schizophrenia

Question 1

What is used to diagnose schizophrenia?

Answer 1

DSM-V

Question 2

Positive symptoms of SZ

Answer 2

an excess or distortion of normal functions, for example hallucinations, delusions.

Question 3

What are classified as hallucinations?

Answer 3

Hallucinations are usually auditory or visual perceptions of things that are not present.

Question 4

What are classified as delusions?

Answer 4

Delusions are false beliefs.

Question 5

Negative symptoms of SZ

Answer 5

loss of normal functions such as psychomotor disturbances, avolition. Symptoms of these might be ‘word salad’ incoherant sentences or jumbled thoughts etc.

Question 6

Avolition meaning

Answer 6

Lack of desire, person becomes apathetic, no motivated etc (a negative symptom)

Question 7

Classification AO3 (EVAL)

Answer 7

Slater & Roth (1969) say that hallucinations are the least important of all the symptoms, as they are not exclusive to schizophrenic people.

Scheff (1966) points out that diagnosis classification labels the individual, and this can have many adverse effects, such as a self-fulfilling prophecy (patients may begin to act how they are expected to act), and lower self-esteem.

Question 8

Reliabilty in SZ

Answer 8

They should use the same diagnosing strategies (DSM) Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures;

Question 9

Reliability in SZ (AO3)

Answer 9

Diagnosis of schizophrenia is difficult as the practitioner has no physical signs but only symptoms

Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females.

Question 10

Validity in SZ

Answer 10

For the classification system to be valid it should be meaningful and classify a real pattern of symptoms, which result from a real underlying cause.

Question 11

Validity in SZ (AO3)

Answer 11

Since their are problems with the validity of diagnois classification, unsuitable treatment may be administered.

Cultural bias – African Americans and those of Afro-carribean descent are more likely to be diagnosed than their white counterparts.

Question 12

Genetics in SZ (studies)

Answer 12

Gottesman (1991) found that monozygotic twins (idential twins) have a 48% risk of getting schizophrenia whereas dizygotic twins (non-idential) have a 17% risk rate. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia.

Question 13

Genetics EVAL AO3

Answer 13

Very important to note genetics are only partly responsible, otherwise identical twins would have 100% concordance rates.

A second weakness is the problem of nature-v-Nurture. It is very difficult to separate out the influence of nature-v-nurture. The fact that the concordance rates are not 100% means that schizophrenia cannot wholly be explained by genes

Question 14

Dopamine hypothesis

Answer 14

The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine.

High dopamine activity leads to acute episodes, and positive symptoms which include: delusions, hallucinations, confused thinking.

Question 15

Dopamine hypothesis AO3 EVAL

Answer 15

One criticism of the dopamine hypothesis is there is a problem with the chicken and egg. Is the raised dopamine levels the cause of the schizophrenia, or is it the raised dopamine level the result of schizophrenia

One of the biggest criticisms of the dopamine hypothesis came when Farde et al found no difference between schizophrenics’ levels of dopamine compared with ‘healthy’ individuals in 1990.

Question 16

Neural correlates SZ

Answer 16

Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia.

People with schizophrenia have abnormally large ventricles in the brain. This means that the brains of schizophrenics are lighter than normal. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002).

Question 17

Neural correlates EVAL AO3

Answer 17

A strength is that the research into enlarged ventricles and neurotransmitter levels have high reliability. The reason for this is because the research is carried out in highly controlled environments,

weakness of the neuroanatomical explanations is that it is biologically deterministic. The reason for this is because if the individual does have large ventricles then does it really mean that they will develop schizophrenia?

Question 18

Family dysfunction sz

Answer 18

abnormal processes within a family such as conflict, communication problems, cold parenting, criticism, control and high levels of expressed emotions. Prolonged exposure to such interactions prevents the development of an internally coherent construction of reality; in the long run, this manifests itself as typically schizophrenic symptoms

Question 19

Family dysfunction sz EVAL AO3

Answer 19

One strength of the double bind explanation comes from further empirical support provided by Berger (1965). They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics.

A second strength of the research into expressed emotion (EE) is that it has practical applications. For example Hogarty (1991) produced a type of therapy session, which reduced social conflicts between parents and their children which reduced EE and thus relapse rates.

Individual differences – EE is associated with relapse but not all patients who live in high EE families relapse and not all patients in low EE families avoid relapse.

Question 20

Cognitive explanations

Answer 20

Examine how people think, how they process information. Researchers have focused on two factors which appear to be related to some of the experiences and behaviors of people diagnosed with schizophrenia.

Question 21

Cognitive Deficits SZ

Answer 21

There is evidence that people diagnosed as schizophrenic have difficulties in processing various types of information, for example visual and auditory information.

Question 22

Cognitive Biases

Answer 22

Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them – delusions of persecution. Research suggests that these delusions are associated with specific biases in reasoning about and explaining social situations.

Question 23

Cognitive biases (AO3)

Answer 23

Strength - Yellowless et al. (2002) developed a machine that produced virtual hallucinations, such as hearing the television telling you to kill yourself or one person’s face morphing into another’s. The intention is to show schizophrenics that their hallucinations are not real.

One weakness of the cognitive explanation is that there are problems with cause and effect. Cognitive approaches do not explain the causes of cognitive deficits – where they come from in the first place.

Question 24

Drug therapies, Typical antipsychotics

Answer 24

Typical antipsychotic drugs are used to reduce the intensity of positive symptoms, blocking dopamine receptors in the synapses of the brain and thus reducing the action of dopamine.

Question 25

Drug therapies, Atypical antipsychotics

Answer 25

Atypical antipsychotic drugs work on negative symptoms, improving mood, cognitive functions and reducing depression and anxiety.

Question 26

Family therapy

Answer 26

Family therapy is a form of therapy carried out with members of the family with the aim of improving their communication and reducing the stress of living as a family. Family Therapy aims to reduce levels of expressed emotion, and reduced the likelihood of relapse.

Question 27

Aims of family therapy

Answer 27

To educate relatives about schizophrenia.

To stabilize the social authority of the doctor and the family.

Question 28

Methods used in family therapy

Answer 28

Families taught to have weekly family meetings solving problems on family and individual goals, resolve conflict between members, and pinpoint stressors.

Communication skills training – teach family to listen, to express emotions and to discuss things.

Question 29

Token economy

Answer 29

Token economies aim to manage schizophrenia rather than treat it.

They are a form of behavioral therapy where desirable behaviors are encouraged by the use of selective reinforcement and is based on operant conditioning.

Question 30

CBT SZ

Answer 30

In CBT, patients may be taught to recognise examples of dysfunctional or delusional thinking, then may receive help on how to avoid acting on these thoughts. May also get methods of coping with problems, relecting on relationships.

ABC Model - Get the patients to understand what is really happening in their life.
Normalisation - Help the patient realise it is normal to have negative thoughts in certain situations. Therefore there is no need to feel stressed or ashamed about them.

Question 31

CBT EVAL

Answer 31

Turkington et al. (2006) CBT is highly effective and should be used as a mainstream treatment for schizophrenia wherever possible.

Tarrier (2005) reviewed trials of CBT, finding evidence of reduced symptoms, especially positive ones, and lower relapse rates.

Question 32

Interactionist approach

Answer 32

The Interactionist approach acknowledges that there are a range of factors (including biological and psychological) which are involved in the development of schizophrenia.

Question 33

Diathesis-stress model

Answer 33

The diathesis-stress model states that both a vulnerability to SZ and a stress trigger are necessary to develop the condition.

Concordance rates are never 100% which suggests that environmental factors must also play a role in the development of SZ.

Question 34

DIASTRESS AO3

Answer 34

Holistic – Identifies that patients have different triggers, genes etc. – Patients can receive different treatments for their SZ which will be more effective.

Falloon et al (1996) stress – such as divorce or bereavement, causes the brain to be flooded with neurotransmitters which brings on the acute episode.