Schizophrenia

• what are the two categories schizophrenia is categorized into?

  DSM-5 (only positive symptoms)

  ICD-10 (only negative symptoms)
• Positive symptoms of schizophrenia are an excess or distortion of normal functions, for example hallucinations and delusions
• Negative symptoms of schizophrenia are a loss of normal functions such as speech poverty
• What is symptom overlap?

  When 2 or more symptoms are the same in multiple idisorders

  Such as schizpohrenia and biploar disorder
• What is comorbidity?

  When there is 2 or more conditions at the saem time

  Such as schizophrenia and depression
• Who conducted a study challenging the validity of psychiatric diagnoses?

  David Rosenhan
• What did David Rosenhan's research look like?

  • People with no mental health problems admitted into a psychiatric unit
  • 1 diagnosed with schizo and other manic depressive psychosis
  • Found diagnoses not valid and reliable, once people labelled as having disorder their behaviours seemed to be caused by diagnosis
• Who researched into gender bias in the diagnosis of disorders?

  Ford and widiger
• What did ford and widigers research look like?

  • TO find out if clinicians were sterotyping genders when diagnosing disorders
  • Self report technique used where health practicioners were given scenarios and asked to make diagnoses
  • Sample of 266 clinicians
  • Independent measures design and random sampling
  • ASPD correctly diagnosed in 42% of males and 15% of females
  • HPD correctly diagnosed in 76% of females and 44% of males
  • Practiciners are biased, females more likely to suffer emotional disturbances than males
• Escobar pointed out white psychiatrists may tend to over interpret the symptoms of black people during diagnosis. Factors such as cultural differences in language and mannerisms and difficulties relating between black patients and white therapists
• Validity – the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms.
• Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms.
• • Gottesman (1991) found that MZ twins have a 48% risk of getting schizophrenia whereas DZ twins have a 17% risk rate. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia.
• genetics are only partly responsible, otherwise identical twins would have 100% concordance rates.
• When talking about the biological explanantions for schizophrenia what should be mentioned?

  • Dopamine hypothesis
  • Genetics - family history/twin stuides
• The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine
• One criticism of the dopamine hypothesis is there is a problem with the chicken and egg. Is the raised dopamine levels the cause of the schizophrenia, or is it the raised dopamine level the result of schizophrenia?
• What is a twin study that can be used when talking about the biological explanantion of schizophrenia?

  The Genain quadruplets (MZ)
• Neural correlates show that people suffering from schizo have enlarged ventricles in the brain
• Allen found a negative correlation between the intensity of auditory halluciantions and activity in the superior temporal gyrus
• Family Dysfunction refers to any forms of abnormal processes within a family such as conflict, communication problems, cold parenting, criticism, control and high levels of expressed emotions.

  These may be risk factors for the development and maintenance of schizophrenia.
•  Bateson et al. (1956) suggested the double bind theory, which suggests that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia
• Reichmann's (1948) psychodynamic explanation based on patients' early experiences of 'schizophrenogenic mothers'. Cold and rejecting mothers
• What evidence is there to support Reichemans study on schizo mothers?

  Read et al - Reviewed 46 studies of schizo and child abuse, found patients diagnosed with schizo had a history of physical/sexual abuse in childhood
• Why do we question the validity of Read et als research?

  Retrospective memories
• How would the cognitive explanation explain schizophrenia?

  Schizophrenia is due to dysfunctional thought processes
• Christopher frith (1979) argues schizophrenia is the result of a faulty attention system
• David Hemsley suggested schizophrenia involves a breakdown in the relationship between memory and perception. People with schizo have a disconnect between their schemas
• What evidence is there of the effectiveness of CBT?

  Tarrier recieved trials of CBT, finding evidence of reduced symptoms especially positive ones and lower relapse rates
• What do antipsychotic drugs do?

  Lower dopamine activity levels to reduce hallucinations, delusions and dementia
• Antipsychotic drugs block dopamine receptors
• What is an example of an antipsychotic drug?

  Clozapine
• Atypical antipsychotics?

  Act on serotonin and dopamine receptors

  More often prescribed due to the adverse reactions from typical antipsychotics

  Can treat both positive and negative symptoms
• Kane et al conducted controlled double-blind trials comparing antipsychotics with placebo drugs showed fewer relapses from those taking the antipsychotics, but more drop out due to side effects
• Advantages of drug therapy?

  • More effective at reducing positive symptoms
  • Successful for most
  • Most widely used and effective form of treatment
• Disadvantages of drug therapy?

  • Not as effective for treating negative symptoms
  • Nomothetic theory
  • Reductionist
  • Side effects
  • Treats symptoms but not cause
  • Takes nature side and ignores interactionist
• What model should be spoke about when reffering to CBT?

  the three C's
• Chadwick et al showed how CBT worked for a case study of 'Nigel' where he was shown 50 scenarios and paused so he could predict what happened next and every scenario he was wrong
• Family therapy was developed by Anderson in 1980
• Anderson found a relpase rate of 40% when patients had drugs only, compared to 20% when family therapy was used and 5% when both combined