Schizophrenia AO3 Flashcards
Evaluate reliability and validity in the diagnosis and classification of Sz
Reliability refers to the consistency of the diagnosis. Inter-rater reliability can be tested between the DSM and ICD
x - Cheniaux tested this by asking two psychiatrists to diagnose 100 patients with either the DSM or ICD
He found the inter-rater reliability was poor
HOWEVER Osorio has found this has improved as of 2019
Culture Bias is inflicting Western Views of Sz onto other cultures
x - this means the classification of Sz is culturally bias as in some cultures, the symptoms of Sz are desired and held very highly.
This then shows that the classification is bias and can’t be put onto other cultures
Evaluate the biological approach to the cause of Sz (the dopamine hypothesis + Enlarged Ventricles)
+ - evidence from PET scans
Wong found an increase in the number of dopamine receptors in brain regions of those with Sz
+ - evidence from Drug Use
Drugs such as Cocaine increase dopamine causing hallucinations (symptom of Sz)
x - you can’t establish causation with neural correlates
It is possible that Sz causes changes in the brain rather than the other way around, Furthermore, some people who have enlarged ventricles but don’t have Sz
Evaluate the genetic explanation of Sz (Biological Approach)
+ - support from Twin Studies
Twin studies have found a concordance rate of 40% in MZ twins compared to 7% in DZ twins
HOWEVER
if Sz is caused by biological factors alone… shouldn’t it be a 100% concordance rate in MZ twins????
+ Support from Adoption studies
We can classify nature vs nurture in adoption studies and Tienari compared adopted children whose biological mothers had Sz compared to a control group of adoptees with no genetic risk, He found a higher rate in those who’s biological mothers had Sz
+ support from gene mapping
Benzel identified how NRG3 interacts with NRG1 and ERBB4 to create susceptibility to Sz
Provides scientific and objective evidence for explanation Sz via genetic factors
Evaluate drug therapy as a treatment of Sz
(Biological approach)
+ - a wealth of supporting evidence of the effectiveness of Typical Drugs.
- Thornley reviewed studies comparing the effects of Chlorpromazine. Some sufferers were given the drug whilst others were given a placebo
- Chlorpromazine was associated with better overall functioning and reduced symptoms compared to the placebo group
+ - there is also evidence supporting Atypical Drugs to treat Sz
- Meltzer concluded that Clozapine was more successful in treating resistant cases of Sz than Typical. Supports the idea that Sz is caused by a chemical imbalance as the drug correct the imbalance of neurotransmitters
Evaluate the psychological explanation for Sz
(FAMILY DYSFUNCTION and cognitive explanations)
+ - supporting Double-Bind
Berger found that sufferers of Sz reported higher recall of double-bind statements from their mothers
This suggests contradictory messages can increase risk of Sz
HOWEVER
most professionals now agree there is very little support for the D-B and Sz mother explanations.
+ - for high expressed emotions
Tienari assessed adopted children whose biological mother had Sz compared to a control group who didn’t.
He found that those who’s mothers show low levels of empathy had an increased risk of Sz
Shows that higher EE can increase the risk but also low EE can prevent Sz
+ real world PAs
One advantage of family dysfunction theory is that it has provided focus on family structure to decrease Sz. This is because by improving the parenting of those who are vulnerable to Sz we can prevent the risk of Sz developing further
(FAMILY THERAPY)
LINK WITH COGNITIVE EXPLANATIONS AO3
Evaluate the psychological explanations for Sz
(COGNITIVE EXPLANATIONS + family dysfunction)
+ - research evidence for Dysfunctional Thought Processing
O’Carrol found cognitive impairments existed in 75% of patients with Sz, which effected attention, memory and verbal learning
+ - Real world PAs
The development of Cognitive Explanations has lead to CBTp (for psychosis) which has been extremely effective in treating Sz
Comparing CBTp to drug therapy, CBTp was far more effective in reducing symptom serverity (NICE 2014)
LINK TO FAMILY DYSFUNCTION
Evaluate how Cognitive Behavioural Therapy is used to treat Sz
(CBTp)
+ - clear benefits of CBTp
Farrier reviewed 20 studies using CBTp and found persistent evidence of reduced positive symptoms, lower relapse rates and faster recovery rates in the short term.
Jauhar found CBTp had a significant but small effect on positive and negative symptoms
x - drop out rates
As the therapy goes on for many weeks, there is reasonable means to drop out for sufferers of Sz. Tarrier found 45% of the sample refused to co-operate or dropped out of the therapy
Furthermore if a patient suffers from Avolition, how can you get them motivated to continue the treatment?
Evaluate family therapy used to treat Sz
+ - proven to be effective and backed by medical experts (NICE)
Pharoah carried out a meta analysis and found family therapy caused a better reduction in relapse and a reduction in hospital admission during treatment than drug therapy. Family Therapy also caused better compliance with medication
+ - Economic Benefits
Linked with significant cost savings, the reduction of hospital admission saves more money than the cost of family therapy
Evaluate how Token Economies are used to manage Sz
+ - evidence for token economies being effective
Evidence has shown this procedure reduces negative symptoms and a decline in the frequency of unwanted behaviour
Demonstrates the effects of Token Economies and promotes the use of this management
x - found to only effect negative symptoms
The lack of focus on positive symptoms have made other managements more desirable, as well as this, operant Conditioning may not cause a change in thoughts but only a change in behaviour
This is negative because they can easily resort back to their old ways outside of hospital
Evaluate the interactionist approach to explaining and treating Sz
Treating AO3:
+ - lots of evidence to support combining treatments
Tarrier studied 315 patients who were randomly allocated to either:
1. Medication + CBTp
2. Medication + counselling
3. Control group (meds only)
He found symptoms were lower in both combination groups compared to the control group.
Clearly demonstrates the benefits of this
Explaining AO3
+ - evidence to support the dual role of vulnerability
Tienari assessed adopted children whose Bio mother had Sz vs those who’s mother didn’t, he found that a negative parenting style could only effect those with a high genetic risk, this shows there is both genetic and psychological characteristics that contribute to the disorder
