Psych Schizo

• Classification of schizophrenia according to the DSM-5:

  • Diagnosis requires two of the following symptoms to be present for at least a month: positive symptoms (hallucinations, delusions) and negative symptoms (loss of normal experiences and abilities)
• Reliability in the diagnosis of schizophrenia:

  • Interrater reliability: measures if two observers agree on the diagnosis
  • Test-retest reliability: measures if the same doctor gives the same diagnosis over time with the same symptoms
• Validity in the diagnosis and classification of schizophrenia:

  • Questions if a person has a disorder when diagnosed or if schizophrenia is a real disorder with clear and unique symptoms
  • Beck 1963 found a low concordance rate between doctors' assessments, suggesting low interrater reliability and potentially incorrect diagnoses
• Comorbidity of schizophrenia:

  • Often diagnosed with other disorders like depression, bipolar disorder, drug abuse, PTSD, and OCD
  • Symptom overlap with other disorders can lead to misdiagnosis
• Gender and culture bias in the diagnosis of schizophrenia:

  • Cotton argues women's experience of schizophrenia is taken less seriously and under diagnosed compared to men
  • People of Afro-Caribbean heritage in the UK are up to nine times more likely to be diagnosed with schizophrenia
• Biological explanations of schizophrenia:

  • Genetic explanation: polygenetic disorder with higher concordance rates in families
  • Neural correlates: variation in neural structure and biochemistry correlated with an increased risk of developing schizophrenia
• Psychological explanations to schizophrenia:

  • Family dysfunction theories: schizophrenia symptoms due to interpersonal relationships within the family
  • Cognitive self-determinants perspective: clients can reconstruct irrational mental processes to control their disorder actively
• Biological treatments for schizophrenia:

  • Antipsychotics (neuroleptics): control symptoms of psychosis like delusions and hallucinations by reducing dopamine activity
• In the 1950s, typical antipsychotics like clopromazine were used but are less popular due to severe side effects; they treat positive symptoms by reducing dopamine activity through blocking dopamine receptors, reducing hallucinations and delusions
• A meta-analysis by Leucht (2013) found that drug treatments targeting the dopamine system are effective in reducing symptoms compared to a placebo
• Bagnall's review of 232 studies showed that atypical antipsychotics were more effective than typical ones, resulting in fewer movement disorder side effects and fewer people leaving the drug treatments early; clozapine was the most effective
• Drug therapies for schizophrenia are cost-effective compared to hospital treatment or one-to-one psychological therapies
• Combining drug therapies with psychological therapies like cognitive behavior therapy (CBT) can significantly improve the severity and number of positive symptoms in patients
• CBT assumes that schizophrenia results from dysfunctional thought processes and aims to challenge irrational beliefs, providing reality testing and cognitive restructuring
• Family therapy in schizophrenia aims to improve the home situation as family dysfunction can increase the risk of relapse; it educates families on symptoms, reduces conflict and stress, and improves communication and problem-solving skills
• Token economies, based on Skinner's operant conditioning, use tokens as positive reinforcement to manage behavior in hospital settings or prepare long-stay patients for community living
• CBT can effectively reduce positive and negative symptoms in schizophrenia patients, with long-lasting improvements even after treatment ends, without the side effects of drug therapies
• Family therapy can reduce relapse rates compared to standard outpatient care, but it's not a cure and may face challenges like the length of therapy and patient dropouts
• Token economies can improve adaptive behavior in schizophrenia patients but do not directly treat symptoms, potentially raising ethical concerns about manipulation
• The interactional approach to treating schizophrenia combines biological and cognitive therapies, considering the interaction of biological, social, and psychological factors in the development and treatment of the disorder
• Genetic studies on schizophrenia show concordance rates in twins, supporting genetic factors, but the influence of environmental factors is also significant, as seen in studies on adopted children of schizophrenic mothers
• An interactionist approach to treating schizophrenia, combining drug therapies and psychological interventions, is more effective than using antipsychotics alone