Schizophrenia 16-marker Plans (AQA A Level Psychology)

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16-marker plans

Biological Approach

Outline

Genes, dopamine hypothesis, neural correlates

Candidate genes, polygenic, 108 combinations (Ripke), twin studies (Gottesman)

Hyper/hypodopaminergia, subcortex and cortex

Low activity in ventral striatum, low activity in superior temporal gyrus

Evaluate

Difficult to identify cause (CGs) so difficult to treat

Twin study evidence (Gottesman)

Support from antipsychotics for DH

Neural correlates may be effect not cause

Doesn't take into account external factors

May be role of mutation

Curran+ Tauscher support hyperdopaminergia, Ripke opposes it

Psychological Approach

Outline

Family dysfunction- schizophrenogenic mother, double bind theory (Bateson), NEE

Cognitive- dysfunctional meta-representation, lack of central control

Evaluate

Fromm-Reichmann- interviewed SG mothers

Stirling- Stroop test

Parent blaming

Over-emphasis of role of family

Origins of cognitions unknown

Ignores role of biology

52% of patients returning to high NEE don't relapse

Kavanagh- 48% compared to 21% not NEE

Berger- schizophrenic+ high recall of double bind

Biological Treatment

Outline

Typical- chlorpromazine, blocks dopamine receptors

Atypical- clozpine, risperidone, dopamine, glutamate and serotonin receptors

Treat hyperdopaminergia

Evaluate

Meltzer 2012- clozapine is effective- 30-50% treatment resistant

Thornley 2003- chlropromazine is effective (vs. placebo)

Side effects- agranulocytosis, tardive dyskinesia higher relapse rates

Effectiveness over-emphasised by drug companies

Use of chlropromazine as a sedative

Cheaper than CBT

Easier, requires less effort

Tarrier found combination treatments more effective

Psychological Treatment

Outline

CBT, personal therapy- identify and change dysfunctional cognitions

Reality testing- how true, less threatening possibilities

Easier to cope

Family therapy- all family open, reduces burden of care, improves communication, targets NEE

Token economies- OC, secondary reinforcers, management not treatment

Evaluate

Jauhar- CBT has minimal effect, may be researcher looking for improvement

Pharoah 2010- support for family therapy- compliance to medication

Improve quality of life but don't cure

Family don't always want to be open

Azran and Ayllan- females exhibited desired behaviours

Family therapy improves negative symptoms

Improvements may be due to drugs

CBT doesn't produce side effects

More expensive+ more effort

NICE found CBT more effective than drug therapy

Interactionist Approach

Outline

Original- Meehl- diathesis= genetic vulnerability, stressor= external stress, schizogene+ schizotypic

Modern= diathesis= not necessarily genetic, stressor= anything that increases risk of onset

Treatment= CBT+ drugs

Evaluate

Tarrier- 2 combinations better than just drugs

Tienari- adopted children with schizophrenic mothers and high NEE adoptive mothers most at risk of onset

Houston- childhood sexual trauma+ smoking cannabis

Tienari- subjective, blames mother, cultural relativism

Only one treatment might be making a difference