Schizophrenia L3 - 4 Flashcards
(36 cards)
In what 3 ways can the family dysfunction theory be described?
1) The schizophrenogenic mother
2) Double-blind theory
3) Expressed emotion
2 main psychological explanations for SZ:
- Family dysfunction
- Cognitive explanation
Who proposed the theory of schizophrenogenic mother and what does this involve? (3)
- Fromm-Reichmann (1948)
- Characteristics of typical mother include controlling, cold and rejecting
- Leads to child having lack of trust in relationships which leads to paranoid delusions and eventually SZ
- Passive father
Who proposed the double-blind theory and what does this involve? (3)
- Bateson et al (1972)
- Parents who give mixed messages
- Children trapped in situations where they fear doing the wrong thing because of this, which makes them feel confused leading to paranoid delusions
Expressed emotion:
- Level of negative emotion expressed towards a patient by their carers
- Possible trigger for SZ and SZ relapse (diathesis stress model)
What does expressed emotion include?
- Verbal criticism
- Hostility towards patient
- Emotional involvement in patient’s life
Strengths and weaknesses of family dysfunction as a risk factor: (+1, -4)
+ Research support –> Tienari et al (1994), Read et al (2000), Bateson (1956), Kavanaugh (1992)
- Conflicting research evidence –> Lien (1974)
- Not all patients in high EE families relapse and vice versa –> Altorfer et al (1998)
- Unethical –> leads to parent-blaming
- Environmentally reductionist
Tienari et al (1994):
- Adopted children w/ schizophrenic biological parents are more likely to have SZ themselves than those without
- This only occurred in situations where family was dysfunctional
Read et al (2005):
- Reviewed 46 studies of child abuse
- 69% of adult women and 59% of men inpatients had a history of sexual/physical abuse or both
- Adults who had insecure attachments to primary carer are more likely to develop SZ
Bateson (1956):
- Case study about interaction between recovering schizophrenic and mother in hospital
- He embraced her warmly but she stiffened to which he withdrew his arms ‘Don’t you love me any more?’
- She blushed and commented ‘Dear, you must not be so easily embarrassed and afraid of your feelings’
- He then assaulted an aide –> shows mixed messages caused this behaviour
Kavanagh (1992):
- 26 studies of expressed emotion
- Mean relapse rate for those who returned to live w/ high expressed emotion families was 48% compared to 21% for those without
Liem (1974):
- Measured patterns of paternal communication w/ schizophrenic child
- Found no difference compared to normal families
Altorfer et al (1998):
Found that 1/4 of patients they studied showed no psychological responses to stressful comments from relatives
What are 2 kinds of dysfunctional thought processing that reflect SZ symptoms and who designed this?
Frith et al (1992):
1) Metarepresentation –> disrupts person’s ability to recognise their actions as being their own rather than someone else’s (explains hallucinations and delusions)
2) Central control –> disrupts cognitive ability to suppress automatic responses (explains alogia and derailment)
Strengths and weaknesses for cognitive explanations of SZ: (+2, -2)
+ Strong research evidence –> Stirling et al (2006)
+ Success of CBT
- Cause and effect
- Reductionist
Stirling et al (2006):
- Compared 30 patients w/ SZ diagnosis w/ 18 non patient controls on range of cognitive tasks eg stroop task
- Found SZ patients took twice as long to say colour of word than controls
What are the 2 types of drugs used to treat schizophrenics?
- Antipsychotics
- Psychotics
What is the most common drug treatment for SZ and what form can they be taken in?
- Antipsychotic
- Tablets/syrup/injections
What is usually the process of treating SZ?
- Nearly all patients are given antipsychotic drugs for a period to control their symptoms
- Once patient is stable they are given psychological therapies eg CBT/family therapy
What 2 types can antipsychotic drugs be divided into?
1) Typical/ 1st gen
2) Atypical/ 2nd gen
How do typical antipsychotics work? (3)
- Bind but do not stimulate dopamine receptors
- Reduces effects of dopamine
- Reduces positive symptoms of SZ
Give one example of a typical antipsychotic drug:
- Chlorpromazine
- Max dose is 1000mg
- Used to calm patients, not just those with SZ
- When first taken, dopamine levels will increase but its production will later decrease
What is different about atypical antipsychotics?
- Fewer side effects
- Beneficial effect on negative symptoms as well
How is it that atypical antipsychotics have fewer side effects?
- They only temporarily block D2 receptors and then rapidly dissociate, which allows normal dopamine transmission
- The rapid disassociation is what reduces the effects
