Schizophrenia A03 Flashcards
(23 cards)
Dopamine imblaances may be caused by genes? Biological a03
What causes the dopmaine imbalances? It may be geentic predisposition.Many twin and fmailiy studys indicate their is some genetic basis. A classic study involving Gottesman et al (1991) looked at the incidence of sz in cousins ect.. As genetic similarity increased so did the probability of the individual having sz. The sz working group found 108 genetic loci associated with sz, so it is a complex matter
The role of Serotonin
Bioogical a03
Dopamine is not the only neurotransmitter in sz. Serotonin has also been identified. Conventional antipsychotics have worked by blocking d2 dopmaine receptor sites. but not a;; sz beneefit, Clozapine blocks the d2 receptor and the serotonin, so dopamine is only a partila explanation
Dopamine cause and effect
Biologicl a03
Does sez cause the imbalances? Are they just another symptom of the disease? Research using PET scans hasnt yet been able to detect dopmaine activity in brains. So a comparison cannot be made between the individual w and w out sz
Structural Abnormalities are not only linked to sz Biological A03
It is unclear whether structural abnormalities are a cause/ effect. Enviromental influences can impact brain tssue. Kenneth lyon et al (1981) reported as doses of antipsychotics increased density of brain tissue decreased. Perhaps after sz is diagnosed and treated. The medication may cause abnormalities.
Structural abnormlaities are found with other conditions. Paul Ray et al (1998) note individuals diagnosed with bipolar and sz also have enlarged ventricles
Research evidence for strucutral abnormalities
Sz AS03
McCarey et al (1999) claim enlarged ventricles are the most reliable finding using brain scans. The link between cortical atrophy and sz is also confirmed
Freudian concepts are out of date
Individual a03
As the century has progressed. Psychologists are dissatisfied with unscientific, unfalsiable nature of psychodynamic concepts. Psych approach has difficulty producing testeable hypotheses
Inconssitent support for schziophrogenic mothers Individual a03)
It was popular from the 1940s to 1970s. Early research, one by Jacob Kasain et al (1934), he examined hospital case records. He found almost 1/3 of the cases did not have a overprotective mother. So unconvinsing evidence
Overlooks genetics
Individual a03
Consequence of early experince, is focused on nuture,. There are strong evidence for biologicl factors. Adoption studies, by Hesten (1966) with 47 adoptees, with a biological mother of Sz. 50 with and without. 10.6% with mother with Sz also had Sz. Suggesting. genetic influence.
Supporting evidence for cognitive approach
Individual a03
Barech et al (1999) compared performance on a stropp test of ppl w and w out sz. Those w sz were lsoer and made more mistakes. those with out Sz cannot filter infor effectively
Reductionist
Individual A03
Frith has offered a casual explanation for the defecits associated with Sz. He proposed the faukty explanation of cognitive mechansisms is due to disconnection of the frontal cortext. But reductionsit as reduced to brain circuits
Intergrated model of Sz
Individual A03
Sz needs to be a more holisitc way. Howes and murray (2014) proposed a intergrated way. Which proposes genes combine with life experiences, provoking dopamine release. So cognitive explanation is not enough but it can expand
Cause and effect
Social Psych a03
Liem (1974) found the communications offered in a structured task by the parents of 11 sons who were no more disordered than the communications offered by 11 sons w iut sz. ,May just be parents adopting communication styles to haveing a child w sz.
Research for EE
Social A03
Vaugh and leff offered clear support for the role of exoressed emotion in relapse rates. Researchers found 53% of individuals with sz who had high ee relatives relapsed, only 12% those with low EE relaosed. Not ll is supported Phillips et al (1998) failed to find higher subsequent 6-12 months relapse rates among individuals with sz in high EE households
Shared enviroment or genes
Social a03
Althogh sz may be due to communication, it could equally be the product of shared genes. Sz working group found 108 genetic loci associated w sz
urbanicity
Social A03
Does living in a urban enviroment actually increase Sz. Generla health is better in urban areas than rurual areas because of easier assess to healthcare, higher employment so may over diagnose
Social Isoaltion may be cause/effect
Social isolation may also be questioned as a cause or effect. Jim Van Os (2000) claimed single ppl living in neighbourhoods with few single more likely to devlop sz
Which comes first
Social A03
Does living in a urban enviroemnt lead to a greater risk of sz or does having sz mean u are more likley to live in a urban enviroment. The social drift hypotheses is that once diagnosed individuals demonstarte a decline in their socioeconomic status and as such move to the inner city. So false impression of urbanicity
Effectivness Antipsychotic AO3
-Joanthon cole et al (1964). The earliest studies into effectiveness of convential antipsychotics. Cole et al found 75% on conventional were much improved compaed to the placebo. Atypical are more effective than conventianol. Ravanic et al (2009) compared effectivness of clozapine in 325 individuals w sz. Over 5 years there were differnces in psychometric scores.
However, assessing the effectivness has a issue. Most individuals tend to lack the necassary insight into their own condition. They dont believe they have a problem, so dont take the emd.
There has been additional research into a drug that atrgets musarinic receptors not dopamine. In a one year trial, over 75% of patients experinced a greater than 30% reduction in symptoms. It also avoided the common side effect of weight gain
Ethical Implications Antipsychotic A03
Side effects. parkinsoniasm and seizures. So are the benefits of the drug worth it? As well as this, when diagnosed w sz, pp may be administered without valid consent. Investigations in the US nursing homes also releaved misdiagnoses of sz to justify the use of antipsychotics as chemical restraints. therefore raising concerns about informed consent
Social Implications
Antipsychotic A03
-A systematic review found side effects like weight gain and involuntry movements contribut eot social withdrawal
- It also has social benefits. ‘Antipsychotic drugs revoloutinalised the care of Sz’, from a incurable condition requiring instituitonalisation to one treated in the community. (2011) patients can live more normal lives
Effectivness CBT A03
-Kuipers et al (1997) carried out research with 60 individuals with sz who had ‘posotive and distressing symptoms medication resistant’. they were randomly allocated to either a CBT and SC group or just a SC group. CBT plys SC had 50% improved, 31% in sc group. However, Jahar et al (2014) reported only a small theraputic effect from using CBT.
-CBT can be used as a beneficial treatment for patients who are unwilling ro take drugs. A study in the lancet found CBT offer small to moderate improvments in general Sz symptoms
Ethical CBT A03
-Potentially a negative expereince for clients. Suffering from sz, being assessed, then prescribed medication and experiences. On top of that, CBT may add negatively to this. Kuipers et al (1997) reported clients were satisifed with their experinces of CBT. Ensuring indormed consent is cruical, as cognitive impairments can effect decision making
Social CBT A03
-CBT can enhance social skills and reduce isolation creating a beter community. Kuipers et al 1998 analysed the economic impact of offering CBT to individuals w sz in additin to using antipsychotics. Although the use of CBT may be initially costly. in th elong run they are effective.
