scriphorenia

Question 1

Evaluate antipsychotics as a therapy for schizophrenia.

Answer 1

use of evidence for effectiveness or otherwise, eg meta-analysis of the use of chlorpromazine (Adams 2005); atypicals, eg risperidone, are more effective than typical anti-psychotics (Bagnall 2003); comparison of chlorpromazine with placebo (Thornley, 2003)
*  relative effectiveness with certain symptoms – typical drugs more effective for positive symptoms
*  side effects, eg weight gain, muscle tremors etc and the need to balance costs and benefits to the patient
*  preventative use – olanzapine used effectively with high risk individuals
*  historical appraisal – revolutionised treatment of patients with psychosis – no longer any need for physical restraint
*  short-term v long-term benefits, possibility of relapse, revolving door effect
*  comparison with alternatives, eg family therapy, cognitive therapy
*  implications for the patient and family, and for the economy.

Question 2

Outline a cognitive explanation for schizophrenia and outline one limitation of this explanation.

Answer 2

*  dysfunctional thinking/information processing/maladaptive thought explains symptoms of schizophrenia
*  poor memory function in people with schizophrenia
*  people with schizophrenia are poor at understanding their own thinking (metacognition) as distinct from environmental stimuli
*  people with schizophrenia are poor at recognising their own output, eg their own drawings
*  central control deficits may explain disordered thinking and language deficits, eg lack of fluency, word salads etc.

Possible limitations:
*  does not explain the underlying cause which is probably biological, only explains some aspects of how people with schizophrenia think
*  does not address the underlying cause, so any therapeutic attempts based on the cognitive explanation might just deal with some symptoms
*  not so good at explaining negative symptoms, can explain certain symptoms, eg delusions, hallucinations better than others
*  reductionist – explaining a complex disorder at the level of individual cognitive symptoms.

Question 3

Schizophrenic mother explanation KAA?

Answer 3

Psychiatrist Frieda Fromm-Reichmann (1948) proposed a psychodynamic explanation for schizophrenia based on the accounts she heard from her patients about their childhoods. Fromm-Reichmann noted that many of her patients spoke of a particular type of parent, which she called the schizophrenogenic mother. “Schizophrenogenic’ literally means ‘schizophrenia-causing. According to Fromm-Reichmann the schizophrenogenic mother is cold, rejecting and controlling, and tends to create a family climate characterised by tension and secrecy. This leads to distrust that later develops into paranoid delusions (i.e. beliefs of being persecuted by another person), and ultimately schizophrenia.

Question 4

Speech poverty refers

Answer 4

to limited speech output with limited, often repetitive content.

Question 5

Avolition refers

Answer 5

Avolition refers to a lack of purposeful, willed behaviour

Question 6

Briefly explain one advantage of cognitive behavioural therapy in the treatment of schizophrenia.

Answer 6

  Allows patient to take some responsibility for own treatment
*  Enhances effectiveness in other areas of life
*  Research supports its effectiveness alongside drug therapy
*  Effectiveness can be long term/ongoing

Question 7

Briefly outline how cognitive behaviour therapy (CBT) is used to treat schizophrenia and explain one limitation of using CBT to treat schizophrenia.

Answer 7

Possible content:
*challenging beliefs (including origin of ‘voices’) and reality testing to reduce distress
*use of positive self-talk
*coping strategy enhancement through education and symptom targeting
*cognitive restructuring via ABCDE framework. Identifying activating event (A), exploring beliefs (B), recognising consequences (C), disputing irrational beliefs (D), restructured belief (E).
Credit other relevant aspects of cognitive behaviour therapy.
Possible limitations:
*CBT requires self-awareness and willingness to engage with process (positive symptoms lead to lack of awareness; negative symptoms lead to reluctance / inability to engage)
*practical issues, eg length of therapy (leading to drop out at times of severe episodes)
*not all clients are suited to vigorous confrontation.

Question 8

xplain what is meant by the ‘positive symptoms of schizophrenia’. (4 marks)

Answer 8

the two positive symptoms are hallustions and deliosuls
they are unusual sensory experiences that go beyond usual experiences
hallistantions they are unusual sensory experices like seeing things
delusions are irrational beliefs usually to do with being percicatued
negative symptoms are loss of usual experiences