Sz

Question 1

List the four positive symptoms of schizophrenia and explain them, ten give examples (12)

Answer 1

Delusions- misinterpreting sensory info e.g. delusions of persecution and grandeur
hallucinations- sensory experience in absence of real stimulus e.g. visual auditory tactile
Disorganised speech- e.g. word salads, neologisms (creating new words)
Disorganised behaviour- Catatonia violating social norms, muscular rigidity

Question 2

Explain the 3 main issues involved in classification and diagnosis of schizophrenia (3)

Answer 2

Reliability- diagnosis vary between clinicians because 2 different diagnostic manuels DSM ICD
Validity- difficult to accurately diagnose because there is symptom overlap
Labelling-diagnosis can do more harm than good

Question 3

What is the issue of symptom overlap?

Answer 3

May be incorrectly diagnosed so incorrectly treated

Question 4

Why is comorbidity an issue?

Answer 4

Have to decide which to treat

Question 5

What is lack of homogeneity between two schizophrenics?

Answer 5

Two people diagnosed with schizo that don’t share any symptoms

Question 6

Advantage of diagnosis of schizophrenia?

Answer 6

Aetiology - want to find cause and course
Treatment- lead to treatment programme
Medicalise- diagnosis medicalises disorder instead of being “crazy person” being someone with mental disorder

Question 7

What are the 2 biological explanations of schizophrenia?

Answer 7

Genetics (concordance rates in families, twins, adoption studies)
Dopamine (excess of dopamine activity)

Question 8

2 strengths of the dopamine hypothesis

Answer 8

drugs that increase dopamine levels (amphetamines) do produce psychotic symptoms
Antipsychotic drugs reduce schizophrenia by blocking dopamine

Question 9

2 weaknesses of the dopamine hypothesis

Answer 9

LOW levels of dopamine can cause symptoms of schizophrenia like avolition
antipsychotics arent effective for all schizophrenics so dopamine can’t be the only cause
Clozapine is the most effective drug and it acts on serotonin as well so dopamine can’t be the only cause
It is reductionist because it

Question 10

Give 2 strengths of the genetic explanation for schizophrenia.

Answer 10

Concordance rate MZ twins 48%

Adoption studies also 58%- not down to environments

Question 11

What are the 2 psychological explanations for schizophrenia.

Answer 11

Cognitive

Family dysfunction

Question 12

What does the psychological cognitive explanation for schizophrenia suggest?

Answer 12

Schizophrenia is because of dysfunctional thought processes
Impaired mental processed like thinking language and attention
Egocentric bias (relate irrelevant things to self so incorrect conclusion

Question 13

Evidence for the cognitive explanation of schizophrenia. (1)

Answer 13

Helmsey 2005 found attention span shorter in schizophrenics, because can’t control automatic responses so attention continually diverted.

Question 14

3 Limitations of cognitive explanation for schizophrenia

Answer 14

Explains whats happening not why (causality)
Explains positive symptoms not negative
Undeniable biological link

Question 15

3 strengths of cognitive explanation

Answer 15

Explains what is happening
Effective in treatment of schizophrenia, CBT
Accepts biological influence
evidence-Helmsey 2005 found attention span shorter in schizophrenics, because can’t control automatic responses so attention continually diverted.

Question 16

In the psychological family dysfunction explanation for schizophrenia, what is the double bind theory?

Answer 16

Schizo caused by mixed parental messages
Contradiction between verbal and non verbal behaviour
Causes incoherant version of reality causing delusions and disorganised behaviour

Question 17

What is the interactionist approach to treating schizophrenia?

Answer 17

Broad approach- acknowledging biological and psychological

Diathesis stress model

Question 18

What is the diathesis stress model? (1)

Answer 18

Says both genetic vulnerability and a stress trigger are needed

Question 19

What are the two biological drug therapies for schizophrenia? (2)

Answer 19

Typical antipsychotics

Atypical antipsychotics

Question 20

How do typical antipsychotics work? (4)

Answer 20

bind to dopamine receptor d2
doesn’t trigger post synaptic response
prevents activation of dopamine receptor
can’t trigger post synaptic action potential

Question 21

How do atypical antipsychotics differ from typical antipsychotics? (3)

Answer 21

binds to d2 receptor more strongly than typical
effective in smaller doses
also effects serotonin
Atypical address negative symptoms also

Question 22

Weakness of antipsychotics. (3)

Answer 22

only treats symptoms not cause
side effects- tremors dizziness
cost-benefit analysis- symptoms maybe better than side effects

Question 23

What is the psychological therapy for schizophrenia?

Answer 23

A form of CBT called CSE

Question 24

What does CSE stand for

Answer 24

Coping strategy enhancement

Question 25

Strength of CSE to treat schiophrenia?

Answer 25

Meta analysis Jauhar 2014 found it does have an effect albeit a small one

Question 26

Weakness of CSE to treat schizophrenia (1)

Answer 26

meta analysis Zimmerman 2005 only effective for positive symptoms and on top of drug therapy.

Question 27

What are some features of family therapy as a treatment for schizophrenia? (4)

Answer 27

``` Information on cause course and symptoms Problem solving strategies Constructive ways of communicating Early signs of relapse Reduce stress of caring Improve ability to anticipate and solve problems Reduce anger and guilt Balance caring and own lives ```

Question 28

Who researched into the effectiveness of family therapy and what 4 things did they find?

Answer 28

Pharoah et all 2010-Meta analysis 53 studies reduction in relapse rates Increased compliance with medication Improvement in social functioning (didnt effect employment or independently living) Some improve mental state some didn't

Question 29

What are four shared limitations of both family therapy and the CBT CSE? (4)

Answer 29

``` Time Cost Require engagement motivation Useful as adjacentgenetics to drug therapy Doesn't address cause/genetics ```

Question 30

What approach is token economy a part of?

Answer 30

Behaviourist

Question 31

What does token economy involve?

Answer 31

Give tokens for behaving appropriately e.g. getting out of bed in the morning, and these can be used to obtain various privileges such as watching tv

Question 32

What is the effectiveness of token economy like? (5)

Answer 32

Sultana (2009) only 1 of 3 studies improved behaviour Dickerson (2005) beneficial effects reported in 11/13 studies less effective in unstructured settings- immediate continuous reinforcement cannot be done easily short lasting superficial changes don't generalise to the outside world- no lasting change only used in management not cure of schizophrenia

Question 33

What is the appropriateness of using token economy to treat schizophrenia like? (2)

Answer 33

Good for motivation/engagement | Bad for severer cases like hallucinating/lack of emotion

Question 34

What is an ethical implication with the use of token economy?

Answer 34

more severe schizophrenics may be unable to comply e.g. cant stop hallucinations so severely ill would suffer most discrimination at no fault of their own

Question 35

Give an example of typical antipsychotics

Answer 35

chlorpromazine

Question 36

Give an example of atypical antipsychotics

Answer 36

risperidone

Question 37

What's an issue with studying twin concordance rates and how can you overcome that?

Answer 37

Twins often share same environment (can't be sure similarity is a result of environment as well as genes) Can control for environment using adoption studies

Question 38

What's the issue of using adoption studies to control for environment in studying the concordance rate between MZ twins?

Answer 38

Small sample- schizophrenic twins seperated by adoption are rare.

Question 39

What does the family dysfunction explanation of schizophrenia suggest? (3)

Answer 39

schizophrenia is due to family experiences of conflict/ communication problems/ criticism/ control Double bind theory High expressed emotiom

Question 40

what is the neural correlates explanation for schizophrenia? (1)

Answer 40

There is a correlation between brain structure and function and symptoms of schizophrenia.

Question 41

Give 2 limitations of the family dysfunction explanation for schizophrenia. (3)

Answer 41

Ethics- parents feel at fault Can't show cause and effect- family dysfunction may be cause of child's behaviour Family dysfunction may be trigger, but main cause biological

Question 42

What does using CBT to treat schizophrenia involve? (3)

Answer 42

Challenging beliefs Positive self talk Symptom targeting