Psychology G543 Health Disorders OCR

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Overview

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
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Characteristics of anxiety disorders

  • 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
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Characteristics of psychotic disorders

  • 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    • may become isolated & withdrawn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)
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Characteristics of affective disorders

  • 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
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Biological explanations of schizophrenia-Gottesman

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
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Behavioural Explanations of schizophrenia-Liberman

  • 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
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Cognitive explanation of schizophrenia- Hemsley

  • 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.
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Biological treatments of schizophrenia - Kane

  • 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
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Behavioural treatment programmes of disorder

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
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Behavioural treatment programmes of disorder -Paul

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
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Cognitive treatment programmes of disorders

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
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Cognitive treatment programmes of disorders

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
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