Schizophrenia

Question 1

Clinical Characteristics: positive symptoms

Answer 1

An additional experience beyond ordinary
- Hallucinations (unusual sensory experience)
- Delusions (irrational beliefs)

Question 2

Clinical characteristics: negative symptoms

Answer 2

Reduction/loss of usual abilities
- speech poverty (amount/quality)
- Avolition (lack interests/ goals/hygiene)

Question 3

Diagnostic Material

Answer 3

Diagnostic and Statistical Manual (DSM-5)
International Classification of Diseases (ICD-10)

Question 4

Whaley (1980)

Answer 4

Reliability
DSM-3 inter-rater low as +0.11

Question 5

Osorio et al (2019)

Answer 5

Reliability
DSM-5 inter- rater +0.97
test-retest +0.92

Question 6

Buckley et al

Answer 6

Co-morbidity
50% also have depression
47% also have substance abuse
23% also have OCD

Question 7

Ellason and Ross

Answer 7

Symptom Overlap
people wit DID have more schizophrenic symptoms than those diagnosed with schizophrenia
Most people diagnosed with schizophrenia have symptoms of other disorders

Question 8

Loring and Powell

Answer 8

Gender Bias
56% psychiatrists gave a diagnosis of schizophrenia when the patient in a case study was male/ no gender info, only 20% when female same cases

Question 9

Longnecker et al

Answer 9

Gender Bias
since 1980s men diagnosed more often, could be due to genetic vulnerability or women tend to function better

Question 10

Copeland

Answer 10

Culture bias
69% US psychiatrists diagnosed patient compared to 2% British psychiatrists for the same patient

Question 11

Luhrmann et al

Answer 11

Culture bias
Interviewed patients in Ghana, India and US about hearing voices
US reported violent and hateful voices
This may be due to cultural beliefs of communication with ancestors

Question 12

Gottesman

Answer 12

MZ 48% DZ 17%

Question 13

Tienari et al

Answer 13

164 adoptees with schizophrenic mother
6.7% also received diagnosis, 2% control group (197 adoptees)
Adoptees with schizophrenic mothers 3 times as likely to receive diagnosis

Question 14

Ripke et al

Answer 14

Genome wide study
genetic makeup 37000 schizophrenic individuals with 113000 controls
108 genetic variations increase risk

Question 15

Brown et al

Answer 15

Role of mutation
(radiation/poison/ viral infection)
evidence comes from positive correlations between parental age and risk of schizophrenia
0.7% in fathers under 25
over 2% in fathers over 50

Question 16

Davis et al

Answer 16

Hypodopaminergia - low dopamine in cortex
-cognitive problems
-may lead to hyperdopaminergia

Question 17

Leucht et al (eval)

Answer 17

meta-analysis 212 studies on anti-psychotics vs placebos, drugs more effective in every case
role of dopamine levels

Question 18

Noll (eval)

Answer 18

Antipsychotics don’t alleviate symptoms in 1/3 patients
biological reductionism

Question 19

Fromm-Reichmann

Answer 19

Psychodynamic
schizophrenogenic mother
-cold, rejecting and creates tension
- leads to distrust and paranoia

Question 20

Bateson et al

Answer 20

Double-Bind hypothesis
-child worries about right/wrong
- feels unable to comment, withdrawal of love as punishment
-develops view of world as confusing and dangerous

Question 21

Frith

Answer 21

Dysfunctional thought processing
metarepresentation - cognitive ability to reflect on thoughts/behaviour
- disrupts ability to recognise own thoughts and behaviour
central control - ability to suppress response
- cannot suppress automatic thoughts and speech - speech poverty

Question 22

Read et al (eval)

Answer 22

46 studies child abuse, 69% femal, 59% male patients history of physical/sexual abuse

Question 23

Tienari et al support family dysfunction

Answer 23

only if adoptive family is disturbed

Question 24

Stirling et al (eval)

Answer 24

30 patients vs 18 non-patients in cognitive task eg. stroop test, patients took over twice as long to complete

Question 25

Jauhar et al (eval)

Answer 25

34 CBT studies, effect on positive and negative symptoms

Question 26

Leucht misleading data

Answer 26

64% placebos relapsed, 34% did not 34% should be 0% if drugs completely effective

Question 27

Pharaoh et al

Answer 27

Family therapy -therapeutic alliances -help with care -reduce anger and guilt -strike balance -improve beliefs

Question 28

Burbach's model

Answer 28

family therapy 1 share basic info 2 identify skills 3 safe space 4 identify unhelpful patterns 5 skills training 6 relapse prevention 7 maintenance for future

Question 29

Jauhar et al CBT support

Answer 29

34 studies small and significant effect

Question 30

Pontillo (eval)

Answer 30

reduction in frequency and severity of auditory hallucinations after CBT

Question 31

McFarlane (eval)

Answer 31

family therapy most effective, relapse reduced 50-60% use when mental health declines

Question 32

Glowacki et al (eval)

Answer 32

7 high quality studies token economies , reduction negative symptoms and frequently unwanted behaviour

Question 33

Chiang et al (eval)

Answer 33

art therapy, pleasant without risks of side effects/ ethical abuse

Question 34

Meehls model

Answer 34

original diathesis stress 1962 diathesis: 'schizogene' - schizotypic personality stress: chronic stress throughout childhood

Question 35

Tarrier et al (eval)

Answer 35

315 patients medication and CBT/ medication and support/ control, 2 combinations showed lower symptoms than control, no difference in readmission

Question 36

Houston et al

Answer 36

Modern stress - anything that risks triggering schizophrenia