Schizophrenia

Question 1

What percentage of people affected by schizophrenia also have a substance abuse problems

Answer 1

50%

Question 2

Define schizophrenia

Answer 2

A mental disorder characterised by withdrawal from reality

Question 3

What are positive and what are negative symptoms

Answer 3

• Positive symptoms= Present in schizophrenic people but not in normal functioning people
• Negative symptoms= Present in normal functioning people but not in schizophrenic people

Question 4

What are the positive and negative symptoms

Answer 4

Positive symptoms:

• Hallucinations= Sensory experiences that aren’t actually there
• Delusions= An irrational belief

Negative symptoms:

• Avolition= Lack of motivation
• Speech poverty= Don’t talk a lot, if they do it’s monotone

Question 5

The two psychological explanations for schizophrenia

Answer 5

1) Family dysfunction

2) Cognitive explanations / Dysfunctional thought processing

Question 6

2 AO1 points for family dysfunction

Answer 6

1) The characteristics of the schizophrenogenic mother which are:
- High levels of interpersonal conflict
- Difficulty communicating
- Excessively critical and controlling

2) The effect on the child which is:
It causes the child to be in a ‘double bind’ state, which is a state of confusion. Causing the child to be withdrawn, little speech or interaction

Question 7

1 AO3 mark, Kavanagh (1992) study on effects of a dysfunctional family

Method, results, conclusion

Answer 7

Method= Meta-analysis of 26 previous studies, measuring relapse rates of schizophrenics who returned to families

Results= -48% rate of relapse when returning to dysfunctional family
- 21% rate of relapse when returning to healthy family

Conclusion= Supporting theory, that household environment impacts rate of schizophrenia

Question 8

2 more AO3 points for dysfunctional family

Answer 8

• Only evidence for negative symptoms, therefore not a comprehensive theory as it doesn’t explain causation for all symptoms
• Therapies focussed on family dynamics, are successful in reducing relapses, Supports theory that environment impacts rate of schizophrenia

Question 9

Cognitive explanations / dysfunctional thought processes

There are two types of thought processing involved according to Frith et al:

Answer 9

Metarepresentation

Central control

Question 10

What is metarepresentation

Answer 10

The ability to represent thoughts, concepts and experiences in the mind

Question 11

What does Frith state about metarepresentation which helps explain positive symptoms such as hallucinations and delusions

Answer 11

Frith states that failure in metarepresentation leads to an inability to distinguish between speech heard externally and internal thoughts

• Helps to explain positive symptoms such as hallucinations

Question 12

What is central control

Answer 12

The cognitive ability to suppress some thoughts while we perform other actions instead

Question 13

What test can measure your central control

Answer 13

The stroop test

Question 14

Stirling (2006) study on cognitive explanations

Method, results, conclusion

Answer 14

Method= Performance of schizophrenia patients on the stroop test was compared with healthy central controls. (Test to measure a persons central control). DV is how quick they can do it

Results= Schizophrenic people take longer

Conclusion= Schizophrenics have no central control, therefore Supports theory

Question 15

2 more AO3 points for cognitive explanations

Answer 15

• Describing the cognitive deficits explains the symptoms, but doesn’t explain what causes the cognitive dysfunctions, therefore not a comprehensive theory
• If occurrence is so common in schizophrenics, there could be possible patterns of cognitive deficit, therefore can use the stroop test as a diagnostic tool

Question 16

Biological treatments

Do antipsychotic drugs cure schizophrenia

Answer 16

They don’t cure schizophrenia but they lessen the symptoms

Question 17

What are the two types of drugs for treating schizophrenia

Answer 17

Typical and Atypical

Question 18

Describe typical antipsychotics

Answer 18

• Developed In 1950’s
• Inhibitory action on the dopamine system (decreases chance of adjacent cell producing an electrical impulse)
• Reduce positive symptoms
• Many side effects

Question 19

Describe atypical antipsychotics

Answer 19

• Developed In 1990’s
• Act on both the serotonin and dopamine systems (excitatory and inhibitory)
• Reduce both positive and negative symptoms
• Fewer side effects

Question 20

Thornley(2003) study on typical antipsychotics

Method, results, conclusion

Answer 20

Method= -Meta-analysis on studies comparing effects of chlorpromazine with a placebo

Results= Chlorpromazine resulted in better functioning, reduced symptom severity and lower relapse rates

Conclusion= Typical antipsychotics are effective

Question 21

Davis (1989) study on antipsychotics

Method, results, conclusion

Answer 21

Method= Compared antipsychotics with placebos

Results= - 70% of cases improved with antipsychotic use
- 25% improved with placebo

Conclusion= Antipsychotic use is effective

Question 22

2 statistics that can help in AO1 about treatment

Answer 22

• Less than 3% of schizophrenics live permanently in hospital in the UK, most live a normal life. This shows treatment is effective enough to allow individuals to live independently
• Relapse rate for treated schizophrenics is 40% in the first year. This shows people stop taking medications, due to side effects

Question 23

What are the 3 Psychological treatments for schizophrenia

Answer 23

• Cognitive Behavioural Therapy (CBT)
• Family therapy
• Token economies

Question 24

Cognitive behavioural therapy

2 AO1 points

Answer 24

• Aims to change the maladaptive thinking and distorted perceptions of schizophrenia
• Antipsychotic medication taken prior CBT so psychotic thoughts are less severe
• Therapist challenges the delusional thoughts
• Techniques are developed to help patient cope with their hallucinations and delusions:
• Distractions (turn radio up to not hear hallucinations)
• Rationalising (asking for evidence/challenge irrational thoughts)
• Increasing social activity (Homework)
• Relaxation techniques (Decrease stress when diagnosed)
• Relapse recognition (Knowing the hallucinations and delusions to know if they come back)

Question 25

Tarrier (2000) study for cognitive behavioural therapy (CBT) 3 conditions for it

Answer 25

Participants receiver either of the conditions to reduce schizophrenia symptoms: 1) Antipsychotics and CBT 2) Just antipsychotics 3) Counselling

Question 26

Results for Tarrier’s study on CBT

Answer 26

Results = - 1/3 of patients in condition 1 achieved a reduction in positive symptoms - 15% of patients in condition 1 were free of all positive symptoms - These numbers were lower in both other conditions - However, 2 years later they were similar in all groups again Conclusion= Condition 1 is an effective treatment, but not long lasting

Question 27

Evaluation for CBT

Answer 27

- Rathod study suggests successful CBT depends on relationship between therapist and patient. Therefore validity is questioned - CBT helps patient ignore hallucinations instead of reducing them. Therefore, ignoring symptoms isn’t really a treatment

Question 28

Family therapy 2 AO1 points

Answer 28

- About the cause of a schizophrenogenic mother - Therapy involves not just the individual but relatives as well Aims for this treatment like: - Form alliance with family members - Reduce levels of expressed emotion and stress - Improve communication within family - Help reach balance between caring and living life

Question 29

Left (1985) study on family therapy Method, results, conclusion

Answer 29

Method= Looked at schizophrenics with families high in expressed emotion. - Comparing 2 treatments: Therapy and family therapy Results= Relapse rate was significantly less for family therapy than normal therapy (individual), however symptoms began again after 2 years Conclusion= Family Therapy is effective in short-term. Not long lasting

Question 30

AO3 points for family therapy

Answer 30

- Schizophrenia commission (2003) states that Family Therapy is cheaper than standard care by around £1,000 per patient, every 3 years. Meaning there’s less relapse in family therapy - Not all people are in contact with their family. Meaning not everyone can benefit from family therapy

Question 31

Token economies as treatment for schizophrenia AO1 points

Answer 31

- Uses operant conditioning to reinforce positive behaviours with tokens - Token economies are aimed at reducing negative symptoms of schizophrenia

Question 32

Ayllon and Azrin study for token economies Method, results, conclusion

Answer 32

Method= Implemented a token economies system in a hospital for schizophrenic patients Results= Average Number of chores completed rose from 5 to 42 Conclusion= Token economy is treating negative symptoms (avolition mainly)

Question 33

2 AO3 points for token economies as treatment

Answer 33

- A token economy can only be implemented in a hospital, therefore not comprehensive - If patient is not paid immediately, the treatment will not work, therefore cannot be used/generalised in outside settings

Question 34

Interactionist explanations and treatments What is a Interactionist theory in terms of schizophrenia

Answer 34

Schizophrenia is seen as developing through 2 interacting factors - Not just having one cause

Question 35

What’s a diathesis

Answer 35

A genetic disposition (genetic vulnerability)

Question 36

What does the diathesis model suggest

Answer 36

Schizophrenia is caused by an underlying genetic vulnerability (diathesis) and the environment an individual lives in (stress)

Question 37

According to the diathesis model, when are you most likely to develop schizophrenia

Answer 37

When you have High diathesis (a gene) and High stress (environment you live in)

Question 39

Study for Diathesis Method, results, conclusion

Answer 39

Method(3 conditions): 1) Antipsychotocs and CBT 2) Just antipsychotics 3) Counselling Results= 1/3 of patients in condition 1 achieved reduction in positive symptoms Conclusion= Supports DS theory, as it targets both genetic and environment, which turns out to be most effective

Question 40

AO3 point for interactionist explanation and treatment

Answer 40

- Combined Therapy is expensive in short term, in the long term it saves money due to reduction of relapse - A study (Walker 1997) suggests there’s higher levels of cortisol in schizophrenics than non-sufferers causing the high levels of stress. However, no cause and effect as don’t know whether stress causes schizophrenia or schizophrenia causes stress