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Psychology
Schizophrenia
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Created by
Amber Cook
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Cards (17)
classification and diagnosis
DSM-5
2 or more symptoms need to be present for at least a month
ICD-11
2 or more symptoms need to be present for at least 6 months
both need to include at least 1 positive symptom
symptoms
positive
hallucinations
delusions - persecution, grandeur, reference, control
negative
avolition
speech poverty
weakness of diagnosis
co-morbidity
often diagnosed with other disorders
symptom overlap
bipolar also has positive symptoms
biological explanation
genetic
polygenic = 108 contributing genes
neural correlates
Juckel et al
negative correlation between avolition and increased activity in the ventral striatum (anticipation of pleasure)
dopamine hypothesis
high levels = hyperdopaminergia = hallucinations
low levels = hypodopaminergia = negative symptoms
biological explanation neurotransmitters
serotonin
dopamine
glutamate = learning, attention, memory
low levels in SZ
genetic study
Gottesman
concordance rates
48% MZ
17% DZ
9% siblings
Tienari
5.8% healthy family adoptees had SZ
36.8% dysfunctional family adoptees had SZ
dopamine hypothesis study
Leucht
meta-analysis of 212 studies
drugs that balance dopamine more effective than placebo
psychological explanation
family dysfunction
schizophrenogenic mother = stress and secrecy
double-bind theory = mixed messages and emotions
expressed emotions = exaggerated involvement
cognitive
dysfunctional central control = derailment of thoughts due to inability to suppress automatic responses
meta-representation = ability to identify own ideas
expressed emotion study
Butzlaff and Hooley
SZ relapse more likely in families with expressed emotion
cognitive study
Stirling
SZ patients in Stroop-test took 2x longer to identify colour
therefore they have dysfunctional thought processing (faulty central control)
biological treatments
typical antipsychotics
less popular
older
bad side effects such as tardiv dyskinesia
only treat
positive symptoms
block
dopamine receptors
atypical antipsychotics
more popular
newer
avoid
severe side effects
block dopamine receptors
work on other neurotransmitters such as
glutamate
address
al symptoms
biological treatments study
Bagnall
review of
232
studies
compared
typical
and
atypical
effectiveness
atypical more
effective
than typical at treating symptoms
less
people quit
atypical
treatment
atypical led to
less
movement-disordered side effects
psychological treatments
CBTp
Ellis ABCDE
model
challenge
irrationality
reality
testing
family therapy - Pharoah et al
educate
family-centered
techniques learnt
psychological treatment study
Sensky
19
CBTp sessions reduced symptoms of people who resisted
drug
therapy
Dickerson
reviewed
13
studies
found that token economies reduce symptoms and increase
adaptive
behaviour
interactionist approach to
explaining
and treatment
diathesis-stress
model - Meehl
genes and stressor
combined CBTp and drug therapy
CBTp change underlying faulty cognitions
drug therapy allows better engagement for severe patients
management of SZ
token economies
behaviour modification using
operant conditioning
tokens =
secondary reinforcer
achieving targets =
reward
=
positive reinforcement
interactionist treatment study
Tarrier
et al
315
patients randomly allocated to
3
conditions
medication
and
CBT
medication
and
counselling
control
group with medication only
combination showed to be more
effective
and patients displayed
less
symptoms after the trials