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58 Cards in this Set
- Front
- Back
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Schizophrenia Classification and Diagnosis Reliability - Inter-rater reliability Carson |
Claimed that DSM-III had fixed the problem of inter-rater reliability once and for all |
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Schizophrenia Classification and Diagnosis Reliability - Test-retest reliability Wilks et al |
Administered two alternate forms of the test (RBANS) to schizophrenic patients over intervals varying from 1-134 days, the test-retest reliability was high as 0.84 |
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Schizophrenia Classification and Diagnosis Validity - Comorbidity Buckley et al |
Estimated that comorbid depression occurs in 50% of patients and 47% of patients also have a lifetime diagnosis of comorbid substance abuse |
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Schizophrenia Classification and Diagnosis Validity - Positive or Negative Symptoms? Klosterkӧtter et al |
Assessed 489 admissions to a psychiatric unit in Germany to determine whether positive or negative symptoms were more valid for a diagnosis of schizophrenia, found that positive symptoms were more useful for diagnosis than were negative symptoms |
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Schizophrenia Classification and Diagnosis Validity - Prognosis Bentall et al |
People diagnosed as schizophrenic rarely share the same symptoms, nor is there evidence that they share the same outcomes, the prognosis for patients varies with about 20% recovering from their previous level of functioning, 10% achieve significant and lasting improvement and about 30% showing some improvement with intermittent relapses |
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Schizophrenia Classification and Diagnosis Reliability - Evaluation Whaley |
Found inter-rater reliability correlations in the diagnosis of schizophrenia as low as +.11 |
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Schizophrenia Classification and Diagnosis Reliability - Evaluation Mojtabi and Nicholson |
Even the central diagnostic requirement lacks sufficient reliability for it to be a reliable method of distinguishing between schizophrenic and non-schizophrenic patients |
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Schizophrenia Classification and Diagnosis Reliability - Evaluation Prescott et al |
Analysed the test-retest reliability of several measures of attention and information processing in 14 chronic schizophrenics, performance on these measures was stable over a 6-month period |
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Schizophrenia Classification and Diagnosis Reliability - Evaluation Cheniaux et al |
Investigated the inter-rater reliability of the diagnosis of schizophrenia according to both DSM-IV and ICD-10, although inter-rater reliability was above +.50 for both classificatory systems, schizophrenia was more frequently diagnosed according to ICD-10 than DSM-IV criteria |
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Schizophrenia Classification and Diagnosis Validity - Evaluation Weber et al |
US study examined nearly 6million hospital discharge records to calculate comorbidity rates, psychiatric and behaviour related diagnoses accounted for 45% of comorbidity |
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Schizophrenia Classification and Diagnosis Validity - Evaluation Kessler et al
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National Comorbidity Survey(NCS), the rate for attempted suicide rose from 1% for those with schizophrenia alone to 40% for those with at least one comorbid mood disorder |
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Schizophrenia Classification and Diagnosis Validity - Evaluation Harrison et al |
Reported that the incidence rate for schizophrenia was 8 times higher for African-Caribbean groups than for white groups |
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Schizophrenia Classification and Diagnosis Validity - Evaluation Ellason and Ross |
People with dissociative identity disorder (DID) actually have more schizophrenic symptoms than people diagnosed with schizophrenia |
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Schizophrenia Biological Explanations Twin Studies Joseph |
Concordance rate, MZ = 40.4%, DZ = 7.4% |
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Schizophrenia Biological Explanations Twin Studies Joseph (2) |
Widely accepted that MZ twins are treated more similarly, encounter more similar environments and experience more 'identity confusion' than DZ twins As a result, reason to believe the differences in concordance rates between MZ and DZ twins reflect nothing more than the environmental differences that distinguish the 2 types of twins |
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Schizophrenia Biological Explanations Adoption Studies Tienari et al |
164 adoptees, mother schizophrenic = 6.7% received a diagnosis of schizophrenia, only 2% of 197 control adoptees (born to non-schizophrenic mothers) Concluded that these findings showed that the genetic liability to schizophrenia had been 'decisively confirmed' |
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Schizophrenia Biological Explanations Adoption Studies Kringlen |
"Because the adoptive parents evidently recieved information about the child's biological parents, one might wonder who would adopt such a child" |
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Schizophrenia Biological Explanations Adoption Studies Kety et al |
No cases of full schizophrenia were found among the first-degree relatives of adopted children identified with a schizophrenia spectrum disorder |
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Schizophrenia Biological Explanations The Dopamine Hypothesis Comer |
Dopamin neurones = key role in guiding attention |
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Schizophrenia Biological Explanations The Dopamine Hypothesis Grilly |
Found some people taking the drug L-dopa to raise their levels of dopamine were developing schizophrenic-like symptoms |
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Schizophrenia Biological Explanations The Dopamine Hypothesis Haracz |
Review of post-mortem studies of schizophrenics, found that most of these studies studied who showed elevated dopamine levels had recieved antipsychotic drugs shortly before death <- ethics?? |
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Schizophrenia Biological Explanations The Dopamine Hypothesis Davis et al |
Meta-analysis of 29 studies that analysed the effectiveness of antipsychotic treatment compared with a placebo, relapse in 55% of placebo, but only 19% who remained on drug <- withdrawal effects in placebo?? |
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Schizophrenia Biological Explanations Evolutionary Perspective Stevens + Price |
Proposed a hypothesis, suggests that schioid personalities have acted in the past to perform the valuable function of dividing tribal communities when they become too large Leader who, because of his psychotic thinking, can separate himself from a group and create a new community |
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Schizophrenia Psychological Explanations Psychodynamic Freud |
Schizophrenia is the result of two related processes, regression to a pre-ego stage and attempts to re-establish ego control |
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Schizophrenia Psychological Explanations Psychodynamic Fromm-Reichmann |
'Schizophrenic mothers' or families who are rejecting, overprotective, dominant and moralistic <- important contributory influences in development of schizophrenia |
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Schizophrenia Psychological Explanations Cognitive Meyer-Lindenberg et al |
Found a link between excess dopamine in the prefrontal cortex and working memory |
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Schizophrenia Psychological Explanations Cognitive Yellowlees et al |
Have developed a machine that produced virtual hallucinations the intention is to show schizophrenics that their hallucinations are not real <- no evidence that this will provide a successful treatment |
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Schizophrenia Psychological Explanations Life Events Brown + Birley |
Prior to a schizophrenic episode, patients who had previously experienced schizophrenia reported twice as many stressful life events compared to a healthy control group <- subjective?? memory?? |
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Schizophrenia Psychological Explanations Life Events van Os et al |
Reported no link between life events and the onset of schizophrenia, patients were not more likely to have had a major stressful life event in the 3 months preceeding onset Prospective part of study - patients who had experienced a major life event had a low risk of relapse |
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Schizophrenia Psychological Explanations Family Relationships Tienari et al |
Adopted children who had schizophrenic biological parents were more likely to become ill theselves than those children with non-schizophrenic biological parents - Supports importance of family relationships in the development of schizophrenia - This difference only emerged in situations where the adopted family was rated (what scale??) as disrupted - diathesis-stress model |
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Schizophrenia Psychological Explanations Double-Blind Theory Bateson et al |
Suggests that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia <- child receives 2 conflicting messages (love+animosity), childs ability to respond is incapacitated because on message invalidates the other - Prevents development of an internally coherent construction of reality + in the long run, this manifests itself as schizophrenia symptoms |
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Schizophrenia Psychological Explanations Double-Blind Theory Berger |
Found that schizophrenics reported a higher recall of double-blind statements by their mothers than non-schizophrenics <- evidence may not bee reliable as patients' recall may be affected by their schizophrenia |
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Schizophrenia Psychological Explanations Double-Blind Theory Liem |
Measured patterns of parental communication in families with a schizophreic child and found no difference when compared to 'normal' families <- knew they were being watched |
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Schizophrenia Psychological Explanations Double-Blind Theory Hall + Levin |
Analysed data from various previous studies and found no difference between families with + without a schophrenic member <- age of child/parents?? social class??` |
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Schizophrenia Psychological Explanations Expressed Emotion (EE) Linszen et al |
Patient returning to a family with high EE is about 4x more likely to relapse than a low EE family <- cause or consequence?? relapse or development?? |
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Schizophrenia Psychological Explanations Expressed Emotion (EE) Kalafi + Torabi |
High prevalence of EE in Iranian culture (overprotective mothers and rejective fathers) was one of the main causes of schizophrenic relapses <- negative emotional climate arouses the patient and leads to stress beyond already impaired coping mechanisms <- triggering an episode |
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Schizophrenia Psychological Explanations Expressed Emotion (EE) Hogarty et al |
Therapy can reduce relapse rate <- no clear whether the EE intervention was key element of therapy or whether other aspects of family intervention may have helped |
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Schizophrenia Psychological Explanations Labelling Theory Scheff |
Evaluated 18 (labelling theory related) studies, judged (subjective??) 13 to be consistent and 5 to be inconsistent, concluding theory was supported by the evidence |
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Schizophrenia Psychological Explanations Labelling Theory Rosenhan |
Once 'label' of schizophrenia had been applied, the 'diagnosis' continued to influence the behaviour of staff toward the patient, een when this was no longer warrented |
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Schizophrenia Biological Therapies Conventional Antipsychotic Drugs Davis et al |
Found a signiificant difference in terms of relapse rates between treatment and placebo groups in every study reviewed, thus demonstrating the therapeutic effectiveness of these drugs <- withdrawals?? |
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Schizophrenia Biological Therapies Conventional Antipsychotic Drugs Vaughn + Leff |
Found that antipsychotic medication did make a significant difference, but only for those living with hostility and criticism in their home environment, in such conditions, reapse of medication = 53%, relapse on placebo = 92% < - withdrawals?? |
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Schizophrenia Biological Therapies Conventional Antipsychotic Drugs Hill |
30% of people taking antipsychotic medication develop tardive dyskinesia, irreversible in 75% of cases |
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Schizophrenia Biological Therapies Conventional Antipsychotic Drugs Ross + Read |
Argue that being prescribed medication reinforces the view that there is 'something wrong with you', prevents individual from thinking about possible stressors that might trigger their condition |
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Schizophrenia Biological Therapies Atypical Antipsychotic Drugs Kapur + Remington |
Suggest these drugs do not involve serotonin or otheer neurotransmitters, but only the dopamine system (D2), they help only temporarily by occupying the D2 recceptors and then rapidly dissociating to allow normal dopamine transmission |
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Schizophrenia Biological Therapies Atypical Antipsychotic Drugs Leucht et al |
Meta-analysis of studies revealed that the superiority of these drugs was only moderate - Two of the new drugs tested were only 'slightly' more effective than conventional antipsychotics, while the other two were no more effective |
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Schizophrenia Biological Therapies Atypical Antipsychotic Drugs Leucht et al (2) |
Negative symptoms 2 of atypical were 'slightly' more effective, 1 was 'as effective' and 1 was 'slightly worse' |
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Schizophrenia Biological Therapies Atypical Antipsychotic Drugs Jeste et al |
Found tardive dyskinesia rates on 30% of people after 9 months of treatment with conventionale antipsychotics but just 5% for those treated with atypical antipsychotics |
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Schizophrenia Biological Therapies ECT Karagulla |
First studies were disappointing, with lower rates of recovery for ECT patients compare to those who did not receive ECT |
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Schizophrenia Biological Therapies ECT Tharyan + Adams |
Review of 26 studies, which included 798 participants in total, to assess whether ECT rsulted in any meaningful benefit for schizophrenic patients - when ECT was compared with placebo or stimulated ECT, more people improved in the real ECT condition, no indication that this advantage was maintained over the medium or long term - when ECT was compared with antipsychotic medication treatment, results favoured the medication groups - conclude that a combination of ECT and medication may be appropriate when rapid reduction of symptoms is required or when patients show limited response to medication alone |
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Schizophrenia Biological Therapies ECT American Psychiatric Association Review |
19 studies that had compared ECT with 'stimulated', concluded that ECT produced results that were no different from or worse than antipsychotic medication |
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Schizophrenia Biological Therapies ECT Sarita et al |
(Indian Study) Found no difference in symptom reduction between 36 schizophrenic patients given either ECT or stimulated ECT <- individual differences?? |
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Schizophrenia Psychological Therapies CBT Drury et al |
Found benefits in terms of a reduction in positive symptoms and a 25-50% reduction in recovery time for patients given a combination of antipsychotic medication and CBT |
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Schizophrenia Psychological Therapies CBT Kuipers et al |
Noted there were lower patient drop-out rates and greater patient satisfaction when CBT was used in addition to antipsychotic medication |
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Schizophrenia Psychological Therapies CBT Gould et al |
All 7 studies in their meta-analysis reported a statistically significt decrease in the positive symptoms of schizophrenia after treatment |
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Schizophrenia Psychological Therapies Psychodynamic Therapy: Psychoanalysis Malmberg + Fenton |
Argue that it is impossible to draw definite conclusions for or against the effectiveness of psychodynamic therapy |
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Schizophrenia Psychological Therapies Psychodynamic Therapy: Psychoanalysis Gottdiener |
Meta-analysis of 37 studies, found ovverall 66% of those receiving psychotherapy improved after treatment, compared with only 35% of those who did not receive psychotherapy <- methodoligcal issues = relatively small number of studies meaning it was difficult to assess the impact of variables, many studies did not allocate patients radomly to treatment conditions, introducing a treatment bias |
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Schizophrenia Psychological Therapies Psychodynamic Therapy: Psychoanalysis May |
Found that patients treated with this therapy together with antipsychotic medication, had significantly better outcomes than those treated with the therapy alone, medication had better outcomes than therapy alone |
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Schizophrenia Psychological Therapies Psychodynamic Therapy: Psychoanalysis Karon + VandenBos |
Found that patients treated with therapy improved more than those receiving medication alone |
