1
Q
Positive symptoms
A
Additional symptoms to normal such as hallucinations
2
Q
Negative symptoms
A
Loss of abilities the everyday person experiences like avolition
3
Q
Reliability
A
Consistancy in diagnosis
4
Q
Validity
A
True
5
Q
Inter rater reliability
A
More than one person agress with diagnosis
6
Q
Co morbidity
A
Schizophrenia and other diagnosis
7
Q
What is needed for a ICD-11 diagnosis of schizophrenia
A
Delusions
8
Q
What is the kappa score for good inter rater reliability
A
0.7
9
Q
Most common hallucination
A
Auditory
10
Q
Time for ICD-11 diagnosis
A
1 month
11
Q
Time for DSM-5 diagnosis
A
6 months
12
Q
Avolition
A
Decreased motivation to perform purposeful activities
13
Q
Alogia
A
Lessening of speech fluency
14
Q
Dsm-v
A
American diagnostic of sz
15
Q
Icd-11
A
English diagnostic of sz
16
Q
Evaluation of dofference between DSM-5 and ICD-11
A
Icd-1 month of symptoms
Dsm-6 month of symptoms
Inability to compare as assessed in different ways and westernised so can’t be generalised to a developing nation
17
Q
Test retest reliability
A
Reach the same conclusion at 2 different points in time
18
Q
Inter rater reliability
A
Different doctirs reach same conclusion
19
Q
Kappa score
A
Like correlation coefficient.
Measured in 0-1good
0.7 above is good
20
Q
Cultural differences study
A
Culture has influence on diagnosis process
Luhrman studied people from Indian Ghana and USA
Ghana and India has positive hallucinations but USA had non.
Positive in one part of world and negative in other threatens reliability
21
Q
Strength Evaluation of cultural differences
A
P- sz is 5 times high in Afro carribean
E- Escobar found culture bias by psychiatrist from different background. Lack inter rater reliability
L- threat to reliability may get different diagnosis
H- some cultures may not experience distress with it
22
Q
Substance abuse percentage to sz
A
47%
23
Q
Anxiety percentage to sz
A
15%
24
Q
Depression percentage to sz
A
50%
25
Weakness Evaluation comorbidity
P- many schizophrenics have substance abuse
E- makes reliable diagnosis hard to achieve as there are lower levels of functioning
L- demonstrates complexity involved in giving reliable diagnosis
Hard to know what are symptoms of sz or drugs and can affect day to day test rest reliability
26
Symptom overlap validity threat
Possibilities that wrong diagnosis is made whixj can affects validity in diagnosis
27
weakness Evaluation of symptom over lap
Many countries relabelled sz
Japan called it integration disorder
Threatens validity of diagnosis uk
28
Gender bias validity threat
Men get diagnosed more and have negative symptoms and substance abuse. Females have better recovery
29
Weakness Evaluation of gender bias
Different treatment offered on gender
Men get serious diag
Women seek help early
Threatens validity based on gender rather then symptoms
30
Rosenhan
Got 8 fake sz and told em to go into hospital and say they have hallucinations. All were admitted but then acted normal and docterd interpreted there behaviour was abnormal.
Shows people diagnosed too easily
31
Hyperdopaminergia
Excess dopamine
Subcortex
Increased d2 receptors (firing)
Positive symptoms hallucinations
32
Hypodoperminergia
Less dopamine
Outer cortex
Less firing
Negative like avolition
33
Neural correlates to sz (biological explanations)
enlarged Ventricals
Positive symptoms
negative symptoms
34
Postive symptoms (neural correlates)
increase activity during auditory hallloucinations in the left superial temporal cortex
35
Negative symptoms (neural correlates)
Lowered activity in ventral striatum
36
Genetic explanations of sz
Twin
Adoption
Family
Gene mapping
37
Twin studies in genetic sz
Higher concordance rate in Mz then dz eg 75% vs 24%
38
Adoption studies in genetic sz
Children are at higher risk of sz even if they grow up in adoptive family.
39
Family in gentic sz
High concordance rate in first degree relatives 46%
40
Gene mapping genetic sz
Found candidate genes for sz like NGR3 and NGR1
41
A03 twin studies in genetic sz
Strength
Gotta man and sheild
75%-91% concordance between Mz twins
Found sz is hereditary
42
A03 twin studies in genetic sz
Weakness
If it was entirely genetic concordance rate would be 100%
However it can be learnt off eachotyer
43
A03 family studies In gentic sz
Strength
Gotts man and sheild found 75%-91% concordance rate between Mz twins
Proving sz is hereditary
44
A03 family studies In gentic sz weakness
Could be conditioned and not hereditary
45
A03 adoption studies in genetic sz strength
Study’s have supported the role genes play
Tienari found adopted children who had biological sz mothers, develop it
Clear evidence of genetics
46
A03 adoption studies in genetic sz
Weakness
Some family’s children’s were adopted into dysfunctional families whixj can contribute to sz.
Conditioned not biological
47
A03 gene mapping in gentic sz strength
Benzel used gene mapping to find evidence that gene NGR3 and NGR1 and erbB4 can cause sz
48
A03 gene mapping in gentic sz weakness
So many genes can cause it so it’s deterministic and has no free will cos it could be the environment
49
Strength of dopamine hypothesis
Kessler used PET and MRI SCANS to compare sz to non sz. Sz had more dopamine
Shows dopamine is an important in sz
However healey stated pharmacy companies promote dopamine issues to sell drugs
50
Weakness of dopamine hypothesis
Doesn’t account for different rates of recovery
Can’t explain why people reciver slower then others
Shows role of dopamine is more complex than high levels equals sz
Aswell glutamate can also cause sz
51
strength of neural correlates
ventricular enlargement found 1970 using ct scans
brain abnormalities have been considered as one of the cause of sz
strength provides objective scientific support
however we have to consider cause and effect.
52
weakness of neural correlates
supporting pieces leave a lot of important questions unanswered
does sz cause abnormalities or abnormalities cause sz
weakness as could be many other reasons for sz
53
what can cause or influence development of sz in families
stress
54
double bind communication
bateson found if the mother tells child 2 contradicting things about their relationship it can cause confusion. physical abuse then embracing them. this can cause symptoms of paranoid delusions and disorganised thinking
55
expressed emotions in families
families of sz patients may act critically in a hostile manor which can cause worse or develop positive symptoms like hallucinations from reaction
56
Schizopherenogenic mother
A personality characteristic of mother that can influence sz on children
Maternal characteristic
Impact on child
Role of fathers
57
Maternal characteristic schizo mum
Over protective and emotionally manipulative and rejecting
58
Impact on child schizo mum
Distorted sense of reality due to conflicting emotions
Can lead to difficulty forming sense of self
59
Role of fathers schizo mum
Father’s role can exacerbate situation if he is absent
60
Strength for family dysfunction study
P- reasearch shows family’s W high EE will increase risk of relapse sz
E- kavanagh 68 studies of EE
48% relapse family’s with high EE 21% for families with low EE
L- shows that EE can increase risk of relapse
A- looking at EE in families can make us alerted to potential relapse and take preventive action
61
Weakness evaluation of sz mother
P- theory has been heavily criticised
E- argues it unfairly blames others for complex illnesses and lacks research like social factors
L- weakens explanation as seen as unscientific and causes feelings of guilt
62
Strength of sz mother
P- highlights imoact of early childhood
E- promotes idea that supportive parenting can help or prevent mh issues
L- part of a holistic approach to treat patients
63
Cognitive deficits- cognitive psychological explanation
Metacognition deficits
Perception deficits
Reasoning deficits
64
metacognition deficits- cognitive psychological
normal- monitering of ones thought processes, knowing the difference betweeen inner voice and reality
sz- beleive in through insertion, voices inserted by an external force, dysfucntional deficits. auditory halloucinations
65
perception deficits- cognitive psychological
normal- understanding expressions
sz- poor at understanding expressions, do poorly on tasks that require facial expressions. delutions, dont have adequate grasp on reality
66
reasoning deficits - cognitive psychological
sz- cant reject deluded thoughts, jump to conclusions, make a negative outcome, attribution bias. hallouicinations
67
strength of cognitive explanations psychological
p- supporting research
e- lysaker metacognition test to 49 sz males. found sz symptoms linked to inability of awareness of thoughts and feelings to another person
l- support idea that metacognitive impairments are linked to sz
68
weakness of cognitive explanations psychological
p- psychologists unsure catalist of cognitive symptoms
e- lot of evidence supporting cognitive explanation but problem establishing where they come from or start
l- cognitive explanations dont tell us why this symptom started in the first place
69
typical antispsychotic and doseage
chlorpromazine 400-800 mg in tablet or liquid form 2-4 times a day
70
atypical antipsychotic
clozapine 300-450 mg tablet once daily
71
Which neurotransmitter(s) does chlorpromazine affect?
dopamine
blocking d2 receptors in the mesolimbic pathway which gives you rewards.
first increases then reduces.
72
Which neurotransmitter(s) does clozapine affect?
Reduces levels of dopamine by blocking d2 receptors . also blocks 5-ht2 receptors which affect serotonin.
73
chlorpromazine side effects and what symptoms does it treat
Uncontrollable muscle ,movement
positive symptoms
74
clozapine side effects and what symptoms does it treat
Tiredness, dizziness and weight gain.
positve and negative
75
strength for drugs therapy
p- Thornely reviewed studies on chlorpromazine to reduce symptoms compared to placebo.
E- Over 1000 participants with similar symptoms were used. Chlorpromazine was associated with better functioning and reduced symptoms and also that relapse rate was lower when drug was taken compared to placebo.
L- This quantitative data shows support for the use of antipsychotics by also using a control group.
76
weakness for drugs therapy
P- One weakness is that typical drugs have many side effects( movement problems and parkinsons).
E- For example 1 in 10 patients experience one or more other side effects such as tiredness, digestive issues, dizziness and weight gain.
L-These can result in patients choosing to stop taking the medication as the side effects are too unpleasant so their symptoms return.
77
Cognitive behavioural therapy
Need to take anti psychotic forst
Assessment- express thoughts
Engagement- therapist empathises
ABC model
Normalisation- p is helped to understand distress is normal when having disorder
Critical collab analysis- gentle questioning to help understand
78
Strength of CBT
Supporting research
jauhar reveiwed results of 34 cbt studies found it has small but benificial effect on p and n symptoms
also trower found cbt didnt reduce intescity of halloucunations but reduced threat
79
weakness of CBT
effectiveness is increased when mixed with drugs
most studies have included drugs so is hard to measure effectiveness
also those with sever sz may not be able to concentrate so it wont work for all cases of sz
80
Family therapy
For family to alter communication patterns by lowering levels of expressed emotions and double bind.
81
Aims of family therapy
Improve positivity
Increase tolerance levels
Decrease feelings of guilt
82
How does family therapy work
Psycho education-understand
Forming an alliance
Reducing high emotion climate
Enhancing relatives-solve problems
83
Strength of family therapy
P- very effective
E- mcfarlane reveiwed therspy results and found increased well being
L- suggest it’s an effective treatment
A-family therapy associated with significant cost savings. Economic benefits
84
What is token economy
A modification procedure
Tokens are given for socially constructive behaviour in ways of positive negative and punishment.
Exchnage tokens for desirable items
85
Primary reinforcer tolen economy
Gives pleasure or removes unpleasant states
86
Secondary reinforcers token economy
Have no value but have reinforcing properties (tokens)
87
Strength of token economy
P- very effective
E- Ayllon and Azrin used token economy in a female ward who were hospitalised for many years
L- supports use of token economy with patients increasing dramatically
A- token economies can be tailored to meet individual requirements, supports positive use
88
Weakness of token economy
P- has ethical concerns
E- drs and staff may excercise control over primary reinforcers like food
H- it is accepted be have human rights that can’t be violated
L- criticised for requiring people to behave appropriately to meet human rights
89
interactionist approach traditional understanding
suggested sz was completely genetic and only had one gene schizogene. meehl said if you didn't have schizogene then stress wont lead to sz
90
interactionist approach modern understanding
include a range of biological and psychological factors like truama which becomes diathesis. read had neurodevelopment theory that early trauma alters the brain development. hypothalamic pituatiary adrenal is overactive leading to stress
91
strength of interactionist
P- support
E- walker reported schizophrenics have higher levels of cortisol which heightens genetically influenced abnormalities in dopamine.
L- supports that sz is an interaction of biological and environmental.
A- genes that predispose somone have increased vulnrability to sz they need epigenetics (particular stressors)
92
issues and debates for interactionists
gender and culture bias
E- Romans-Clarkson study only used women from New Zealand to study sz. this means it cant be generalised to other genders or to non westernised countries.
L- this is a weakness as it means it cant be generalised to it lacks representitivness and ecological validity of the study.
Psychology
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