Master this deck with 23 terms through effective study methods.
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-SZ is a serious mental disorder where contact with reality and insight are impaired -it affects around 1% of the worlds population -classify a disorder by identifying symptoms that cluster and diagnosis using classfication systems to identify disorders in an individual -DSM-5 (US): one positive symptom must be present for a diagnosis -ICD (UK): two or more negative systems are sufficient
Postive symptoms: additional experiences beyond ordianary existence 1) Hallucinations: unsual sensory experiences that can be related/unrelated to the environment. They can be experienced in relation to any sense (auditory, visual etc) 2) Delusions: irrational beliefs, delusions of grandeur involve a person believing they are an important political/historical/religious figure, delusions of persecution involve believing they are being persecuted by someone Negative symptoms: loss of usual abilities and experiences 1) Speech poverty/disorganised speech- reduction in the amount and quality of speech 2)Avolition- difficulty beginning or keeping up with goal directed activity, reduction in motivation to carry out activities
P: One strength is its reliability and consistency E: -A psychiatric diagnosis is considered reliable when two diagnosing clinicians reach the same diagnosis for the same individual(high inter-rater reliability) and when the same diagnosing clinician reaches the same diagnosis for the same individual on two occasions(high test-retest reliability) -Prior to the DSM-5, reliabilty for diagnosis was very low but has now improved -Osario reported excellent reliabilty in the diagnosis of 180 individuals using the DSM-5, pairs of interviewers achieved a inter-rater +.97% and test-retest +.92% L: This suggests that the diagnosis of SZ is consistently applied
P: One limitation is its validity E: -Validity concerns whether we are actually measuring what we are intending/trying to measure. -Cheniaux had 2 psychiatrists assess the same 100 individuals using the ICD vs the DSM-5 - ICD: 68 -DSM-5: 39 L: This suggests that SZ may be over-diagnosed (ICD) or under-diagnosed (DSM-5) showing low criterion validity
- antipsychotics are the most common treatment for SZ -they are drugs used to reduce the intensity of the symptoms especially positive symptoms -can be taken in the form of tablets, syrups or injections -may be required in the short term/long term- some individuals require lifelong use whilst others can stop their use without symptoms coming back
- Chlorpromazine -can be taken as a tablet, syrup or injection -up to a max of 1000mg -chlorpromazine is an antagonist which are chemicals that reduce the action of a neurotransmitter -they block dopamine receptors in synapses of the brain -strong association between the use of typical antipsychotics and the dopamine hypothesis, this dopamine antagonist effect normalises neurotransmission in key areas, reducing positive symptoms -sedation effect-effective in calming psychotic patients -mainly prescribed to patients admitted into hospital and are very anxious -chlorpromazine acts as a dopamine antagonist, it acts againt dopamine by blocking dopamine receptors at the postsynaptic neuron
-clozapine -in the 1970s it was withdrawn following deaths due to a fatal blood condition- agranulocytosis which is a lower white blood cell count -in the 1980s clozapine was found to be more effective than typical antipsychotics and used when other treatments failed -still used today but not available as an injection due to potential fatality- patients are required to get regular blood checks to ensure they do not develop agranulocytosis -works by binding to dopamine receptors but also works on serotonin and glutamate receptors - helps improve mood and reduce depression and anxiety -used for individuals who are considered a high risk of suicide -risperidone -available as tablet, syrup and injection -recently developed atypical antipsychotic -developed to produce a drug that was just as effective as clozapine but without as many side effects - binds to dopamine and serotonin receptors - binds more tightly to dopamine- effective in much smaller doses -might lead to fewer side effects than other drugs
P: One strength is there is evidence for the effectiveness of drug therapy at reducing symptoms of SZ E: -Thornley reviewed 13 trials comparing chlorpromazine to a placebo control, found improved overall functioning and reduced symptom severity. Supports research that typical antipsychotics are effective in reducing positive symptoms like hallucinations. -Meltzer found clozapine to be effective in 30-50% of treatment resistant cases which shows that atypical antipsychotics can be more effective than typical drugs L: This evidence suggest that antipsychotics work to reduce symptoms, supporting their continued use in clinical practice
P: One limitation is the likelihood of side effects E: -Typical antipsychotics can cause dizziness and in long term use tardive dyskinesia due to dopamine supersensitivity. The most serious side effect is neuroleptic malignant syndrom which is rare but potentially fatal -Although atypical antipsychotics were developed to reduce these risks they still carry dangers such as cardiovascular problems and agranulocytosis. These advserse side effects can reduce patient compliance leading to discontinuation of treatment L: Therefore whilst antipsychotics are effective in reducing SZ symptoms, their overall usefulness is limited by the challenges of managing side effects
-Schizophrenogenic mother -a mother that is cold, controlling and rejecting and creates a family climate characterised by tension and secrecy -this can lead to distrust that later develops into paranoid delusions and ultimately SZ -Double bind theory -Bateson suggested that family climate is important but emphasised the role of communication style within a family - A developing child who is trapped in situations where they fear of doing something wrong and receives mixed messages on what wrong is, feels unable to comment on the unfairness of the situation -when the child gets something wrong they are punished by the withdrawal of love -this leaves them with an understanding that the world is confusing and dangerous which is reflected in their symptoms -Expressed emotion -the level of emotion expressed to someone with SZ by their carers who are often family members -elements of serious stress include: verbal criticism (often accompanied by violence), hostility, emotional over-involvement including unnecessary self sacrifice -primary explanation for relapse
P: One strength is there is evidence linking family dysfunction to SZ E: -Indicators of family dysfunction include insecure attachement and exposure to childhood trauma especially abuse -John Read found that adults with SZ are disprportionately likely to have an insecure attachment especially Type C or D -reported that 69% of women and 59% of men with SZ had a history of physical/sexual abuse L: This suggests that family dysfuncion makes people more vulnerable to SZ
P: One limitation is weak evidence to support it E: -There is little to no evidence to support the importance of the schizophrenogenic mother or the double bind theory -both these theories are based on outdated concepts -This socially sensitive research has also lead to parent blaming where parents had to take the blame for their childs condition L: This undermines the appropriateness and credibilty of the family based explanation
- SZ is characterised by the disruption to normal thought processing -reduced processing in ventral striatum is linked to negative symptoms -reduced processing on information in the temporal is associated with hallucinations -this lower than usual level of information processing suggest that mental processes are likely to be impaired
-metarepresentation is the cognitive ability to reflect on our thoughts and behaviours -dysfunction would disrupt our ability to recognise our own thoughts and actions as being carried out by ourselves
- central control is the cognitive ability to suppress automatic respones while we performdeliberate actions -speech poverty and thought disorders might result due to the inability to suppress automatic thoughts
P: One strength is there is strong evidence for dysfunctional thinking E: -Stirling compared 30 individuals with SZ to a control group on different cognitive tasks including the stroop test -they found that people with SZ took twice as long on the stroop test than the control L: This shows that people with SZ have poorer cognition which supports the central control as they were unable to suppress automatic thoughts such as the urge to read the word aloud rather than the colour
P: One limitation is that it procides only proximal rather than distal explanations of SZ E: -cognitive explanations are descriptive rather than explanatory focusing on proximal processes that produce symptoms rather than distal explanations such as genetics and family dysfunction -this creates issues of cause and effect e.g it is unclear whether cognitive dysfunction drives neurochemical changes or results from them L: Therefore the cognitive theories offer only a partial explanation, describing how symptoms occur but not why SZ develops
-aims to reduce stress for the patient, improve family communication and lower relapse risk -the therapist meets with the patient and their family members to encourage open, productive discussion and establish a strong therapeutic alliance -key strategies identified by pharoah include psychoeducation which teaches family members about the disorder and realistic expectations and reducing expressed emotion such as anger, criticism and over-involvement -Burbach highlights the importance of developing communication and problem-solving skills to manage interactions and provide effective support
P: One strength of FT is that it offers long term benefits for the whole family E: -Lobban and Barrowclough found that about 60% of studies on family intervention reported significant positive outcomes such as reduced stress and better coping -By strengthening family functioning, FT enables families to provide consistent support which benefits both the patient and their caregiving network -This highlights the holistic value of FT by promoting recovery while also improving the wellbeing of relatives L: This suggests that FT is an effective and durable intervention as it supports sustained improvements
P: There may be challenges assoicated with FT E: -the willingness of family members to commit the required effort may vary -the accessibility of such therapies could be limited due to financial constraints especially considering the large number of people with sz in lower socioeconomic groups -Moreover, the patient may still hold paranoid beliefs, suspecting collusion between their family and the the therapist which could hinder the efficacy of the therapeutic process L: This suggests that while FT offers notable benefits, its implementation may require careful consideration of various factors
-cognitive behaviour therapy targets both thoughts and behaviour to help patients manage their symptoms. It helps patients understand how irrational thoughts such as hallucinations and delusions affect their thoughts and actions -cognitive restructuring challenges these irrational beliefs e.g helping a patient reframe the thoughts that voices are trying to harm them into understanding they are a part of misfiring brain activity and are not dangerous -normalisation complements this by showing that hearing voices is an extension of ordinary thinking reducing fear and stigma -reality testing allows the patient and the therapist to jointly examine the likelihood of their delusional beliefs are true -cbt also teaches coping strategies such as positive self talk, distraction techniques and behavioural strategies to help manage symptoms, reduce distress and improve daily functioning -while cbt does not eliminate sz it helps patients cope effectively with theirexperiencesandengageineverydaylf
P: One strength of CBT is that it provides long-term benefits E: -CBT may enhance an individuals ability to ignore auditory hallucinations and so experience less anxiety and be more able to function adequately -CBT has also been shown to improve an individuals quality of life. This may be because the role of the client is active e.g they are responsible for being involved in reality testing and carrying out new behaviours L: This suggest that CBT can be seen as a partial cure for SZ
P: One limitation is that CBT may not be suitable for all individuals with SZ E: -CBT requires self-awareness and willingness to engage with the process. Positive symptoms lead to a lack of awareness and negative symptoms lead to reluctance -CBT may also have practical issues such as the length of the therapy could lead to patient drop outs at times of severe episodes, and not all individuals are suited for vigorous confrontation -CBT may be unsuitable for individuals with SZ due to ethical issues, therapist could be interferring with the patients freedom of thought L: This means that while CBT is effective, its success varies between individuals