

Who’s research supported the influence grey matter deficits (Evaluation)

A

Vita et al. (2012) via a meta analysis of 19 studies

60
Q

What are the implications of neural correlates finding on treatment (Evaluation)

A

Early detection of neural correlates allows treatment to prevent full development of psychosis.

61
Q

What is token economy

A

A form of behavioural therapy used in the management of schizophrenia

62
Q

How does token economy work

A

Uses tokens in exchange for rewards to increases target behaviours

63
Q

Who used token economy on a female schizophrenic ward

A

Ayllon and Azrin (1968) and found it greatly increased desirable behaviours

64
Q

Are tokens primary reinforcers

A

No they are secondary reinforcers that are exchanged for primary reinforces.

65
Q

How do tokens acquire reinforcing abilites

A

Through association with rewards (primary reinforcers)

66
Q

How are tokens made more powerful

A

When they are used as generalised reinforcers

67
Q

What are generalised reinforcers

A

A token that can be exchanged for a variety of different privileges and rewards

68
Q

What is important when trading tokens with patients

A

The timing of reinforcement

69
Q

Who provided research support for token economy (Evaluation)

A

Dickerson et al. (2005) reviewed 13 studies and 11 of 13 studies reported it being beneficial

70
Q

What makes it difficult to assess the success of a token economy (Evaluation)

A

Tends to not involve a control group making it difficult to assess the effectiveness

71
Q

What type of patients is it less useful for (Evaluation)

A

Patients living in the community as it is more difficult to administrate

72
Q

What are the ethical concerns with using token economy (Evaluation)

A

Involves taking control of basic human rights (access to food, etc.)

73
Q

Does token economy actually work (Evaluation)

A

It is difficult to assess as there are very few randomised trials and it is no longer a front line treatment in the UK