SZ Psychological models Flashcards by Ekta Merwaha

Psychosis

loss of touch with consensual reality

How well did you know this?

Not at all

Perfectly

Bleuler (1915) definitions of
SZ
positive
negative

split mind
excesses/ distorions
behavioural deficits

How well did you know this?

Not at all

Perfectly

Positive symptoms

delusions
disorganised speech/ thought disorder/ loosened associations
heightened perception/ hallucinations
inappropriate affect

How well did you know this?

Not at all

Perfectly

Negative symptoms (4As)

avolition
alogia (poverty of speech)
anhedonia/ flat affect
asociality

How well did you know this?

Not at all

Perfectly

Psychomotor symptoms

catatonia

How well did you know this?

Not at all

Perfectly

How do diagnose SZ?
rule out
duration
symptom criteria

rule out mood/ organic/ substance-induced disorder
overall presence for >6 months
2+ of the following for >1 month
- one positive symptom
decline in self-care, occupational +// social functioning

How well did you know this?

Not at all

Perfectly

Schizophreniform disorder

symptoms for 1-6 months

How well did you know this?

Not at all

Perfectly

Brief psychotic disorder

symptoms for 1 day- 1 month

How well did you know this?

Not at all

Perfectly

Schizoaffective disorder

many episodes of mood disorder (mania+//depression) and at least 2 weeks of mood disorder-free psychosis

How well did you know this?

Not at all

Perfectly

SZ tends to be first diagnosed in

early adulthood

How well did you know this?

Not at all

Perfectly

Saha (2005) lifetime prevalence

1/250

How well did you know this?

Not at all

Perfectly

Galderisi (2013)
x leading cause of disability in M/ x in F
SZ die x years before average population

5th, 6th

12-15 years

How well did you know this?

Not at all

Perfectly

Longden (2012) what percentage of people hear voices in life?

8% general population

40% student population

How well did you know this?

Not at all

Perfectly

Cognitive deficits approach

Rosenfarb (2000)

(biological) impairments in perception, memory, attention

makes it hard to cope with environmental stress

How well did you know this?

Not at all

Perfectly

Cognitive biases approach

description

traumatic events in childhood can affect ways we interpret info in later life

How well did you know this?

Not at all

Perfectly

Cognitive biases description of verbal hallucinations

difficulty distinguishing in/external thoughts/voices
beliefs/ explanations affect distress levels
worse when highly aroused

How well did you know this?

Not at all

Perfectly

Cognitive biases delusions= normal…

resistance to change
bias towards confirmatory evidence
thinking errors eg jumping to conclusions

How well did you know this?

Not at all

Perfectly

Freeman+ Garety (2004)

VR study on persecutory delusions

10-25% populations have persecutory thoughts at any one time

How well did you know this?

Not at all

Perfectly

Delusions are attempts to explain experience

ambiguous social information
coincidences
negative, irritating, stressful events- vulnerability/ anxiety
importance of internal feelings
reasoning processes

How well did you know this?

Not at all

Perfectly

Token economy programmes
reference?
what does it reduce?
how does it reduce it?

Ayllon+ Michael (1959)

operant conditioning to reduce symptom expression

How well did you know this?

Not at all

Perfectly

Social skills training
reference?
3 aspects?

Huxley (2000)
role playing
modelling
positive reinforcement

How well did you know this?

Not at all

Perfectly

Beck+ Rector (2000)

reattribution therapy

question where voices come from+ use behavioural testing
explore alternative beliefs about the hallucinations
test reality of belief+ their supporting evidence
develop coping strategies (eg music)

How well did you know this?

Not at all

Perfectly

Acceptance and Commitment Therapy

Hayes+ Lillis (2012)
accept problematic thoughts rather than judging/ changing them
become detached observers of hallucinations

How well did you know this?

Not at all

Perfectly

Cognitive-behavioural evaluation

usually used with meds in SZ

How well did you know this?

Not at all

Perfectly

Schwartz et al (2012)

TEP+ SST= relatively successful but may not generalise/ last (Benton+ Schroeder, 1990) 50% decrease in rehospitalisations when SZ is Rx with CBT

NICE recommended Rx for SZ

CBT, but often unavailable

Freud (1924)

regression to pre-ego, symptoms/ efforts to re-establish control unsuitable for psychoanalysis insight means agreeing with stigmatising/ dubious diagnosis

Psychodynamic aetiology Fromm-Reichmann (1948) Jung (1953) Sullivan (1953)

schizophrenogenic mothers invasion of unconscious material difficulties arising from personal/ social relationships

Psychodynamic treatment | how does it increase insight?

- interpret covert meaning behind symptoms - explore past experiences/ seek connections with present - intensive in time/ emotion

Willick (2001) meta-analysis

little evidence for schizophrenogenic mothers

Stone (1986)

Rx may expose patients to memories/ insights that they're unable to deal with emotionally

Gottdiener (2006) | CBT vs psychodynamic vs no Rx

similarly to CBT, 67% with psychodynamic Rx will improve compared to 34% who don't get Rx

Social approach aetiology Mechanic et al (1994) Bebbington+ Kuipers (2011) Fox (1990)

acceptance of label associated with low mood/ self-esteem high expressed emotions sociogenic hypothesis vs social selection theory

Social treatment= rehabilitation

focus changes from reducing symptoms to prevention of relapse to improved functioning in the world

Millieu therapy

Maxwell Jones (1953)

Gunter (2005)

therapeutic communities+ community

Warner (1994)

occupational therapy | employment has a huge positive impact

Burbach (2010)

family interventions

Social evaluation

draws attention to the cultural biases+ vulnerabilities of minority population

Fernando (1995) and Lawson (2008)

black people are more likely to be diagnosed with SZ, be detained by compulsion, receive higher doses of neurolepric medication

Russinova (2002)

vocational recovery+ success are viable outcomes for people with SZ spectrum disorders

Burns+ Drake (2011)

community care shows promise | often too poorly resourced+ coordinated

Stress-vulnerability model | Tost+ Meyer Lindenberg (2012)

``` prime environmental suspects urban upbringing migration disintegration of family networks social fragmentation growing class differences minority status social marginalisation things that make you different from social surroundings ```

Freeman+ Garety (2004) | VR study

methodology should differentiate suspicions/ persecutory thoughts from realistic/ appropriate worries increased paranoia in daily life associated with VR suspicion

Oltmann's (1988) criteria for it to be delusional

not shared, firm, evidence against, preoccupation, functional interference, don't try to resist

Delusions | Freeman+ Garety (2004)

attempts to explain ambiguous social information/ internal states

Freeman+ Garety (2004) | Suspicious thoughts increase after

distress eg bullying/ isolation

Freeman+ Garety (2004) | Are suspicious beliefs influenced by previous experiences?

Yes

Freeman+ Garety (2004) | How does lack of trust in others/ isolation worsen perceived threat?

alone rumination/ prevents discussion of these thoughts

Freeman+ Garety (2004) | Beliefs that the persecutor= powerful increases/ decreases levels of depression?

increases

Freeman+ Garety (2004) | Treatment

explains experiences/ alternatives/ adapt situation to increase understanding to prevent rumination/ interference/ distress not stopping thoughts

Fox (1990) SSDHfSMI

Social selection- drift hypothesis for serious mental illness - intergenerational social mobility differences between SMI+ genpop in previous studies barely support this - log-linear analysis

Fox (1990) | Social causation perspective hypothesis

class causes SMI

``` Fox (1990) SSDH says class is associated with SMI ```

SMI causes no increase/ a decrease in class

Fox (1990) | Results supporting SSDH are based on

methods/ assumptions which lack support when tested with newer techniques

Longden+ Waterman (2012) | Voice hearing- dissociative or psychotic?

dissociative | supported by clinical+ epidemiological research

Longden+ Waterman (2012)

general population | adolescents> adults

Longden+ Waterman (2012) | Voice hearing is

dissociated/ disowned parts of self | results from trauma/ loss/ stress

Longden+ Waterman (2012) how should clinicians use psychotherapeutic methods to

integrate life events as precipitating +// maintaining factors for distressing voices

Longden+ Waterman (2012) | Voice hearing

experience without stimulus, human, conscious, non-organic, state dependent

Longden+ Waterman (2012) | APA: dissociation is

defence to trauma= abnormal psychobiological functioning | manifestations include depersonalisation, derealisation, identity confusion, psychogenic amnesia

Longden+ Waterman (2012) | when dissociation becomes a habitual way of responding to anxiety, it leads to

impairment/ distress

Read (2001)

SZ aetiology= post-traumatic

Longden+ Waterman (2012) | Those abused <16 are sig. more likely to

experience VH/ delusions

Longden+ Waterman (2012) | VH can precipitate PTSD

esp with inhumane Rx | severity of trauma associated with symptoms

Longden+ Waterman (2012) | HIT helps

hallucinations- focused integrative therapy