Schizophrenia evaluations Flashcards
Validity of diagnosis
1+,3-
+evidence eg. Loring + Powell found male psychiatrists were more likely to diagnose males than females (56% to 20%). gender bias wasn’t as evident among female psychiatrists
-difference in prognosis, people rarely share same symptoms and little predictive validity as some never recover
-people diagnosed with psychiatric disorders tend to receive lower standard medical care, effecting prognosis of Sz
-Rosenhan - DSM invalid way to measure Sz as patients without Sz were diagnosed
Reliability of diagnosis
3-
-Whaley found low inter-rater reliability in diagnosis (0.11) even with more reliable DSM 5
-for diagnosis only one of the characteristics symptoms is required if delusions are ‘bizarre’ , subjective
-cultural differences, prognosis for members of ethnic minorities are more positive due to the protective characteristics of their culture
Genetic
-family 1+,1-
-twins 1+,1-
-adoption 1+,1-
-other 1-
Family studies
+supports genetic explanation as shows sz runs in families, risk is increased if a member of the family has sz
-families share same enviro so isn’t testing only genetic factors
Twin studies
+Gottesman, high concordance for MZ than DZ, large sample over 40 studies
-environmental factors could play a role, MZ twins likely to share same enviro
Adoption studies
+Tienari, shows those with bio. mother with sz more likely to develop it, good as separates bio and enviro factors
-problems as not all mothers with sz have babies adopted, therefore possible mothers whose children were adopted may have caused adoptions
Other
-reductionist, should use diathesis stress model
Dopamine hypothesis (2+,2-)
+prac app as antipsychotic drugs improve symptoms by reducing dopamine, so develop treatments
+evidence from post mortem and PET scans, increase in dopamine of left amygdala of people with sz
-drugs only alleviate positive symptoms, may worsen negative. Only 1/3 respond to drugs so must be other factors
-cause and effect, dopamine cause schizophrenia or a consequence of it. Abnormal dopamine levels could be due to antipsychotic drugs which alter levels of dopamine in the brain
Neural correlates
2+,1-
+support, Juckel, found negative correlation between activity in ventral striatum and severity of negative symptoms. As negative symptoms become more severe, activity decreases
+support Allen, compared brain scans of SZ with auditory hallucinations to control group. Sz had lower activity in superior temporal gyrus and anterior cingulate gyrus
-correlations, can’t state cause and effect. Sz cause change in activity of brain or brain activity causes Sz.
Family dysfunction
2+,2-
+support eg. Tienari found adopted children with sz parents more likely to develop sz however the difference only emerged when adopted family was rated as disturbed
+support eg. Berger found sz have higher recall of double bind statements by mothers
-However this evidence isn’t reliable as recall may be affected by sz
-problem with double bind as it leads to parent blaming, parents who already have suffered and have to bear life long responsibility of care also are blamed for their child’s condition
Cognitive explanations
2+,1-
+support Sarin and Wallin found evidence to support the claim that positive symptoms have origins in faulty cognition eg. delusional patients show biases in information processing
+ practical applications eg. cognitive explanation developed therapy eg. cognitive behavioural therapy for psychosis (CBTp). Patients test validity of faulty beliefs
-psychological models only focus on one factor and ignores others such as neurochemical changes. Diathesis stress model
Drug therapies
2+,2-
+Thornley- did study on over 1000 patients, compared chlorpromazine to placebo. The group given chlorpromazine symptoms reduced
+quick and easy, fast acting
-only treat symptoms not cause
-side effects eg. weight gain, fidgeting, tardive dyskinesia may cause patients to stop taking them all together
CBT
2+,2-
+Jauhar, meta analysis 34 studies found has significant effect on positive and negative symptoms
+life skills
-methodological problems, most patients who have CBT also take antipsychotics. Therefore don’t know if effects due to CBT or drugs
-costly, time consuming 5-20 sessions, dependent on motivation
Token economies
1+,3-
+better relationships between patients and psychiatrists helps with smooth running of hospital
-issue as when re enter society no longer rewarded so may return to old habits of behaviour
-don’t get rid of positive symptoms and don’t actually target cause of sz
-McMonagle and Sultana criticised research as all used independent measures without random allocation, subject to researcher bias
Family therapy
2+,2-
+Pharoah, meta analysis and found lower relapse rate within a year of those who received family therapy
+long term benefits as teaches lift skills for family and patient
-not providing cure for symptoms just ways to cope
-family members have to be willing to engage with therapists
Interactionist approach
3+,1-
+Tienari, looked at adoptive parenting styles, develop sz more likely if parenting style was high in criticism and low in empathy
-study was completed in finland, so lack pop validity
+Husted, early childhood trauma linked to onset of sz
+Read, vulnerability related to nervous system, when traumatic experiences occur, related to bio abnormalities eg dopamine acts as diathesis
Interactionist approach treatment
3+,1-
+Tarrier, random assigned sz patients to medication + CBT, medication and counselling, control group. Found combination groups showed less symptoms
+Tarrier used random allocation, no researcher bias
+Holistic approach, targets every aspect of sz, eg, drugs target positive symptoms, therapies target maladaptive behavious
-Tarrier, no difference in relapse rates between conditions, combination treatment doesn’t lead to long lasting effects
