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28 Cards in this Set
- Front
- Back
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Atleast 1 symptom for 1 month [4] |
• Thought echo, withdrawal, broadcast • Delusions of control • Hallucinatory voices • Persistent delusions |
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Atleast 2 symptoms for at least 1 month [4] |
• Persistent hallucinations w/over valued ideas • Neologisms (new words) — breaks in thought = incoherent speech • Catatonic beh • Neg symptoms |
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Positive Symptoms |
An addition to an individual's beh: • auditory hallucinations • extreme displays of emotion • delusions |
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Negative Symptoms |
Taking away from individual's beh: • Avolition — reduced motivation, poor hygiene, lack of energy • Speech Poverty — reduced amount + quality of speech |
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Issues with diagnosis and classification of sz — Reliability |
A01 Consistent results when diagnosing sz (if doctors can agree on the same diagnosis) + how consistently ICD is used to diagnose sz
A03 🙁 Research to contradict — 2 psych's separately diagnosed 100 patients using both DSM + ICD criteria. 1 diagnosed 26 (DSM)&44 (ICD)+1 diagnosed 13 (DSM)&24 (ICD). Inconsistent tools used but each one diagnoses differently (inconsistent diagnosis)
🙁 Subjective info used to diagnose sz. Patient opinion then how doctor interprets it unlike physical evidence i.e. x-ray of broken leg. Impacts reliability.
😶 Early vol of ICD = not clearly defined→inconsistent diagnosis. Problems now addressed→now standardised methods used when diagnosing sz + detailed definitions of what sz is. |
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Issues with diagnosis and classification of sz — Validity |
A01 Whether ICD measures what it is intended to (sz)
A03 'Symptom overlap' =when 2+ conditions share same symptoms e.g. dep+sz share avolition. Suggests symptoms like avolition should be an illness by itself.
'Co-morbidity' = 2+ conditions occur at same time e.g. sz+OCD → unnecessary treatment
Wide range of symptoms → sub categories of sz (undifferentiated). Once diagnosed with undifferentiated, patient can be re-diagnosed. Shows ICD doesn't measure sz in first attempt. |
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Gender bias in diagnosis |
Men have been diagnosed more often than women as women typically function better than men → Suggests women can handle their symptoms better |
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Culture bias in diagnosis |
Classification systems developed by western so cannot use on other cultures. Imposed etic — ICD (tool) created by western, used on non-western. Positive symptoms such as hearing voices is worshipped in African cultures whereas in west=sz |
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Biological explanations of SZ: Genetic theory |
• Hereditary, passed via genes • predisposition to sz • Several maladaptive genes (polygenic) • Twin study: MZ (48%) + DZ (17%) • closer the genetic link, the more chance of having sz
😊Research→adoption study→155 adopted children w/ SZ biological mothers, concordance rate 10%, compared to 1% w/o SZ parents. SLT didn't contribute, so good support
🙁Nurture suggests concordance rates found in families = result of time genetically similar family members tend to spend together as could develop SZ through observation and imitation (SLT) |
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Biological explanations of SZ: Dopamine Hypothesis |
Neurotransmitters work differently in SZ brain→dopamine (D) involved
Hyperdopaminergia in subcortex: High D in central areas→poverty of speech/auditory hallucinations
Hypodopaminergia in cortex: Low D in prefrontal cortex→neg symptoms of SZ
😊 antipsychotic drugs (phenothiazines) block D receptor sites→reduces symptoms (example)
🙁 Bio reductionism→reduces complex disorder (SZ) to one sole factor (D). Stress-diathesis model=appropriate→predisposition triggered by environmental factor |
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Biological explanations of SZ: Neural Correlates |
Abnormalities in specific brain areas associated with SZ (larger ventricles) • scans used to compare SZ brain to non-sufferers to identify brain areas linked to SZ. Pos+Neg symptoms have neural correlates. •Ventral striatum→avolition (neg) •lower activation levels in superior temporal gyrus + anterior cingulate gyrus→Auditory hallucinations 😊 Research→measured activity levels in ventral striatum→lower activity than a control group of non-SZ patients. Ventral striatum→neural correlate of neg 🙁Research→larger ventricles in male sufferers→not generalised to women (gender bias→beta bias) |
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Outline family dysfunction as an explanation of SZ (2 marks) |
Family dysfunction due to difficulties in communication. Critical + controlling parents, high lvl interpersonal conflict. |
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Schizophrenogenic mother |
SZ caused by rejection of patient's mother. SZ=distrusting + resentful due to childhood interactions w/ mother SZ mother=cold, rejecting, emotionally unresponsive + family climate of tension and secrecy→distrust (develops in to paranoid delusions in SZ) |
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Double Bind Communication |
•SZ=faulty communication patterns within fam. •Parent communicates verbal message mismatched with non-verbal message e.g. verbally loving but emotionally anxious •conflicting, confusing communication=SZ. Can lead to child becoming increasingly anxious→withdrawing + avoid social contact (neg)/illogical thinking. |
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Family Dysfunction (FD) A03 |
😊Research > 207 children at risk of SZ as raised with schizophrenogenic mother > 10 years later 17 diagnosed with SZ > supporting FD
🙁Schizophrenogenic mother based on retrospective data > inaccuracies in recall as long period of time has passed > reduces internal validity of research
🙁Socially sensitive research > blames mother > damaging to families especially mother = guilt, and sufferer = resentment towards mother. 😊Research (Double Bind Communication (DBC)) > SZs recall more instances of DBC from mother during childhood than non-sufferers
🙁/😊Methodological? |
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Cognitive Explanations A01 |
1) Metarepresentation = ability to reflect on thoughts + beh. Allows insight to own intentions, allows to interpret people's actions. Dysfunction = disrupt ability to recognise own actions + thoughts as being carried out by ourselves > auditory hallucinations
2) Central Control = ability to suppress automatic responses. Dysfunction = Disorganised speech + thought disorder |
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Cognitive Explanations A03 |
😊studies show CBT=effective > meta-analysis fouynd CBT=pos effect on SZ symptoms > supports cog
😊Research > compared 30 SZ with 18 control on range of cog tasks e.g. Stroop Test. SZ took twice as long to complete tasks as control group supporting central control
🙁Links between symptoms and dysfunctional thought processing = clear, origins of cognitions/SZ=unclear > limited explanation of SZ > doesn't get to aetiology
🙁Too simplistic > too much emphasis on thoughts as cause of SZ > SZ = complex disorder + multidimensional approach considering other factors such as genes = appropriate |
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Biological Treatments A01 |
Chlorpromazine used to tranquilise w/o sedating > Psych's realised it removed pos symptoms
1) Chlorpromazine; 1st gen, typical. Dopamine antagonists (reduces). Awful side effects similar to Parkinsons. Binds D2 receptors > Dop reduced > Pos symptoms reduced
2) Clozapine; 2nd gen, atypical, dop + serotonin antagonists (reduces dop, regulates serotonin). Blocks dop receptors D1, D3, D4, selectively D2. Reduces pos + neg. Life threatening illness (agranulocytosis)
Anti-psych's=effective in controlling pos + neg. Allow SZs to live outside of institutions. Continued use at low dosage = helps prevent relapse. |
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Biological treatments A03 |
😊Cheap, effective > rapidly reduce symptoms + enable SZ to live relatively normal lives. Quick (reduce symptoms in 6 months) but symptoms return when patients stop.
😊Typical=effective in reducing pos not neg. Atypical=most effective + few side effects. 🙁 Ineffective treatment as doesn't get to aetiology, only controls symptoms. Adverse effects when treatment ends = Revolving Door Phenomenon (relapse)
🙁 Aetiology Fallacy→psychologists believe since drugs work they explain the cause of SZ→pro's not understanding real cause→inappropriate
🙁 Ethical issues→chemical straitjacket→dehumanising, distressing, irreversible side effects (SEs)→minor SEs=drowsiness, severe SEs=Tardive Dyskinesia (24% get uncontrollable lip movements) |
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CBT A01 |
Aim: change irrational thoughts and beliefs in to rational ones. Logical – does it make sense? Empirical – Where is the evidence? Pragmatic – is this way of thinking helping?
Client learns those ways and practices on daily basis. Cognitive: use of distraction, concentration on specific task, pos self talk Behavioural: social contact, breathing techniques, ways to drown hallucinatory voices. |
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CBT A03 |
😊 effective→study found 73% managed symptoms→researcher developed Coping Strategy enhancement (taught how to develop+apply coping strategies)
🙁 Reduces irrational thoughts, not eliminates→doesnt get to aetiology, just controls symptoms
🙁 Most studies researching effectiveness of CBT use CBT alongside so cannot establish cause + effect
😊 Long term benefits unlike drugs. CBT = freedom + control unlike drugs' chemical straitjacket
😊 Pos symptoms = cog→75% ppts with pos symptoms used cog based coping strategies + ¾ found them useful. Not appropriate for neg symptoms. |
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Psychological therapies Family Therapy A01 |
Aims to reduce lvl of neg emotion in families. Family is educated on SZ and managing it e.g. improving communication Family therapy reduces anger, guilt, stress, and improves beliefs + beh towards SZ in family members |
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Psychological therapies - Family Therapy A03 |
😊 a study compared Family therapy with routine outpatient care. In 9 months, 50% routine relapsed, 8% fam→effective
🙁 Emphasis on openness→issue as some may be reluctant to share→cause/reopen fam tensions→lowering effectiveness |
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Psychological therapies - Token economies A01 |
Aim: change patient's beh so easier to manage, have better quality of life + enabling them to leave institution
Behaviourist approach, used on institutionalised patients
Uses principles of OC. Reinforcements (tokens) for doing a good behaviour (washing) tokens are exchangeable for goods/privileges |
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Psychological therapies - Token Economies A03 |
😊 Researcher reviewed 13 token economy studies. Increases adaptive beh especially alongside drug/psychosocial therapies→effective 🙁 Ethical issues→privileges more available to mild patients + less to severe→severe suffer discrimination→use of token economies = reduced as not appropriate for all |
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Interactionist Explanation |
The diathesis-stress model: •genetic vulnerability (diathesis) but SZ onset by environmental trigger (stress) • original diathesis-stress model = diathesis due to single 'schizogene' + stress in childhood/adolescence • now = many genes + diathesis can be factors other than genetics e.g. Psychological trauma (HPA = over active) • original saw stress as Psychological in nature but now also believed factors such as cannabis use could trigger (stress) SZ |
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Interactionist Treatment |
Research suggests combination of treatments = most effective
Which combination is best depends on patient e.g. family therapy only suitable for patients with dysfunctional families
Antipsychotics given first to reduce symptoms so psychological therapies have greater effect |
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Interactionist Approach A03 |
😊 Research→19000 adopted children in Finland whose mothers had SZ. Child rearing styles of adoptive parents = observed. Family dysfunction linked to SZ but only in children w/ genetic risk 🙁 Original diathesis-stress model= too simplistic, argued diathesis "genetic". Diathesis can be result of early, severe, psychological trauma. New model = more valid 😊 Research→combined therapy = reduced symptoms than control w/ meds 😊 Holistic views from bio + psychological→effective treatments→but interactionist = more appropriate than reductionist alternative e.g. drug therapy 🙁 May not be correct. Combining = more effective but, not necessarily right→drugs+CBT combined reduce symptoms, doesn't mean SZ due to both bio + psychological factors → treatment causation fallacy |
