Schizophrenia

Question 1

Clinical Characteristics

Answer 1

• 1% of population
• affects thought processes and ability to determine reality, type 1 and type 2
• First ranks symptoms, thought disorders, hallucination and delusions
• many different subtypes

Question 2

Reliability and validity

Answer 2

• DSM is more reliable than ICD and reliability has improved over time
• far from 100% reliable but do classifications systems allow practitioners a common language
• reliability higher than anxiety disorders
• diagnosis also often invalid, doesn’t lead to successful treatment and studies showed that practitioners often cant discern real from pseudo patients
• no diagnosis explains cause
• diagnosis must be accurate so patients get correct help and the attached stigma is hard to get rid of
• no physical signs of disorder, all self reported
• unlikely one single cause so hard to get aetiological validity

Question 3

Genetics

Answer 3

• research usually used twins, families and adoptions studies where schizophrenia occurs
• Has indicated genetic component, but hard to separate from environmental factors
• gene mapping has showed us that several gens can make individuals more vulnerable

Question 4

Genetics Evaluation

Answer 4

• studies often don’t include environmental factors
• not 100% concordance rate, but is higher than average of 1%
• generalisation difficult due to abnormal sample group
• gene mapping can identify high risk individuals but this has ethical concerns

Question 5

Biochemical

Answer 5

• excess dopamine causes the disorder
• discovered dopamine blocking drugs reduced the symptoms
• L-dopa a dopamine releasing drug created schizophrenic behaviour in non psychotic people
• depending on what part of the system there is excess will affects whether an individual will have positive or negative symptoms

Question 6

Biochemical evaluation

Answer 6

• inconclusive evidence
• several neurotransmitters may be involved
• can’t explain why sufferers only recover slowly when drugs block dopamine straight away
• may be an effect rather than a cause

Question 7

Cognitive

Answer 7

• Maladaptive thinking linked to many symptoms such as hallucinations
• interest on role of attention, believed they can’t filter out relevant information and so become so overwhelmed with information that they can’t interpret it
• breakdown between inform in stored memory and new incoming data
• schemas aren’t activated and so sensory overload occurs leading to delusional thinking

Question 8

Cognitive evaluation

Answer 8

• allows useful therapies to be created
• cognitive impairment aren’t all the same supporting existence of different subtypes
• some believe including cognitive impairment in diagnosis will increase validity

Question 9

Socio-cultural explanations

Answer 9

• focus on social and cultural factors such as family and social environments
• labelling theory sees being identified as a schizophrenic is a social phenomenon where others such as the family label individuals as schizophrenic
• Labelling creates a social role where individuals behave in a stereotypically expected way and it also affects how others interpret and react to behaviour
• degree of expressed emotion within a family is seen as an indicator of relapse in schizophrenics
• Double bind theory, schizophrenic is a learned response to conflicting messages and demands during childhood, over time this leads to disorganised thinking and communication
• Social causation, lower social classes, who are subject to more stressors have heightened levels of schizophrenia suggesting this could be a cause

Question 10

Socio-Cultural evaluations

Answer 10

• social status may not be a cause but an effect of having schizophrenia
• helps to target areas that could cause relapse
• methodological problems with research

Question 11

Drugs

Answer 11

• primary treatment, not a cure but do dampen symptoms
• work to reduce dopamine levels and some on serotonin
• some have to take one course others have it regularly and some don’t respond at all

Question 12

Drugs evaluation

Answer 12

• effective, cheap and practical, only 3% of schizophrenics are permanently in hospital
• high relapse rate and serious side effects

Question 13

ECT

Answer 13

• logic is that you can’t have both schizophrenia and epilepsy so inducing an epileptic fit in a schizophrenic would remove the disorder
• works best bilaterally and consists of two to three treatments a week for 12 treatment

Question 14

ECT evaluation

Answer 14

• 20-50% relapse rate after 6 months
• serious side effects, bad image to get rid of
• always a risk having a general anaesthetic

Question 15

CBT

Answer 15

• works to modify hallucinations and delusional beliefs as people with schizophrenia have maladaptive thinking which causes them
• every 10 days for 12 sessions to identify and alter irrational thinking
• one approach is personal therapy (PT) this is where problems and experiences are evaluated and what causes them and then work on strategies to cope, such as distractions and challenging their meanings

Question 16

CBT evaluation

Answer 16

• good evidence support
• relationship with therapist is key
• training is essential
• not suitable for all patients as they have to be able to trust therapist

Question 17

Psychodynamic

Answer 17

• causes are developed in early relationships, treatments aim to provide links between symptoms and early life experiences
• poor early relationships lead to a poor sense of self which leads to schizophrenics having faulty meta-representation and cant distinguish between inner thoughts and external sources
• P’s taught forms of communication to achieve insight into problems, aim to identify roots of problems

Question 18

Psychodynamic Evaluation

Answer 18

• not much research into it as a standalone treatment
• could have adverse effects, increased suicide rate found
• can be administered outside of hospital
• theoretical basis is weak
• evidence for long term benefits is mixed