Schizophrenia

Question 1

Define positive symptoms of schizophrenia

Answer 1

Positive symptoms of schizophrenia are additional experiences beyond those of ordinary existence

Question 2

Define negative symptoms of schizophrenia

Answer 2

Negative symptoms of schizophrenia involve the loss of usual abilities and experiences

Question 3

Give 2 examples of positive symptoms of schizophrenia

Answer 3

Hallucinations and Delusions

Question 4

Give 2 examples of negative symptoms of schizophrenia

Answer 4

Avolition And Speech poverty

Question 5

What are hallucinations?

Answer 5

Hallucinations are unusual sensory experiences e.g. hearing voices in your head

Question 6

What are delusions?

Answer 6

Delusions are irrational beliefs that are resistant to confrontation with the truth

Question 7

What are the 3 types of delusion?

Answer 7

Delusions of Persecution
Delusions of grandeur
Delusions of control

Question 8

Define delusions of persecution

Answer 8

The belief that others want to harm / manipulate you

Question 9

Define delusions of grandeur

Answer 9

The idea that you are an important individual, even god like, and have extraordinary powers

Question 10

Define delusions of control

Answer 10

Individuals may believe that they are under control of an alien force which has invaded their mind

Question 11

What is avolition?

Answer 11

Avolition can be described as findings it difficult to begin or keep up with goal directed activity

Question 12

What is Alogia?

Answer 12

Alogia can be called speech poverty which is categorised by changing patterns in speech in turn reducing the amount and quality of speech

Question 13

How can the diagnosis of schizophrenia be reliable?

Answer 13

Multiple therapists agree in the diagnosis unanimously

Question 14

How can the diagnosis of schizophrenia be valid?

Answer 14

If patients who are diagnosed actually have schizophrenia

Question 15

What are 2 key issues in diagnosing schizophrenia?

Answer 15

Co-morbidity
Symptom overlap

Question 16

Evaluate rosenhans study as a limitation of the diagnostic system AO3

Answer 16

P: a limitation of the diagnostic system is the study from Rosenhan
E: Rosenhan arranged for 8 confederates to act as pseudo patients in 12 different hospitals with the staff not knowing of the experiment. The pseudo patient would arrange an appointment and complain of hearing voices which were unfamiliar. Once placed on the ward the pseudo patients were told to act completely normal and were only discharged when they had convinced staff they were sane. On admission 11 of the 12 were diagnosed with schizophrenia
E: this is a limitation as staff were unable to correctly diagnose patients due to system overlap so was not reliable. Furthermore. Validity was questioned by behaviour being misinterpreted

Question 17

Evaluate sample size as a limitation of Rosenhans study AO3

Answer 17

P:

Question 18

Evaluate symptom overlap as a limitation of diagnosing Schizophrenia AO3

Answer 18

P: a limitation in the diagnosis of schizophrenia is symptom overlap. This is when there is considerable overlap between the symptoms of schizophrenia and other conditions.
E: for example, both schizophrenia and bipolar disorder involve positive symptoms like delusions and negative like Avolition
E: this is a limitation as it calls into question the validity of both classification and diagnosis of schizophrenia since bipolar patients may be diagnosed with schizophrenia

Question 19

How does the diagnosis of schizophrenia demonstrate culture bias? AO3

Answer 19

P: a limitation in the diagnosis of schizophrenia is that there is culture bias
E: for example, the diagnosis has a bias with regard to a diagnostic system which means that certain people are more likely to be classed as having a disorder than other types of people. The diagnostic tool reflects westernised abnormalities and therefore is culturally biased.
E: this is a limitation because African Americans are several times more likely to be diagnosed with schizophrenia. Several factors play a part in this, one being that hearing voices is more accepted in African cultures due to cultural beliefs in communication with ancestors.

Question 20

What are the 3 ways to test whether schizophrenia has a genetic basis?

Answer 20

Twin studies
Family studies
Adoption studies

Question 21

Explain Gottesmans twin studies

Answer 21

Gottesman summarised the findings of 40 twin studies and found a 48% concordance rate for MZ twins and only a 17% rate for DZ twin.
This shows that if MZ twins are more concordance than DZ twins then the greater similarity is due to genetics

Question 22

Explain Gottesmans Family studies

Answer 22

Gottesman found that if both parents had schizophrenia then there was a 46% chance of developing the disorder, 16% if one parent had it and 1% if neither had it
A higher concordance rate for children with 2 schizophrenic parents instead of one suggests that the concordance rate is due to genetics, similar to having a 1% chance with no schizophrenic parents

Question 23

Explain Tienaris adoption studies

Answer 23

Tiernari studied 112 adopted children who had been separated from their schizophrenic mothers and compared them to 135 adopted children with no schizophrenic mother, he found that by the time they reached adulthood 10.3% of those with schizophrenic mothers had developed schizophrenia compared to 1.1% of control group
This shows that genes still impacted the children’s behaviour despite being in a different environment so there is a genetic element to schizophrenia

Question 24

Outline what is meant by candidate genes?

Answer 24

Candidate genes are genes associated with the risk of inheritance. Schizophrenia is polygenic so requires a number of factors to work in combination not just one gene. Schizophrenia is also aetiological heterogenous so different combination of genes can lead to the condition

Question 25

Explain research into candidate genes

Answer 25

Ripke combined all previous data from genome wide studies of schizophrenia and found that the makeup of 37,000 patients compared to 113,000 controls; 108 separate genetic variations were associated with increased risk of schizophrenia. This shows that there is no single gene that causes schizophrenia but multiple genes which explains why there are so many different types of schizophrenia

Question 26

What are the 3 topics in the dopamine hypothesis

Answer 26

Neurotransmitters Hyperdopaminergia Hypodopaminergia

Question 27

Outline the role of neurotransmitters in the dopamine hypothesis

Answer 27

Neurotransmitters in the brain of a schizophrenic appear to function differently. In particular, dopamine seems to be involved, dopamine is important for the functioning of several brain systems which may be implicated in the symptoms of schizophrenia

Question 28

Outline what is meant by Hyperdopaminergia in the sub cortex

Answer 28

The original version of the dopamine hypothesis focuses on the possible role of Hugh levels of dopamine in the sub cortex which leads to positive symptoms of schizophrenia

Question 29

Outline what is meant by hypodopaminergia in the prefrontal cortex

Answer 29

More recent versions of the dopamine hypothesis focus on low levels of dopamine in the prefrontal cortex which leads to negative symptoms of schizophrenia

Question 30

Outline what is means by neural correlates

Answer 30

Neural correlates are the measurements of the structure or function of the brain that correlate with an experience

Question 31

What is the neural correlate of negative symptoms?

Answer 31

One negative symptom is Avolition which involves the loss of motivation. Motivation involves the anticipation of a reward and certain areas of the brain. The Ventral Stratum is believed to be involved in this anticipation

Question 32

What research was done by Juckel into neural correlates of negative symptoms?

Answer 32

Juckel measured activity levels in the ventral striatum in schizophrenia and found low levels of activity than those observed in controls. They observed a negative correlation between levels of activity in the central striatum and severity of schizophrenic symptoms

Question 33

What was found by Allen et al regarding neural correlates of positive symptoms?

Answer 33

Allen et al scanned the brain of patients experiencing auditory Hallucinations and compared them to a control group. They identified pre recorded speech as theirs or others. Lower activation levels in the superior temporal gyrus and anterior cingulate gyrus were found in the hallucination group. So we can say that the reduced activity in these areas of the brain is a neural correlate of auditory hallucination

Question 34

Evaluate Gottesmans / Tiernaris / ripkes research as support for the genetic basis AO3

Answer 34

P: a strength of the genetic explanation is that there is strong evidence to support the genetic vulnerability link to schizophrenia E: for example, Gottesmans study shows how genetic similarity and shared risk of schizophrenia are closely related. Tiernaris adoption studies show that children to schizophrenic sufferers are still at heightened risk even when adopted into families who aren’t not at risk. Furthermore, Ripkes study shows that no particular genetic variation significantly increases the risk of schizophrenia E: this is a strength as there is overwhelming evidence to support the idea that genetic factors make people more vulnerable to schizophrenia

Question 35

How is the role of mutation a strength of the genetic basis of the biological explanation? AO3

Answer 35

P: another strength is that the role of mutation supports the genetic explanation E: for example, schizophrenia can take place in the absence of a family history to the disorder. One explanation for this is mutation in parental DNA which can be caused by radiation or viral infections. This is a strength as research from Brown supports the idea, he found a positive correlation between paternal age and the risk of schizophrenia (0.7% when the dad was under 25 and 2% if the dad was over 50)

Question 36

Evaluate the mixed evidence as a limitation of the dopamine hypothesis AO3

Answer 36

P: a limitation of the dopamine hypothesis is that we have mixed evidence in support E: for example studies that support the hypothesis have found that dopamine agonists that increase the levels of dopamine make schizophrenia worse and can produce schizophrenic blood symptoms in non sufferers Studies that critique

Question 37

Evaluate the correlational causation problem as a limitation of the neural correlates approach AO3

Answer 37

P: a limitation of the neural correlates explanation is the correlation causation problem E: for example, there are a number of neural correlates of schizophrenia symptoms, including positive and negative symptoms. However it is unclear whether the unusual area of the brain causes the symptom or if the symptom causes the abnormality in the brain. E: this is limitation because it is unclear which factor causes the other. It could also be the case that a 3rd factor effects the negative / positive symptoms and the ventral striatum activity

Question 38

How is it a limitation of biological explanations that it fails to consider other explanations? AO3

Answer 38

P: a limitation of the biological explanation is its failure to consider other explanations E: for example, there are a number of other factors that could influence the probability of developing schizophrenia such as the influence of the environment E: this is a limitation as even in MZ twins we don’t see a 100% concordance rate despite sharing 100% of DNA suggesting other factors are in play. There is also evidence that family functioning can play a role in the development of schizophrenia L: this means that the biological explanation lacks a degree of validity since it may be a combination of factors which cause schizophrenia

Question 40

What are the 3 topics in family dysfunction?

Answer 40

The schizophrenogenic mother Double bind theory Expressed Emotion

Question 41

What is a schizophrenogenic and how does she lead to the development of schizophrenia?

Answer 41

The mother is cold rejecting and controlling and tends to make a family climate characterised by tension and distrust. This leads to distrust which causes paranoid delusions and then schizophrenia

Question 42

Outline the double bind theory

Answer 42

The child fears doing the wrong thing but recieves mixed messages, feeling unable to comment on unfairness and seek clarification. When the child gets it wrong they are punished with the withdrawal of love which can lead to disorganised thinking and paranoid delusions

Question 43

What are the 3 types of expressed emotion?

Answer 43

Verbal criticism Hostility Emotional over involvement

Question 44

Define expressed emotion

Answer 44

EE is the level of mainly negative emotion expressed towards a patient by their carers

Question 45

What are the 2 types of dysfunctional thought processing?

Answer 45

Meta representation Central control

Question 46

Define meta representation

Answer 46

The cognitive ability to reflect on our own thoughts and behaviours allowing us insights into our own intentions. Dysfunction disrupts the ability to recognise our own thoughts

Question 47

Define central control

Answer 47

The ability to suppress automatic responses while we perform deliberate tasks. Dysfunction leads to disorganised speech

Question 48

Evaluate supporting research (Read) of family dysfunction AO3

Answer 48

P: a strength of family dysfunction is that it is supported by research E: for example, Read received 46 studies of child abuse and schizophrenia and concluded that 69% of adult schizophrenic women had a history of abuse in childhood. E: this is a strength because there is evidence supporting the principles of family dysfunction as an explanation for schizophrenia

Question 49

Evaluate how evidence supporting family dysfunction is weak AO3

Answer 49

P: a limitation of the explanation is that supporting evidence is weak E: for example, almost none of the research supports the importance of the schizophrenogenic mother or double bind as the large body of evidence supports the broad principles of family dysfunction E: this is a limitation because evidence used to support the Theory is weak so we cannot be certain that there is a link between key concepts and schizophrenia

Question 50

Evaluate supporting evidence from Stirling of the cognitive explanation AO3

Answer 50

P: a strength of the cognitive explanation is that there is supporting research E: for example, Stirling compared 30 patients with a diagnosis of schizophrenia to 18 non patient controls on a range of cognitive tasks, including the strip test. Stirling found that patients took twice as long to name the ink colours than the control group E: this is a strength because evidence supports that information processing in schizophrenics is different to the mind of the control group

Question 51

Explain how the direction of causality is a limitation of the cognitive explanation AO3

Answer 51

P: a limitation of the cognitive explanation is direction of causality E: for example, there is a mass of information concerning abnormal cognitions but it remains unclear whether cognitive factors are a cause or a result of the. E: this is a limitation because the relationship between cognitive processing and schizophrenia remains unclear, there could also be a 3rd factor which effects both

Question 52

What is the difference between typical and atypical antipsychotics?

Answer 52

Typical antipsychotics only treat positive symptoms whereas atypical reduce both positive and negative symptoms

Question 53

Give an example of a typical antipsychotic

Answer 53

Chlorpromazine

Question 54

Give an example of an atypical antipsychotic

Answer 54

Clozapine

Question 55

Outline the function of clozapine

Answer 55

Clozapine is an atypical antipsychotic which binds to dopamine, serotonin and glutamate receptors to reduce positive and negative symptoms of schizophrenia

Question 56

Outline the function of Chlorpromazine

Answer 56

Chlorpromazine is a typical antipsychotic which acts as a dopamine antagonist, blocking dopamine at receptors to reduce the positive effects of schizphrenia

Question 57

What are the evaluation points for drug therapies? AO3

Answer 57

+ highly effective compared to placebo - side effects - questionable evidence relating to its effectiveness - chemical cosh

Question 58

Evaluate research suggesting drug therapies to be highly effective in reducing symptoms of schizophrenia AO3

Answer 58

P: a strength of the biological approach to treating schizophrenia is that we have evidence to suggest that drug therapy is highly effective E: for example, Thornley et al reviewed studies comparing the effects of Chlorpromazine to a placebo with identical experiences. Data from 1121 participants showed that Chlorpromazine was associated with better functioning and reduced symptom severity E: this is a strength as the findings from Thornley suggest that drug therapies are effective L: so if drug therapies are effective then the explanation they are based on must have atleast a degree of validity

Question 59

Evaluate side effects as a limitation of drug therapies AO3

Answer 59

P: a limitation of drug therapies is that they can have serious side effects E: for example, typical antipsychotics are associated with a range of side effects such as dizziness and agitation. In Addition long term use can lead to trice diskenesia. E: this is a limitation because patients may stop taking the drugs due to the side effects which means that they can’t be effective L: so side effects are a massive weakness of anti psychotic drugs

Question 60

Evaluate evidence being questionable as a limitation of drug therapies AO3

Answer 60

P: a limitation of the biological approach to treating schizophrenia is that evidence relating to its effectiveness is questionable E: for example, Healy suggested that some successful trials have had their data published multiple times, exaggerating the evidence for positive effects E: this is a limitation because research may be overstated and distort the reality around the effectiveness of drug therapies

Question 61

Evaluate drugs simply being a chemical cosh as a limitation of the biological explanation AO3

Answer 61

P: a limitation of the use of drug therapies is that it may be unethical as the drugs may simply be a ‘chemical cosh’ E: for example, it may be that drugs are used to calm patients in hospitals to make it easier for staff to work for them rather than for the benefits to the patients themselves E: this is a limitation because although the short term use of drug therapies is recommended, the long term use is considered human rights abuse which raises ethical questions

Question 62

Outlines CBT as a psychological therapy

Answer 62

CBT helps patients identify irrational thoughts and dispute them. This can involve an argument or discussion on how likely the patients beliefs are to be true. This can be done through hypothesis testing . This does not get rid of the symptoms but helps patients cope with them.

Question 63

Define hypothesis testing

Answer 63

The patient keeps a diary as evidence to dispute the irrational beliefs

Question 64

Describe family therapies

Answer 64

Family therapies aim to improve the quality of communication between family members, in line with theories of the schizophrenogenic mother and double bind. The strategy works by reducing stress levels and expresses emotion whilst increasing the chances of the patient complying with the medication so reducing the chances of relapse

Question 65

What are the evaluation points for psychological therapies? AO3

Answer 65

+ supporting evidence + improve quality of life - ethically questionable - evidence for effectiveness is limited

Question 66

Evaluate supporting research for psychological therapies AO3

Answer 66

P: a strength of psychological therapies is that there is supporting research E: for example, Jauhar reviewed the results of 34 studies of CBT and concluded CBT had a significant effect on both positive and negative symptoms Paroah reviewed evidence for family therapy and concluded that there is moderate evidence to show that family therapy prevents hospital readmission over a year E: this is a strength because it suggests that symptoms can be decreased and patients can learn to dispute symptoms

Question 67

How can the treatments improve the quality of life? AO3

Answer 67

P: a strength of the treatments is that they can improve the quality of life E: for example, CBT allows patients to make sense of and challenge their symptoms Furthermore, family therapy helps reduce the stress of living with schizophrenia in a family E: this is a strength because this proves psychological therapies can reduce the severity of some symptoms which decreases the strain on the NHS L: if the treatments are effective then the explanation they are based on must have atleast a degree of validity

Question 68

Evaluate the ethics of psychological treatments AO3

Answer 68

P: a limitation of the psychological treatments is that they are ethically questionable E: for example, CBT challenges a persons paranoia but at what point does it interfere with an individuals freedom of thought E: this is a limitation because treatments may be ethically dubious and should be avoided

Question 69

Evaluate limited evidence for the effectiveness of psychological treatments AO3

Answer 69

P: a limitation of psychological treatments is that the evidence for its effectiveness is limited E: for example, many small scale studies have compared patients before and after treatment and found positive results, however these studies lack a control group or patients aren’t avidly allocated E: this is a limitation as we can’t be certain of the extent that the treatments are effective so the conclusions tend to be more optimistic

Question 70

What theory is token economy based on?

Answer 70

Token economy is based on the reinforcement notion found within Operant Conditioning

Question 71

Describe token economy

Answer 71

When a patient displays a positive behaviour they are rewarded with a token. These tokens can be exchanged for rewards such as advanced privileges. These rewards have to be immediate to prevent delay discounting.

Question 72

What are the 2 evaluation points for token economy? AO3

Answer 72

+ supporting research - ethically questionable

Question 73

Evaluate supporting research for the effectiveness of token economy AO3

Answer 73

P: a strength of token economy as a management technique is that we have evidence for its effectiveness E: for example, 7 high quality studies demonstrated that time economy was effective in reducing negative symptoms of schizophrenia E: this is a strength as Roman economies can help make patients behaviour more socially acceptable and reintegrate them into society

Question 74

Explain the ethical limitation of token economy AO3

Answer 74

P: a limitation of token economy is that it is ethically questionable E: for example, in token economy systems, rewards are more available for patients with mild symptoms compared to patients with more severe symptoms since it is easier for them to display these desirable behaviours E: this is a limitation because ethical issues like this means that patients with more severe symptoms are discriminated against

Question 75

Describe the diathesis stress model as an interactions explanation of schizophrenia

Answer 75

Diathesis means that the individual has a genetic predisposition to schizophrenia and stress means that environment triggers cause schizophrenia in patients who are vulnerable

Question 76

What was argued by Meehl in the original interactionist study?

Answer 76

The original model suggests that the vulnerability was entirely genetic caused by a single schizogene. Meehl argued that without the gene no ammount of stress could cause schizophrenia

Question 77

What was argued by Ripke in the interactionist approach?

Answer 77

Ripke argued that there was no single schizogene but that schizophrenia was polygenic and atiologically hetergenous.

Question 78

What was argued by Houston?

Answer 78

Cannabis acts as a trigger of schizophrenia in those vulnerable. Making individuals 7x more likely to display schizophrenic symptoms

Question 79

What treatment is used according to the interactionist approach?

Answer 79

The interactionist model acknowledges both biological and psychological factors so used both types of treatment; combining both CBT and drug therapy

Question 80

What are the evaluation points for the interactionist approach? AO3

Answer 80

+ supporting research - Tiernari + large sample size - original model was reductionist + supporting research for effectiveness of combined treatment - Turkington

Question 81

Evaluate supporting research of the interactionist approach AO3

Answer 81

P: a strength of the interactionist approach is that there is supporting research E: for example, Tiernari et al investigated the combination of genetic vulnerability and parenting style. Children adopted from 19,000 schizophrenic mothers was used as the sample. The adoptive parents were assessed for their child rearing style and the rates of schizophrenia were compared to a control group of those without any genetic risk. A child rearing style with high levels of criticism and low empathy implicated the development of schizophrenia but only for children with the high genetic risk E: this is a strength as it suggests both genetic vulnerability and family related stress are important in the development of schizophrenia

Question 82

Evaluate the sample used in Tiernaris research AO3

Answer 82

P: a strength of Tiernaris research is that it had a large sample size E: for example, 19,000 Finnish adopted children were used as the sample. E: this is a strength since the sample size is relatively large which increases the generalisability of the results.

Question 83

How is the original model of the interactionist explanation reductionist? AO3

Answer 83

P: a limitation of the interactionist approach is that the original model is reductionist E: for example, multiple genes are needed for the development of schizophrenia but Meehl suggested that schizophrenia was caused by a single schizogene E: this is a limitation since it is now believed that schizophrenia is polygenic and ateologically heterogenous so the original model is deemed oversimplistic

Question 84

Evaluate research supporting the effectiveness of combined treatment AO3

Answer 84

P: a strength of the interactionist approach is that we have support for the effectiveness of combined treatments E: turkington et al pointed out that it’s not possible to used a combination of treatments without adopting the interactionist approach. And multiple research seems combined treatment as the most effective E: this is a strength as if the treatment is effective then the explanation it is based on must be atleast partially valid