Psychological therapies

• What is the key advantage of Clozapine for patients with schizophrenia?

  Improvements in cognitive functioning and mood
• Why is the improvement in mood from Clozapine particularly useful for schizophrenia patients?

  Because schizophrenia has a 50% comorbidity rate with depression
• What serious side effect is associated with Clozapine?

  Agranulocytosis, a severe and dangerous leukopenia
• How does Risperidone differ from Clozapine in terms of dosage requirements?

  Smaller doses are required for Risperidone
• For which type of patients is Risperidone particularly suited?

  Patients who do not suffer from depression but have a history of blood-related illnesses
• What hypothesis was the development of antipsychotics mainly based upon?

  The dopamine hypothesis
• What does the original dopamine hypothesis suggest about schizophrenia?

  It suggests hyperdopaminergia in the subcortex is responsible for symptoms
• What paradox arises from the action of antipsychotics in relation to the revised dopamine hypothesis?

  A further reduction in dopamine levels should worsen symptoms, not alleviate them
• What are the short-term side effects of typical antipsychotics?

  Relatively mild effects like agitation and weight gain
• What are the long-term risks associated with typical antipsychotics?

  Tardive dyskinesia and neuroleptic malignant syndrome (NMS)
• What characterizes neuroleptic malignant syndrome (NMS)?

  Fever, altered mental states, muscle rigidity, and autonomic dysfunction
• Why must patients taking Clozapine be monitored with blood tests?

  To check for agranulocytosis
• What should be considered in a cost-benefit analysis when using antipsychotics?

  Whether the benefit of symptom reduction outweighs the cost of side effects
• What evidence supports the use of typical and atypical antipsychotics?

  Studies by Thornley et al (2003) and Meltzer (2012)
• What validity issues are raised by Healy (2012) regarding antipsychotic studies?

  Studies may measure sedative effects rather than actual symptom control
• How do drug companies potentially distort the validity of antipsychotic research?

  By focusing on short-term benefits and using inappropriate control groups
• What are the three main psychological therapies for schizophrenia?

  • Cognitive Behaviour Therapy (CBT)
  • Family Therapy
  • Token Economy Systems
• What is the initial step in cognitive behaviour therapy (CBT) for schizophrenia?

  An assessment of the patient's symptoms and problems by a therapist
• What does CBT emphasize for patients with schizophrenia?

  The importance of understanding the causes of their symptoms
• How does CBT help patients with upsetting hallucinations or paranoid delusions?

  It reassures patients that they are not 'crazy' and increases self-awareness
• How can CBT challenge a patient's paranoid beliefs?

  By questioning the reality of their beliefs and considering reasonable alternatives
• What is the goal of family therapy for schizophrenia patients?

  To reduce stress within the family and improve attitudes towards schizophrenia
• How does family therapy reduce the likelihood of relapse in schizophrenia patients?

  By lowering stress and increasing cooperation with medical advice
• What principles are token economy systems based upon?

  Behaviourist principles
• How do token economy systems work?

  Patients are rewarded with tokens for displaying desirable behaviours
• What do tokens act as in a token economy system?

  A secondary reinforcer
• What can tokens be exchanged for in a token economy system?

  Rewards or privileges
• What is the main outcome of using token economies in psychiatric institutions?

  Increased likelihood of patients following hospital rules
• Do psychological therapies cure schizophrenia?

  No, they improve quality of life and make symptoms more manageable
• What does an interactionist approach to treatment suggest for schizophrenia?

  Both biological and psychological therapies should be used
• What is central to the interactionist approach?

  The use of the diathesis-stress model
• What did Meehl (1962) propose in the original diathesis-stress model?

  That the diathesis is biological in origin, causing a schizotypic personality
• What are the ethical issues associated with token economies in psychological therapies?

  • Privileges may be seen as rights
  • Restrictions can increase patient stress
  • Severe patients may struggle to comply with rules
• What ethical concerns are raised by CBT in treating schizophrenia?

  • Therapist control over patient beliefs
  • Potential for negative changes in personal beliefs
• What alternative psychological therapy is suggested to address issues with traditional therapies?

  • Art therapy
  • Provides a creative outlet
  • Reduces stress without changing beliefs
• How should psychological therapies be selected for schizophrenia patients?

  • Based on the type and severity of symptoms
  • Not all therapies are appropriate for every patient
• What is the revised view of the diathesis-stress model compared to Meehl's original proposal?

  The original model is considered outdated and overly simplistic