Treatments of Schizophrenia


A-Levels PY4 (Abnormal Psychology) Mind Map on Treatments of Schizophrenia, created by Hayd23 on 15/06/2013.
Mind Map by Hayd23, updated more than 1 year ago
Created by Hayd23 almost 11 years ago

Resource summary

Treatments of Schizophrenia
  1. Electroconvulsive Therapy (ECT)
    1. ECT works by using electricity to induce an epileptic-like seizure in the patient
      1. we know this as chimps became less aggressive when their frontal lobe was removed
        1. ethical issues with using chimps
      2. first developed by Cerletti and Bini (1938) under the belief that by inducing a seizure in a schizophrenic patient, they should reduce/eliminate the symptoms
        1. Side effects
          1. the general anaesthetic carries its own risk
            1. makes the mortality rate for ECT look quite low
            2. physical harm could come from the effects of an epileptic seizure; reported that patients have suffered broken bones and bruising due to restraints
              1. however, without it, more harm could've been caused
              2. disruption to memory; patient is often confused and disorientated for about 40 minutes after the treatment; could be distressing
                1. however, recall gradually returns
                2. Royal College of Psychiatrists (1997) - ECT does not have any long term effects on memory / intelligence
                  1. however, critics have said that ECT also caused mental / emotional dysfunction, as well as memory loss
                3. How does ECT work?
                  1. although it's not clear how it works, Benton (1981) identified 3 possible explanations:
                    1. patients come to see ECT as a punishment for their behaviour
                      1. the memory loss caused allows the restructuring of the patient's view of life
                        1. however, unilateral ECT causes less memory loss and is effective
                        2. the shock produces a range of changes in the brain. Lilienfield (1995) - neurotransmitters are particularly stimulated
                          1. however, in some cases the effects of ECT are permanent; would be temporary if due to neurotransmitters
                      2. Effectiveness
                        1. an American Psychiatric Association (APA) review in 2001 listed 19 studies that had compared ECT with 'simulated ECT' (patients are given general anaestesia but no ECT - a form of placebo)
                          1. the review concluded that ECT produced results that were no different from or worse than anti-psychotic medication
                          2. however, some evidence that ECT combined with anti-psychotic medication may be more effective than either alone (Tharyan and Adams, 2005)
                        2. Cognitive Behavioural Therapy (CBT)
                          1. aim - challenge maladaptive thoughts and replace them with constructive thinking leading to healthy behaviour
                            1. therapist will try to make these maladaptive thoughts conscious, and the patient will see that there is no basis for these thoughts
                            2. CBT techniques
                              1. understanding where symptoms originate can be crucial for some patients
                                1. EG. patient hears voices and believes they are demons; they are naturally afraid
                                  1. offering a range of psychological explanations for the existence of hallucinations can help reduce anxiety
                                2. patients are encouraged to evaluate the content of their delusions/hallucinations and to consider ways in which they can test the validity of their faulty beliefs
                                  1. the therapist may draw diagrams to show patients the links between their thinking, behaviour and emotion
                                  2. Drury (1996) found benefits in terms of a reduction of symptoms and a 25-50% reduction in recovery time with patients given a combination of anti-psychotic medication and CBT; medication allows access to the benefits of CBT
                                    1. CBT cannot completely eliminate the symptoms
                                    2. Kulpers (1997) - CBT seems to be effective
                                      1. however, Kingdon & Kirschen (2006) found that CBT wasn't for everyone, as it will not benefit people who don't fully engage
                                      2. patients are taught strategies to protect them against the wishes of the voices; EG. relaxation, choosing to pay attention to the voices at particular times of day
                                        1. however, focussing on voices can be damaging as you're not fixing it; listening to the voices can enforce them
                                          1. however, Romme & Escher (2000) - focussing on the voices reduces the likelihood of harm to others or yourself
                                        2. CBT ignores the role of family and society in both the cause and the maintenance of schizophrenia
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