1. Schizophrenia • Clinical characteristics of the chosen disorder
• Issues surrounding the classification and diagnosis of their chosen
disorder, including reliability and validity
• Biological explanations of their chosen disorder, for example, genetics, Biochemistry
• Psychological explanations of their chosen disorder, for example,
behavioural, cognitive, psychodynamic and socio-cultural
• Biological therapies for their chosen disorder, including their evaluation in terms of appropriateness and effectiveness
• Psychological therapies for their chosen disorder, for example,
behavioural, psychodynamic and cognitive-behavioural, including their
evaluation in terms of appropriateness and effectiveness

2. Sz– Characteristics/Symptoms
Thought process disorder, characterised by disruption to a person’s perceptions, emotions and beliefs
Hallucinations / Delusions
Social Withdrawal
Though Control
Catatonic behaviour
Type 1 Symptoms – Positive (add something eg. Hallucinations)
Type 2 Symptoms – Negative (withdraw something eg social behaviour)

3. Sz – Diagnostic Criteria
Positive Symptoms
Negative Symptoms
Diagnosis
2 or more characteristic symptoms
Social/occupational dysfunction
Duration (at least 6 months)
Exclusion of mood disorders
Exclusion of organic cause
2 classification systems – ICD and DSM, recognise different subtypes of schizophrenia.

4. Sz - Issues Surrounding Classification
Reliability
Extent to which psych’s agree on same def
Whaley (2001) inter-rater reliability 0.11
Positive symptoms more useful for diagnosis
Lower inter-rater reliability on bizarre vs non-bizarre symptoms
Issues with cultural bias (DSM and ICD)
Further development of classification systems

5. Sz - Issues Surrounding Classification
Validity
Is it measuring what it claims to measure?
No, as classification systems are not consistent
When people are labelled psychiatrists are not objective to identify the symptoms
Difficult to define the disorder from others
Validity of subtypes are questioned as some overlap

6. Sz – Biological Explanations – AO1
(Genetic, biochem, neuroanatomical)
S more common among bio relatives
Twin studies (higher concordance for MZ)
Adoption – showed genetic support
Increase in dopamine = Sz
Enlarged ventricles.
Linked to negative not positive symptoms
Result of poor brain development rather than disorder?

7. Sz - Biological Explanations – AO2
No consistency with twin results (concordance rates and issues of reliability of definitions) – may reflect environment similarity. Never 100% concordance
Small samples
Ethics – adoption, twins, mental health etc.
Difficult to analyse brain – PET scans
Drugs can increase S symptoms i.e. Amphetamines
Dopamine link – correlational
question of Cause & Effect
Reductionist and deterministic – based on biology
Neuroanatomical – usually from post-mortems
again, cause & effect

8. Sz - Psychological Explanations – AO1
(Family, cognitive, diathesis)
Diathesis (genetic vulnerability and environmental trigger = disorder)
Family – usually found in dysfunctional families, high levels of expressed emotion e.g. hostility
Cognitive (Frith and Helmsley’s models) – impaired thought processes

9. Sz – Psych Explanations – AO2
Most are ‘partial’ apart from D-S Model (draws together genetics and environment)
Sz may be a result of the environment and living with a disturbed individual (EE)
Nature vs. nurture – bring in genetics as an opposing side
Expressed Emotion has lead to effective treatment for relatives & patients
Cultural Bias – most research based on western, individualistic society
EE studies usually correlation
Ethics – research highly sensitive area, issues of consent and withdrawal

10. Sz – Biological Therapies
Biological – Chemotherapy
Prior to Chemo surgery and ECT – show awareness – not humane etc
Antipsychotic drugs – alleviate some of the symptoms i.e. hallucinations
Phenothiazines are most effective, work by reducing dopamine
Low dose can prevent relapse

11. Sz – Therapies – Bio – AO2 Not effective against negative symptoms
Reduce symptoms within 6 months
If medication stopped symptoms return
Treat symptoms but not the cause, needs to work alongside another form of treatment
Reductionist
Can produce distressing side effects eg. Facial tics
Regulation and monitoring important
Ethics – right to refuse medication!
Chemical straightjacket?

12. Sz - Therapies
Psychological (social/family intervention, CBT, psychodynamic therapy)
Psychodynamic – causes relapse and makes worse! (Tarrier)
CBT – altering thoughts and behaviours (Tarrier)
Social intervention – reliable as findings replicated. Has also improved treatment settings (application). Wing and Brown, negative symptoms improved if socialised
Family intervention – altering the environment and give practical coping skills. Reduces relapse

13. Sz – Psych Therapies – AO2
Therapies provide coping strategies and alleviate symptoms but do not cure
Only work if the person is of sound mind (need medication as a first line of intervention)
Difficult to distinguish whether therapy is having an affect or if it is the antipsychotic drugs
Most therapy occurs in controlled environment and then the individual has to apply to real life. Needs to be maintained otherwise relapse
Most are active processes
Support for CBT from a range of studies
Gives patient responsibility for disorder & treatment
More holistic as have to be used in combination.