Schizophrenia Theories Flashcards
Positive Symptoms of Schizophrenia
Experiences that add to schizophrenia
Positive Symptoms of Schizophrenia-Hallucination
Sensory experiences with no basis in reality
Positive Symptoms of Schizophrenia-Delusions
Beliefs that are not based in reality
Negative Symptoms of Schizophrenia
Experiences that involve the loss of usual abilities and experiences
Negative Symptoms of Schizophrenia-Avolition
A loss of motivation in the things that they normally care about
Negative Symptoms of Schizophrenia-Speech Poverty
The amount and quality of speech is reduced
Classification of Schizophrenia-Evaluation
- Research shows poor validity in diagnosis-Cheniaux study
- Cheniaux study also shows poor reliability in diagnosis
- Buckley Study shows a lot of Co-Morbidity between Schizophrenia and other illnesses
- Symptom Overlap between Schizophrenia and Bi-Polar-Are they the same thing?
- Gender Bias-Longenecker study
- Cultural Bias-Those of African and Caribbean origin are more likely to be diagnosed-In these cultures, voices are seen as natural
Biological Explanations-Genetics-Runs in families
According to Gottesman, identical twins have a 48% chance of developing schizophrenia. This decreases as genetic similarity decreases
Biological Explanations-Genetics-Candidate Genes
There many many different genes that create the vulnerability to schizophrenia, according to Ripke, there are 108 different candidate genes
Biological Explanations-The Dopamine Hypothesis-Neurotransmitter
Dopamine is the most important chemical in the development of schizophrenia
Biological Explanations-The Dopamine Hypothesis–The Subcortex
In the early version of the theory,focus was on high levels of dopamine in the subcortex (areas like Brocas area). This could explain speech avolition
Biological Explanations-The Dopamine Hypothesis-The Cortex
Recent version of the hypothesis focus on the cortex,where there is low levels of dopamine,which causes negative symptoms
Biological Explanations-Neural Correlates-Negative Symptoms
Avolition is related to motivation. The ventral striatum is involved in motivation. So an abnormality functioning ventral striatum (low activity levels) May be involved in developing schizophrenia
Biological Explanations-Neural Correlates-Positive Symptoms
According to Allen,Hallucinations are caused by low activity levels in the Superior Temporal Gyrus and the Anterior Cingulate Gyrus
Biological Explanation-Evaluation
+Research Support-Gottesman and Tienari studies
- Mixed Evidence for Dopamine Hypothesis-Some dopamine agonists make symptoms worse, but some genes code for unrelated chemicals (not dopamine)
- Correlation Causation Problem-Don’t know if Neural Correlates cause schizophrenia,or are an result of schizophrenia
Psychological Explanations-Family Dysfunction-Schizophrenogenic Mother
According to Fromm Reichmann,the schizophrenogenic mother is cold,rejecting and controlling which creates a tense family environment. This leads to distrust,and then paranoid delusions which lead to schizophrenia
Psychological Explanations-Family Dysfunction-Double Bind Theory
According to Bateson, the child receives mixed messages on what the right thing to do is. When they do the wrong thing, they are punished with a withdrawal of love. This leaves them thinking that the world is cold and confusing,and they start to develop paranoid delusions,which increases the chance of getting schizophrenia
Psychological Explanations-Family Dysfunction-Expressed Emotion
Expressed Emotion is the level of negative emotion expressed towards a patient. It contains certain elements
-verbal criticism
-Hostility
-Emotional Over involvement
High levels of EE causes stress for the patient. This can be a source of stress that triggers the genetic vulnerability for schizophrenia
Psychological Explanations-Cognitive Explanations-Metarepresentation
Metarepresentation is the ability to reflect on our thoughts and behaviors. Dysfunction in this ability can be used to explain hallucinations as we cannot recognize our own thoughts
Psychological Explanations-Cognitive Explanations-Central Control
The ability to suppress automatic responses while we carry out deliberate actions. Disorganized speech and thoughts could be the result of the inability to suppress automatic thoughts triggered by other thoughts
Psychological Explanation-Evaluation
+Research Support-Read study
-Weak evidence for family based Psychological Explanations-Cognitive Explanations-nation-no direct evidence for schizophrenogenic mother and double bind-these explanations may encourage parent blaming
+Research support for cognitive-Strirling Study
-No clear evidence for the direction of causality between cognitive and biological factors
Biological Treatments for Schizophrenia-Drug Therapy- Typical Anti psychotics
These were used in the 1950’s and 1960’s and are a dopamine antagonist. Chlorpromazine is an example of one of these drugs. They dampen down dopamine receptors reducing symptoms like hallucinations. However, Chloropromazine is also a sedative, and has been used to sedate patients rather than help them treat their schizophrenia
Biological Treatments for Schizophrenia-Drug Therapy- Atypical Anti Psychotics-Clozapine
Developed in 1960’s, and after killing some patients from a blood condition, it was discovered to be more effective than typical anti psychotics. It works the same way as Chloropromazine does, but without the side effects of a sedative
Biological Treatments for Schizophrenia-Drug Therapy- Atypical Anti Psychotics-Risperidone
Developed in 1990’s. Works like Clozapine but without the dangerous side effects
Biological Treatments for Schizophrenia-Drug Therapy- Evaluation
+Research Support- Thornely and Meltzer studies
- Serious Side Effects
- Use of Antipsychotics depends on Dopamine Hypothesis-For these drugs to work, we need to accept the dopamine hypothesis as fact
- Biologically Reductionist
Psychological Therapies for Schizophrenia-CBT
CBT can be used to help the patient make sense of how their delusions and hallucinations impact on their behaviour. Just understanding where symptoms come from can help the patient. CBT will also challenge those beliefs, so the patient learns that the beliefs are not based on reality
Psychological Therapies for Schizophrenia-Family Therapy
Family therapy works with the patient and their families to improve communication within the family, and to reduce expressed emotion
Psychological Therapies for Schizophrenia-Family Therapy- How it Helps
According to Pharaoh, a range of strategies by which family therapies aim to improve communication:
- Forming a Therapeutic Relationship with all family members
- Reducing stress of caring for a schizophrenic
- Improving the ability of the family to anticipate and solve problems
- Reducing anger and guilt
Psychological Therapies for Schizophrenia-Token Economy
Used in institutional settings for patients who have picked up maladaptive behaviours. Token economy can be used to modify these behaviours to help the patient live outside of the institution. It works on the principal of Operant Conditioning
Psychological Therapies for Schizophrenia-Token Economy- Tokens
Tokens are given to the patient immediately after they have done the behaviour that is to be reinforced. It is important to reward behaviour immediately, as it prevents “delay discounting” which reduces the effect of the reinforcement
Psychological Therapies for Schizophrenia-Token Economy- Rewards
The tokens can be swapped for rewards. These rewards also reinforce the desired behaviour, as to get the reward again, they have to collect enough tokens
Psychological Therapies for Schizophrenia-Evaluation
+Research Evidence- Pharaoh and McMonagle and Sultana studies
- Treatments improve the Patients quality of life- But they do not cure schizophrenia, they only make patients life’s more manageable
- Ethical Issues- CBT- Challenges patients beliefs that might be part of their identify, Token Economy- Deprive the most severely effected people from small pleasures-reduces Q.O.L
The Internationalist Approach to Schizophrenia-Diathesis-Stress- Meehl’s model
In the original model of diathesis-stress, the vulnerability was genetic, the result of a “schizo gene”, which lead to the schizotypic personality, where a characteristic of this is an sensitivity to stress. If a person does not have the schizo gene, they will not develop schizophrenia, however, if they carry the gene, the schizophrenogenic mother could act as a stressor to cause schizophrenia
The Internationalist Approach to Schizophrenia-Diathesis-Stress-Modern Understand of Diathesis
There is no single “schizo gene” but many candidate genes. Modern views of diathesis include a range of factors that can create a vulnerability, not just genetics
The Internationalist Approach to Schizophrenia-Diathesis-Stress-Modern Understanding of Stress
Stress is now anything that can trigger schizophrenia. Recent research into factors include cannabis use , as it interferes with the dopamine system, increasing a persons vulnerability
The Internationalist Approach to Schizophrenia-Treatments
To treat Schizophrenia using this approach, a combination of CBT and drug therapy is used
The Internationalist Approach to Schizophrenia-Evaluation
+Research Support-Tienari study
-Older model of Diathesis-Stress is over simple-new version does not have this problem
+Research support for effectiveness of combinations of treatments-Tarrier study
-We do not know exactly how diathesis and stress works
