Psychological explanations for schizophrenia

Question 1

Define the term ‘family dysfuntion’

Answer 1

The presence of problems within a family that contribute to relapse rates in recovering schizophrenics, including lack of warmth between parents and child, dysfunctional communication patterns and parental overprotection

Question 2

Outline the role of the Double Bind Theory in family dysfunction

Answer 2

• frequent contradictory messages = schizophrenia
• for example, mother saying she loves the child then turns her head in disgust - conflicting messages on a different communicative levels - affection on verbal level then animosity on non verbal level.
• child doesn’t know how to respond to conflicting messages - prevents a coherent construction of reality = schizophrenia

Question 3

Outline the role of Expressed Emotion in family dysfunction

Answer 3

• high degree of EE = negative emotional climate
• EE = communication style = family talk about patient in a hostile manner or are over-concerned
• high EE increases relapse rates - patient returning to a family with high EE = 4x more likely to relapse than a patient whose family is low in EE (Linszen)
• negative emotional climate = arouses patient and leads to stress beyond his or her already coping mechanisms - triggering schizophrenic episode.

Question 4

AO3 (FAMILY DYSFUNCTION)

Does family relationships influence an individual to develop schizophrenia?

Answer 4

P: Family relationships = important - adoption study Tienari et al (1994)
E: Adopted children with a schizophrenic parent = more likely to get ill. However this difference emerged only in situations where family = disturbed.
E: illness manifests only under appropriate environmental conditions, therefore genetic vulnerability alone is not sufficient.

Question 5

AO3 (FAMILY DYSFUNCTION)

What does research show about the double bind theory??

Answer 5

P: Mixed research evidence about double bind theory
E: Berger (1965) - schizophrenics = high double bind statements compared to non schizophrenics.
Liem (1974) - found no difference in communication between schizophrenics and normal families.
E: Despite inconsistencies - Gibney (2006) = real value of double bind theory = led to family therapy.

Question 6

AO3 (FAMILY DYSFUNCTION)

Are there individual differences in the vulnerability to EE?

Answer 6

P: There is individual differences - not all in high ee relapse and not all in low ee homes avoid relapse.
E: Altorfer et al (1998) - 1/4 of patients = showed no response to stressful comments from relatives.
Vulnerability may be psychologically based.
Lebell et al (1993) claims that how patients appraise the behaviour of the relatives is important.
In cases where high EE behaviours are not perceived as being negative or stressful, patients can do well regardless of how the family environment is objectively rated.
E: not everyone is equally vulnerable to high levels of EE within the family environment - individual differences.

Question 7

Define the term ‘dysfunctional thought processing’

Answer 7

Cognitive habits or beliefs that cause the individual to evaluate information inappropiately.

Question 8

Explain the link between ‘cognitive explanations’ and ‘dysfunctional thought processing’

Answer 8

Cognitive explanations of schizophrenia emphasise the role of dysfunctional thought processing particularly evident in those who display the characteristic positive symptoms of schizophrenia such as hallucinations and delusions.

Question 9

Outline the cognitive explanation of delusions in cognitive explanations

Answer 9

• interpretations are caused by inadequate information processing
• individual puts themselves in the centre of events (egocentric bias) and so jumps to conclusions about external events.
• relate irrelevant events to themselves and arrive at false conclusions.
• Muffled voices = people criticising, flashed of light = sign from God.
• patients don’t believe they are wrong, they are considered to have ‘impaired insight’

Question 10

Outline the cognitive explanations of hallucinations in cognitive explanations

Answer 10

• hallucinating individuals = high hyper vigilance, so have higher expectancy for the occurrence of a voice than normal individuals
• find it difficult to distinguish between imagery and sensory-based perception - the inner representation if an idea (e.g. ‘what other people think of me’) overrides the actual sensory stimulus and produces and auditor image (‘he is not a good person’) that seems real - so think people are actually saying it.
• The individual will keep this thought as they don’t reality test it by asking someone for example (‘can you hear what they’re saying?’)

Question 11

AO3 (COGNITIVE EXPLANATIONS)

What is the evidence that supports the cognitive model of schizophrenia?

Answer 11

P: Sarin and Wallin (2014) - evidence for positive symptoms being the result of faulty cognition
E: Delusional patients = bias in information processing, would jump to conclusions and won’t reality test.
Hallucinating patients = impaired self monitoring & tended to experience their own thoughts as voices.
E: Consequence - therapist can use techniques specifically for treatment.

Question 12

AO3 (COGNITIVE EXPLANATIONS)

Explain the success of cognitive based therapies for schizophrenia and how it links to faulty cognition?

Answer 12

P: origin in faulty cognition of schizophrenia is reinforced by the success of cognitive-based therapies for schizophrenia
E: The effectiveness of CBTp was demonstrated in the NICE review of treatments for schizophrenia. Found consistent evidence = when compared with treatment by antipsychotic medication, CBT = more effective in reducing symptom severity and improves levels of social functioning.
E: Supports the view that faulty cognitions have an important causal influence in the development of schizophrenia.

Question 13

AO3 (COGNITIVE EXPLANATIONS)

What is a current weakness with the cognitive model of schizophrenia?

Answer 13

P: Only deals with one aspect of the disorder (cognitive impairment) but ignores other aspects (e.g social adversity).
E: Howes and Murray (2014) addressed this problem with an integrated model of schizophrenia. - Early vulnerability factors (genes, birth complications, etc) and social stressors causes the level of dopamine to increase. Biased cognitive processing of this increased dopamine activity = paranoia and hallucinations = development of schizophrenia
E: By putting the impact of life events at the centre of the process leading to schizophrenia, this model fits in with more recent research (diathesis-stress) that genes and environment increase the risk of developing this disorder.