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Summary CAIE A level clinical psychology notes

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Notes from the CAIE/CIE psychology syllabus, focused clinical psychology, its a summary (there may be some spelling mistakes)

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, Schizophrenia

E
-
C
Icd-11: schizophrenia is characterised by disturbances across many aspects of a




3
person's thoughts, feelings, experiences and behavior
The four negative symptoms include




3
For a diagnosis of schizo to be made, symptoms must have •Avolition- lack of motivation
persisted for at least 1 month and not due to other health conditions • flattened affect (blunted emotional
expression)
• imposed cognitive function (reduced,


X 2-J
passivity or control )
: waxy flexibility ( the body's resistance to
being moved)
S
Diagnosis
(m)
(a)
The four core symptoms ( positive




?
symptoms ) are:
• persistent delusions
• persistent hallucinations
• thought disorder




-,
• experiences of influence, passivity or
Tianeri

was control
Schizo in 6.7% of adoptees with with a
biological mother with schizo -




4% of control group (adoptees with biological


he
mothers without schizo)




=GuCASE STUDIES
Hiker et al
. 30,000 twin pairs from the Danish twin
register and the Danish psychiatric
research register (Denmark )
. 79% genetic contribution

W- I
Y
Gr
Aneja et al
• three case studies on individuals who had early


- onset schizo




i
• boy's behavior began to change ( academic decline




s
Gottesman et al
and general behavioral decline




Si
•Longitudinal twin-study in monozygotic (MZ) ( identical twins sharing all DNA) and
• from 12 he had been hearing voices and visual
dizygotic (DZ) (fraternal sharing 50% DNA).
hallucinations (believed his mother and other people
.57 pairs of twins (24 mz, 33Dz) were drawn from 467 twins registered at mandsley
were communicating.
hospital (London).



3
. Behavior became more erratic (shouted at people
•Participants took cognitive test: case summaries of each participant were independently who weren't there), he barely slept and his level of


&
evaluated by external judges to find co-twin schizo concordance self-care declined dramatically
RESULTS - mz twins share 48% schizo concordance, dz only have 17% concordance • admitted to hospital several times and given a range




he
general population is 1% of medications to attempt to keep his symptoms
under control.
EVALUATION- large sample (generalizable to twins not non-twins) • diagnosed with early onset 8 released with meds
assesment made by independent judges, reducing researcher bias that kept his anger under control
Qualitative data collection (in depth but subjective)

, • Persecutory ideation is the belief (without evidence) that other • Aims: investigate whether participants without a history of

people are being hostile towards you or have negative feelings mental illness have thoughts of persecutory nature in vr
- to find out whether there are cognitive or emotional factors
towards you. it is the most common symptom of schizo.
that predict the likelihood of persecutory ideation
- can lead to social withdrawsand inability to maintain usual
activities due to fear of hostility from others • Hypothesis: A small number of participants would have
• Vr → was primarily used to investigate spatial awareness and thoughts of a persecutory nature in vr and these would be
people with higher levels of emotional distress and paranoia
other cognitive skills as well as social interactions.




--
-It is used to treat phobias and anxiety disorders as well as • Sample: 24 participants (12 male, 12 female), All students /




&




=
-to carry out exposure therapy admin staff from UCL, Average of 26 years, No history of
-to reduce a fear of public speaking (Slater et al.) mental illness, Volunteer sampling (advertisement within UCL)


• Lab exp was used: participants trained on how to use vr
equipment and then asked to enter the virtual environment for
5 minutes (library scene).



FREEMAN ET AL




F
-
• Participants were not told the research was on persecutory
- KEY STUDY
W




• Most participants had positive opinions about the
r

ideation, but were asked to try and form an impression of
M




the people in the room and what those people may think of avatars but some had ideas of persecution (hypothesis
the ppts proven)
• There were 5 avatars in the scene; 3 sat at one desk and 2 • significant correlation between scores on the
sat at another (occassionally, the avatars showed
paranoia questionnaire and the paranoid scores given
v




ambiguous behavior eg smiling, talking to eachother,
looking)
based on the interview
• No significant differences between those who took
the test before and after the vr and those who only
After leaving the vr, participants were given a range of questionnaires:
took after the vr.
• The brief symptom inventory (bsi) → A 53 self-report measure designed
to assess 9 symptom dimensions such as hostility, anxiety, psychotism • persecutory thoughts of avatars did not significantly
and depression over the last 7 days correlate with paranoia score
• questionnaires that measured anxiety, paranoia, - sense of presence) • higher levels of interpersonal sensitivity and anxiety
• measure of anxiety (20 item measured on a 1-4 scale) were significantly correlated with higher levels of
persecutory thoughts in vr
Half of the participants completed questionnaires before und after the vr
• people more likely to show persecutory ideation if
experience
Semi-structured interviews were also carried out to find out the they show high levels of anxiety
participants, thoughts and feelings about the vr experience

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