Schizophrenia essay plans
These are some plans I've made for the main schizophrenia essay questions. Lighter coloured boxes contain AO1 points, darker boxes provide commentary (AO2/AO3).
- Created by: Jessica B.
- Created on: 26-12-13 20:38
View mindmap
- Schizophrenia essay plans
- Reliability and validity issues
- Reliability - consistency of measure
- Inter-rater high = high +ve correlation
- Whaley (2001) low +ve (+0.11) with DSM
- Further revisions needed so patients who need help can receive it
- Copeland et al. (1971) cross-cultural 2% UK diagnosed, 69% US
- Improvements since 1971
- Still an issue in ensuring patients receive necessary treatment
- Improvements since 1971
- Whaley (2001) low +ve (+0.11) with DSM
- Diagnosis
- Rosenhan (1973)
- Suggested that situation more important than characteristics so reliability is low
- Study - 8 pseudopatients claimed to hear voices, all diagnosed
- Follow-up - 21% detection rate when no pseudopatients sent
- Psychiatrists didn't trust own diagnoses
- Diagnosis unreliable, so unhelpful for patients
- Rosenhan (1973)
- Suggested that situation more important than characteristics so reliability is low
- Study - 8 pseudopatients claimed to hear voices, all diagnosed
- Follow-up - 21% detection rate when no pseudopatients sent
- Psychiatrists didn't trust own diagnoses
- Diagnosis unreliable, so unhelpful for patients
- Psychiatrists didn't trust own diagnoses
- Professionals unable to distinguish fakes from those who truly need help
- Follow-up - 21% detection rate when no pseudopatients sent
- Psychiatrists didn't trust own diagnoses
- Professionals unable to distinguish fakes from those who truly need help
- Follow-up - 21% detection rate when no pseudopatients sent
- Rosenhan (1973)
- Inter-rater high = high +ve correlation
- Reliability - consistency of measure
- Biological explanations
- Genetics
- Gottesman (1991) MZ= 48% DZ=17%
- Kety et al. (1978) more common in bio than adoptive relatives
- MZ environments more similar
- Gottesman and Bertelsen (1989) MZ parent = 17% parent's MZ = 17%
- Diathesis-stress model useful to explain why both MZs weren't schizophrenic
- Brain structure
- Torrey (2002) 15% larger ventricles
- Inconsistent findings
- May be due to variety of symptoms
- Cause or effect?
- Harrison (1995) brain damage doesn't worsen
- Neurotransmitters
- High dopamine levels/ sensitivity
- Deterministic - high dope leads to sz
- Antipsychotics increase dopamine and are effective
- Doesn't mean dopamine was the cause
- Only linked to positive symptoms
- Other factors for negative symptoms
- Genetics
- Psychological explanations
- Cognitive
- Frith (1992) faulty filter model
- Meyer-Lindenberg et al. (2002) physical basis of cognitive functions
- Yellowlees et al. (2002) virtual hallucinations treatment
- Not a full explanation (relies on bio)
- Frith (1992) faulty filter model
- Socio-cultural
- Life events
- Brown and Birley (1968) 50% life event 3 weeks prior
- Retrospective & self-report - symptoms may influence recall
- Hirsch et al. (1996) prospective
- Retrospective & self-report - symptoms may influence recall
- Brown and Birley (1968) 50% life event 3 weeks prior
- Expressed emotion
- Linszen et al. (1997) 4x more relapse
- Correlational - symptoms may cause high EE
- Hogarty et al. (2001) EE reduction therapy effective
- Linszen et al. (1997) 4x more relapse
- Life events
- Conclusion
- Bio evidence - diathesis-stress model more suitable
- Cognitive
- Biological therapies
- Antipsychotic drugs
- Conventional
- Bind to/block dopamine receptors
- Effective Davis et al. (1980) relapse 19% (meds), 55% (placebo)
- Inappropriate Hill (1986) 30% tardive dyskinesia
- Atypical
- Temporarily bind to dop. receptors, delaying release
- More appropriate Jeste et al. (1999) 5% side effects
- Leucht et al. (1999) Slightly more effective on negative symptoms
- Reduce dopamine in brain
- Patient doesn't have an active role in recovery
- Placebos may not provide a fair complarison
- Conventional
- Electro-convulsive therapy
- 0.6 amp current between 2 electrodes to elicit seizure
- APA (2001) ECT+meds no more effective than meds alone
- Sarita et al. (1998) ECT impairs memory
- Use declined by 59% between 1979 & 1999 due to risks
- Conclusion
- Antipsychotics still used widely, Drury et al. (1996) best with psychotherapy e.g. CBT
- Antipsychotic drugs
- Psychological therapies
- Cognitive behavioural therapy
- Identify and correct faulty interpretation of events
- e.g. delusions of control
- Develop alternatives & practise with behavioural assignments
- Drury et al. (1996) CBT+meds reduce +ve symptoms & recovery time
- Can't easily separate out effects of CBT & meds
- Kuipers et al. (1997) CBT+meds = fewer patient dropouts
- Kingdon and Kirschen (2006) many patients unsuitable
- Identify and correct faulty interpretation of events
- Psychodynamic therapy (psychoanalysis)
- Form alliance - offer help for perceived problem e.g. that someone's in control of their behaviour
- Replace punishing conscience w/ supportive one
- Help ego regain control in non-symptomatic ways (not hallucinations)
- Gottdiener (2000) 66% improved w/ psychotherapy
- Not 100% - not effective on all
- Sz Patient Outcome Team - can be harmful (inappropriate?)
- Expensive so not widely available
- Karon and VandenBos (1981) overall cost decreases
- Require less inpatient treatment, have better prospects
- Karon and VandenBos (1981) overall cost decreases
- Cognitive behavioural therapy
- Reliability and validity issues
Comments
No comments have yet been made