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Flashcards in Schizophrenia Deck (89):
1

What type of disorder is Schizophrenia ?

Psychotic disorder

2

What is a psychotic disorder and how does it effect someone’s day to day life ?

A psychotic disorder involves a loss of contact with reality making it difficult for a person to function because their ability to perceive, process and respond to an environmental stimuli is impaired.

3

What is a positive symptom ?

A strange addition to normal behaviour.

4

What is a negative symptom ?

A loss of normal characteristics.

5

What are the 4 main positive symptoms of schizophrenia ?

Delusions
Hallucinations
Disorganised thinking/ speech
Abnormal motor behaviour

6

What are delusions ?

Delusions are false or bizarre beliefs which persist even in the presence of disconfirming evidence.

7

What are delusions of reference ?

Delusions of reference are when someone believes that other people’s behaviour is directed specifically at them. E.g. if someone with schizophrenia sees his neighbours talking, he may be convinced they are talking about him.

8

What are delusions of grandeur ?

Believing you are someone significant or important in society e.g believing you are Jesus Christ.

9

What are delusions of persecution ?

Involves the belief that one is being plotted or conspired against .

10

What is thought insertion ?

This is where the person believes that their thoughts have been implanted by some kind of external force over which they have no control.

11

What is thought broadcasting ?

Where they believe that others can hear their thoughts.

12

What are hallucinations ?

Perception of stimuli that are not actually present, these can be visual, auditory or olfactory.

13

What are the most common type of hallucinations ?

Auditory hallucinations

14

What are auditory hallucinations ?

Auditory hallucinations i.e hearing voices are typically from outside the individuals head and saying something relevant to the persons life. Often commenting on what the person in doing or their character usually in an insulting manner, or they can even give a command.

15

What is disorganised thinking/speech ?

Disorganised thinking/speech is where there is an underlying problem with conscious thought that has a. effect on a persons language. Jumbled speech can be described as “word salad” and is due to loose Association in thoughts which one idea constantly triggering another so they jump from topic to topic.

16

What is abnormal motor behaviour ?

This usually refers to agitated movement such as repeating movements over and over again. Catatonia may also be present which refers to not moving or responding to others.

17

What are the six negative symptoms associated with schizophrenia ?

1) lack of energy and motivation
2) social withdrawal e.g. avoiding family and friends
3) flatness of emotion
4) not looking after appearance and self
5) lack of pleasure in everyday things
6)speaking little even when required to interact.

18

What are the 3 cognitive symptoms of schizophrenia ?

1) difficulties in concentrating and paying attention.
2) problems with the working memory
3) difficulties with executive functioning ( understanding and decision making )

19

What is the typical onset of schizophrenia ?

The onset it’s typically between late teens and mid 30s .

20

What is the difference between peak onset in males and females ?

For males the peak onset is mid-twenties .
For females the peak onset is late twenties.

21

What is the prevalence of schizophrenia ?

Schizophrenia is a universal illness as it has been observed all around the world. The likelihood of someone developing schizophrenia is between 0.7% and 1%

22

What factors can effect the likelihood of someone developing schizophrenia ?

Prevalence is influenced by racial / ethnic background, country of residence and country of birth. People who have experienced social problems such as poverty and unemployment are more likely to develop schizophrenia than other section of the population

23

What is the prognosis of schizophrenia ?

About 25% of people who have had schizophrenic episode recover and do not have another one.
About 50% who have a schizophrenic episode have recurrent episodes, between episode they are symptom free.
25% of people experience schizophrenic symptoms continually without any breaks,

24

What is the the life expectancy of those with schizophrenia like compared to those without it ?

Average life expectancy for a person suffering from schizophrenia is 10 years less than the overall population.

25

How does prognosis differ in males and females ?

Males are likely to show higher proportion of negative symptoms and have longer duration of the disorder than females .

26

What is the genetic explanation of schizophrenia ?

If schizophrenia has a genetic cause then someone who is genetically related to a schizophrenic should be more likely to have or develop schizophrenia themselves. Also the chances of them having schizophrenia should be higher than the general prevalence of 0.7%-1%. Research has shown some element of heritability in schizophrenia, the closer relative with schizophrenia the higher the likelihood of getting schizophrenia.

27

What are the three major types of research that have investigated the possibility of the role of genetics in schizophrenia ?

1) Family studies
2) Adoption studies
3)Twin studies.

28

How do family studies investigate whether schizophrenia is genetic ? How useful are family studies ?

Family studies investigate whether close biological relatives to a schizophrenic also suffer from schizophrenia. However they can be problematic as the closer the relative the more likely they are to share the same environment. it is difficult to separate out the effects of nature (in the form of genetics) and nurture (due to upbringing).

29

How are adoption studies useful for investigating whether schizophrenia has a genetic basis ?

Adoptions studies are useful because a genetic factor can be investigated in adopted children who have been 'reared apart' from their biological parents. This allows the effects of nature (genes) to be separated from nurture (upbringing). thus controlling the extraneous variable of environment. If schizophrenia is explained through genes rather than environment, the adopted children whose biological parents are schizophrenic will have higher risk of developing schizophrenia; even though they have been brought up by non schizophrenic parents.

30

What is a neurotransmitter ?

Neurotransmitters are chemicals released from the pre-synaptic neurone into the synaptic cleft after an action potential. typically the stimulate the spot synaptic neuron and assist the next neuron to create its own action potential. Therefore the function of neurotransmitter is to allow nuerons to communicate with one another. This communication allows our brain to think and feel and control our body actions.

31

What is dopamine ?

Dopamine is a neurotransmitter associated with many functions including motivation and feeling pleasure.

32

What is the dopamine hypothesis ?

The dopamine hypothesis is the oldest biological explanation of schizophrenia and suggest schizophrenia can be explained by changes of dopamine functioning in the brain.

33

What are the 3 possible ways dopamine may be related to schizophrenia ?

1) excess dopamine in with in the brain
2) to many dopamine receptors in the brain
3) hypersensitivity if certain dopamine receptors (D2)

34

Explain how excess dopamine is related to schizophrenia.

Excess dopamine in the brain may be a cause of schizophrenia, it is believed an increase in dopamine in the mesolimbic pathways could account for positive symptoms of schizophrenia, whereas decrease of dopamine in the mesocortical pathway could account for negative symptoms in schizophrenia.

35

What is the mesolimbic pathway ?

A dopamine pathways associated with reward and pleasure and is often associated with addictive behaviour.

36

What is the mesocortical pathway ?

A dopamine pathways associated with motivation and emotion.

37

Explain how dopamine receptors are related to schizophrenia ?

One of the possible causes for schizophrenia is believed to be to be excess number of dopamine receptors at the synapses of the brain. Owen (1978) found from post -mortem examinations of the brains of people with schizophenia which showed they had a higher density of dopamine receptors in the cerebral cortex than people who had not suffered from schizophrenia.

the dopamine hypothesis also suggests that schizophrenia may be due to hypersensitivity of certain dopamine receptors (D2 receptors).

38

What supporting evidence does the dopamine hypothesis have ?

The dopamine hypothesis is backed up by evidence from drug treatments. Many antipsychotic medications used to treat schizophrenias work by blocking dopamine receptors.

Supporting evidence also come from treatment for Parkinson disease. Parkinson disease is associated with low levels of dopamine and people with the disease are given levodopa a drug which increases the production of dopamine. people given levodopa can experience schizophrenic like symptoms, such as hallucinations. This provides testable evidence for the theory that excess dopamine plays a role in schizophrenia.

39

What are the strengths of the dopamine hypothesis ?

The theory explains both positive and negative symptoms, whereas some explanations struggle to explain negative symptoms of schizophrenia. With increase in dopamine in the mesolimbic pathway believed to be the cause of positive symptoms and decrease of dopamine in the mesocortical pathways causing negative symptoms.

40

What are the weaknesses of the dopamine hypothesis ?

the theory cannot provide clear cause and effect links, instead changes to dopamine levels and the receptors may be a symptoms of schizophrenia.

The supporting evidence is limited as not all patients with schizophrenia respond to drugs as Alpert and Friedhoff (1980) found that some patients show no improvements after taking dopamine antagonists. Also other drugs such as antipsychotic medications have been successful in treating schizophrenia however they do not impact dopamine but instead focus on serotonin.

the explanation can also be viewed as reductionist as it only focuses on the neurotransmitter dopamine ad ignores other biological factors, social and psychological factors. Brown and Birley (1968) found that 50% of patients with schizophrenia reported a major life event in the threes weeks prior to relapse, suggestion that social conditions may trigger relapse.

41

How can twin studies be used to investigate whether schizophrenia is genetic ?

Schizophrenia in monozygotic and dizygotic twins can be compared. The degree to which twins are similar on a particular characteristic is known as the concordance rate. If one twin has schizophrenia and the condition is entirely caused by genetic factors, we would expect that the concordance rate in monozygotic twins to be 100% whereas in dizygotic tins it should be lower, as they only share 50% of their genetic material.

42

Who conducted a twin study on the genetic basis of schizophrenia ?

Gottesman and Shields (1966)

43

What was the aim of Gottesman and Shields twin study ?

The researchers aimed to see whether schizophrenia had a genetic basis. They examined records of patients in a psychiatric hospital over a sixteen year period.

44

What was the procedure of Gottesman and Shields twin study ?

The patient who was initially admitted to the hospital was referred to as the proband. Once the researchers had collected data on each twin, each proband and their twin were categorised in one of the following four ways:
Category 1 - both the proband and co-twin had been hospitalised and diagnosed with schizophrenia.
Category 2 - both twins had been hospitalised, but the co-twin has be given another diagnosis related to schizophrenia.
Category 3 - the co-twin had some psychiatric abnormality, but nothing related to schizophrenia
Category 4 -the proband twin had schizophrenia but co-twin was diagnosed as clinically normal.

45

What was the sample of Gottesman ad Shields twin study ?

They identified 57 schizophrenic patients that were one member of a twin. They tracked down the other twin of each participant. 24 of the pairs were monozygotic and 33 were dizygotic twins.

46

What data did the researchers collect on the sample in Gottesman and Shields twin study ?

The researchers collected data on the participants in a variety of ways including :
1) hospital notes
2)self -report questionnaires
3) self report interviews
4) personality testing
5) test to measure disordered thinking

47

What were the results of Gottesman and Shields study ?

1) concordance rate for schizophrenia was higher in females compared to males for both monozygotic and dizygotic twins.
2) concordance rate was higher for both monozygotic twins and dizygotic twins for severe schizophrenia compared to mild schizophrenia.
3) the concordance rate for severe schizophrenia was much higher in monozygotic twins (75%) compared to dizygotic twins (22%)
4) 21% of monozygotic twins with schizophrenia had a twin who was diagnosed as clinically normal.

48

What were the conclusions of Gottesman and Shields study ?

1) the results suggest schizophrenia has a biological basis as the chance of developing schizophrenia seems to be influenced by genetics.
2) However, schizophrenia is not totally caused by genes as the concordance rates for monozygotic twins was not 100%. In fact 21% of monozygotic twins had a twin that was clinically normal therefore, it can be concluded that genes are a risk factor for developing schizophrenia but not the only cause.

49

What are strengths of the genetic explanation of schizophrenia ?

The genetic explanation of Schizophrenia has supporting evidence from tin studies that suggest there is a significant genetic factor in schizophrenia for example Gotteman and Shields results show their is a 75% concordance rate in severe schizophrenia in monozygotic twins compared to 22% concordance rate in dizygotic twins.

50

What are weaknesses go the genetic explanation of schizophrenia?

The research that underpins the explanation has a flawed methodology. As twin studies don't take into account that monozygotic twins are likely to be treated more similarly than dizygotic twins as they look identical. Therefore high concordance rate could still be used by the environment.

Additionally the explanation is reductionist as evidence suggests that genetics is only a risk factor for schizophrenia and not the only cause and that environmental factors and other biological factors may be involved in the development of schizophrenia.

51

How does the cognitive approach explain schizophrenia ?

The Cognitive approach tries to explain human behaviour in terms of information processing. Therefore the cognitive approach explains symptoms of schizophrenia in terms of the way in which schizophrenics are processing information about their experiences.

52

What two possible cognitive factors do we study which explain schizophrenia ?

1) problems with attention
2) problems with memory

53

how does the cognitive theory of problems with attention explain schizophrenia ?

Cognitive psychologists have suggested that people with schizophrenia have attentional processes that work in a different way to those without schizophrenia. People without schizophrenia are able to ignore irrelevant stimuli, allowing them to focus on whats important. Whereas people with schizophrenia may not have this ability.

54

How do the filter Mechanisms of those with schizophrenia differ from the without it and how does this relate to problems with attention ?

Our brains pick up more information from our surroundings that we can consciously pay attention to so we have a filter mechanism that processes incoming stimuli. These filtering mechanism allow us to pay attention to certain important stimuli while ignoring other irrelevant stimuli; helping us to function effectively. Its believed people with schizophrenia do not have normal functioning of these filtering processes, leading them to pay attention to irrelevant stimuli. This prevents them from making sense of the world in a way which most can.

55

How did Frith (1979) explain symptoms of schizophrenia relation to attention problems ?

Frith suggested that schizophrenia is a result of patients increased self awareness whereby there is an inability to filter out unnecessary cognitive noise created by internal information processing. This inability to self monitor effectively leads to thought and ideas being attributed as external sources such as delusions and hallucination because he individual doesn't realise they are self generated.

56

Who suggested that problems with memory can result in schizophrenia and what did they suggest ?

Hemsley suggested there is a breakdown in the relationship between memory and perception in schizophrenics. Hemsley suggested people with schizophrenia are not able to activate the relevant schemas to perceive new information. As a result they experience a sensory overload and do not know what aspects to attend to or ignore. Because of this, people with schizophrenia are often unable to predict what will happen next, their concentration is poor and they attend to irrelevant aspects of the environment. Their poor integration of memory and perception leads to disorganised thinking and behaviour.

57

What three pieces of research support the cognitive explanation for schizophrenia ?

1) McGuigan (1966) found the larynx (a muscular organ that holds the vocal cords and controls the volume and pitch of your voice ) of patients with schizophrenia were often active during the time they said they were experiencing auditory hallucinations. This suggests they mistook their own inner speech for that of someone else.

2) McGuire et al (1996) found people with schizophrenia to have reduced activity in those parts of the brain involved in monitoring inner speech.

3) PET scans show under-activity in the frontal lobe of the brain of people suffering with schizophrenia, which is linked to self -monitoring.

58

What are the strengths of the Cognitive explanation for schizophrenia ?

One strength is that it explains some of the key symptoms of schizophrenia. for example delusions and hallucinations are explained by increased self awareness meaning they unable to filter out unnecessary cognitive noise created by internal processing, the person perceives this noise as external stimuli such as hallucinations or delusions. it also can explain disorganised behaviour as those with schizophrenia find it difficult to activate relevant schemas when perceiving new information so they do not know what part of a situation to pay attention to, resulting in their behaviour seeming stranger disorganised.

Another strength of this explanation is that it is useful as research into cognitive explanation of schizophrenia has been useful in developing effective treatments for those with mental disorders by alleviating their symptoms and improving their lives. for example Morrison et al (2014) found cognitive therapy significantly reduced psychiatric symptoms of those with schizophrenia spectrum disorders who have chosen not to the antipsychotic drugs.

59

What are the weaknesses of the cognitive explanation for schizophrenia ?

A weakness of this explanation It is difficult to find out whether cognitive problems shown by patients with schizophrenia are the cause of their disorder or the effect of it.

Additionally the cognitive explanation can be criticised for being reductionist as it underestimates factors such as genetics, stressful life events and social factors in the development of schizophrenia. However it does include the idea that strange sensory experiences arise from biological problems, thus suggesting a complex interaction between biological and cognitive causes of schizophrenia.

A Third weakness of cognitive explanation for schizophrenia is it has disproving evidence with many brain -damaged patients having problems with attention or with the relationship between memory and perception. Despite this brain -damaged patients fail to develop symptoms of schizophrenia; challenging the validity of the cognitive explanation.

60

What are the similarities between genetic explanation for schizophrenia and the cognitive explanation for schizophrenia ?

1) Both are considered reductionist, even though cognitive explanation discusses links to the biological approach neither of them consider how stressful life events or social factors could impact the development of schizophrenia.

2)Both have supporting evidence as the genetic explanation is backed up by Gottesman and Sheild's twin study on schizophrenia and the cognitive approach is supported by McGuigan's research that found the larynx was active during auditory hallucinations suggesting those with schizophrenia took their own voice as someone else.

61

What are the differences between genetic explanation for schizophrenia and the cognitive explanation for schizophrenia ?

1) the genetic explanation can show case and effect links between genes and schizophrenia because the psychosis disorder cannot change someones genes. Whereas cognitive problems shown by those with schizophrenia could be a symptom rather than a cause of disorder.

2) the cognitive approach could be deemed more useful than the genetic explanation. As cognitive explanation has allowed for the development of cognitive therapy such as CBT to reduce psychiatric symptoms as shown by Morrison et al (2014). Whereas genetic explanation doesn't help develop treatments as its unethical to manipulate patients genes.

62

Why are drug treatments used to treat mental disorders like schizophrenia ?

Biological treatments for schizophrenia are based on the medical model of abnormality . In this model mental disorders are seen as illness which have biological causes. If it is assumed that abnormal behaviour displayed by schizophrenics has a biological cause such as biochemical imbalance then any treatment used for this psychotic disorder will have a biological basis. Treatments based on this approach are therefore physical in nature rather than psycholoigcal for example drug treatments. The drugs used in treatment for psychotic conditions such as schizophrenia are known as anti-psychotic drugs.

63

Describe the typical drugs used to treat schizophrenia ?

The first anti-psychotic drugs used to treat schizophrenia are known as typical drugs such as Phenothiazines which worked by blocking the receptor site for the neurotransmitter dopamine. The means that the effects of dopamine are not picked up by the brain. This has the same effect as reducing dopamine levels in the brain.

64

Why are typical drugs used less now to treat schizophrenia ?

A major problem with typical drugs such as Phenothiazines are the side effects they cause like shaking muscle tremors and jerky movements. Because of this these drugs have since been superseded by more effective drugs with fewer side effects known as atypical drugs.

65

Describe the atypical drugs used to treat schizophrenia ?

Atypical drugs have fewer side effects and are more effective than older drug treatments. Clozapine is an atypical drug which acts by blocking serotonin receptors to treat schizophrenia. More recently newer antipsychotic drugs such as olanzapine and risperidone have also been used to treat schizophrenia.

66

What are the strengths of drug treatments for schizophrenia ?

1) Drug treatments have been shown to be effective in reducing the symptoms of schizophrenia. Evidence of this comes from Meltzer et al (2004) who found the Haloperidol gave significant improvements in all areas of functioning compared to a placebo.

2) Overall, drug therapy is probably more effective than any other from of therapy in treatment of schizophrenia because it reduces symptoms more quickly than psychological therapies do.

3) Drug therapies have allowed many patients with schizophrenia to live relatively normally lives. Prior to the introduction of Phenothiazines in the 1950s schizophrenia was considered untreatable and patients were interned into mental institutions. As Rosenhan and Seligman (1995) vividly explain, the wards of mental hospitals were called snake pits and were filled with inmates who were unreachable or catatonic ( immobile )or were wild with delusions and in strait jackets.

67

What are the weaknesses of drug treatments for schizophrenia ?

1) Drug therapy is a reductionist approach to treating schizophrenia. It ignores all psychological or social factors that may contribute to the symptoms of the disorder.

2) The effectiveness and therefore usefulness of drug therapy for schizophrenia is limited as it is palliative rather than curative. This means that drug therapy suppresses the symptoms of the disorder without addressing the underlying cause. Because the underlying processes are not eliminated patients often have to take dugs for several years.
furthermore the effectiveness can be argued to be limited due to relapse as drugs do not offer a long term cure in many cases symptoms can recur when drugs are no longer taken.

3) Ethical issues are raised by drug therapies. The drugs often produce side effects, some of which can be unpleasant and have serious health effects. Because of these side effects patients may be reluctant to take drugs which reduces the effectiveness if people are not completing the full course of treatment. This can be seen in Lieberman et al (2005) who found that many people stop taking medication for schizophrenia because of side effects. In addition other ethical issues with using drug treatments include people with very serious conditions would be unable to give informed consent and taking drugs may lead to addiction and dependency.

68

How do cognitive treatments aim to reduce symptoms of mental disorders ?

The cognitive model of abnormality assumes mental disorder is created by errors in thinking. Thought influence emotions and feelings. Treatments based on this approach therefore, attempt to change abnormal behaviour by first changing the way people think.

69

What cognitive treatment do we study ?

Cognitive Behavioural Therapy also known as CBT

70

Describe cognitive behavioural therapy for mental disorders in general ?

There are several therapies that can be called cognitive behavioural therapies but generally the therapeutic process follows a similar pattern. It is believed that behaviour change results from changes in cognitive processes. The therapist processes listens to a client's thoughts and then challenges the client's assumptions. The therapist then tries to illustrate that alternative thoughts can be used to explain the same situation.
Cognitive behavioural therapy assumes that patients have irrational thoughts and beliefs about themselves and about the world around them. The irrational thoughts are typically negative and self-defeating and contribute to the development and maintenance of mental disorders. Therefore therapists using CBT try to challenge these thoughts, showing patients they are wrong and help eliminate them. From changing the thoughts, therapists try to change the patients behaviour.

71

How does cognitive behavioural therapy try to change patients intrusive thought and intern change their behaviour ?

1) By focusing on the present symptoms and not going back to past issues that may have caused the problem.
2)Looking at how the person thinks about an event has affected a person- how they felt and how they behaved
3)Challenge negative thoughts and reinterpret/change then for more realistic and positive thoughts.

72

What is the aim of cognitive behavioural therapy as a treatment for schizophrenia ?

CBT can be used to target symptoms of delusions and hallucinations. The aim of CBT is to reduce the stress felt by a patient with schizophrenia and allow them to help manage and understand their symptoms. However, it will not treat the underlying cause of schizophrenia.

73

How has the view of cognitive behavioural therapy for psychotic disorders changed overtime ?

The cognitive approach used to be considered of little value in psychotic disorders where the patient loses tough with reality. However, nowadays most patients with schizophrenia receive drug therapy, which males them more responsive to CBT than they would be without drug therapy. Secondly many patients with schizophrenia use coping strategies from cognitive behavioural treatments to control their delusions and hallucinations. Almost 75% of those who used such strategies, reported that it was fairly successful I controlling their symptoms.

74

How is cognitive behavioural therapy used for treating schizophrenia ?

CBT for schizophrenia focuses on the individual. Most people need between 8 and 20 session. Group therapy may also be used along with family sessions. CBT involves the following three techniques:
1) Belief Modification: where delusional thinking is challenged directly and there is testing against reality.
2) Focusing and Reattribution: This is used to help with auditory hallucinations. The therapist focuses on the attributes of voices e.g. how many, the loudness, tone, gender etc. Then the content of the voices is looked at. Next, the focus moves to what the patients believes and thinks about the voices. The therapist aims to show that the voices are self generated and need not to be feared.
3) Normalising the experiences of the person with schizophrenia. Patents are encourages to look at their experiences rationally. They are taught to examine the evidence, look for alternative explanations and faulty thoughts are challenged. The psychotic symptoms are looked at as more normal and less of a catastrophe, to reduce the fear and distress related to them.

75

What are the strengths of cognitive behavioural therapy as a treatment for schizophrenia ?

1) Research has shown that CBT is useful as it can be effective in treating schizophrenia. Patients show an increase in coping skills and decrease in the number and severity of delusions and hallucinations. Evidence of this comes from Sensky et al (2000) which compared to CBT with non-specific befriending intervention for patients with schizophrenia and found that CBT was more effective in reducing both positive and negative schizophrenia.

2) CBT is perhaps the most ethical of the treatments we have studied. it can be argued that it is able to empower patients by educating them and half-help strategies. The patients has more control over the process than in for example drug therapies. Patients can also use the skills which they have learned on their own, without needing the presence of a therapist. This means that it allows them to be more independent. Furthermore it can be seen as very ethical because unlike drug therapies it doesn't have any negative side effects.

3) It is argued that strategies learned can be easily incorporated into a patient's life. This makes it a particularly useful treatment.

76

What are the limitations of cognitive behavioural therapy as treatment for schizophrenia ?

1) CBT is subject to reductionism in that it focuses on the thought processes of the patient but does to address the underlying cause of the mental disorder as it overlooks the biological causes therefore limiting its usefulness.

2) The effectiveness of CBT for schizophrenia is believed to be limited. This is because, some argue, for CBT to be effective a patient must have insight into their condition and good problem solving skills. A patient suffering from severe schizophrenia may lack these skills so cognitive behavioural therapy may be not be successful for them.

3) Effectiveness is hard to judge for example most studies compare CBT to a control treatment and find it to be superior. However, the differences may be because cognitive treatment is superior, or because the control treatment is inadequate. Control treatments are sometimes (but not always) given non experts. Thus the use of inadequate control treatment conditions might explain some of the findings.

77

Describe two similarities between Cognitive Behavioural Therapy and drug therapy as treatments for schizophrenia ?

1) Both therapies are reductionist as they do not consider all the causes of the psychotic disorder instead isolating on variable as a potential cause of schizophrenia. As drug therapies focus on biological causes ignoring psychological and social factors that may effect schizophrenia and cognitive behavioural therapy doesn't address the causes of schizophrenia on the patients thought processes.

2) Both treatments are effective at reducing the symptoms of schizophrenia and have supporting evidence to show this. Sensky found CBT was more effective at reducing both positive and negative of schizophrenia than a non-specific befriending intervention. Additionally Metzer found drug treatments such asHaloperidol gave significant improvements in all areas of functioning compared to a placebo.

78

Describe two differences between Cognitive Behavioural Therapy and drug therapy as treatments ?

1) A differences between the two treatments is the ethical issues raised. As CBT is considered to not have any ethical problems as it empowered patients by educating them on self help strategies giving them control over the process. However drug treatments can cause side effects such as nausea, headaches and shaking muscle tremors making the use unethical.

2) Drug therapies are deemed to be more reductionist than CBT as drug therapies only consider biological factors of neurotransmitters whereas cognitive behavioural therapy considers cognitive and behavioural factors.

79

Who conducted the Contemporary study for schizophrenia, When did the study take place and whites the study's title ?

The schizophrenia contemporary study is titled network interactions in schizophrenia: therapeutic implications and was conducted by Carlsson in 2000.

80

What type of study was Carlsson's contemporary study ?

Carlsson completed a article review, this isa review which summarises previously published studies rather than reporting new facts.

81

What was the aim of Carlsson's contemporary study ?

the aim of this study was to review research to investigate
neurotransmitters functioning in specific areas and Neurotransmitters functioning in psychosis looking beyond the dopamine hypothesis at the interaction of neurotransmitters. Carlsson also aimed to use the information on psychosis and neurotransmitters functioning to produce new antipsychotic drugs that could be more effective, with less side effects.

82

what was the procedure of Carlsson's contemporary study review ?

The procedure in this research is a literature review, in which the methods and findings of 33 studies to do with neurotransmitters interactions in schizophrenia are analysed. This literature review looks at:
1) studies using rodents to test neurotransmitters functioning and related to brain structure functioning.
2) Studies of people with acute schizophrenia and people in remission.
3) Evidence from studies looking at mice.

83

What are the results from Carlsson's literature review the neurotransmitter dopamine ?

Carlsson points out that PET scans provide evidence to show high levels of dopamine are related to psychosis as supported by Abi-Dargham et al (29980 and Breier et al (1997). This supports the dopamine hypothesis. However, the changes in dopamine levels mat result from some other changes in people with schizophrenia. For example there may be interactions with other neurotransmitters such as serotonin, glutamate GABA etc.

84

What are the results from Carlsson's literature review the neurotransmitter glutamate ?

It was also suggested the low levels of glutamate may play a role in schizophrenia. Evidence of this comes from research which shows that PCP (a class A drug also known as angel dust) can induce psychosis by inhibiting the action of glutamate in the brain. Further investigations showed that glutamate failure in the cerebral cortex may lead to negative symptoms of schizophrenia, whereas glutamate failure in the basal ganglia could be responsible for positive symptoms.
Some research has found an interaction between dopamine and glutamate. Reduced levels of glutamate seems to be associated with increased levels in dopamine.

85

What are the results from Carlsson's literature review the neurotransmitter Serotonin ?

Serotonin may also be implicated in schizophrenia. Serotonin levels are related to dopamine. Clozapine (an antipsychotic drug) works by reducing both dopamine and serotonin levels in the brain. NDGA antagonists, which limit glutamate seem to stimulate serotonin.

86

What two main theories did Carlsson results show could cause schizophrenia ?

It is difficult to decided between two main theories of whether high levels go dopamine (known as hyperdopaminergia) cause schizophrenia or low levels of glutamate (known as hypogluamatergia ) cause schizophrenia. This has limitations for drug treatments.

87

What were the conclusion's from Carlsson's contemporary study ?

1) There may be different subpopulations of those with schizophrenia, where schizophrenia is caused by different abnormal levels of different neurotransmitters, not just dopamine. This has implications for treatment.
2) Glutamate deficiency should be studied to explain schizophrenia.
3) Glutamate defence may explain increased dopamine responsiveness.
4) Increased serotonin activity is found in people with schizophrenia. It is thought that both dopamine and serotonin contribute to both the positive and negative symptoms in schizophrenia.
5) More focus on other neurotransmitters, such as acetylcholine, GABA and neuroepetides is needed.

88

What are the strengths of Carlsson's contemporary study ?

1) One strength of this research is that it is supported by another review article (sends et al 2012) which also suggest s that glutamate is important in explaining schizophrenia. The title of Sendt's review article is "Beyond Dopamine: Glutamate as a target for today's antipsychotics". So this research provides evidence for Carlsson's suggestion that dopamine levels on their one do not fully explain schizophrenia.

2) The study supports the argument of psychology as a science as all the secondary data used were labatory studies meaning extraneous variable could be controlled to develop clear cause and effect links. however this used of laboratory studies reduces ecological validity of the study.

3) The use of a review article meant that data which would have taken large amount of time and money for Carlsson to collect himself therefore the used of a review study meant lots of information could be drawn in a concise and effective way.

89

What are the weaknesses of Carlsson's contemporary study ?

1) One weakness of Carlsson's study is the sample of some of the studies reviewed were animals reducing the generalisability to humans.

2) A second weakness of Carlsson's research is that she of the studies used scanning to investigate neurotransmitter functioning. Because the participants may have found this stressful, it may have affected their neurotransmitter functioning, and therefore may not have produced valid findings about dopamine functioning.

3) The study suffers from bottom draw bias as it can only use research which has ben published and research on the link neurotransmitters and schizophrenia. There are two reason why the research on neurotransmitters is limited. the first being that some neurotransmitters are much more difficult to study than others so try little research is none into these areas. Therefore other neurotransmitters may be linked to schizophrenia however thy haven't been investigated. secondly if a study doesn't find any significant results then it won't be published so they couldn't be analysed by Carlsson in his review study reducing its validity.

4) a weaknesses of using a review study is that it relies research from various different sources meaning the reliability and validity is questionable. Carlsson's study is dependent on the studies used being reliable and valid.