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Creado por Grace Fawcitt
hace más de 6 años
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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
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