SCHIZOPHRENIA

• Inter-rater reliability


  Two or more health professionals come to the same diagnosis
• Con-current Validity


  Different methods of assessment come to the same diagnosis
• Co-morbidity


  Two or more conditions occur simultaneously
• Symptom overlap


  The same symptoms occur within different conditions
• Cheniaux et al (2009)

  Two psychiatrists independently diagnosed 100 patients using two different assessments
• Buckley et al (2009)

  Investigated those with schizophrenia and found they were likely to also suffer from another condition
• Gottesman (1991)


  Schizophrenia runs in families. Probability of schizophrenia = 48% between MZ twins, 46% if both parents had it and 10% between DZ twins.
• Tienari et al (2004)

  Children adopted from 19,000 Finnish mothers at birth. More likely to develop schizophrenia when biological relatives had it, but not when adoptive parents did. High EE levels also implicated in development, but only for those with a genetic risk.
• Hyperdopaminergia


  High levels of dopamine in the brain's subcortex
• Hypodopaminergia


  Low levels of dopamine in the brain's cortex
• Neural Correlates


  Patterns of structure or activity in the brain that occur in conjunction with an experience
• Juckel et al (2006)

  Conducted a study involving reward anticipation on 10 schizophrenic males and a matched control group.
• Juckel et al (2006)

  Found healthy males had higher levels of activity in the ventral striatum (involved in reward anticipation) than those who were schizophrenic. The lower the activity the worse the symptoms of schizophrenia.
• Typical anti-psychotics


  Used since the 1950's. Includes Chlorpromazine
• Chlorpromazine


  Can be taken as a syrup, tablet or injection. Side effects include: dizziness, agitation, sleepiness, still jaw, weight gain, itchy skin and tardive dyskinesia.
• Atypical anti-psychotics


  Used since the 1970's. Includes Clozapine.
• Clozapine


  Can be taken as a syrup or a tablet. Side effects include: Agranulocytosis
• Thornley et al (2003)

  Meta-analysis of Chlorpromazine studies. 13 trials with 1121 participants. Schizophrenic control group given a placebo.
• Thornley et al (2003)

  Found better overall functioning and reduced symptom severity in those who took Chlorpromazine.
• Risperidone


  Can be taken as a tablet, syrup or injection. Works on both dopamine and serotonin receptors. Developed to combat serious side effects of Clozapine.
• Meltzer (2012)


  Found Clozapine to be more effective than typical anti-psychotics. Effective in 30-50% of cases where typical anti-psychotics failed.
• Fromm-Reichman (1948)


  Cold, rejecting and controlling mothers may contribute to schizophrenia through distrust that leads to paranoid delusions (Psychologist not theory) Developed by accounts patients gave about childhoods
• Expressed Emotion


  High levels of this towards a child causes significant stress (e.g. verbal criticism, hostility) More applicable to relapse not cause. (Theory)
• Brown et al (1966)

  Examined progress of discharged schizophrenics who returned to their families. Families were characterised as High EE or low EE.
• Central control


  Ability to suppress responses and perform deliberate actions. (Disorganised speech could be due to this)
• Stirling et al (2006)

  30 schizophrenics and 18 non-schizophrenics completed the stroop test - measures central control
• Stirling et al (2006)

  Mean time for 'non-compatible' word list: 123.2 seconds fro schizophrenics. 58.12 for non-schizophrenics.
• Metarepresentation


  Cognitive ability to reflect on ones own thoughts and behaviours, knowing our intentions and being aware of others behaviours.
• Cognitive behaviour therapy


  5-20 sessions of this. Identify irrational thought and change them. Helps to make sense of delusions and hallucinations to reduce anxiety.
• Jauhar et al (2014)

  reviewed results of 35 studies assessing impact of CBT on positive and negative symptoms of schizophrenia.
• Gumley et al (2003)

  144 participants with schizophrenia. Received either treatment as usual or treatment as usual with CBT. Followed up between entry and 12 months.
• Sensky (2000)


  Found CBT to be effective in reducing hallucinations, delusions and depression in schizophrenic patients.
• Family Therapy


  Aims to improve quality of communication and interaction between family members as well as reduce levels of expressed emotion.
• Pharoah et al (2010)

  Identifies a range of strategies therapists use to improve functioning of a family (e.g. improves families ability to anticipate and solve problems)
• Pharoah et al (2012)

  Meta-analysis of 53 studies investigating family therapy compared to standard care alone.
• Pharoah et al (2012)

  Family therapy increased patients compliance with medication. Didn't have much of an effect on social functioning. Some studies reported an improvement in overall mental state whilst others didn't.
• Token economy


  Reward system to manage schizophrenic patients behaviour, especially if it is maladaptive as a result of institutionalisation.
• Interactionist approach


  Acknowledges biological, psychological and societal forces involved in the development of schizophrenia
• Diathesis-stress model


  Vulnerability and a stress trigger are necessary to develop schizophrenia
• Meehl (1962)


  Diathesis = purely genetic. Schizogene leads to development of schizophrenic personality. Without this gene, no amount of stress will cause schizophrenia.