PSYA4 : Schizophrenia :Outline and Evaluation points for use with each section 1 . Clinical characteristics- this part only requires you to know symptoms(so no evaluation) You need to know: Schizophrenia is a mental disorder characterised by a split between thinking and emotion. How long symptoms need to last for someone to be diagnosed(the DSM and ICD have different times) How many positive and negative symptoms someone needs to be diagnosed and a few examples of each Two sub-types of Schizophrenia and 3-4 symptoms of each subtype. Exam questions: Likely to be 5 marks. 1) Outline Clinical Characteristics of Schizophrenia (5 marks). Describe how somebody a psychiatrist would diagnose someone with schizophrenia (4 marks) 3) Outline two sub-types of schizophrenia. (5 marks) 2. Issues 0T classlTlcatlon ana Olagnosls: How rellaDle ana now valla tne ways 0T diagnosing schizophrenia are. There are many issues. In case you get a 24 mark essay you need to know 6 in detail. Choose from: Using two manuals (DSM and ICD)with different criteria is not valid. Sub-types-ICD and DSM have different sub- types. Cultural variations Inter-rater reliability: If a tool is reliable specialists should agree using the same tool on one patients diagnosis.
Similarity to other disorders Ethics Labelling/stigma The classification system is valid its people using them that are not using them correctly. A/A*: Does Schizophrenia actually exist? Exam questions: These could range from 9/10 marks to 24 marks. 1) Explain issues associated with the classification and/or diagnosis of Schizophrenia (10 marks)(use 3 issues) 2) Discuss the validity and Reliability of diagnosis and classification of Schizophrenia( 24 marks)(8 marks AOI AND 16 A02)NB discuss= outline and evaluate! Here it asks for reliability and validity-don’t panic at this as all the issues we have overed link to reliability and validity.
Refer to reliability of classification systems, inter-rater reliability of diagnosis, validity of diagnosis and symptom overlap, issue of labelling and discrimination (and make sure you include twice as much evaluation) 3) Some people argue that many people are misdiagnosed with schizophrenia. Using your knowledge of the diagnosis and classification of Schizophrenia discuss this statement. (24 marks)(8 AOI and 16 A02) Again don’t panic it is asking you to do the same as 1 and 2. The trick here is to occasionally refer back to the statement that ome people are misdiagnosed. ) Discuss the issues which apply to diagnosing Schizophrenia (5 marks) this is 5 A02 marks. It is similar to ql but there are only 5 marks available for it . Therefore, you cannot cover it in the same detail as you would for 10 marks. Again it says issues so you must cover 2. Practice writing an answer for this. It could Just be a summary of what you have said for 10 marks. 3. Biological explanations of Schizophrenia: Genetics: This is the main one and needs to be learnt in detail Blocnemlst ry(aopamlne nypotnes s Brain structure Evaluation triggers:
Cause and effect- did genes/dopamine cause schizophrenia or was it the psychoactive drugs which caused the changes in dopamine or the brain structure. Concordance rates in mz twins are not 100% which means it is not genes alone- suggest diathesis stress model would take into account genes and environment. Sample sizes of twin studies: not many to use Same environment in womb-even adoption studies cannot take away fact twins share the same environment before separation. Concordance rates are not always calculated the same way. Contradictory research.
A03- Nature-nurture debate Cultural bias eterminism reductionism AJA* :Aietology Fallacy-using treatment to state your theory of the cause is correct(in case of dopamine hypothesis) Two syndrome hypothesis. Exam questions- could range upto 24 marks 1)Outline and evaluate one or more biological explanations for schizophrenia. In your evaluation you should refer to research evidence. (24marks) (Here it says one or more-always use at least two) 2)Compare and contrast psychological and biological explanations of schizophrenia(24 marks)Here you must look at genes and/or dopamine hypothesis and compare to family theories and/or cognitive theories.
Your onclusion paragraph should say that the Diathesis stress model links both together so is the best explanation. 3)Explain how biological explanations support the nature side of the nature -nurture debate(6 marks)Explain suggests AOI and A02. This question sounds scary but really is asking you what the genetic explanation is and why it is nature and not nurture (as it says genes are inherited and cause S supporting nurture and it takes no account of environmental influences (nurture). )Outline one biological explanation of Schizophrenia (8 marks)This is all AOI so do not include any evaluation use studies though to support the outline. . Psychological explanations: Family Factors(Mother-child relationship, Double bind, EE) Cognitive models(Friths’ model ,Helmsleys’ model) Evaluation points EE is strongest psychological explanation and has therapy based on it (could link in Aetiology fallacy here) Cognitive factors: Don’t explain what caused the abnormal filters etc.
Useful in explaining auditory hallucinations but not all symptoms of scnlzopnrenla. Nature/nurture cause and effect-family causing the schizophrenia or the schizophrenic child causing the family to act harshly? Diathesis -stress model: Use at the end of essays on Psychological and biological explanation answers as overall conclusion. AJA* extension points: Refer to Psychodynamic theory( not in great detail)and social drift hypothesis.
Exam questions: Could range up to 24 marks 1) Outline one or more psychological explanations of Schizophrenia (8 marks)(no evaluation needed! ) 2) Discuss psychological explanations of Schizophrenia (10 marks)(so describe and evaluate)(for 10 marks you cannot possibly cover all family explanations and all cognitive explanations)(Focus on EE and 1 cognitive explanation)Rmemeber examiners look for breadth versus depth trade off- so if you over two your evaluation needs to be deeper you cover three it can be broader). ) Evaluate psychological explanations of schizophrenia. (16 marks) 4)Asses to what extent psychological explanations can explain Schizophrenia (8 and 16 marks) This is a more difficult way of asking you to think about whether psychological explanations are good or bad. It is basically outlining and evaluating how good they are . To do this follow PEES and in your Evaluation bit bring in biological explanations, saying they might explain schizophrenia better. Finish by saying neither biological or psychological explanations explain it fully. Biological treatments: Need to evaluate in terms of appropriateness (side effects, is there a better alternative) and effectiveness (how well they work) 1) ECT- Learn this as your second biological treatment- you should know a lot about this from AS. Evaluation trigger- ECT and culture- it is not common in the I-JK, but is used in other countries e. g. India and in severe cases suggesting it is appropriate and effective. 2) Anti-psychotic drugs- Typical Antipsychotic drugs: Conventional Antipsychotics (1950’s) that reduce Dopamine only. Also they usually only reduce positive symptoms.
They are very likely to cause the side effect of Tardive Dyskinesia in 20-30 % of users. Atypical Antipsychotic drugs: Newer Antipsychotics (1990’s) that reduce Dopamine and Serotonin. Also they reduce positive and negative symptoms. They are much less likely to cause the side effect of Tardive Dyskinesia. Evaluation triggers Cultural differences : people who suffer from schizophrenia in the Third World are twice as likely to recover as sufferers in the West- they don’t have any drugs so maybe drugs are not effective or appropriate and psychological therapy(e. . family support)is better. reatment of the mentally ill in western/individualistic societies has changed radically for the better as now many live outside hospitals. This happened at tne same time as arugs were Introaucea suggesting tney work . Placeoo erec Nature/nurture debate- drugs support nature debate. Link to psychological treatments(been found using both has better outcomes) Appropriateness? -As S is a lifelong disorder it may be more bad side effects are seen as S suffers stay on the drugs for many more years than other illnesses such as depression.
Effectiveness- seems to work. AJA* :Aetiology fallacy- if drugs work suggest the cause is biological not sychological,link back to dopamine hypothesis Exam questions-could be upto 24 marks 1)”Therapies can be time-consuming and in some cases uncomfortable for the client, it is therefore essential to offer the most effective and appropriate type of treatment” Outline and evaluate two or more therapies used in the treatment of Schizophrenia (8 and 16marks). For this you can use any of the treatments covered whether biological or psychological . t says two or more but you should be looking at three. The strongest three to use would be drugs, EE therapy (family interventions)and 1 other psychological therapy). ) Outline and evaluate one or more biological treatments of schizophrenia (10 marks)(this is AOI and A02)Use drugs and ECT. You may wish to mention psychosurgery. 3) Discuss the use of biological treatments in treatment of Schizophrenia (8 and 16 marks)(so asking to outline and evaluate the appropriateness and effectiveness of drugs and ECT. 7) Psychological treatments Family intervention(EE therapy) Social intervention(milleutherapy) CBT Evaluation triggers Evaluation should be in terms of effectiveness and appropriateness. Nature-nurture Psychological therapies are often used with drugs which suggests that drugs may be ore effective but that using psychological therapies as well is helpful Effective as they have been linked with getting suffers to take medication EE therapy strongest as based on strongest psychological approach.
Some argue that psychological therapy is worse than doing nothing(especially for psychodynamic therapies) Conclude an essay by suggesting psychological therapies may be important in stopping relapse, especially EE if the sufferer is returning to a stressful family home. Psychological therapies take into account individual differences. Hard to measure if they work or not whereas with drugs chemical changes it can be seen. Exam questions- could be up to 24 marks. 1)Outline one or more psychological treatments for Schizophrenia( 8 marks)This is all AOI so don’t include evaluation.
It asks for one but to make it easier use two or three. Use the two you can outline the most in-depth. Remember again the depth-breadth trade off-outline one or two if you are confident you know it in enough detail ,use 3 if you’re not sure) 2)Discuss the use of psychological treatments for Schizophrenia(24 marks, 8 marks AOI and 16 marks A02)So outline and evaluate as many psychological treatments as you can. You definitely need to use 2 or more to gain the marks)