1. 4 Cerys Zoe Abi 3 Lily Alice Nat 6 Jess Joe Lauren 5 Emily Fran Harry2
Maisie
Sophie
Olivia
Martha 1
Vicki
Jamie
Tammy
Annabel

2. Spiral question: Approaches
Explain one way in which social learning theory overlaps with one other approach in psychology. (Total 2 marks)

3. Spiral question: Approach
Social Learning theory overlaps with the Behaviourist approach. According to both approaches we learn behaviour through our environment (1). Furthermore, both approaches highlight the role of observational learning and reinforcement in acquiring behaviour (1).
Social Learning theory overlaps with the cognitive approach. Both highlight the role of mental processes in learning (1)

4. Biological explanations Drug treatments

5. Starter
Task 1: Decide whether the statements are true or false. If the answer is false, replace with the correct answer. Task 2: Match up the statements to the correct biological explanation of schizophrenia. As an extension – can you answer the questions in bold?

6. Biological Treatments Drug therapy

7. Lesson Objectives
To understand (describe), apply (give examples of) and evaluate (discuss) biological therapies for Schizophrenia.

8. How would the biological explanation treat Schizophrenic?
Anti Psychotic drugs
Typical (traditional)
Atypical (newer)
It is thought that schizophrenics produce too much of the neurotransmitter or have more dopamine receptors than non-schizophrenics.
Dopamine
Dopamine receptor

9. Typical antipsychotics
e.g. chlorpromazine Associated with the dopamine hypothesis Work by acting as antagonists (reduce the action of the neurotransmitter dopamine) in the dopamine system

10. How do they work?
They block the dopamine receptors in the synapse in the brain.
Dopamine levels initially build up after taking chlorpromazine but then production is reduced
This normalises neurotransmission in key areas of the brain, which in return reduces positive symptoms of the disorder, such as hallucinations and delusions.

11. Task: on your handout Draw a synapse. Label the following:
Pre-synaptic neuron
Post-synaptic neuron
D2 receptors
Chlorpromazine
Dopamine
Explain how antipsychotics work in reducing the symptoms of schizophrenia

13. Side effects: typical antipsychotics
Muscle tightening in neck and jaw,
Tardive dyskinesia (slow involuntary repetitive movements)
decrease of spontaneous movement,
decrease in emotional spontaneity and motivation, motor restlessness and fidgeting,
dry mouth, constipation, weight gain,

14. Reflection
Kapur et al (2000) estimate that between 60% and 75% of D2 receptors in the mesolimbic pathway must be blocked for these drugs to be effective. Unfortunately, in order to do this, a similar number of D2 receptors in other areas of the brain must also be blocked. Why might this be problematic for the individual taking typical antispychotics? There are several dopamine pathways in the brain and it appears that blocking dopamine receptors in only one of them is useful. Whereas blocking dopamine receptors in other remaining pathways may be harmful for the person. This problem has been addressed by the development of atypical antipsychotic drugs.
Kapur et al (2000) estimate that between 60% and 75% of D2 receptors in the mesolimbic pathway must be blocked for these drugs to be effective. Unfortunately, in order to do this, a similar number of D2 receptors in other areas of the brain must also be blocked, leading to undesirable side effects. This represents the high cost of using typical antipsychotics to treat schizophrenia. There are several dopamine pathways in the brain and it appears that blocking dopamine receptors in only one of them is useful. Whereas blocking dopamine receptors in other the remaining pathways may be harmful for the person. This problem has been addressed by the development of atypical antipsychotic drugs.

15. Atypical antipsychotics
e.g. Clozapine and Ripseridone
The aim of developing new antipsychotics was to improve upon the effectiveness of drugs in suppressing symptoms and also to minimise the side effects (carry a lower risk of extrapyramidal side effects)
suitable for treatment-resistant patients.

16. Atypical antipsychotics
bind to dopamine receptors in the same way that Chlopromazine does, but in addition it acts on serotonin and glutamate receptors.
It is believed that this action helps improve mood and reduce depression and anxiety in patients, and that it may improve cognitive functioning.
These benefits mean that it is sometimes prescribed when a patient is considered at high risk of suicide.

17. Risperidone Binds to dopamine and seretonin receptors
However, risperidone binds more strongly to dopamine receptors.
Therefore, it is more effective in smaller doses than most antipsychotics.

18. Side effects: atypical antipsychotics
Fewer side effects
Similar side effects to typical anti-psychotics but tardive dyskinesia much reduced.

19. Task: on your handout
Explain how atypical antipsychotics work in reducing the symptoms of schizophrenia

20. Consolidation activity
You will now be given a type of medication to take, either labeled as typical or atypical antipsychotics.
You need to explain the following to your partner…
How the drug you are taking works
Give an example of the antipsychotic
What symptoms are treated
What are the side effects of taking the medication (can be found in your pack)
Take one pill for each time you successfully explain a bullet point to your partner. Your partner will decide whether you have explained it in enough detail.
5 minutes to gather information before task begins.
Please note: Some of you might not have enough medication for each bullet point. If this is you and your partner, I want you to answer the following question:
Identify one limitation of drug therapy for the individual? Create a PEE evaluation point.

21. Plenary: Exam focus: Apply it!
Brendan has recently been diagnosed with schizophrenia with accompanying depression and suicidal thoughts. Brendan is a scientist and is curious about how anti-psychotics work.
How might Brendan’s Psychiatrist explain the effects of antipsychotics (typical or atypical) ? Refer to the dopamine hypothesis. (3 marks)

22. Evaluation

23. Guardian Article: AO3
Read the article on anti psychotics in the Guardian. Highlight any useful AO3 points. Overall – what is it trying to argue about using drugs to treat schizophrenia?

24. AO3 Face Off and application
Each of you have a role card.
You must write a fully elaborated evaluation point based on your role card.
Once finished you will each go around and share your points – but you must make it convincing! You can debate it out if you wish…
At the end you must all come to a conclusion to this question…
Tips for writing a strongly effective evaluation point.
Clearly state the direction of your point or argument.
Use evidence to support your claim.
Explain how the evidence supports your point.
Make it relevant, linking it back to treating schizophrenia.
Point – Evidence – Explain - Link
PEEL
Should Schizophrenia be treated using anti psychotic drugs?
Once finished, stick your post it notes onto a blank sheet of paper with your conclusion and I will photocopy for your notes 

25. Argue against anti-psychotics due to serious side effects.
You are conducting a PhD at the University of Leicester investigating the relationship between dopamine and schizophrenia, and have stumbled across a piece of research suggesting that schizophrenia could be due to low levels of dopamine in some part of the brain. As a result you are at a loss to understand how anti-psychotics can always work as it is much dependent on the cause.
Argue against anti-psychotics due to uncertainty about the dopamine hypothesis.
You are the editor for the Guardian and after reading the article, strongly disagree with the use of antipsychotics due to the horrendous side effects they have. Prolonged use of Typical neuroleptics can lead to side effects such as involuntary movements of tongue, face, jaw etc. (Tardive Dyskinisia)
You also believe that the evidence for their effectiveness is largely exaggerated, being published after the peer review process multiple times.
Argue against anti-psychotics due to serious side effects and over exaggerated evidence.
You are a clinical psychiatrist and believe that anti-psychotics are a no brainer due to the large body of scientific evidence proving their effectiveness.
Argue for anti-psychotics due to a great amount of successful research evidence.
You are a mental health nurse working in a mental health institution and have relied on anti-psychotics for a number of years to sedate and calm patients so they are easier to work with and more co-operative.
Argue for anti-psychotics due to the help they give to carers looking after schizophrenic patients.
You are a private cognitive psychologist and believe that using antipsychotics is a short term fix only and cannot treat the underlying causes of the illness. You are even more against the drugs being used to calm patients as this won’t aid their long term recovery.
Argue against anti-psychotics due to them not treating the symptoms and not the cause.
You are a doctor who strongly disagrees with the use of anti-psychotics to treat mental illness. You have experience of dealing with schizophrenic patients suffering from neuroleptic malignant syndrome due to taking anti-psychotics.
Argue against anti-psychotics due to serious side effects.

26. Exam focus
Apart from effectiveness, briefly explain one limitation of drug therapy for schizophrenia. (Total 2 marks)
AO3 = 2
Content:
•        All drugs have side effects that can be severe and may lead to patients avoiding medication and hence to relapse
•        It is questionable whether or not severely affected patients can give informed consent to medication
•        Drugs may simply be supressing symptoms
2 marks for a clear and coherent limitation
1 mark for a vague/muddled limitation or limitation merely identified
Additional point from this question – are there any ethical issues arising from treating schizophrenics with anti-psychotic drugs?

27. Evaluation

28. Evaluation: drug therapy
Issues of appropriateness could include:
•        the nature of the disorder means that some therapies are more appropriate than others
•        factors affecting the choice of treatment, eg financial constraints, availability of appropriate therapist, accuracy of original diagnosis
•        ethical issues, eg possible harmful side-effects, issues of informed consent, dehumanising effects of some treatments.
Issues of effectiveness could include:
•        problems of measuring effectiveness, eg when to measure, how to measure, what criteria to choose
•        wide range of symptoms – treatments might be effective for some but not others
•        placebo effects.
comparison of side-effects, either physical or other unintended outcomes; differences in attitudes towards the two types of treatment, either patient attitudes or more widely; preference for combination treatments; individual differences in preference and responsiveness; role of patient, ie passive / active; discussion of the usefulness of specific treatments in the context of institutionalisation v community care can also be credited.