I've combined and summarized the content from my schizophrenia videos into this schizophrenia revision video if you don't understand any of the content like over here go to my longer videos for a full explanation but if you just need a reminder of the key points quickly this is a video for you but don't just use this video I've got a psych boost app and it's designed to test your knowledge of all the topics in a level psychology actively using flashcards it's an IOS and Android and you can use it for all of paper on for free if instead you want tutorial support videos of questions from all three papers you can access over 16 hours of these as well as hundreds of printable resources over on my patreon but enough of that let's get started classification of schizophrenia according to the dsmi for the diagnosis of schizophrenia two of the following symptoms need to be present for at least a month one being positive positive symptoms experiences that are in addition to normal experiences hallucinations additional sensory experiences such as seeing distortions in objects that look like faces hearing critical voices delusions or rational beliefs about themselves or the world for example persecution the government is out to get me or grander I am the President negative symptoms loss of normal experiences and abilities avolition a lack of purposeful World Behavior no energy social ability affection or attempt at personal hygiene generally apathetic speech poverty brief verbal communication style loss of quality and quantity of verbal responses it can be classified as a positive symptom if speech is excessively disorganized with sufferers wandering off the point reliability and validity reliability in the diagnosis of classification schizophrenia interr reliability measures if two observers agree for example if two doctors give the same diagnosis test retest reliability is the same doctor giving the same diagnosis over time with the same symptoms validity in the diagnosis and classification of schizophrenia in the context of schizophrenia validity questions if a person has a disorder when diagnosed or if schizophrenia is a real disorder with clear and unique symptoms back 1963 found 153 patients diagnosed by multiple doctors only had 54% concordance rate between the doctor's assessments this lack of agreement suggests there's low interr reliability in diagnosing schizophrenia this also suggests many people diagnosed incorrectly low validity potentially receiving inappropriate treatments comorbidity schizophrenia is often diagnosed with other disorders this could lead to an inaccurate diagnosis of schizophrenia when it could be a severe case of depression symptom overlap bipol disorder also has hallucinations and delusions as a symptom positive if the two disorders are so similar they may not be distinct and should be redefined Bley 2009 found co-morbidity rates with schizophrenia depression 50% drug abuse 47% PTSD 29% and OCD 23% gender bias Caron argues women's experience of schizophrenia is taken less seriously and underdiagnosed compared to men due to women's better social coping strategies leading to being less likely to seek treatment culture bias people with africaribbean Heritage in the UK are up to nine times more likely to be diagnosed with schizophrenia Fernando argues this is due to category failure when Western definition of mental illness are applied to people from non-western cultures luring and pal 1988 sent 290 psychiatrist two identical case studies altering ethnicity and gender the researchers found overdiagnosis of the case study claimed to be of a black client and under diagnosis if the case study claimed it was of a female client the most accurate diagnosis was when the gender and race of the psychiatrist were the same as in the case study this suggests the existence of gender and cultural bias in psychiatrist diagnosis of schizophrenia biological explanations of schizophrenia the genetic explanation for schizophrenia genes code for biological processes including variations in neural brain structure and biochemistry there's not one single schizophrenia Gene but a collection of Gene locations that are associated with a higher risk of developing schizophrenia meaning the disorder is polygenetic concordance rates are higher in families than found in the general population at 1% and the Clos closely related the family member the higher the concordance with schizophrenia this is argued to be due to the increased genetic similarity neuro corat of the variation in neural structure and biochemistry that are correlated with an increased risk of developing schizophrenia the dopamine hypothesis symptoms of schizophrenia are due to too much or an imbalance of the dopamine neurotransmitter across the brain excessive amounts of dopamine hyper dopam iner in speech centers like brochas area may lead to audit hallucinations lower levels hypo dopam iner in areas like the frontal cortex are linked to negative symptoms like avolition or speech poverty glutamate is an excit neurotransmitter involved in learning attention and memory and it's found in low quantities in people with schizophrenia en llarge ventricles voids in the brain filled with SOS spinal fluid has been correlated with schizophrenia gotsman 1991 found a concordance rate for schizophrenia of 48% for identical twins monozygotic MZ and 177% for non-identical twins diotic DZ the general population rate is 1% this suggests there are genetic factors however as the concordance rate is far less than 100% for monotic twins there must be a role for environmental factors tari 2004 studi the biological children of schizophrenic mothers who had been adopted finding 5.8% of children adopted into psychologically Healthy Families develop schizophrenia compared to 36.8% of children raised in dysfunctional families amilies This research supports the influence of biological factors due to the high rate even in psychologically Healthy Families still a higher figure for dysfunctional families suggests a psychological trigger is a factor in a met analysis including 2012 studies Lett found that drug treatments that work via normalizing dopamine levels were more effective than the pero the efficacy of treatments directly influencing the dopamine system supports the dopamine hypothesis biological theory of schizophrenia claiming schizophrenia is biologically determined due to genetics and neurochemistry may make sufferers feel disempowered when diagnosed and passively reliant on drug therapies the cognitive soft determinist perspective suggests that clients can reconstruct irrational mental processes empowering sufferers to control their disorder actively explaining schizophrenia at the basic cellular and chemical level has the advantage of the scientific principle of parsimony it has also led to highly effective drug therapies however taking a biologically reductionist approach fails to consider the evidence for psychological causes of schizophrenia the diaphysis stress approach to explaining schizophrenia is more likely to be valid than biology alone this suggests that the root cause is a biological genetic weakness a diis however an environmental stressor such as family stress must be present to trigger the disorder psychological explanations for schizophrenia family dysfunction schizophrenia symptoms are due to the interpersonal relationships within the family schizophrenic mother a psychonomic fairy paranoid delusions result from the influence of a cold rejecting and controlling mother and a passive father an atmosphere of stress and secrecy triggers psychotic thinking double bind Theory due to mixed messages feels unable to do the correct thing disorganized thinking and paranoia expressed emotion verbal interactions exaggerated involvement indicating the sufferer is a burden by a self-sacrifice criticism and control of the sufferer's behavior physical and verbal emotional hostility towards the sufferer he rejection con explanations the ability to process thoughts is dysfunctional F's attention deficit Theory a faulty attention system cannot filter preconscious four and gives too much significance to the information that would usually be filtered overloading the mind this accounts for positive symptoms like hallucinations and delusions delusions of a control A Fault In met representation the ability to identify your thoughts and actions as your own in a Metro analysis including 27 studies B and Huli showed that relapse into schizophrenia is significantly more likely in families with issues of expressed emotion tanari found that only 5.8% of biological children of schizophrenic mothers adopted into psychologically Healthy Families develop schizophrenia compared to 36.8% of children adopted into dysfunctional families it's socially sensitive to suggest that the family causes schizophrenia as this likely to cause additional stress and anxiety research evidence that schizophrenia has a biological cause such as genetics gsman and neurotransmitters lashette Sterling 2006 found patients with schizophrenia took twice as long to name the color in the strip test as the controls suggest people with schizophrenia have dysfunctional thought processing in this case with faulty central control the ability to suppress and override automatic actions and speech are M toate actions to achieve goals the evidence in this area is correlational and it could be that having a schizophrenic child is the cause of family dysfunction biological treatments for schizophrenia antis psycotic also known as neuroleptic on medications used to control the symptoms of psychosis for example delusions and hallucinations they're taken in pill form or injected typical antipsychotics first generation drug therapy used since the 1950s are less popular due to severe side effects and they only treat positive symptoms for example clo promazine these drugs work as dopamine antigonous they reduce calm dopamine activity by blocking dopamine receptors at the syapse reducing positive symptoms such as hallucination and delusions side effects include dry mouth constipation leery confusion and of discinesia atypical antis psychotics second generation drug therapy 1970s onwards for example clopine these avoid the more severe side effects of typical antic psychotics block dopamine receptors but also act on other neurotransmitters for example accetto Coline glutamate and serotonin atypical also addresses the negative symptoms such as abolition side effects include weight gain and cardiovascular problems atypical is less likely to cause involuntary movements in her met analysis including 212 studies lashette found that drug treatments of symptoms was more effective than a PBO this suggests drug treatments that Target the doping system are effective in reducing symptoms bagnor reviewed 232 studies comparing the effectiveness of atypical and typical antipsychotics atypical drugs were found to be more effective than typical in treating overall symptoms resulting in fewer movement disorder side effects and fewer people leaving the drug treatments early overall clopine was the most effective drug drug therapies are cheap especially compared to providing hospital treatment or onetoone psychological therapies terer Place patients randomly into routine care Antico CBT or a combined treatment patients in the combined treatment significantly improved the severity and number of positive symptoms as well as fewer days in the hospital receiving care this suggests drug therapies are effective but better when combined with psychological therapy dug therapies may only suppress symptoms and not treat the underlying problem which may be cognitive hey there I should still watching I'm guessing you find this video useful as I release content right up to the exams don't forget to subscribe so you know when new videos are uploaded also as this video is being released I'm on around 50,000 subscribers and I'd love to get to 100K at some point in the next few years psychological treatments for schizophrenia cognitive behavior therapy assumes that schizophrenia results from dysfunctional thought processes ABCDE modeled by Ellis the therapist role is to identify and challenge irrational beliefs by logically disputing the reality of the faulty cognitions delusions and then cognitively structuring the beliefs into Alternatives effect e reality testing is the process in which the patient can demonstrate that their irrational thoughts hallucinations and Illusions are not real symptom targeting for example if they claim to see the future test this family therapy attempts to improve the home situ ation of the person with schizophrenia as family dysfunction can increase the risk of relapse into schizophrenia the treatment is family centered intended to change the whole family's Behavior not just the person with schizophrenia the family is educated on symptoms psycho education develops techniques to reduce conflict stress and self-sacrifice and improves communicational problem solving skills token economies are designed to make Behavior more manageable within a hospital or to prepare longstay patients for transfer into the community based on skinners oper and conditioning tokens are used as positive reinforcement patients are immediately rewarded when they show a predefined Target Behavior such as washing tokens are exchanged for something else that they want activities or chocolate behaviors are progressively changed Behavior shaping with tokens given first for small changes in Behavior towards the ideal con to behavior therapy sensy found patients who had resisted drug treatments had a reduction in positive and negative symptoms when treated with 19 sessions of CBT also they continue to improve even 9 months after the treatment had ended CBT does not produce the unpleasant side effects of drug therapies making get a preferred treatment plan for many patients the high cost of working with a trained therapist over multiple sessions means drug therapy is cheaper dropping out of CBT is common this may be due to the length of the treatment and symptoms may become severe CBT requires engagement negative symptoms can lead to an unwillingness to participate or positive can lead to distrust of the process family therapy left review the Aftercare of patients with schizophrenia of those with standard out patient care 50% is relapse within 9 months compared to only 8% who receive family therapy however after 2 years this has risen to 50% with family therapy and 75% with standard out patient care family therapy is about improving symptoms aiding the family's home life and ultimately avoiding admission into a mental health facility however it's not cure for the disorder and while more manageable symptoms remain there are problem practical issues such as the length of the therapy family therapy can often take up to a year patients may drop out during this time especially if they have severe symptoms or family incidents Dickerson found when reviewing the findings of 13 studies token economies can effectively improve the Adaptive behavior of people with schizophrenia token economies do not directly treat symptoms of schizophrenia they only attempt to manage negative symptoms such as po motivation poor attention and social withdrawal using scenarium principles could be seen as degrading the patient effectively manipulating them like labrats ethics the interactional approach explaining and treating schizophrenia interactionalist approach suggest the development of schizophrenia is due to the combined effect and interaction of biological and social psychological factors and treatment is effective when combining biological and cognitive therapies the importance of interaction as approach in explaining schizophrenia the diis stress model is a psychological concept that a disorder is due to the interaction between a predisposed V mobility diaphysis and environmental trigger later in life stressor diaphysis and schizophrenia consider the genetic vulnerability potentially resulting in aopi imbalance stresses and schizophrenia negative environmental experience such as family dysfunction emotional stress and anxiety or a major adverse life event this emotional event then triggers the disorder the importance of an intera approach in treating schizophrenia suggests that as there's both a biological and psychological aspect of schizophrenia development the effective treatment of schizophrenia would combine psychological aspects such as CBT and biological Dr therapies to address both causes in patients with severe schizophrenic symptoms biological treatments can allow them to reduce their symptoms to engage in psychological therapies CBT can give sufferers the cognitive skills to change their underlying faulty cognitions gotsman found a conord TR for schizophrenia 48% for identical twins martic MZ and 177% for nonidentical twins diotic DZ the general population rate is is 1% this suggests there are genetic factors however as the concordance rate is far less than 100% for mon twins there must be an interaction with environmental factors tanari studied the biological children of schizophrenic mothers who had been adopted finding 5.8% of children adopted into psychologically Healthy Families develop schizophrenia compared to 36.8% of children raised in dysfunctional families This research supports the influence of biological factors due to the high Reign even in psychologically Healthy Families still the higher figure for dysfunctional families suggests a psychological trigger is needed interaction the mechanism by which an adverse psychological event triggers a complex biological response resulting in symptoms is still uncertain reducing confidence in the interactionist approach as a full explanation for schizophrenia the diaphysis for schizophrenia is no longer considered a single Gene now researchers understand its polygenetic it also includes for abilities like early emotional trauma like child abuse acting as a diis by altering neurological development read 2001 also the understanding of risk triggers have developed to include factors such as drug abuse ter assign patients to routine care antic psychotics or routine care and CBT patients in the combined treatment significantly improve the severity and number of positive symptoms and had fewer days in the hospital receiving care this suggests an interact approach to treating schizophrenia is more effective than antis psychotics alone taking an interactionist approach to treating schizophrenia has the same limitations as both treatment options the unpleasant side effects of drug therapy and the high Financial cost of one toone support from a trained therapist don't forget you can now test yourself on the schizophrenia unit with the Cy boost app and if you want to try out the app all the topics in paper one a free and 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