schizophrenia

• CHENIAUX [AGAINST DSM + ICD]

  2 psychiatrists independently diagnose 100 patients using the DSM + ICD = poor inter rather reliability (inconsistency = limitation of the diagnosis) 1st researcher - 26(dsm) + 44(icd) 2nd researcher - 13(dsm) + 24 (icd)
• COTTON ET AL [AGAINST DSM + ICD] 

  found females typically function better than men (better interpersonal functioning + may bias practitioners to under diagnose schizophrenia 
• GOTTESMAN [BIOLOGICAL EXPLANATION]

  shows the link through META-ANALYSIS of 40 studies = monozygotic: 48% / dizygotic: 17% / siblings: 9%  (shared risk from family studies)
• RIPKE ET AL [BIOLOGICAL EXPLANATION]

  studied 37k patients and found 108 separate genetic variations with higher risk)
• JUCKER ET AL [BIOLOGICAL EXPLANATION; NEGATIVE SYMPTOMS] 

  (avolition = ventral striatum - anticipation of the reward) lower levels of activity than in the controls + saw a negative correlation between activity levels in the ventral striatum and the severity of overall negative symptoms [activity in this area is a neural correlate]
• ALLEN ET AL [BIOLOGICAL EXPLANATIONS; POSITIVE SYMPTOMS]

  (hallucinations = superior temporal gyrus) patients experiencing auditory hallucinations record lower activity levels in the superior temporal gyrus + anterior cingulate gyrus = more errors [low activity in these areas is neural correlate]
• GOTTESMAN [SUPPORT BIOLOGICAL EXPLANATION]

  family study shows how genetic similarities + shared risk of schizophrenia are closely related 
• TIENARI ET AL [AGAINST BIOLOGICAL EXPLANATION] 

  adoption studies; children of ppl with schizophrenia still at heightened risk of schizophrenia if adopted into family without history) -> may not be entirely genetic
• FROMM REICHMANN [PSYCHOLOGICAL EXPLANATION]

  FAMILY DYSFUNCTION psychodynamic explanation based on patients early experiences of ‘schizophrenic mothers’ (mothers who cause schizophrenia = cold, rejecting, controlling + creates family climate of tension + secrecy -> leads to distrust + paranoid delusions + schizophrenia)
• BATESON ET AL [PSYCHOLOGICAL EXPLANATION - DOUBLE BLIND THEORY]

  cannot express their feelings about unfairness of the situation - described how a child may be regularly trapped in situations where they fear they are doing the wrong things but receive conflicting things about hat is wrong + when they ‘get it wrong’ the child is punished by withdrawal of love + then leads them to learn the world is dangerous + leads to disorganised thinking + delusions 
• FIRTH ET AL [PSYCHOLOGICAL EXPLANATION]

  dysfunctional though processing; meta representation (cognitive ability to reflect on our thoughts + behaviour) -> interrupts our ability to recognise our thoughts as our own + could lead to hallucinations + central control (cognitive ability to suppress automatic responses while performing deliberate actions) - identified dysfunction of central control as a way to explain speech poverty -> ppl with schizophrenia experience derailment of thoughts + spoken sentences as each word triggers automatic associations that they cannot suppress 
• READ ET AL [MIXED SUPPORT PSYCHOLOGICAL EXPLANATION] 


  [family dysfunction as a risk factor] reviewed 46 studies of child abuse and concluded 69% women with diagnosis of schizophrenia  had a history of physical/sexual abuse in childhood (symptoms may have distorted patients recall of childhood experiences - low validity)
• STIRLING ET AL [SUPPORT PSYCHOLOGICAL APPROACH]

  compared 30 patients with schizophrenia with 18 non patients + (strop test - name ink colour of colour words) -> patients took 2x as long to suppress impulse, read words) but doesnt say anything about the origins
• THORNLEY ET AL [SUPPORT BIOLOGICAL THERAPIES = ATYPICAL]

  reviewed studies comparing the effects of chloropromazine to control conditions using a placebo - data from 13 trials with 1121 participants showed that chloropromazine was associated with better overall functioning and lower symptom severity
• MELTZER ET AL [SUPPORT BIOLOGICAL THERAPIES = ATYPICAL] 

  concluded clozapine is more effective than typical antipsychotics (30-50% more effective) 
• HEALY [AGAINST BIOLOGICAL THERAPIES = ATYPICAL]

  suggests data from successful trials have been published multiple times (exaggerating the positive effects) + only reviews short term effects; doubts about true effectiveness 
• PHARAOH ET AL [PSYCHOLOGICAL THERAPIES]

  family therapies; lowers stress of caring of caring for relatives with schizophrenia , increases ability to anticipate + solve problems, reduce anger + guilt build up to family members + improve beliefs -> reduce likelihood of relapse + readmission to hospital + more likely to comply to taking meds + reviewed evidence of family therapies but only very effeclive when with drug therapies = EVIDENCE IS INCONSISTENT
• JAUHAR ET AL [AGAINST PSYCHOLOGICAL THERAPIES]

  CBT had significant but small effects on positive + negative symptoms 
• MEEHLS MODEL [INTERACTIONIST APPROACH; DIATHESIS STRESS MODEL - vulnerability + stress trigger are needed to develop schizophrenia]

  someone without the ‘schizogene’ should never develop schizophrenia no matter how much stress they were exposed to; schizogene is necessary but not sufficient for development of schizophrenia 
• RIPKE ET AL [MODERN DIATHESIS STRESS MODEL]

  no single gene (ripke) + involves psychological trauma (INGRAM + LUXTON)
• TURKINGTON ET AL [TREATMENT; INTERACTIONIST]

  antipsychotic medication + CBT -> possible to believe in biological causes of schizophrenia + still practise CBT to relieve psychological symptoms (UK more interactionist approach = accepted as supposed to US)
• TIENARI ET AL [SUPPORT TREATMENT; INTERACTIONIST]


  adopted children away from schizophrenic mothers + adoptive parenting styles (trigger) compared with control group ; child rearing style with high lvls of criticism + conflict -> low lvls of empathy was implicated in development but only of children with a high genetic risk
• HOUSTON ET AL [AGAINST TREATMENT; INTERACTIONIST APPROACH]

  found childhood trauma (sexual) was a diathesis + cannabis use a trigger - stress can also include biological factors (doesnt need to be psychological) 
• TARRIER ET AL [SUPPOR INTERACTIONIST APPROACH; TREATMENT]

  randomly allocated 315 patient to 1 medication + CBT or 2 (medication) + supportive counselling or control; patients in combinations showed lower symptom levels 
• LURHMAN ET AL [AGAISNT DIAGNOSIS + CLASSIFICATION OF SCHIZOPHRENIA]


  interviewed 60 adults with schizophrenia (20 in ghana, india and the US) = each were asked about voices they heard [person who claimed they were god on earth = delusional in western society but in india is a spirit who is the human incarnation of a hindu god
• CHENIAUX [AGAINST DSM + ICD]

  poor validity ; more likely to diagnose ppl with ICD [suggest either over diagnosis of ICD of under diagnosis of DSM -> love validity + not standardised]