schizphernia A03

what is co-morbidity

where two conditions/ disorders frequently occur toghther- it questions the validity of diagnosis of the disorder, as an individual may be diagnosed with one disorder, but actually have another.

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who provided support for this

buckley found that around 50% with schizphrnia also had depression, this questions validity of diagnosis. May lead to incorrect diagnosis.

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what is sympton overlap

some of the symptons of schizphernia, such as negative symptons like avolition- also occur in other conditions/ disorders like depression. Positive symtpons like delusions can also occur in an individual with bi-polar disorder- meaning that incorrect diag

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low reliability in the diagnosis

beck in a review of 153 patients who had been diagnosed via multiple criteria found a concordance rate of just 53% between doctors- demonstrates that diagnosis criteria are not comprehsnive and unreliable

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what is the differnece between DSM-5 and ICD-10

ICD- 10 requires two or more negative symptons to persist over a month, used in europe- overdiagnoses people. DSM- 5 is mostly used in the USA and requires 1 or more positive symtpon for a diagnosis to be made.

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cultural biases

african caribean people are 9 times more likely to receive a diagnosis- given the fact that rates arent that high in these cultures, suggests its because of cultural differneces/ bias- hearing voices is normal but not in UK

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what is a strength of the genetic explanation

theres overwelming research support for genetic basis from Ripke(37k parctipants and found around 108 genetic loci) and gottsman who looked at concordance rates. greater in identical twins(48%) than non identical(17%).

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research support from adoption studies

tiernari found that children adopted into healthy families, had an increased risk of developing the disorder if it ran in their families.

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weakness

biological determinism

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disorder cant be entirley gentic

concordance rate in identical twins who share 100% of their genes was only 50%, suggesting pyschiolgical factors must play a role- diathesis stress model may be more apporpiate here, genetics act as vulnrability- triggered by env factor.

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what is the dopamine hypothesis

states that in individuals w the disorder, they have abnormal levels of dopamine(inhibitory neurotransmitter). Original hypothesis- excess in brains SUBcortex- brocas area, results in positive synmtpins. more recent one- low levels in brains cortex

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what are neural correlates

measures of patterns of structure/ activity/ function in the brain that correlate with experience.

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whats a strength of the dopamine hypothesis

typical anti-pyschotics work by acting as dopamine antagonists- block dopamine receptors at synapse to normalise transmission- reduce action of dopamine- sugests that dopamine hypothesis is correct

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weakness of dopamine hypothesis

theoretical issue- original one isnt complete, recent evidience has shown that dopamine in brains cortex is lower rather than high

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strength of neural correlates

brain scan evidience, but evidience is correlational not casuality- we can see that structures are different- but not why? it may be the case that the symptons cause the neural correlates or the other way round

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what is a strength of the family dysfunction explanation

tiernari research supports the idea those in dysfunctional families are more likely to develop schizphrenia- those that were adopted into healthy families only 5.8% compared to dysfunctional families- 36.8%- suggests diathesis has a role tho....

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theres research support for EE- expressed emotions

butzlaff and hooley have shown that EE increases likelyhood of developing the disorder- in a meta analysis of 27 studies he also showed that those that faced EE were at greater risk of relapse.

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therapies like family therapy, and pyschoedcuation

suggest that dysfunctional family explanation is valid.

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weakness

very socially senstive, blames the victim of the parents- they already experience enough trauma- this will add excessive anxiety and stress on top of it- guilt/ responsibility

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weakness

most research on dysfunctional family explanation is drawn from people who already have the symptons- means that cant demonstrate cause/ effect.

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what is a strength of cogntive explanations

CBT- aims to challenge and reduce dysfunctional thought processing, reduce metarepresentation- ability to recognise our own thoughts as our own- and has been effective,

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weakness

ignores biologcal factors that will influence thought processing

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strength

research support from stirling- used 30 people with a diagnosis and 18 controls- asked them to do tasks like naming ink colours- inline with central control theory(frith) those with diagnosis took much longer to identify colours

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why?

they couldnt supress their own automatic thoughts/ beliefs when doing something

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whats a strength of anti-pyschotic drugs

research support for the effectiveness. thornley supported typical, reviewed studies where the effectiveness of chlorpromazine was compared to placebos- data from all of the 13 trials showed that the drug reduced sympton severity- lower risk of relapse, b

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who supported a-typical drugs

meltzer concluded that clozapine was very effective in treating symptons, and was 30/50% effective where other drugs have failed

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weakness in general of drug therapy

relies on the dopamine hypothesis, which is disputed and changing. a theoretical issue.

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side effects of typical

in the short term. chlorpromazine can cause dizzyness. tiredness.ithcy skin. in long term can result in tardadive dyskinia- the uncontrolled sensitivity of dopamine manifests in uncontrolled facial movements. Fatal malignant syndrome- high temperatures,

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side effects of a-typical

cause agranulocytosis(clozapine is used as a last resort treatment)- have to take regular blood tests to avoid this.

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discussion point

the interactionalist treatment plan is the best which combines the use of drug therapy and CBT to treat indivoduals, as drugs just reduce symptons- make them manageable

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strength of CBT

research support from sensky. patients that were resistant to drug treatments had a reduction in symtpons after just 19 seshions of CBT- he followed up, after 9 months symtpin severity contintued to decrease- effective in LT.

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futhermore

no side effects, make it the preferable treatment as well as the safest.

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weaknesses

practical issues- its commonly ended early due to its time consumning elements, can take up to 20 seshions- negative symtpons can result in lack of motivation to parctipate, so drugs needed first- interactionalist

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strength of family therapy

research support from leff who looked at the aftercare in patients with the disorder and found that greater people relapsed if they had received standard outpatient care, than if they had received family therapy(50% versus 9%

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however,

however after 2 years, this had risen to 50% suggesting that family therapy is effective in the short term, reducing imeediate readmission but not in maintaining long term patterns of behaviour

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practical issues

takes time, family conflicts may arise making it challenging to contune- patients and familes refuse.

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doesent cure- just

helps to manage- dont actually reduce severity of symtpons just makes them manageable to improve quality of life

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strength of token economies

research support from dickerson, improve quality of life allowing individuals to be re-intergrated back into society instead of hospitcal

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weakness- unethical

the pleasent rewards are more acsessible to those with mild rather than strong symtpons- most sevre patients who need the most help are discriminated agaisnt- families have raised concerns.

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strength of the interactionalist approach

can explain the results of previous studies- gottesman twin studies and tiernari adoption studies.

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supporting research from tarrier

patients were randomly placed in routine care(cbt or drugs) or both. Patients who in combined condition had the most significant improvements- fewer days in hospital- suggests interactionalist approach is best for treatment

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a holistic explanation

less reductionalist and includes all factors- also diathesis is no longer a single gene or gentic vulnrability has now includes other vulnrabilities like drug abuse and early emotional abuse

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whats a weakness of the interactionalist approach

it does not explain how the stressor and diathesis actually cause the disorder- doesnt explain what fundemental mechnaims are involved- reduces its confidence as a full explanation

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schizphernia A03

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