Schizophrenia Flashcards
What is drug therapy
The treatment of mental disorders through the use of antipsychotics to reduce the symptoms of the disorder
What are the two types of antipsychotics used in treating schizophrenia
Typical and Atypical antipsychotics
What are Atypical antipsychotics
Carry a lower risk of extrapyramidal side effects, have a beneficial effect on negative symptoms and cognitive impairment and suitable for treatment resistant patient
What are typical antipsychotics
dopamine antagonists in that they bind to but not stimulate dopamine receptors and so reduce the symptoms of schizophrenia (Hallucinations and delusions)
how do antipsychotics work
they work by reducing dopaminergenic transmission in areas of the brain associated with schizophrenia
What percentage of receptors must be blocked for the drugs to be effective.
Between 60 and 75%
What do a typical antipsychotics show relating to D 2 receptors
rapid disociation from D 2 receptors as well as strong affinity for serotonin receptors
What do a typical antipsychotics act as agonist for
serotonin
What is the benefit of having them as serotonin agonist
Leads to increase dopamine release in prefrontal cortex to reduce negative symptoms and cognitive impairment
What did Leucht et al. find regarding the placebo effect. (Evaluation) (support)
Antipsychotics were more effective than placebo of reducing relapse rates
What were the extrapyramidal side effects (Evaluation) (Weakness)
Can produce movement problems as typical antipsychotics impact areas of the brain that control motor activity
What are the ethical concerns with using typical antipsychotics (Evaluation) (weakness)
Cost benefit analysis maybe negative as well as human rights abuse because of side effects
What are the advantages of a typical of atypical antipsychotics (Evaluation)
There are fewer side effects using typical antipsychotics so patients are more likely to continue with the medication
What did Crossley et al. conclude regarding which antipsychotics are better (Evaluation)
There is no difference in efficacy but there are different side effects
What are motivational deficits of using antipsychotics (Evaluation)
Antipsychotic treatment reinforces the idea that something is wrong and reduces motivation to look for other possible causes
what are the 2 main psychological explanations for schizophrenia
family dysfunction and cognitive explanations
What is family dysfunction
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
What is the double bind theory of family dysfunction
The idea that conflicting messages within the family prevent coherent construction of reality, giving rise to schizophrenic symptoms
What is expressed emotion regarding family dysfunction
Family communication style is likely to influence relapse rate call stop suggests lower tolerance for intense environmental stimuli
Who had the double bind theory
Bateson et al. (1956)
Who performed research on expressed emotion
Kuipers et al. (1983)
What did Kuipers et al. (1983) find
High EE relatives are likely to talk more and listen less leading to increased relapse rates.
Who conducted research on relapse rates relating to expressed emotion and what were the findings
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
What are the 2 aspects of cognitive explanations to schizophrenia
Cognitive explanations of delusions and cognitive explanations of hallucinations
what are cognitive explanations of delusions
Egocentric bias leads people to relate irrelevant events to themselves and arrive at false conclusions
What are cognitive explanations of hallucinations
Hypervigilance leads to greater expectation to stimuli; a person is therefore likely to attribute these to external source
How can family relationships trigger schizophrenia (Evaluation)
Disturbed adoptive families on more likely to trigger schizophrenia in children with genetic vulnerability
Who found supporting evidence for the double bind theory (Evaluation)
Berger (1965)
What did Berger (1965) find in his research (Evaluation)
Schizophrenics reported a higher recall of double bind statement by their mothers than non schizophrenics
What is negative to the idea of expressed emotion (Evaluation)
There are individual differences in vulnerability to EE as not all schizophrenics respond negatively to high levels of EE
Who found supporting evidence for the cognitive model of schizophrenia (Evaluation)
Sarin and Wallin (2014)
What did Sarin and Wallin (2014) find (Evaluation)
They found evidence that supports positive symptoms arising from faulty processing
How are cognitive explanations for schizophrenia supported by therapies (Evaluation)
The success of cognitive based therapies for schizophrenia reinforces the idea that symptoms of schizophrenia have their origin and faulty cognition
What is a problem with the cognitive model for schizophrenia (Evaluation)
It deals adequately with one aspect of the disorder (cognitive impairment) but fails to deal with other aspects of the disorder (social adversity)
What is the integrated model of schizophrenia (Evaluation)
The idea that early vulnerabilities sensitised open in systems meaning more dopamine is released in the biased processing results in paranoia/hallucinations
What are genetic factors
Inherited factors that make certain individuals more likely to develop a behaviour or mental disorder
What are the 3 types of studies of genetic factors affecting schizophrenia
Family studies, adoption studies and twin studies
Who carried out family studies of genetic factors
Gohesman
What did gohesman find in his family studies
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%
Who carried out twin studies into genetic factors
Joseph (2004)
What did Joseph (2004) find in his twin studies
Greater concordance between MZ twins compared to DZ twins. 40.4% concordance for MZ twins compared to 7.4% for DZ twins
Who carried out adoption studies into schizophrenia
Tienari
What did tienari find in his adoption studies
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
What is the evaluation point for twin studies
MZ twins encounter more similar environments which explains higher concordance rates
What is the evaluation point for adoption studies
Adoptees may be selectively placed so adoptive parents of children at risk of schizo are not typical
What is the dopamine hypothesis
An excess of the neurotransmitter dopamine in certain areas of the brain is associated with positive symptoms of schizophrenia
What types of drugs increase dopamine
Amphetamines
What can be a result of using amphetamines
Produce schizophrenic symptoms
What types of drugs decrease dopamine levels
Antipsychotics
What is the benefit of using antipsychotics
Reduce symptoms
What is the revised dopamine hypothesis
Includes dopamine underactivity in the prefrontal cortex
What provides support for the dopamine hypothesis (Evaluation)
Treatments
How do treatments provide support for the dopamine hypothesis (Evaluation)
Success of usage of antipsychotics to reduce dopamine indicates the cause is an excess of dopamine
What are the challenges to the dopamine hypothesis (Evaluation)
Antipsychotics don’t decrease symptoms in everyone and some schizophrenics have normal dopamine levels
What are neural correlates
Changes in neuronal events and mechanisms that result in the characteristic symptoms of a behaviour or mental disorder
What is a cause of cognitive symptoms of schizophrenia
Impairment in the prefrontal cortex and its connection to other regions of the brain (hippocampus)
What did Cannon et al. (2014) find schizophrenics show on the brain
Grey matter deficits and enlarged ventricles
What did Du et al. (2013) find
Reduced myelination of white matter pathways in schizophrenic patients
Who’s research supported the influence grey matter deficits (Evaluation)
Vita et al. (2012) via a meta analysis of 19 studies
What are the implications of neural correlates finding on treatment (Evaluation)
Early detection of neural correlates allows treatment to prevent full development of psychosis.
What is token economy
A form of behavioural therapy used in the management of schizophrenia
How does token economy work
Uses tokens in exchange for rewards to increases target behaviours
Who used token economy on a female schizophrenic ward
Ayllon and Azrin (1968) and found it greatly increased desirable behaviours
Are tokens primary reinforcers
No they are secondary reinforcers that are exchanged for primary reinforces.
How do tokens acquire reinforcing abilites
Through association with rewards (primary reinforcers)
How are tokens made more powerful
When they are used as generalised reinforcers
What are generalised reinforcers
A token that can be exchanged for a variety of different privileges and rewards
What is important when trading tokens with patients
The timing of reinforcement
Who provided research support for token economy (Evaluation)
Dickerson et al. (2005) reviewed 13 studies and 11 of 13 studies reported it being beneficial
What makes it difficult to assess the success of a token economy (Evaluation)
Tends to not involve a control group making it difficult to assess the effectiveness
What type of patients is it less useful for (Evaluation)
Patients living in the community as it is more difficult to administrate
What are the ethical concerns with using token economy (Evaluation)
Involves taking control of basic human rights (access to food, etc.)
Does token economy actually work (Evaluation)
It is difficult to assess as there are very few randomised trials and it is no longer a front line treatment in the UK
