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Flashcards in Schizophrenia Deck (18):

Clinical Characteristics

- 1% of population
- affects thought processes and ability to determine reality, type 1 and type 2
- First ranks symptoms, thought disorders, hallucination and delusions
- many different subtypes


Reliability and validity

- DSM is more reliable than ICD and reliability has improved over time
- far from 100% reliable but do classifications systems allow practitioners a common language
- reliability higher than anxiety disorders
- diagnosis also often invalid, doesn't lead to successful treatment and studies showed that practitioners often cant discern real from pseudo patients
- no diagnosis explains cause
- diagnosis must be accurate so patients get correct help and the attached stigma is hard to get rid of
- no physical signs of disorder, all self reported
- unlikely one single cause so hard to get aetiological validity



- research usually used twins, families and adoptions studies where schizophrenia occurs
- Has indicated genetic component, but hard to separate from environmental factors
- gene mapping has showed us that several gens can make individuals more vulnerable


Genetics Evaluation

• studies often don't include environmental factors
• not 100% concordance rate, but is higher than average of 1%
• generalisation difficult due to abnormal sample group
• gene mapping can identify high risk individuals but this has ethical concerns



- excess dopamine causes the disorder
- discovered dopamine blocking drugs reduced the symptoms
- L-dopa a dopamine releasing drug created schizophrenic behaviour in non psychotic people
- depending on what part of the system there is excess will affects whether an individual will have positive or negative symptoms


Biochemical evaluation

• inconclusive evidence
• several neurotransmitters may be involved
• can't explain why sufferers only recover slowly when drugs block dopamine straight away
• may be an effect rather than a cause



- Maladaptive thinking linked to many symptoms such as hallucinations
- interest on role of attention, believed they can't filter out relevant information and so become so overwhelmed with information that they can't interpret it
- breakdown between inform in stored memory and new incoming data
- schemas aren't activated and so sensory overload occurs leading to delusional thinking


Cognitive evaluation

• allows useful therapies to be created
• cognitive impairment aren't all the same supporting existence of different subtypes
• some believe including cognitive impairment in diagnosis will increase validity


Socio-cultural explanations

- focus on social and cultural factors such as family and social environments
- labelling theory sees being identified as a schizophrenic is a social phenomenon where others such as the family label individuals as schizophrenic
- Labelling creates a social role where individuals behave in a stereotypically expected way and it also affects how others interpret and react to behaviour
- degree of expressed emotion within a family is seen as an indicator of relapse in schizophrenics
- Double bind theory, schizophrenic is a learned response to conflicting messages and demands during childhood, over time this leads to disorganised thinking and communication
- Social causation, lower social classes, who are subject to more stressors have heightened levels of schizophrenia suggesting this could be a cause


Socio-Cultural evaluations

• social status may not be a cause but an effect of having schizophrenia
• helps to target areas that could cause relapse
• methodological problems with research



-primary treatment, not a cure but do dampen symptoms
- work to reduce dopamine levels and some on serotonin
- some have to take one course others have it regularly and some don't respond at all


Drugs evaluation

• effective, cheap and practical, only 3% of schizophrenics are permanently in hospital
• high relapse rate and serious side effects



- logic is that you can't have both schizophrenia and epilepsy so inducing an epileptic fit in a schizophrenic would remove the disorder
- works best bilaterally and consists of two to three treatments a week for 12 treatment


ECT evaluation

• 20-50% relapse rate after 6 months
• serious side effects, bad image to get rid of
• always a risk having a general anaesthetic



- works to modify hallucinations and delusional beliefs as people with schizophrenia have maladaptive thinking which causes them
- every 10 days for 12 sessions to identify and alter irrational thinking
- one approach is personal therapy (PT) this is where problems and experiences are evaluated and what causes them and then work on strategies to cope, such as distractions and challenging their meanings


CBT evaluation

• good evidence support
• relationship with therapist is key
• training is essential
• not suitable for all patients as they have to be able to trust therapist



- causes are developed in early relationships, treatments aim to provide links between symptoms and early life experiences
- poor early relationships lead to a poor sense of self which leads to schizophrenics having faulty meta-representation and cant distinguish between inner thoughts and external sources
- P's taught forms of communication to achieve insight into problems, aim to identify roots of problems


Psychodynamic Evaluation

• not much research into it as a standalone treatment
• could have adverse effects, increased suicide rate found
• can be administered outside of hospital
• theoretical basis is weak
• evidence for long term benefits is mixed