Year 2 - Schizophrenia

Question 1

what are positive symptoms of Sz?

Answer 1

additional behaviours or experiences beyond those of normal

Question 2

give examples of positive symptoms

Answer 2

hallucinations
disordered thinking
delusions

Question 3

what are negative symptoms?

Answer 3

atypical experience which represents a loss of normality

Question 4

give examples of negative symptoms

Answer 4

alogia - poverty of speech
avolition - lack goal based behaviour
affective flattening - less emotional range

Question 5

why is co-morbidity an issue in the classification of Sz?

Answer 5

means more than one illness is present such as Sz and personality disorder, frequent co-morbidity causes questions to be asked about the classification of Sz being separate

Question 6

evaluate the diagnosis and classification of Sz

Answer 6

• lack of inter-rater reliability due to differences in diagnosis between DSM 5 and ICD
• poor criterion validity, more likely to diagnose with ICD
• Sz commonly diagnosed with other conditions, is it individual? (co-morbitity)
• symptom overlap e.g. severe cases of depression
• gender and cultural bias in diagnosis - black, afro-caribbean men most likely to be diagnosed

Question 7

outline the research and findings of twin studies research into Sz

Answer 7

the concordance rates for MZ twins are never more than 48% suggesting genes play a strong role but are not the only factor

Question 8

what are of the brain does hyperdopaminergia affect?

Answer 8

high levels of DA in the subcortex such as Broca’s area where it is associated with poverty of speech and auditory hallucinations

Question 9

what areas of the brain does hypodopaminergia affect?

Answer 9

low levels of DA in the cortex e.g. prefrontal cortex causing negative symptoms

Question 10

what role do neural correlates play in the ventral striatum?

Answer 10

negative correlation between activity levels and severity of negative symptoms activity in ventral striatum is neural correlate of neg.

Question 11

what neural correlates where found in the superior temporal gyrus and anterior temporal gyrus?

Answer 11

neural correlates found between lower activation levels in gyrus and auditory hallucintaion

Question 12

evaluate the biological explanations for Sz

Answer 12

• adoption studies show children of Sz sufferers still likely to suffer from Sz in different environment
• DA agonists e.g. drugs can increase Da production and induce temporary Sz type symptoms
• correlation or causation, neural correlates could show symptoms rather than causes
• mutation of male gametes shown to increase risk of Sz in children of men over 50

Question 13

describe characteristics of a schizophrenogenic mother and how this may cause Sz

Answer 13

harsh
cold 
uncaring
dominant
conflicting
overbaring 
these cause family tension which leads to paranoia in child causing Sz in adult

Question 14

outline the double bind communication theory

Answer 14

• mixed messages
• withdrawal of love
• sarcastic nature, not saying what you mean
• causes disorganised thinking and uncertainty

Question 15

what is expressed emotion in relation to Sz?

Answer 15

• verbal criticism
• anger, rejection
• emotional smothering
  these factors cause extreme stress and can trigger initial symptoms or most likely relapse in patients (caused by carers)

Question 16

outline the possible cognitive explanation of Sz

Answer 16

dysfunctional thought processing :

• dysfunction to metrepresentation
• central control (lacking)

Question 17

evaluate the psychological explanations for Sz

Answer 17

• support for family dysfunction 69% female and 59% male Sz in-patients had experienced abuse in childhood
• weak evidence for family based explanations
• stroop test provides strong evidence for dysfuntional information processing
• biological or psychological, can they really separately produce the same symptoms?

Question 18

how do typical psychotics work? (give an example)

Answer 18

act as antagonistswhich reduce the action of DA through blocking of receptors in the synapses in the brain, e.g. chlorpromazine

Question 19

what additional neurotransmitters do atypical drugs work on?

Answer 19

serotonin and glutamate

Question 20

name the 2 most common atypical drugs used in the treatment of Sz

Answer 20

Clozapine

Resperidone

Question 21

evaluate biological treatments for Sz

Answer 21

• research support for drugs over placebos
• severe side effects, such as tardive dyskinesia
• they work but we arent sure why
• studies only show short-term improvements not long-term benefits

Question 22

outline how CBT can be used to treat Sz

Answer 22

help the patient to challenge delusions and help them make sense of how these delusions and hallucinations affect their behaviour

Question 23

outline family therapy as a treatment for Sz

Answer 23

mostly focus on reducing the stress within the family that might contribute to a relapse for the patient, form an alliance with all family members and seek to reduce feelings of anger and guilt and other help

Question 24

describe token economies

Answer 24

a form of behavioural therapy which rewards desirable behaviour with tokens which can be exchanged for treats in an institutional setting

Question 25

outline 3 limitations of the token economy

Answer 25

• only usable in institutional settings
• only tackles behavioural symptoms
• ethically questionable

Question 26

outline 3 positives of the token economy system

Answer 26

• enables patient to regain social skills
• agree goals are sought
• some research support

Question 27

evaluate the psychological therapies for Sz (2)`

Answer 27

• evidence for effectiveness of CBT

- treat but don’t cure

Question 28

what is the interactionist approach

Answer 28

broad explanation of Sz including biological factors

Question 29

what is the diathesis-stress model?

Answer 29

Sz is explained by a pre-existing vulnerability and a trigger due to stress. genes and trauma recognised as diathesis

Question 30

what treatment is most effective in the treatment of Sz according to the interactionist model?

Answer 30

the combination of the antipsychotic medication and psychological talking therapies, most commonly CBT

Question 31

what are the limitations of the interactionist approach (2)

Answer 31

• classic stress model over simple, mutliple genes implicated and many forms of stress
• don’t understand how stress is a contributor to Sz

Question 32

what are the positives of the interactionist approach (2)

Answer 32

• research evidence by Pekka Tienari

- support for combination treatments