Schizophrenia Flashcards

Question

what was Rosenhan's follow up study?

Answer 1

A follow up study was conducted after Rosenhan revealed the results of his initial research.in this follow-up a hospital was informed that one or more pseudo patient would attempt to gain admission within a specific period. The hospital staff were tasked with identifying which patient they believed were pseudo patients. During this time no pseudo patients were sent yet the staff identified 41 individuals as likely imposters. This revealed that hospitals could err in the opposite direction, mistaking genuine patients for pseudo patients, thus illustrating the potential for both false positives and false negatives in psychiatric diagnosis.

Answer 2

The study revealed several key findings that raised serious questions about the validity and reliability of psychiatric diagnosis. The fact that all pseudo patient were admitted and diagnosed, despite their lack of symptoms after admission, demonstrated how diagnostic symptoms could pathologize normal behaviour once a label has been applied. Normal behaviour such as note taking or pacing due to boredom, were often interpreted as symptoms of schizophrenia suggesting that labels could heavily bias the perceptions of mental health professionals. The follow up study further demonstrated the unreliability of psychiatric diagnosis, as the staff's suspicions of imposters led to a significant number of false positives. Rosenhan concluded that psychiatric diagnosis was not as objective or scientific as it claimed to be and that the labels applied to individuals could lead to stigmatization and misinterpretation of behaviour. He famously stated 'it is clear that we cannot distinguish the sane from the insane in psychiatric hospitals.

Answer 3

- The Diagnostic and statistical manual of mental disorder edition 5 was last published in 2013 - The DSM is produced by the American psychiatric Association. - It is most widely used diagnostic tool in psychiatric institutions throughout America and some parts of Europe.

Answer 4

- International statistical classification of diseases knowns as ICD - produced in Europe by the world health organisation WHO and is currently in its 10th edition - used in the UK and many other European countries

Answer 5

- Validity refers to the extent that a diagnosis represents something that is real and distinct from other disorders and the extent that a classification system such as ICD or DSM measure what it claims to measure. - Reliability and validity are linked because if scientists cannot agree who has schizophrenia low reliability then questions of what it is ie validity become essentially meaningless reliability - reliability refers to the consistency of a measuring instrument, such as a questionnaire or scale, to assess for example the severity of the schizophrenic symptoms. - reliability of such questionnaires or scales can be measured in terms of whether 2 independent assessors give similar diagnosis inter- rater reliability or whether used to deliver these diagnosis are consistent over time test -restest reliability.

Answer 6

- An important measure of reliability is inter-rater reliability - in relation to diagnosis, this means that different clinicians make identical, independent diagnosis of the same patient - Cheniaux et al 2009 had two psychiatrists independently diagnose 10 patients using both DSM and ICD criteria. psychiatrist 1 26- dsm 44- icd psychiatrist 2 dsm 13 icd - 24

Answer 7

Gave 134 US and 194 British psychiatrists a description of a patient. -69% of the US psychiatrists diagnosed schizophrenia - only 2%of British psychiatrists diagnosed schizophrenia

Answer 8

Interviewed 60 adults with a diagnosis of schizophrenia and asked about the voices they heard. - 20 from Ghana, 20 from India 20 from US - pps from Ghana and India reported positive experiences with their voices playful offered advices - US pps reported only negative experiences hateful, violent maybe the harsh/violent voices prevalent in the west is not inevitable in schizophrenia - African Americans and english people of Afro-Caribbean origin are more likely then white people to be diagnosed with schizophrenia. Given that rates in Africa and the west indies are not particularly high this almost certainly not due to genetic vulnerability. instead diagnosis seems to beset with issues of culture bias. - Positive symptoms such hearing voices may be more acceptable in African cultures because of cultural beliefs in communication with ancestors so people are more ready to acknowledge such experiences. when reported to a psychiatrist from a different cultural tradition these experiences are likely to be seen as bizarre and irrational. in addition javier escobar 2012 has pointed out that overwhelmingly white psychiatrists may tend to over interpret symptoms and distrust the honesty of Afro-Caribbeans during diagnosis.

Answer 9

Julia Longenecker et al 2010 since the 1980s men have been diagnosed with schizophrenia rather more often than women prior to this there appears to have been no difference - this may simply be because men are more genetically vulnerable to developing schizophrenia than women. However, another possible explanation is gender bias in the diagnosis of schizophrenia. - it appears that women typically function better then men being more likely to work and have good family relationships. - this high functioning may explain why some women have not been diagnosed with schizophrenia where men with similar symptoms might have been their better interpersonal functioning may bias practitioners to under diagnosis schizophrenia either because symptoms are masked altogether by good interpersonal functioning or because the quality of interpersonal functioning makes the case seem too mild to warrant a diagnosis.

Answer 10

Ellason and Ross 1995 point out that people with dissociative identity disorder have more schizophrenia symptoms than people diagnosed as being schizophrenic bipolar disorder also shared a lot of symptoms with schizophrenia e.g. delusions , hallucinations and avolition. This causes problems because the same persons can be diagnosed with schizophrenia using the ICD but bipolar using the DSM criteria. Ketter 2005 points out that misdiagnosis due to symptom overlap can lead to years of delay in receiving relevant treatment, during which time suffering and further degeneration can occur, as well as high levels of suicide- so symptoms overlap can have serious consequences. Focusing on fixing this issue could save money and lives.

Answer 11

- Comorbidity is the occurrence of two illnesses or conditions together; for example, a person has both schizophrenia and a personality disorder -it questions the validity as psychiatrists might not being able to tell the difference between the two conditions. - Buckley et al 2009 concluded that around half patients with a diagnosis of schizophrenia also have a diagnosis of depression 50% or substance abuse 47% post- traumatic stress occurred in 29% cases and ocd in 23% showing that schizophrenia commonly occurs alongside other mental illnesses and the disorders are co-morbid

Answer 12

- The risk of developing schizophrenia is higher for those who have family member with the disorder than those who don't - Schizophrenia is thought to be polygenic - this means that its development is not determined by a single gene but requires a number of factors to work in combination maybe as many as 108 genes - this means that there is little to predictive power from this explanation.

Answer 13

- Tienari et al 2000 conducted a study in finland -164 adoptees whose biological mothers had been diagnosed with schizophrenia - 11 also recieved a diagnosis of schizophrenia - control group of adoptees with non- schizophrenic mothers - 4 diagnosed with schizophrenia

Answer 14

- there is strong evidence to support the idea that genetic factors plqay a significant role in vulnerability to schizophrenia - however there is also evidence to support environmental factors such as family function during childhood - and the concordance rate for mz twins is only 48% identical share 100% gene so concordance rate should be too.

Answer 15

- measurements of the structure of function of the brain that correlates with an experience - positive and negative symptoms have neural correlates negative symptoms - the ventral striatum plays a crucial role in selecting actions required to reach a target location and guiding goal-directed behaviour (rewards and motivation) - ventral striatum is a neural correlate of negative symptoms -Juckel et al 2006 measured activity levels of ventral striatum in schizophrenics - as activity levels increase, avolition decreases as activity decreases avolition increases. positive symptoms Anterior cingulate cortex is known to be associated with motor execution, but also vocalisation emotional processing. The superior temporal gyrus is involved in auditory processing.

Answer 16

- scanned brains of patients experiencing auditory hallucinations ( positive symptoms) - compared to control group whilst they identified pre-recorded speech as theirs or others. - lower activation in superior temporal gyrus and anterior cingulate gyrus found in hallucination group- made more errors - reduced activity in these parts of the brain is a neural correlate for auditory hallucinations

Answer 17

there are several neural correlates of schizophrenia symptoms but could the unusual activity in the brain cause the symptoms. for example the correlation between negative symptoms and the ventral striatum could just mean that the symptoms caused reduced activity or that another factor influence both negative symptoms and the ventral striatum. therefore the existence of neural correlates in schizophrenia tells us relatively little.

Answer 18

- Dopamine is a chemical substance (neurotransmitter) manufactured in the brain that transmits messages between neurons (Brain cells) - dopamine appears to work differently in patients with schizophrenia - dopamine is particularly important in the functioning of several brain systems that may cause symptoms of schizophrenia - in particular the cortex and subcortex

Answer 19

hyper meaning too much - the original version of the dopamine hypothesis focused on the possible role of high levels or activity of dopamine hyperdopaminergia in the subcortex i.e. the central areas of the brain - for example an excess of dopamine receptors in Broca's area which is responsible for speech production may be associated with poverty of speech and/or the experience of auditory hallucinations

Answer 20

- more recent versions of the dopamine hypothesis have focused instead on abnormal dopamine systems in the brain's cortex -Goldman- Rakic et al 2004 have identified a role for low levels of dopamine hypodopaminergia in the prefrontal cortex responsible for thinking and decision making in the negative symptoms of schizophrenia it may be that both hyper- and hypodopaminergia are correct explanations - both high and low levels of dopamine in different rain regions are involved in schizophrenia.

Answer 21

the original dopamine hypothesis claimed that the positive symptoms of schizophrenia are caused by an excess of dopamine. Dopamine transmitting neurons fire too easily or too often. schizophrenics are believed to have an excess of D2 receptors on recieving neurons resulting in more dopamine binding are more neurons firing. David and kahn created the revised dopamine hypothesis which says that the positive symptoms of schizophrenia.

Answer 22

Falkai et al 1988 found increased dopamine levels in the left Amygdala in post mortems of schizophrenic patients. this shows there is research evidence for biological explanation of schizophrenia

Answer 23

there is some evidence to suggest that dopamine is not the only neurotransmitter involved. Moghaddam & javitt 2012 found evidence for the role of a different type of neurotransmitter called glutamate in which it appeared that schizophrenics have a deficiency in glutamate function.

Answer 24

- well, the answer is drugs in the form of tablets or medicine and can be taken long term or short term. - antipsychotic drugs- typical ( traditional & atypical newer - It is thought that schizophrenics produce too much dopamine or have more dopamine receptors than non-schizophrenics. We cannot decrease the amount of dopamine or reduce the number of receptors so the next best thing is to block the receptors. this is what typical anti psychotics do.

Answer 25

in non-schizophrenic individuals and exacerbate symptoms in schizophrenic individuals. These drugs activate dopamine systems in the brain and can also induce similar symptoms in non-sufferers curran et al 2004. supports increased levels dopamine contributes to schizophrenia.

Answer 26

the first generation of antipsychotics developed during the 1950s. block receptors and you still need them

Answer 27

a newer generation of antipsychotics developed during the 1990's

Answer 28

chlorpromazine -they reduce positive symptoms - blocking receptors neurotransmitters dopamine - 60&75% of d2 receptors must be blocked to be effective - as always blocked cause side effects like blurred vision tremors and increased heart rate also act a sedative to calm patients

Answer 29

olanzapine risperidone positive and negative symptoms have benefitted effect on and claimed benefit on cognitve impairment block d2 receptors but only temporaily then they rapidly dissociate to allow normal dopamine transmission and also act on other neurotransmitters e.g acetylcholine and serotonin side effects are weight gain unresponsiveness to insulin fatal seizures

Answer 30

- Ben Thornley et al 2003 reviewed studies comparing the effects of chlorpromazine to control conditions use of placebo - data from 13 trials with a total of 1121 patients showed that chlorpromazine was associated with better overall functioning and reduced symptom severity . - data from three trials with a total of 512 patients showed that relapse rate was also lower when chlorpromazine was taken - in a review herbert meltzer 2012 concluded that clozapine is more effective than typical antipsychotics and other atypical antipsychotics, and that it is effective in 30-50% treatment resistant cases where typical antipsychotics have failed.

Answer 31

the body of evidence supports that antipsychotics both typical and atypical work for majority of patients. these medications are effective in reducing symptoms improving overall functioning, and lowering relapse rates. this makes them a reliable treatment option in managing schizophrenia.

Answer 32

- David Healy 2012 has suggested that some successful trials have had their data published multiple times, exaggerating the evidence for positive effects. - Healy also suggests that because antipsychotics have powerful calming effects, it is easy to demonstrate that they have some positive effect on people with schizophrenia. this is not the same as saying they really reduce the severity of psychosis. - also most published studies assess short term benefits rather than long term benefits and compare people who keep taking antipsychotics with those experiencing withdrawal having just stopped taking them.

Answer 33

These issues suggest antipsychotic drugs may not be effective after all. At least there is evidence for their effectiveness than we might suppose it may be that their effectiveness has been exaggerated by drug companies

Answer 34

Typical antipsychotics are associated with a range of side effects including dizziness, agitation sleepiness stiff jaw , weight gain and itchy skin. - Tardive dyskinesia caused by dopamine super sensitivity and manifests as involuntary facial movements such as grimacing blinking and lip smacking. - Neuroleptic malignant syndrome nms This is believed to be caused because the drug blocks dopamine action in the hypothalamus, an area of the brain associated with the regulation of must body systems . NMS results in high temperature , delirium and coma, and can be fatal. Atypical also have a side effect, people taking clozapine must have regular blood tests to alert doctors to early signs of agranulocytosis?

Answer 35

Severe side effects challenge the ethical justification of prescribing drugs that might harm patients in significant ways, even if the drugs help to manage the symptoms. Some patients may not tolerate the side effects and stop taking them altogether, leaving them to relapse or worsening symptoms side effects diminish the effectiveness and appeal of drug therapy by negatively effecting patient adherence them sticking to the drugs quality of life and safety which are critical to successful treatment outcomes.

Answer 36

Our understanding of the mechanism of antipsychotic drugs is strongly tied up with the dopamine hypothesis in its original form. Remember this is the idea that there are higher than usual levels of dopamine activity in the subcortex of the brain. There is however quite a bit of evidence to show that this original hypothesis is not a complete explanation of schizophrenia, and that in fact dopamine levels in parts of the brain other than the subcortex are too low rather than too high. If this is true then it is not clear how antipsychotics which are dopamine antagonists can help with schizophrenia when they reduce dopamine activity

Answer 37

The contradiction between the use of antipsychotics and the dopamine hypothesis is a weakness of drug therapy because it challenges the theoretical basis for why these drugs are believed to work. A disconnect between the explanation for schizophrenia and the mechanism of the drugs undermining the scientific rationale behind their use. Since it’s unclear why antipsychotics work at all it raises doubt about their true effectiveness and whether they address the root cause of the disorder.

Answer 38

- Frieda Fromm- Reichmann 1948 proposed a psychodynamic explanation for schizophrenia based on the accounts she heard from her clients about their childhoods - Fromm. Reichman noted that many of her clients spoke of a particular type of parent which she called schiziphrenogenic mother. “ schizophrenogenic “ literally mean schizophrenia causing . According to Fromm Reichman the schizophrenogenic mother is cold, rejecting and controlling and tends to create a family climate characterised by tensions and secrecy. This leads to distrust that later develops into paranoid delusions I.e the belief that one is being persecuted by another person and ultimately schizophrenia.

Answer 39

Mednick 1984 identified 207 children they considered to be at high risk of developing schizophrenia because of being reared in dysfunctional families. More specifically mothers who were temperamental cold rejecting and emotionally aggressive. They were compared to a control group of 107 people. None of the partcipants or their mothers had schizophrenia at the beginning of the study within ten years 17 of the high risk group were diagnosed with schizophrenia whereas only one in the control group.

Answer 40

Bateson et al 1972 Role of communication style within a family - Developing child finds themselves trapped in situations where they feel doing wrong thing - receive mixed messages about what this is - feel unable to seek clarification -when they get it wrong which is quite often child punished by withdrawal of love - feel world is confusing and dangerous - reflected in disorganised thinking and paranoid delusions This is a risk factor

Answer 41

A mother tells her son/ daughter that they are not affectionate enough but when the child shows affection the mother pushes them away with th e comment grow up you big baby. - small children in particular have a difficulty with these contradictory messages and can neither ignore the message nor leave the relationship because they are so dependant upon their parents. - if the situation can not be resolved by the individual by being ignored or leaving the situation then the situation becomes a double bind one - parents who send out mutually contradictory signals such as in the example above place their children in impossible situations when they cannot act in one way without in some way going against their parents apparent wishes. - the child doesn’t know how to respond to the conflict between the words and the body language - if the child cannot resolve the confusion and leads to state of internal conflict -prolonged exposure to such interactions prevents in development of an internally coherent construction of reality.

Answer 42

- the result is that children lose their grip on reality and if double bind messages are presented continually and habitually within the family context from infancy on by the time the child is old enough to have identified the double bind situation, it has already been internalised and the child is unable to confront it.

Answer 43

Berger 1965 found that schizophrenic patients when compared to controls, had a higher recall of double bind statements ( messages contradicts actions ) from their childhood. They remembered contradictory messages from their mother more often than those without schizophrenia. However, this is not a concrete result memory and recall are related symptoms associated with schizophrenia and this may affect the results.

Answer 44

Expressed emotion EE is a qualitative measure of the amount of emotion displayed within the family setting, usually by family members or care takers. It can be measured by using the Camberwell family interview or the five minute speech sample. The theory proposes that high levels of EE within the home of the schizophrenic can : worsen the prognosis in patients with schizophrenia

Answer 45

Worsen prognosis in patients with schizophrenia Increase the likelihood of relapse and readmission into hospital for the patient A high EE household is made up three dimensions

Answer 46

Hostility Emotional over -involvement Critical comments

Answer 47

Hostility is a negative attitude directed at the patient because the family feels that the disorder is controllable and that the patient is choosing not to get better. Problems in the family are often blamed on the patient. The family believes that the cause of many of the family’s problems is the patients mental illness.

Answer 48

It is termed emotional over-involvement when the family members blame themselves for the mental illness. This is commonly found in females. The family member shows a lot of concern for the patient and the disorder. This is the opposite of a hostile attitude but still has the same negative effect on the patient as it makes the patient feel guilty. The pity from the relative causes too much stress and the patient relapses to cope with the pity .

Answer 49

Critical attitudes are combinations of hostile and emotional over involvement. It shows an openness that the disorder is not entirely in the patients control, but there is still negative criticism. Critical parents often influence the patients siblings to be the same way.

Answer 50

Altorfer 1998 found that 1/4 patients they studied showed no physiological responses to stressful comments from their relatives. Vulnerability to high EE may also be physiological based. For example research by Lebell 1993 suggest that how patients appraise the behavior of their relatives is important. In cases where high EE behaviours are not perceived as being negative or stressful , they can do well regardless of how the family environment is objectively related showing not all patients are equally vulnerable to high level of expressed emotion.

Answer 51

In a person without schizophrenia , they however distinguish between information that is important and information that isn’t - however, in the mind of a person with schizophrenia they have a faulty processing system and it said they have an inability to distinguish between information that is already stored and new incoming information. - as a result the person with schizophrenia is subjected to sensory overload and does not know which aspects of an situation to attend to and which to ignore. This may result in them : Being confused Not being able to grasp what actually reality is - in a normal brain there is a mechanism that filters incoming stimuli - in the brain of a person with schizophrenia the mechanism malfunctions and lets in too much stimuli - cannot focus - unable to interpret information correctly - world is very different - the most dramatic distortions of perception are hallucinations - more often auditory 74% than visual - can be very frightening

Answer 52

Meta representation Central control

Answer 53

Cognitive ability to reflect on thoughts/ behaviour. Allowing use insight into our own goals and allow us to interpret the actions of others. Dysfunction. Would disrupt our ability to recognise our own thoughts and actions. This therefore can explain hallucinations as the inner voice is experienced as coming form an external voice.

Answer 54

Ability to suppress automatic response while we perform deliberate actions. Disorganised speech / thought due to inability to suppress automatic thought. Each word triggers associations and these can’t be suppressed.

Answer 55

Stirling compared 30 patients with diagnosis of schizophrenia with 18 non patient controls on cognitive test stroop task - patients took twice as long to name the ink colours as the control group - shows they could not suppress impulse to read the words - suggest that info processing different in minds of people with schizophrenia - However do not tell us about the origins of conditions can explain cause of the symptoms

Answer 56

Patients are encouraged to evaluate the content of their delusions and the validity of their faulty beliefs. This supports the notion that patients with schizophrenia must have dysfunctional thoughts

Answer 57

Ie where the dysfunction comes from in the first place. A causing the schizophrenic behaviour or is the schizophrenia the cause of the cognitive deficits causing.

Answer 58

The CBT for psychosis approach to treatment differs slightly from conventional CBT methods. To challenge and modify delusory beliefs To help the patient to identify delusions To challenge those delusions by looking at evidence To help the patient to begin to test the reality of the evidence

Answer 59

Assessment Engagement The ABC model Normalisation Critical collaborative analysis Developing alternative explanations

Answer 60

the client expresses their experiences and symptoms to the therapist. Goals and expectations of therapy can be established here

Answer 61

- the therapist provides a therapeutic environment for the patient where they can engage in therapy - this includes the therapist empathising with the patients perspective feelings of distress etc -the therapist must also stress that explanations for the patients distress can be developed together

Answer 62

patients describe activating event that is the cause of their irrational beliefs/behaviour as well as the consequences - these beliefs can then be challenged or disrupted and changed " people wont like me if i tell them about my voices " becomes some may some may not. friends might find it interesting

Answer 63

knowing that there are other people who experience the same things as you can help to greatly reduce feelings of isolation and anxiety - placing psychotic experiences on a continuum of normal experience can help patients feel less stigmatised

Answer 64

- Gentle questioning is used by the therapist to help the patient understand their illogical though processes " if your voices are real why cant anyone else hear them " - the therapeutic relationship is essential here so that questioning can be used in a non threatening way - This means there needs to be trust between therapist and patient

Answer 65

- CBT technique of discussing alternative explanations for unhealthy assumptions - This can be done in collaboration with the therapist.

Answer 66

- CBT is more effective in reducing rehospitalisation rates after 18months than standard care alone neuroleptics - CBT is also effective in reducing severity of symptoms and can improve social functioning. CBT in conjunction with antipsychotic medication or on its own if medication is declined can improve outcomes such as psychotic symptoms. It should form part of a broad based approach that combines different treatment options tailored to the needs of individual service users.

Answer 67

as most patients use it in conjunction with anti psychotics - Despite the NICE recommendations, approximately 1 in 10 of those who need it are able to access CBT

Answer 68

of 187 randomly selected schizophrenic patients from the north west of england 6.9% had been offered CBT

Answer 69

- ie not suitable when the patient are deluding as they cannot fully engage with the therapy - depending on the stage of disorder depends on the success of treatment - Addington and Addington 2005 suggest that initial acute phase is not conducive to self-reflection therefore engagement will be a problem - They say that once symptoms have stabilised with medications group CBT may be more beneficial

Answer 70

Family therapy aims to improve the communication and interactionn between family members. As we know, high EE can cause a patient to relapse. It lasts between 3-12 months with sessions every 2-4weeks. A minimum of 10 sessions are recommended by NICE. The therapists work with the family and the patient to develop strategies to cope better with the mental disorder and its symptoms. This leads to a more supportive and warmer atmosphere which helps the patient make better progress.

Answer 71

- Encourage family to discuss what it is like to live with a person with schizophrenia _ Allow everyone's voice to be heard, to reduce tension in the family - Give the family the info they need to understand the illness - Help family understand that they are not to blame

Answer 72

pharoah et al 2010 phraoah identified a number of strategies t make this more effective 1 Form therapeutic alliance with the family members 2 Reduce the stress of caring for their relative 3 Improve family's awareness of relapse triggers 4 Reduce anger and guilt in family members 5 Help family achieve a carer - own life balance 6 Improve beliefs about schizophrenia

Answer 73

- Evidence shows that family therapy is effective at reducing readmissions to hospitals and encourages patients to comply with medicine. Therefore, it is cost effective when family therapy is combined with antipsychotics. Although add costs to government initially, overtime this offset by reduced hospital readmissions. - It benefits all family members. By strengthening the function of the whole family, family therapy lessons the negative impact of schizophrenia on other family members.

Answer 74

This is NOT a cure or treatment. it is a system to encourage positive behaviour and change patterns of maladaptive behaviour, which has developed through spending a long period of time in a institution. token economies is where they get rewarded for good behaviour and rewarded for it e.g in prison they get to listen to music or watch tv

Answer 75

one strentgh of the program is simple and easy to follow. This is because it is easy to implement with little need for expertise and specifically trained professionals like anger management. this means that they a relatively cost effective and easy for staff members to follow. However while easy to implement, they do require consistency between staff members and so staff do require training. Inconsistency of the staff can lead to the program to fail. one weakness is that programs offer little rehabilitive value. for example many offenders do not leave the token economy system changed individuals and any positive changes seen in offenders are quickly lost after release. Behaviourists would argue that this is inevitable because once you remove the rewards like after release the positive behaviours are repeated and their schizophrenic behaviours may increase more eg not washing or taking care after themselves. However while it has no lasting effects it is argued it does create a more positive and beneficial environment when in a psychiatric facility

Answer 76

All psychological therapies improve the quality of life in some way - CBT making sense of the world - family therapy reducing stress at home - Token economies reinforcing acceptable behaviour so that ps can reintegrate into society - washing etc

Answer 77

- Drugs = reduce severity of symptoms , often need to be prescribed before other types of therapy can take place - drugs are cheaper - drugs have a direct impact on neurotransmitters rather than just improving their quality of life

Answer 78

Although research shows the importance of biological factors in schizophrenia , it also highlights the significance of environmental factors. An explanation that links biological vulnerability to environmental stressors is the diathesis stress model. This model explains that individuals will develop schizophrenia if they have a biological predisposition and if they are exposed to stressful situations. have to have predisposition otherwise cant be diagnosed with schizophrenia diathesis- a predisposition to develop a medical condition + stress- any environmental factor that could trigger the disorder = schizophrenia

Answer 79

- Diathesis , vulnerability is entirely genetic - the result of single schizogene, which led to a biologically based schizotype personality- extremely sensitive to stress - no amount to stress will lead to schizophrenia if the gene is not present - However, chronic stress in someone with the gene could lead to the development of the disorder - nature and nurture interact

Answer 80

- Now clear that many genes appear to increase genetic vulnerability slightly - Modern views also include a range of factors beyond the genetic- including psychological trauma - Read et al proposed a neurodevelopment model where early childhood trauma affects the development of the brain- child abuse HPA system can become overactive , making the person more vulnerable to stress

Answer 81

- A modern definition of stress includes anything that risks triggering schizophrenia - Recent research has concerned cannabis use. In terms of diathesis stress cannabis is a stressor because it increases the risk of schizophrenia by up to 7 times according to dose - cannabis interferes with the dopamine system. Most people do not develop schizophrenia after smoking cannabis so it seems there must be also one or more vulnerability factors.

Answer 82

Tienari et al 2004 - carried out a prospective study of 19,000 finish children adopted away from their biological family who had mothers diagnosed with schizophrenia. They also assessed the rearing style of the adoptive family. They compared this group with a group of children with no parent diagnosed with schizophrenia. After 21 years they found that in the adoptees at high genetic risk of schizophrenia, but not in those at low genetic risk an adoptive family with a high level of criticism and conflict was a significant predictor .

Answer 83

As this model acknowledges an interaction of biological and psychological causes , it believes that a combination therapy should be employed between antipsychotic drugs and psychological therapies such as CBT. Turkington et al - we can still believe that schizophrenia has a biological basis but use CBT to relieve the psychological symptoms as in doing so , an interactionist approach has been adopted as both psychological and biological factors are addressed. Uk - it is perfectly acceptable to use a combination of both therapies USA - conflict between biological and psychological therapies which has led to slower adoption of the interactionist model. Medication alone is more common here,.

Answer 84

- Tarrier et al 2000 found that receiving twenty sessions of CBT and four booster sessions within a year and taking antipsychotic drugs functioned better and had lower symptoms levels than patients receiving drugs alone or attending counselling and taking drugs. However, after two years theses patients did no better than the ones taking drugs and attending counselling however both groups functioned better than the group only receiving drugs. - Morrison et al 2014 found that drug treatment given with CBT led to lower levels in the severity of symptoms and lower rehospitalisation than drug treatment alone.

Answer 85

There is strong evidence to suggest that some sort of underlying vulnerability coupled with stress can lead to schizophrenia. We also have well informed suggestions for how vulnerabilities and stress may lead to symptoms. However, we do not yet fully understand the mechanisms by which the symptoms of schizophrenia appear and how both vulnerability and stress produce them.

Answer 86

Turkington et al argue that there is a good logical fit between the interactionist approach and using combination treatments . However, the fact that combined biological and psychological treatment are more effective than either on their own does not mean the interactionist approach to schizophrenia is correct. Similarly the fact that drugs help does not mean that schizophrenia is biological in origin. This error of logic I called the treatment t- causation fallacy.

Schizophrenia Flashcards

(111 cards)