Schizophrenia

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Classification & diagnosis - Rosenhan
Highlighted the unreliability of diagnosis. 'Normal' people presented themselves to phychiatric hospitals claiming they heard voices in heir head. All diagnosed as sz. Throughout stay, no one noticed they were 'normal'.
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Classification & diagnosis - Rosenhan - follow up study
In a follow up study, Rosenhan warned hospitals of his intention to send out more 'pseudopatients'. This resulted in a 21% detection rate, although none actually presented themselves
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Classification & diagnosis - Buckley et al
Estimate that comorbid depression occurs in 50% of patients and 47% of patients also have a lifetime diagnosis of comorbid substance abuse. Such comorbidity creates difficulties in the diagnosis of a disorder.
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Classification & diagnosis - Schneider
Identified a group of symptoms of sz but rarely found in other mental disorders. Called them 'first-rank symptoms'. These now form the basis of ICD-10
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Biological explanation - Kendler et al - Family Studies
Have shown that first-degree relatives of those with schizophrenia are 18 times more at risk than the general population
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Biological explanation - Joseph - Twin Studies
Calculated the polled data for all schizophrenic twin studies carried out prior to 2001 show a concordance rate for MZ twins at 40.4% and for DZ twins at 7.4%
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Biological explanation - Gotessman - Twin Studies
Reviewed 40 twin studies and found a 48% concordance rate for MZ twins and 17% concordance rate for DZ twins
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Biological explanation - Tenari - Adoption studies
Of the 164 adoptees whose biological mothers who had been diagnosed at sz - 11 received a diagnosis of sz, compared to just 4 of the 197 control adoptees
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Biological explanation - Kety - Adoption Studies
Found high rates of schizophrenia in people whose biological parents had the disorder but who had been adopted by psychologically healthy parents
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Biological explanation - Comer - Dopamine Hypothesis
Dopamine neurons play a key role in guiding attention, so disturbances in this process may lead to the problems relating to attention, perception and thought found in people with sz.
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Biological explanation - Brown et al - Neuroanatomical
Found decreased brain weight and enlarged ventricles, which are the cavities in the brain that hold verebrospinal fluid
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Biological explanation - Castner et al - Brain damage
A study on monkeys. The researchers subjected the monkeys to brain-damaging x-rays during foetal development and found that they showed no ill effects during childhood compared with the control group. But at puberty they developed symptoms of sz.
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Biological explanation - Wood et al - Brain structure
Compared hippocampus size of 79 males deemed to be at high risk of developing schizophrenia and 49 healthy males with no predisposing factors and found that the high-risk groupo had significantly smaller hippocampuses than the control group.
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Biological explanation - Torrey et al - Pregnancy & Birth
Claimed that the link between viral infection and schizophrenia only occurs in those who are already genetically predisposed. However, if this was the case then MZ twins would have a 100% concordance rate
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Psychological explanation - Psychodynamic - Freud
Believed that schizophrenia was the result of two related processes, regression to a pre-ego stage and attempts to re-establish ego control.
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Psychological explanation - Cognitive - Frith - faulty cognitive processes
SZ's unable to distinguish between actions that are brought about by external forces and those that are generated inerally. *Inability to generate willed action *Inability to monitor willed action *Inability to monitor beliefs of others
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Psychological explanation - Brown - Expressed Emotion
Showed that patients with schizophrenia who returned to homes where a high level of emotion was expressed showed a greater tendancy to relapse than those returning to low EE homes
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Psychological explanation - Hirsch - Life Events
Followed 71 schizophrenic patients over a 48-week period. It was clear that life event made a significant cumulative contribution in the 12 months preceding relapse
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Psychological explanation - Fox - Socio-economic status
Examined data from his own and others' studies and found no evidence for the so-called 'social drift hypothesis'. It seems that it is the factors associated with living in poorer conditions that may trigger SZ
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Psychological explanation -Scheff - Labelling theory
The label of 'schizophrenic' may lead to the self-fulfilling prophecy that promotoes the development of other symptoms of schizophrenia
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Psychological explanation - Bateson - Double-Bind Theory
Children who frequently receive contradictory messages from their parents are more likely to develop SZ. E.g. affection of verbal level and animosity on non-verbal level. The child's inability to respond is incapacitated by the contradictions
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Biological treatment - Davis et al - Drug Therapy
Some patients refuse to comply with drug reatment regimes, possible because of the side effects or sometimes because of poor memory. Research has indicated that if antipsychotic drugs are stopped abruptly, then symptoms recur (revoling door syndrome)
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Biological treatments - Ross & Read - Drug Therapy
Argue that being prescribed medication reinforces the view that there is 'something wrong with you'. The prevents the individual from thinking about possible stressors that might be a trigger fro their condition. This reduces their motivation.
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Psychological treatments - Brown - Family Intervention
Family environment had a potential role in influencing he course of sz. Sz in familes that expressed high levels of criticism, hosility or over involvement had more frequent relapse.
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Psychological treatments - Pharoh - Family Intervention
Meta-analysis found that family interventions of this type were effective in significantly reducing rates of relapse and of admission to hospital in people with schizophrenia.
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Psychological treatments - NICE - Family Intervention
Review of family intervention studies demonstrated that family intervetnion is associated with significant cost savings when offered to people with schizophrenia in addition to standard care
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Psychological treatments - Jones et al - CBT
Carried out a meta-analysis on trails of belief modification and found that it reduced both the frequency and the intensity of hallucination. It was less effective in changing delusional beliefs but it did reduce the accompanying distress
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Psychological treatments - Pilling - Family Intervention & CBT
Meta-analysis comparing family intervention with CBT. They found that family intervention had clear preventative effects on relapse. CBT produced higher rates of 'important improvement' in mental state.
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In a follow up study, Rosenhan warned hospitals of his intention to send out more 'pseudopatients'. This resulted in a 21% detection rate, although none actually presented themselves

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Classification & diagnosis - Rosenhan - follow up study

Card 3

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Estimate that comorbid depression occurs in 50% of patients and 47% of patients also have a lifetime diagnosis of comorbid substance abuse. Such comorbidity creates difficulties in the diagnosis of a disorder.

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Card 4

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Identified a group of symptoms of sz but rarely found in other mental disorders. Called them 'first-rank symptoms'. These now form the basis of ICD-10

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Card 5

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Have shown that first-degree relatives of those with schizophrenia are 18 times more at risk than the general population

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