Discuss psychological explanations of schizophrenia. (8+16)

Question 1

Cognitive Explanations

Answer 1

schizophrenia is characterised by profound thought disturbance. Cognitive psychologists suggest that disturbed thinking processes are the cause not the consequence of schizophrenia. Thought that mechanisms that operate in normal brains to filter information and process incoming stimuli are somehow defective in the brains of people with schizophrenia

Question 2

Cognitive theories

Answer 2

Frith’s cognitive deficit model (positive symptoms), Shallice (negative symptoms)

Question 3

Frith’s Cognitive deficit model

Answer 3

a deficit in the ‘central monitoring system’ underlies positive symptoms such as hallucinations and delusions. The CMS is the cognitive process which labels thoughts and actions as ones own or ‘done by me’. Hallucinations are caused when inner speech is not recognised as self-generated.
Also proposed that there is a faulty filtering process in the brain of schizophrenic patients. There might be a failure to filter out irrelevant thoughts and information gained from the world around us. This would lead to a cognitive overload; the conscious mind being overloaded with thoughts which might be interpreted as more important than they really are - therefore be difficult to focus on anything for any period of time

Question 4

Shallice

Answer 4

We have two potential types of action. The first are self-willed actions and the second are actions driven by environmental stimuli. People with negative symptoms have a deficit in the ‘supervisory attention system’. This is the cognitive process responsible for generating self-initiated actions.

Question 5

Bentall (Frith)

Answer 5

participants were asked to either generate category items or read out category items. one week later, ppts were given a list of words and asked if they had generated them themselves, read them or if the words were new. The results showed that schizophrenic patients with hallucinations performed worse than schizophrenic patients without hallucinations

Question 6

Frith and Done (Shallice)

Answer 6

patients asked to generate as many responses as possible to a verbal prompt by the experimenter. Compared with control participants, schizophrenic patients with negative symptoms produced very few words. Such patients either did nothing, repeated their previous response or responded to some irrelevant environmental stimuli.

Question 7

Methodological - V

Answer 7

Laboratory experiments - ecological validity (artificial tasks testing for complex cognitive mechanisms, can't be sure that the results of the tasks are a true reflection of the cognitive deficits)
Internal validity (memory - bent all, drugs - frith and done)

Question 8

Methodological - C

Answer 8

Causality - Park et al - identified working memory deficits in people with schizophrenia and their first-degree non-schizophrenic relatives - deficit runs in the family and appears before the schizophrenia

Question 9

Diathesis-stress model

Answer 9

one explanation on its own is not sufficient

Question 10

Family models

Answer 10

The schizophrenogenic family, the double-bind, expressed emotion

Question 11

The schizophrenogenic family

Answer 11

used to describe families with high emotional tension, many secrets, close alliances and conspiracies. In particular a cold, domineering, manipulative and conflict-causing mother might cause her child to feel resentment and distrust. This in turn might lead to the psychotic symptoms of schizophrenia

Question 12

The Double-Bind

Answer 12

Bateson - schizophrenic symptoms are an expression of social interactions in which the individual is repeatedly exposed to conflicting injunctions, without having the opportunity to adequately respond to those injunctions or to ignore them. Once victims have learned to perceive their universe in terms of contradictory environmental input, all environmental stimuli is perceived as such

Question 13

Mischler

Answer 13

various observations and found that mothers talking to their daughters who had schizophrenia were rather aloof and unresponsive. However, the same mothers were normal and responsive when talking to healthy daughters

Question 14

Berger

Answer 14

research with white males aged 16-35. 4 conditions identified in the research, including one experimental condition consisting of individuals identifies as exhibiting schizophrenic symptoms and 3 controls. Found that those in the experimental group reported a higher recall of double-bind statements by their mothers than the non-schizophrenic control groups

Question 15

Liem

Answer 15

measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to controls

Question 16

Expressed Emotion

Answer 16

a qualitative measure of the ‘amount’ of emotion displayed, typically in the family setting, usually by a family member or caregiver. A high level of EE in the home can worsen the prognosis or act as a potential risk factors for the development of schizophrenia. Determined whether a family has high EE through the Camberwell Family Interview

Question 17

Three dimensions of EE

Answer 17

Hostility, Critical comments, emotional over-involvement

Question 18

Hostility

Answer 18

negative attitude directed at the patient because the family feels that the disorder is controllable and that the patient is choosing not to get better.

Question 19

Critical comments

Answer 19

may come about because the relative feels that the patient is wholly or at least partly responsible for their disorder

Question 20

Emotional over-involvement

Answer 20

when a family member blames him or herself for the disorder. The family member shows a lot of concern for the patient. The pity causes too much stress and the patient relapses to cope with the pity

Question 21

Brown

Answer 21

shows that patients with schizophrenia who returned to homes characterised by high EE showed greater tendency to relapse than those returning to low EE homes

Question 22

Vaughn and Leff

Answer 22

found similar results, with 51% relapse in those in high-EE homes and only 13% relapse in those in low EE homes

Question 23

Correlational research EE

Answer 23

high EE may well develop as a response to the burdens of living with a person suffering from schizophrenia. It doesn’t of course rule out the idea that high levels of EE are resulting in the re-admissions

Question 24

Practical Application of EE

Answer 24

well established ‘maintenance’ model of schizophrenia. It is such an accepted model that treatment programmes for schizophrenia usually include education and training for family members in controlling levels of EE.

Question 25

Diathesis-stress model

Answer 25

The role of family models on its own is not sufficient in establishing the cause of schizophrenia.