Schizophrenia Therapies And Approaches Flashcards
CBT
Identify negative/irrational thoughts (delusions/hallucinations) , then with the help of the therapist discusses them which can help understand where symptoms come from & reduce fear of hallucination. Help patient to develop alternative beliefs and coping strategies
CBT research
Turkington
CBT has a good effect on positive and negative symptoms of sz. Some aspects can be delivered by nurses in brief intervention programmes
CBT research
Jauhur
Meta analysis 34 studies
CBT has a small but significant effect on positive and negative symptoms
CBT research
NICE 2014
CBT - more effective than just meds
Helps improve social functioning, reduced hospitalisation for up to 18 months, effective when combined with meds
Evaluation of CBT
Positive
improving quality of life - Psychological treatments aim to make a said more manageable CBT allows patients to make sense of and challenge some of the symptoms
CBT Comparison with drug treatment
Found consistent evidence that when compare to drug therapy standard care (my medication alone) CBT was effective in addressing rehospitalisation rates up to 18 months from the end of treatment also effective in reducing symptoms severity and some evidence of improvement in social functioning. However it is hard to measure effectiveness.
Evaluation of CBT
Negative
It’s very is an availability at haddock at out and found in Northwest England only 13 out of 187 randomly elective patients have been offered CBT for schizophrenia additionally there are economic implications Of those who are offered some don’t/won’t attend limiting effectiveness as not everyone has access
CBT - Meta representation
Ability to reflect on thoughts and behaviour dysfunction of flexibility to recognise who is carrying out actions
CBT - central control
Ability to suppress automatic responses so we can carry out deliberate actions dysfunction can lead to this organised because they cannot suppress other thoughts interrupting and triggering others
Stirling et al
Support for CBT - faulty info processing
Found information processing is deafening schizophrenics your street test and schizophrenics 30 in controls 18 and schizophrenics took over double the length of time to process the activity
Drug therapies
Antipsychotics- two types typical (chlorpromazine)and atypical (clozapine risperidone)
Blocks dopamine receptions in the synapses of the brain reducing the action of dopamine - atypical also affects serotonin and glutamate improve cognitive function
Research support for drug therapies
Metlzer
Concluded that clozapine as well affected them both typical answers antipsychotics atypical antipsychotics effective in 30 to 50% of treatment resistant cases where typical antipsychotics have been ineffective
Evaluation of drug therapies
Positive - research support
There is research support through thornely chlorpromazine associated with a lower relapse rate and better overall functioning in 13 of 1112 studies and meltzer
Evaluation of drug therapies
Negative - chemical cosh
Ethical problems of control and harm associated with the use of drugs therapies as moritz et al self patient report - main subject of effect without a nanny on with your dampening emotion rather than treating symptoms, antipsychotics are used to make it easy for staff in hospitals to deal with patients rather than the benefit of the patient Moncrieff states that this can be seen as human rights abuse
Evaluation of drug therapies
Negative - side effects
Tardive dyskinesia
Neural malignant syndrome
Diathesis stress model
Underlying vulnerability (trauma or genes) and negative psychological experience leads to Sz Both are needed for onset to occur
Original diathesis stress model
Meel
Role of genetics - schizogene - would lead to the development of a biologically based schizotypal personality a characteristic is sensitivity to stress
Important stressors chronic stress through childhood
Schizophrenogenic mother
Modern understanding
Read et al
Early trauma alters development of brain early and severe trauma can seriously affect many aspects of brain development - neurodevelopmental model hypothalamic pituitary adrenal system can become over active making a person vulnerable to later stress. Cannabis is a stressor increasing risk by 7 times
