Treatment & Management of Schizophrenia (AQA A Level Psychology): Flashcards
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Define psychotic.
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Define psychotic.
Psychotic refers to any condition in which a person loses touch with reality. Antipsychotic drugs are used to treat such conditions, including schizophrenia.
Typical antipsychotics are also known as antipsychotics, as they have been in use since the 1950s.
Typical antipsychotics are also known as first-generation antipsychotics, as they have been in use since the 1950s.
How do typical antipsychotics work?
They are dopamine antagonists, inhibiting dopamine activity by blocking dopamine receptors in the synapse.
Name two typical antipsychotics.
Any two of chlorpromazine, trifluoperazine, acetophenazine and haloperidol.
True or False?
Typical antipsychotics are effective at treating the negative symptoms of schizophrenia.
False.
They are effective at treating positive symptoms, e.g. delusions.
Give three side effects of haloperidol and chlorpromazine.
Any three of drowsiness, agitation, dry mouth, blurred vision, lack of emotional response, dizziness, and muscle stiffness or spasms.
What may over-use of typical antipsychotics lead to?
Tardive dyskinesia or neuroleptic malignant syndrome, a result of dopamine being blocked in the hypothalamus.
Why were atypical antipsychotics developed?
To maintain or improve effectiveness while minimising the side effects of typical antipsychotics. They are second-generation drugs, in use since the 1970s.
How does the action of atypical antipsychotics differ from typical ones?
Both are dopamine antagonists, but atypicals may also act on serotonin receptors and, in clozapine's case, glutamate receptors.
True or False?
Atypical antipsychotics treat both positive and negative symptoms.
True.
Unlike typical antipsychotics, they are used to treat both positive and negative symptoms of schizophrenia.
Name two atypical antipsychotics.
Any two of risperidone, olanzapine, brexpiprazole and clozapine.
People taking clozapine must have regular because of its potentially fatal side effect, agranulocytosis.
People taking clozapine must have regular blood tests because of its potentially fatal side effect, agranulocytosis.
Why is clozapine's action on serotonin receptors important?
It is believed to improve mood and reduce depression and anxiety. This matters because 30–50% of people with schizophrenia attempt suicide at some point.
What did Marder and Meibach (1994) find?
People with schizophrenia taking risperidone showed significant improvement in both positive and negative symptoms compared to haloperidol or a placebo.
True or False?
Geddes et al. (2000) found atypical antipsychotics more effective than typicals.
False.
Their review found no real difference in effectiveness between first- and second-generation antipsychotics.
When should typical antipsychotics be prescribed?
In the early stages of an episode of schizophrenia, unless the patient has previously had side effects such as disjointed movement or muscle spasms.
Which patients benefit most from antipsychotics (Furukawa et al., 2015)?
Those with the most severe symptoms, who may not be treatable using non-drug therapies.
Why might antipsychotics be less suitable for milder forms of schizophrenia?
These patients benefit less from antipsychotics and may additionally experience adverse side effects.
It is not clear how effective antipsychotics are in preventing in patients who are in remission.
It is not clear how effective antipsychotics are in preventing relapses in patients who are in remission.
Why do drug therapies support a biological determinist view?
They assume symptoms are caused by neurochemical imbalances, undermining the patient's sense of control and implying behaviour is driven by biology, not personal choice.
True or False?
Drug therapies take a holistic approach to schizophrenia.
False.
They are biologically reductionist, treating schizophrenia as purely a chemical imbalance and overlooking psychological and social factors, which may reduce long-term success.
What does the cognitive aspect of CBT enable a client to do?
Challenge negative or dysfunctional thoughts. The behavioural aspect then helps the client modify their actions and responses to those thoughts.
CBT for schizophrenia usually takes place over between sessions, either in groups or individually.
CBT for schizophrenia usually takes place over between five and twenty sessions, either in groups or individually.
True or False?
CBT is generally a long-term treatment for schizophrenia.
False.
CBT is generally a short-term solution to treating schizophrenia.
How does CBT reduce the fear caused by hearing voices?
By offering a psychological explanation for the voices.
How does CBT address delusional beliefs?
By gently challenging them and considering less threatening alternative explanations.
How does CBT address avolition?
By putting in place routines and strategies to live life productively.
What skills might CBT help a client with schizophrenia develop?
Social skills and problem-solving skills, giving them the tools to manage their condition and avoid relapse.
Define family therapy.
Family therapy is a therapy which involves the family members of the person with schizophrenia, addressing the family dynamic as a possible contributing factor to the illness.
What do family therapy sessions aim to do?
Reduce stress for the patient and their family, help family members process their thoughts and feelings about the illness, and find practical problem-solving solutions.
Name three strategies of family therapy identified by Pharoah et al. (2010).
Any three of: forming a therapeutic alliance; reducing the stress of caring; improving the ability to anticipate and solve problems; reducing anger and guilt; helping members balance caring with their own lives; improving beliefs and behaviour towards schizophrenia.
Family therapy should support the person so that the symptoms of schizophrenia reduce significantly.
Family therapy should support the person so that the aversive symptoms of schizophrenia reduce significantly.
What did Kart et al. (2021) conclude about CBT?
CBT is an effective therapy, particularly in treating the positive symptoms of schizophrenia.
What did Turkington et al. (2006) find?
CBT can be combined with family therapy to treat both positive and negative symptoms and generally improve outcomes.
What did Caqueo-Urizar et al. (2015) emphasise?
The vital role of family therapy given cut-backs in mental health care facilities, and the need for professionals to assist and guide family members.
True or False?
CBT has good validity as a treatment for schizophrenia.
True.
It has been tried and tested for schizophrenia and for comorbid disorders such as depression.
How might family therapy benefit the economy?
The person feels less alone and isolated, reducing reliance on external mental health providers, and may be able to work, so fewer days are lost to sickness.
Why might CBT not be suitable for everyone with schizophrenia?
Schizophrenia exists on a spectrum, so CBT may only be appropriate for those whose symptoms are mild or easily managed.
How might family therapy worsen someone's symptoms?
If they feel forced to interact with or depend on emotionally destructive people, but cannot express or admit this to a health professional.
Psychological therapies take a more approach, considering social, emotional and cognitive aspects rather than just biology.
Psychological therapies take a more holistic approach, considering social, emotional and cognitive aspects rather than just biology.
True or False?
CBT supports the idea of free will in managing schizophrenia.
True.
It encourages patients to take control of their thoughts and behaviours, promoting personal agency in contrast to biological determinism.
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