Schizophrenia

Question 1

what is schizophrenia

Answer 1

a serious long term illness, where an individual fails to understand what is real and is characterized by abnormnal social behaviour

Question 2

what is ICD10 and DSMIV

Answer 2

icd- diagnosis requires 2 or more negative sysmptoms
dsm- disgnosis requires 1 or more positive symptom

Question 3

state the differences between ICD and DSM

Answer 3

Both are manuals used to diagnose mental health disorder
both are inteded to be used by psychirtists and health professionals
however
Icd is used internationally, Dsm is used primarily in USA, british research uses dsm to fit in with american research
-iCD is larger, only chapter. is about mental health disorder whereas dsm is relatively small and is just about mental health disorders
-icd shows subcategorues of sz whereas dsm does no longer

Question 4

state a weakness of diagnosing Sz

Answer 4

inter rater reliability, idea where 2 or more people agree when diagnosing the same patients
Cheniaux et al, did a study where he gave 2 psychologists had to diagnose 100 patients using both DSM and ICD, it was found that different people were diagnosed depending on who was diagnosing and which manual they used, show poor reability, which is a weakness in how sz is diagnosed
some may be under diagnosed, left untreated

Question 5

State another finding of the cheniaux study

Answer 5

study also found that more people were diagnosed with Sz with ICD than DSM, showing how dsm may be underdiagnosing and over for icd, labelling to many people
the difference shows that there is issue with validity of diagnosing sx, and diagnosis may not be truly accurate

Question 6

state the to type of symtpoms in sz

Answer 6

positive- which add to a persons experience such as hallucination and delusions
negative-take away from persons normal behaviour such as avolition and speech poverty

Question 7

what are delusion and hallucinations

Answer 7

delusion- set of beleifs which have no basis in reality
hallucination perceptions of stimuli which have no basis in reality
auditory hallucinations is hearing voices of loved/deceased ones as a reuslt of excess dopamine in brocas area

Question 8

what is avolition and speech production

Answer 8

avolition- is subjective reduction indesires goals interest and inability to cope with normal pressures and motivations in everyday living
speech poverty- abnormally low levels of frequency and quality of speech

Question 9

state 4 validity issues

Answer 9

co-morbidity
symptom over lap
gender/culture bias
difference in prognosis

Question 10

state how gender bias is an issue

Answer 10

men are diagnosed more than women as people think women are being dramatic
-loring/powell did a study, where they gave psychiatrists case studies and diagnostic criteria to diagnose pateints with sz, when no gender was given 56% were diagnosed with sz, when gender was given it dropped
however, gender bias was not evident in female doctors showing how diagnosis is based on doctor itself and gender of patient
issue as less women are diagnosed, underdiagnosed left untreated, more men over diagnosed

Question 11

symptom over lap

Answer 11

where symptoms of sz overlap with symptoms of other mental health disorders such as lack of motvation synmptom of both depression and sz
issue as leads to misdiagnosis

Question 12

co-morbidity

Answer 12

when person has 2 illnesses at the same time, such as those with sz also have depression as a reuslt of sz
cannot disutinguisgh netween the two leading to misdiagnosis

Question 13

culture as reliability issue

Answer 13

lurham did study
where interviewed patients woth sz
20 from Ghana,india ,USA
those in india reposted positivr vouces in their head
showing how sz lacks consistent set of chara teristics globally

Question 14

Jakobsen et al. (2005) tested the reliability of the ICD-10 classification system in diagnosing schizophrenia. A hundred Danish patients with a history of psychosis were assessed using operational criteria, and a concordance rate of 98% was obtained. This demonstrates the high reliability of the clinical diagnosis of schizophrenia using up-to-date classification.

Question 15

state genetic vulnerability

Answer 15

genetic component which predisposes some to ilnesses more than others, whether person develop sz is partly due to their genes

Question 16

state research support for genetic explnantion family studies

Answer 16

-gottesman conducted a large study where he found that if both parents have sz, person is 46% more likely to develop sz than others,
however if genes are only cause for sz, then prevalance should be 100% if both parents have it
-theory is deterministic, just because were predisposed does not mean we will develop it
-

Question 17

state research support for twin studies

Answer 17

gottesman and shields
found concrodance rates in twins
mz= 0.48%
dz= 0.17%
suggesting sz inherited through genes
-the fact that both pairs do not always develop sz shows that environment also plays a role
sample size to small
concordnace rate is not 100% showing genes are not the only cause

Question 18

state adoption study linked to SZ

Answer 18

Tienari et al, did a study where he found that 155 adoptees who’s biological mothers had sz, 10% of them were diagnosed with sz, compared to 1% of 185 control group adoptees
-however study done in Finland, so cannot generalise

Question 19

state the dopamine hypothesis

Answer 19

chemcial messenger which tranismits messages between neurones
neurons that transmit dopamine fire too easily or too oftenwhich leads to the developemt of symptoms of sz
-issues with dopamine lead to problems with attention, perception and thought which are all characteristics of sz

Question 20

state how levels of dopamine can cause sz

Answer 20

hyperdopaminergia= excess levels of dopamine in brocas area, leads to positive symptoms
hypodopaminergia= low levels of dopamine in the prefrontal cortex, lead to negative symptoms of sz

Question 21

state drug evidence for dopamine hypothesis

Answer 21

antipsychotic drugs, block activity of dopamine in the brain, eliminating symptoms such as hallucination, strengthens case for dopamine being a strong factor in causing sz

Question 22

state AO3 for dopamine hypothesis

Answer 22

-Noll 2009 argues that 1/3 patients do not respond to drugs which block dopamine so other —neurotransmitters may be involved
-deterministic theory as does not take into account idea of free will, and does excess dopamine always mean a person will get sz
-contradictory research farde et al found no difference in dopamine levels in sz patients and normal patients

Question 23

state what is meant by neural correlates and how it leads to sz

Answer 23

neural correlates is the idea that brain acitvity corresponds with particular behaviour
research has show structural abnormalities in the brain can case SZ

Question 24

neural correlates positive symptoms

Answer 24

reduced activity in the anterior cingulate cortex has been shown to lead to the development of hallucinations

Question 25

neural correlates negative symptoms

Answer 25

ventral striatum is involved in anticipation of reward for certain actions if there is abnormality in this area it leads to avoltion, lack of motivation

Question 26

AO3 for neural correlates

Answer 26

-research support Suddath et al, did mri scans to look at brains of twins where one twin had sz, it was found that the one with sz had larger ventricles and reduced anterior hypothalamus, not only that in 12/15 pairs, doctors could tell which twin had sz just by looking at brain scans, support idea that structural abnormalities can lead to the developemt of sz -theory is deterministic,states that if has larger ventricles they will develop sz with no idea of free will or control, does not take into account other factors such as environment which may play a role -most research done on brain structures are highlt relaible, done in controlled conditions using reliable technology, which provide accurate images of brain areas, meaning id studies were repeated more likely ti produce same realists inc reliability

Question 27

How would the cognitive approach look st sz

Answer 27

look at how people think and prcess information led to psychologist to think that it is the result of dysfuntional and maladative thought processing

Question 28

state the 2 areas of concern when psychologist look at cognitive explanation

Answer 28

cognitive biases cognitive deficits

Question 29

what are cogntive biases

Answer 29

-remembering certain information more than others -helps to explain some symptoms in sz like delusions in persucution- thought that other are trying to harm you, research shows that those with delusions are more likely to inerpret social situations in the wrong way and blame others for whatever negative thimgs happen in their life leading to distorted thinking about others intentions

Question 30

what are cognitive deficits

Answer 30

-issues with thoughts,memory and attention -problem with processing visual and auditory information and oten easily distracted -defecits lead to impair in social understanding, leading to difficulties with interpreting others behaviour leading to social difficulties

Question 31

AO3 for cognitive explanation

Answer 31

-practical applications, yellowless et al developed a machine which showed virtual hallucinations, such as hearing the telivision to kill yourself, or one persons face morphing into another, used to show sz patients that hallucinations aree not real,showing how understanding cognitive defecits allows psychologists to create new initiatives for sz patients and improving their quality of life -takes on board nurture approahc suggests that sz behaviour is the cause of environmental factors such as cognitive defecits -reductionist does not condier other factors such as genes, could be do the level of neurontransmitters, offers a simplistic explnation too sz -takes into account both negative and positive symptoms of sz -can be combied with other explanationms giving a fuller explanation -problems with cause and effect, states cognitive defecits cause sz, but do not state where they appear from in the first place, could sz be a result of cognitive defecits or could cognitive defeicts be a reuskt of sz

Question 32

state the Schizophrenogenic mother

Answer 32

-cold, dominating mothers who cause conflict can be a cause of sz, the mothers are over protective,fearful of intimacy and moralistic about sex, which lead to instability and resentment in children, leading to sz

Question 33

State AO3 for schizophrenogenic mother

Answer 33

however, only a small % of women like this have children with sz and by 1970s research shows there was no such link -problem with cause and effect, as mischler and waxler found a significant differnce in the way sz mothers talk to their daughters in comparison to normal, suggesting dysfunctional communication could be a reuslt of living with sz than being the cause for it -gender bias issue, as mother tends to be the one who is blamed, suggesting suchresearch is socially sensitive, so does not protect individuals from harm

Question 34

state double bind theory

Answer 34

when chidlren receive contradictory info from parents rhey learn they cannot trust messages from others, leading to them not trusting their own feelings and perceptions so theyre left confused and lose grip on reality leading to negative symptoms such as social withdrawal

Question 35

state AO3 for double bind theory

Answer 35

-research support,berger found that sz patients stated a higher recall of double bind statemnts than non szs -however, recall may not be reliable as memory, recall is affected by sz -not only that hall and levin found no differnence in the patterns of parental communication in families with a child with sz and without -ethical issues, as theres no evidence we have that family may have caused sz so not ethical enough to blame them

Question 36

what is expressed emotion

Answer 36

qualative way of meuring communication style based on the amount of emotion displayed in family settings

Question 37

what does a high EE mean

Answer 37

-critical tone, often with violence -emotional overinvolvment in the individuals life -hostility towards the individual and including rejection, anger

Question 38

How is expressed emotion measured

Answer 38

camberwell family interview- semi structured interview with the sz patients family before and after hospitalisation 5 minute speech sample, where relatives talk about patient for 5 mins straight

Question 39

AO3 for ee

Answer 39

-research into ee has practical applications, hogarty developed a type of therapy session which reduced conflicts between parents and children, and reduces ee and reduces relapse rate suggesting gaining insight into families helps imrppves quality of life of patient -family dysfuntion incomplete explanation, individual differences as those who live in high ee environment do nit always relapse and those who do not could still relapse -

Question 40

state the term diathesis stress model

Answer 40

-proposed that sz is the result of a combination of psychological/environmental and genetics/biological influences

Question 41

what does the diatheis stress model state

Answer 41

-states that sz symptoms are triggerred and worsened when a person experiences environmental stressors alngside a biological vulnerability -family studies state that people do have varying levels of inherited geentic vulnerability to sz, from very low to very high -so whther or not a person develops SZ is partly based on their genetic vulnerability and partly based on the environmental triggors they experience -meaning both nature and nurture play a role

Question 42

state the Tienari study

Answer 42

-longitudinal study, 303 adoptees,14 developed sz over course, 11 from high risk group, had gentic vul and stress environment, low risk only had genetic vulnerability,supports theory as those in healthy adoption had genetic risk but did not develop, -however study was longitudinal so high drop out rate, so results affected, small sample so cannot genelrize

Question 43

AO3 for diathesis stress model

Answer 43

-research support faloon, found that stress event such as divroce can overload chemicals in the brain leading schizophrenic episode -brown and Bailey, research support found that those with sz epidoe had gone through major life event 3 weeks befire -research support for how the environment may impact mental health and lead to sz, vasos found those living in cities are 2.47 times more likely to devlop sz due to higher stress levels -holistic view, sz is best understood holistically, as looks at the whole persons, people have different genetic risk and life experneices so triggers vary

Question 44

state one treatment for Sz

Answer 44

drug therapy can be in the form of talets and medicines, usually see improvment in 3 weeks may take a while to find suitable one, some may not even respond to any anti psychotics are used they work by blokcing the dopamine receptors produced

Question 45

state the two types of anti psychotics and their uses

Answer 45

typical- which work by blocking the receptors that block the dopamine which reduces the positve symtpoms, have side effects like dry mouth, contipation and low blood pressure, long term can be untrollable movment of mouth which is permanent -atypical which act on dopamine and seratonin production systmems, reduce negative synptoms, less side effects but inc chance of cardiac death stroke

Question 46

give an example of a typical drug

Answer 46

chloropromazine, work by blocking dopamine receptors reducing positive symptoms

Question 47

AO3 for drug treatment

Answer 47

-research shows highly effective, cheap to produce easy to administer, and have positive effect on sufferes, however does not cure the sz only relives symptoms -side effects and add on medication, those with sz often feel depressed could be prescribed antidepressants and older antipsytics have unpleasant effects such as haloperidol -everyone with sz is at relapse risk, however those with sz, and those without medication are more frequent and severe, showing it does have an effect -kahn et al, did a study on the eeffectiveness, found they work for atleast a year, neweer generations like risperdone are not as effective as first