Diagnosis and classification
What are the 2 manuals used to diagnose SZ and, besides place of origin, what's one key difference?
ICD-10 & DSM-V
DSM-V- looks for only 1 positive symptom to diagnose
ICD-10-2 or more negative symptoms need to present.
What does the term 'genetic basis of sz' mean and what sort of genes cause SZ?
When a person has a genetic vulnerability- they inherited a candidate gene from their family and now have SZ (Gottesman)
Schziogene- main one but SZ is polygenic and A.H- Ripke found 108 genetic variations
What is family dysfunction?
Abnormal processes within a family e.g. poor communication/cold parenting/ee. May be a risk for the development and maintenance of SZ.
What is CBT, how does it help and who examined this?
CBT- 5-20 sessions to identify irrational thought and challenge them with a discussion on how they are not true/considering less threatening possibilities.
This helps them make sense of their delusions and thus reduces anxiety (Turkington mafia example).
What is the diathesis stress model? How does this look in Meehl's model?
Vulnerability and stressor combining to cause SZ
Meehl: schziogene (diathesis) and stress= mother. No stress? No SZ.
What is co-morbidity and what is the difference between this and symptom overlap?
Co-morbidity- occurrence of 2 disorders together e.g. sz and personality disorder
Symptom overlap- when 2 or more conditions share the same symptoms e.g. sz and ptsd
How is the genetic explanation reductionist?
Ignores the impact of the environment e.g. high levels of EE
What is the SZPG mother and what researcher proposed this?
Cold, controlling and uncaring. Leads to tension and secrecy ultimately resulting in delusions and therefore SZ (Fromm-Reichmann).
What is family therapy, who examined this and how does it help?
Pharoah's strategies- alliance, reduces stress of carer, reduce guilt, balance of life and beliefs.
Makes one more likely to comply with medication and thus not relapse.
How was this model updated?
Diathesis is no longer just biological- can be stress in life of abuse or smoking cannabis.
Name all the positive and negative symptoms of SZ
Hallucinations (Auditory and visual)
Delusions
Negative:
Avolition
Speech poverty
Catatonia
What is the dopamine hypothesis and what sort of real-life application does this have?
Hyper in the subcortex e.g. broca area
Hypo in the cortex e.g. prefrontal cortex
IRL: Drug therapy e.g. chlorpromazine is a dopamine antagonist
What is the double-bind theory and who proposed this?
Bateson )family with mixed messages and the kid can't clarify. When they get something wrong- withdrawal of love and makes them see the world as confusing- therefore disorganised thinking and delusions
What are token economies and what is one strength?
OC- Positive
Secondary reinforcers
Easy to implement.
How do we treat using this approach?
Combination, especially in the UK. eg. medication of antipsychotic drugs and use either CBT, T.E. or F.T
What is reliability and what researcher found the issue of reliability in diagnosing SZ?
Consistency of findings/diagnosis
Reigler found a 0.46 kappa score in diagnosis, meaning it is not consistent. This is an issue because it can cause patients to either become misdiagnosed or under
What are neural correlates in the context of SZ? Give examples in your answer.
Brain regions associated with a certain symptom of SZ e.g. ventral striatum=avolition
S.T.G/A.C.G. for hallucinations
What are 2 cognitive explanation to SZ and what is one strength of this?
Metarep- reflect on thoughts
CC- suppress
IRL- CBT
What is the evidence for effectiveness concerning CBT and family therapy? Why is this a strength?
Pharoah reviewed FT and found moderate evidece showing it reduces hospital admissions
Jauhar reviewed 34 studies of CBT and found small effect on pos and neg symptoms
Reduces strain on NHS, improving QOL.
Who supported the effectiveness of treatment? How many patients did they use? Why is this a strength?
Tarrier - with 315 people
Supports the central assumption, improves Q.O.L and reduces strain on NHS- clear practical advantage.
What is validity and which researchers pointed out an issue of validity in relation to SZ?
-Culture bias (Copeland) who found 69% of US doctors diagnose SZ but on 2% of UK doctors did. Could lead to a difference in treatment depending on the country they live in.
-Loring and Powell- gender bias 56% of psychiatrists gave a diagnosis of SZ for males but only 20% for females- diagnosis lacks universality & could lead to further problems
Which researcher suggested there is problems with the evidence of effectiveness of drugs? Why is this a weakness?
Healy- drug companies exaggerate the effects and only look at them short term. Suggests these drugs aren't really effective at all.
Why is the psychological explanation socially sensitive?
Parent blaming- negative implications for the mother to not have children- discrimination.
The quality of the evidence on effectiveness is concerning. Why and why is this a weakness?
No control groups or random allocation-
can't really conclude they got better due to therapy or due to some extraenous variable.
What is one weakness of the old model? Why is this a weakness?
Over simple
Houston points out childhood sexual trauma can be a vulnterability and cannabis use is the trigger. Partially reductionist to assume vulnerability is only biological.