Psychology G543 Health Disorders OCR

Health - Disorders

• Characteristics of disorders:
  • An anxiety disorder
  • A Psychotic disorder
  • An effective disorder
• Explanations of one Disorder - Psychotic:
  • Biological - Gottesman & Shields
  • Behavioural - Liberman
  • Cognitive - Hemsley
• Treatment Programmes:
  • Biological - Kane
  • Behavioural - Paul & Lentz
  • Cognitive - Sensky

• Anxiety causes continuous feelings of fear and anxiety
  • disabling & can impose on daily function
  • avoid situations that trigger or worsen symptoms
  • could suffer from depression + drug & alcohol abuse to relieve symptoms
• Phobias: Persistent fear of situation or object
  • stimulus may cause immediate panick attack like reaction
  • may cause shortness of breath, intense terror, loss of control
  • realise fear is irrational: response outweighs realistic consequence
  • categorised as disorder only if disrupts persons life
    • e.g. can't leave house for fear of seeing a spider
  • DSM classification: all of the above + phobia lasts at least 6 months in under 18 year olds

• Psychosis causes a loss of contact with reality
  • may become isolated & withdrawn
  • Hallucinations leading to confusion and disorientation
    • treatable with drug therapies
    • substance abuse leads to increase in likelihood of psychotic illness
• DSM classification of schizophrenia
  • Delusions
  • Halucinations
  • Negative symptoms
  • Disorganised speech
  • Disorganised behaviour
  • Social or occupational dysfunction
  • No other explanation present (e.g. drug abuse)

• Any disorder that affects your mood
• DSM classification of depression:
  • Insomnia most nights
  • fidgeting or lethargy
  • feelings of worthlessness
  • Recurrent thoughts of death
  • Inability to concentrate
  • Tiredeness

Gottesman & Shields

• Disorder is due to Brain Damage, genes & chemicals
• Aim: Review research on genetic transmission of schizophrenia
• Participants: 711 total - 210 MZ twins (identical) & 319 DZ twins
• Results: Increased schizophrenia in adopted children if biological parent had it
  • Biological siblings of children with schizophrenia (19.2%), adopted (6.3%)
  • 58% concordance rate for MZ twins; 12 for DZ twins
• Conclusion: significant genetic input
  •  However; concordance rates below 100% therefore must be environmental factors

• Behavioural: all born blank slates & all behaviour is learnt
• Aim:Identify social skills that schizophrenic patients lack
• Methodology: Review of patients with schizophrenia
  • Identified key features of social skills analysis from research
  • Aimed to identify problems psychotic patients have in behaving appropriately
• Results: Some schizophrenic patients lack learning from past experience
  • Institutionalisation can lead to loss of social skills
  • Anxiety can impede social performance
  • Cognitive deficits may lead to faulty perception of peoples' actions
• Conclusion: Lack of social skills leads to lack of positive reinfocers
  • therefore abnormal behaviour is maintained

• Cognitive: disturbed thinking processess are the cause rather than the conseqence of schizophrenia
• Study: Schemas are packages of information stored in our memmory
  • Central deficit in schizophrenia is a break down in relationship between information that has already been stored in memmory and new information
    • Don't know what information to ignore: causes information overload
      • some irrelevant information seen as highly relevant
        • e.g. a conversation on a next door table in a restaurant
          • could explain delusions
    • Internal thoughts may not be recognised and might be experienced as suditory halucinations
  • Poor at laboratory tasks that require attention to specific stimuli.

• If schizophrenia is biologically induced then biological treatments must be effective
  • which they are. This supports biological explanation
• Methodology: Longitudinal study
  • patients randomly assigned to groups
    • 2 treatment groups, 1 placebo group
  • assessed on whether they have a relapse from remission
• Participants: 28 patients diagnosed with schizophrenia
  • remission for at least 4 weeks last year
  • none had drug abuse
• Findings: No significant difference in drug treatments groups
  • none relapsed in the drug group: only 3 had toxic side effects
  • Both performed better than placebo group

Paul & Lentz - part 1

• Methodology: 4.5 year longitudinal study
  • clinics already used one of 3 treatment methods
  • observational, interviews, rating scales - 6 month intervals
• Participants: 84 insitutionally psychotic patients - not fit for community
• Procedure: Used 3 psychometric tests assesing social functioning
  • Social learning therapy: based on operant conditioning
    • stimulus response training
    • Material reinforcements
    • total treatment 85.2 of available free time
  • Milieu therapy: residents helped with social skills to raise confidence
    • safe environment: social exposure with immediate feedback
    • group work and group problem solving
    • total treatment 85.2 of available free time

Paul & Lentz - part 2

• Procedure:
  • Hospital condition
    • treatment not consistent accross hospitals
    • low social interraction
    • More drug focus
    • Less structure, treatment 4.9% of the time
• Findings: social learning therapy was most effective
  • 96% of social learning were released
  • 74% of Milieu programme release
  • 46% of hospital treatment released

Sensky - part 1

• Participants: 90 patients diagnosed with schizophrenia
  • Did not respond to medication
• Procedure: Alocaed to one of 2 groups  
  •           Delivered by 2 experienced nurses - both had regular supervision
  • Cognitive Behavioural Therapy
    • engage with patients, examine psychotic disorder, develop reason for behaviour
      • patients helped to change beliefs
      • taught coping strategies to deal with voices
      • Delusions and thought disorders addressed with cognitive strategies
  • Befriending: same time + allocation
    • therapists focused on hobbies, sports & current affairs. No attempt at therapy

Sensky - part 2

• Results: Signigicant reductions in positive + negative symptoms & depression

• at 9 month follow up evaluation cognitive showed greater improvements
  • befriending group lost some benefits