Schizophrenia

Question 1

What is the definition of schizophrenia?

Answer 1

A severe mental disorder characterised by disruption of cognitive and emotional functioning. It effects language, thoughts, perception and sense of self. The individual may hear voices and see visions.

Question 2

What are some causes of schizophrenia?

Answer 2

1) genetics
2) brain damage
3) drugs and alcohol
4) childhood trauma

Question 3

What is type 1 acute schizophrenia?

Answer 3

Obvious positive symptoms appear suddenly usually after stressful events

Question 4

What is type 2 chronic schizophrenia?

Answer 4

The illness takes many years to form and gradual chnages of increased distrurbance and withdrawal occur. Characterised by negative symptoms.

Question 5

What are the two manuals that diagnose schizophrenia?

Answer 5

ICD-10- produced by world health organisation and focuses on subtypes of schizophrenia
DSM-V- subtypes of schizophrenia were removed

Question 6

What is the DSM-V criteria for schizophrenia?

Answer 6

A- need 2 or more of the following (delusions, hallucinations, disorganised speech, grossly disorganised/ catatonic behaviour, negative symptoms eg flattening/avolition)

B- since the onset of schizophrenia, one or more areas of functioning will be negatively affected eg work or interpersonal life.

C- continuous signs of disturbance will be present for 6 months or more. Symptoms from criteria a have been present for at least 1 month.

Question 7

What is the meaning of positive symptoms?

Answer 7

This refers to excesses or symptoms that have been added to the patinet’s personality because they now have the illness of schizophrenia. These symptoms were not present when the person was healthy eg hallucinations and delusions.

Question 8

What is the meaning of negative symptoms?

Answer 8

This refers to loss of normal functioning. The person will have a weakened ability to cope and manage everyday life. They lose the ability to do certain things eg speech poverty.

Question 9

What are some positive symptoms of schizophrenia?

Answer 9

1) hallucinations - these can be auditory, visual, olfactory or tactile. They may see or hear things that do not actually exist.

2) delusions- they have a strong belief about something even though it’s based on mistaken and unrealistic views.

3) disorganised speech- the individual may make up random words or string random words together in a sentence that don’t make any sense.

4) catatonic behaviour- the patient have reduced reactions to environmental stimuli and can adopt rigid postures and standing completely still for long periods of time.

Question 10

What are some examples of negative symptoms?

Answer 10

1) speech poverty- speech is lessened in terms of fluency and patinets thinking is slow and thoughts may be blocked. Usually leads to brief replies and minimal elaboration.

2) avolition - the patient have reduced interest and motivation to complete goals and are happy sitting around doing nothing.

3) affective flattening- the patient has restricted ability to respond to emotional stimuli. They may behave inappropriately in social situations eg laugh when told bad news.

4) anhedonia- general lack of interest in almost all activities and a lack of interest in pleasurable stimuli eg interacting with others.

Question 11

What is reliability in schizophrenia?

Answer 11

Reliability is the level of agreement on the diagnosis by different psychiatrists across time. For the classification system to be reliable, different clinicians using the same system eg the DSM-V and should arrive at the same diagnosis for the individual.

Question 12

What is validity in schizophrenia?

Answer 12

Validity is the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms. For the classification system to be valid, it should be meaningful and classify a real pattern of symptoms, which result from a real underlying cause.

Question 13

What is co-morbidity?

Answer 13

This refers to the extent that two or more conditions occur simultaneously in the same individual. For example a patient with schizophrenia may also be suffering from depression. This makes validity difficult because the symptoms of the two disorders may be the same for example depression and schizophrenia both involve low levels of motivation, so which causes issues in classifying the illness as schizophrenia. This also causes reliability issues as psychologists may diagnose one condition but not the other and there may be differences in diagnosis.

Question 14

Evaluation of co-morbidity?

Answer 14

1) The DSM ans ICD can be criticised because they lack validity. There is too much of an overlap between schizophrenia, mood disorders and OCD so it is very easy to misdiagnose patients. A second opinion from a clinician may be necessary to make a valid diagnosis.

2) research conducted by SIM found that the diagnosis of schizophrenia can be invalid and unreliable because of co-morbidity. He found that 32% of 142 hospitalised schizophrenic patients had additional mental disorders which is an issue when diagnosing the illness.

3) it has been found that schizophrenia patients have used alcohol, drugs and suffer from substance abuse before they were diagnosed with the illness making it difficult to give a reliable and valid diagnosis of schizophrenia, because some of the symptoms of the illness are the same as those who use drugs and alcohol.

Question 15

What is culture bias?

Answer 15

Culture has an influence on diagnosis and classification of schizophrenia. Luhrmann interviewed 60 adults with schizophrenia and found that though all reported hallucinations, patients from the USA reported the most significant negative symptoms compared to India and Ghana so culture has na affect on reliability of diagnosing schizophrenia.

Davidson and Neale explain that in Asian cultures, some people are praised if they do not show that they are suffering from a psychological problem so there is less data available from these regions so there is a cultural bias.

Question 16

Evaluation of culture bias?

Answer 16

1) research has found evidence for cultural relativism. Afro-Caribbean people have little immunity to the flu, and children born to mothers who has the flu during their second trimester has an 88% chance increase in developing schizophrenia. Therefore there may be cultural vulnerability which means Afro-Caribbean’s might be more at risk from developing schizophrenia than the white population.

2) Barnes found research evidence for cultural differences when diagnosing schizophrenia. The ethnic culture hypothesis predicts that ethnic minorities experience less distress if they suffer from schizophrenia because social structures exists in their culture. 184 individuals were studied from different backgrounds and found that Americans has more symptoms than other cultures because they have less supportive features in their cultures.

3) one weakness is cultural relativism. Psychologists might not be able understand a patinet’s symptoms correctly due to not fully understanding the patient’s cultural background and can lead to the misdiagnosis of schizophrenia.

Question 17

What is gender bias?

Answer 17

Male sufferers of schizophrenia tend to show more negative symptoms than women, and also seem to suffer from more substance abuse. Males have an earlier onset (18-25 years old) of schizophrenia than females (25-35 years old).

There seems to be disagreement amongst clinicians when diagnosing schizophrenia, especially when gender is taken into account. Critics argue that the DSM displays healthy behaviour for males rather than females. Therefore the DSM can be seen as gender biased, especially when classifying schizophrenia.

Question 18

Evaluation of gender bias?

Answer 18

1) research by Kulkarni has found supporting data to suggest that females might be less vunerable than males to schizophrenia. He found the female sex hormone estradiol can help treat schizophrenia in females, especially when paired with anti-psychotic drugs, so estradiol can be seen as a protective factor for females.

2) gender bias affects diagnosis of schizophrenia. In a study, Psychologists had to judge two patients using diagnostic criteria. When the patient was male, 56% of psychologists diagnosed schizophrenia however when the patient was female 20% of psychologists diagnosed schizophrenia, so there is a gender bias that males are more likely to be classified as schizophrenic.

3) the validity of the diagnosis of schizophrenia can be questioned, especially since females develop schizophrenia 4-10 years later than males, and there are also different types of schizophrenia that males and females are more vulnerable to, which must be taken into account when diagnosing schizophrenia.

Question 19

What is symptom overlap?

Answer 19

The positive and negative symptoms of schizophrenia are a valid diagnosis, however some of the symptoms of schizophrenia can also be found in other disorders such as depression and bipolar disorder and this is known as symptom overlap, so shared symptoms can lead to an invalid diagnosis.

Some illnesses that have symptom overlap with schizophrenic are bipolar depression, depression and schizotypical personality disorder. The person may exhibit a symptom typical of schizophrenia eg delusions but could have another condition with the same symptom eg bipolar disorder.

Question 20

Evaluation of symptom overlap?

Answer 20

1) to support correct diagnosis of schizophrenia in a valid way, clinicians should conduct a brain scan or EEG. This can examine the brain in detail, and especially check the grey matter in the brain, Since schizophrenic people suffer from the deterioration of grey matter. People with bipolar disorder do not have reduced grey matter so can help lead to more valid diagnosis.

2) Ketter found evidence of schizophrenia being misdiagnosed as another illness, because of symptom of overlap. This causes years of delays where schizophrenic patients do not get the correct treatment that they need and their illness gets worse. Therefore is it important that patients gets a valid diagnosis first time.

3) research evidence has also shows inter-rated reliability is actually quite low, especially when asking psychologists to agreement on diagnosing schizophrenia and not another condition. It was found that only 54% of psychologists agree on the same diagnosis, so shows how different psychologists give different diagnosis to the same patient who display the same symptoms of schizophrenia.

Question 21

What is the genetics explanation of schizophrenia?

Answer 21

Schizophrenia is inherited through generations and transmission of genes and DNA. Schizophrenia runs in families and involves a combination of genes (polygenic). The gene NRG1 contributes to the genetics of schizophrenia. NRG1 participates in glutamatergic signalling. NRG3 is another schizophrenia susceptibility gene so if these are inherited from the parent, the individual is more likely to develop schizophrenia.

Question 22

What is the dopamine hypothesis?

Answer 22

Schizophrenic patients tend to have excess levels of the neurotransmitter dopamine in subcortical areas of the brain which increases the firing of neurons. This is known as hyperdopaminergia. They also tend to have a greater number of D2 receptors that dopamine binds to. When drugs such as phenothiazine’s are given to patients’ that block dopamine at synapses in the brain, yhe positive symptoms of schizophrenia seem to reduce eg hallucinations but negative symptoms of schizophrenia tend to remain.

Question 23

Strengths of the dopamine hypothesis?

Answer 23

1) there is a lot of research to support the hypothesis that schizophrenic patients have high levels of dopamine in their brain. For example Davidson found that when schizophrenic patients were given the drug L-Dopa their schizophrenic symptoms got worse.

2) one strengths is that it uses a lot of scientific evidence and support for the dopamine hypothesis as a cause of schizophrenia. Most respect has used evidence that have come brain scans such as PET and fMRI which is highly valid and reliable.

Question 24

Weaknesses of the dopamine hypothesis?

Answer 24

1) a problem is that cause and effect is not clear. Could it be that an increase in dopamine causes schizophrenia to develop or could it be that schizophrenia develops first and this causes a rise in dopamine levels.

2) another issue is that the dopamine hypothesis can be seen as reductionist. It looks at the complicated phenomenon of the causes of schizophrenia and reduces it down to the component of dopamine alone. There may be other factors such as neuroanatomy that are ignored.

Question 25

What are the neural explanations of schizophrenia?

Answer 25

Schizophrenia may develop due to structural and functional brain abnormalities. we use fMRI to investigate brain abnormalities. Swayze conducted a Study where Patients with schizophrenia were given cognitive and memory tasks to do and this was compared to normal healthy patients whilst conducting MRIs. It found that schizophrenic patients had structural abnormalities like:
- a decrease in brain weight
-enlarged ventricles
- a smaller hypothalamus
-less grey matter and some structural differences in the prefrontal cortex.

Question 26

Strength of neural explanations?

Answer 26

1) there is a lot of research support to suggest that neural correlates seem to be an important factor when looking at the cause of schizophrenia eg the research by Swayze have pointed out problems in brain functioning that could have contributed to causing the illness.

Question 27

Weaknesses of neural explanations of schizophrenia?

Answer 27

1) a problem is that cause ans effects needs to be established. It is that brain abnormalities cause schizophrenia or does schizophrenia occur first and this leads to brain abnormalities later on.

2) Andreason has criticised the neural correlates explanation of schizophrenia. He found that the extent to which the ventricles in the brain are enlarged in schizophrenic patients is not significant and there is actually very little difference between neural correlates of schizophrenic patients’ and normal people.

Question 28

Rosenhan’s study on schizophrenia?

Answer 28

It was a field experiment in the USA where 8 sane people sought admission to 12 different mental hospitals.
Patients claimed they had hallucinates and heard words like “thud” “hollow” and “empty”
When admitted in hospital they stopped showing symptoms of schizophrenia and behaved normally.
All pseudo patients except one were given the diagnosis of schizophrenia.
35/118 of the genuine patients could tell that the pseudo patients did not have schizophrenia whereas psychiatrists couldn’t.

Question 29

Evaluation of Rosenhan’s study?

Answer 29

1) a problem is that this study was conducted a long time ago. The DSM and ICD have improved since then and are better at diagnosing and classifying schizophrenia. Also nowadays, you need at least two psychiatrists to agree that the patient has schizophrenia to be diagnosed so Rosenhan’s study does not apply to today’s world.

2) This Study raises many issues. For example, if we accept Rosenhan’s statement that psychiatrists cannot detect the sane from the insane, then this means psychiatrists cannot be trusted to accurately make a diagnosis of schizophrenia. This means they should use multiple opinions before deciding on a diagnosis.

3) you have to be cautious when saying that the psychiatrists were misdiagnosing. If a patient shows up to a hospital with schizophrenic symptoms, most psychiatrists would measure the symptoms and diagnose them with schizophrenia and it would be negligent to turn the patient away. We could argue that the psychiatrists made the valid decision to admit the patients into the hospital thinking they needed help.

Question 30

What are the two reasons why family dysfunction cause schizophrenia?

Answer 30

1) the double bind theory of communication by Bateson

2) expressed emotion by Kavanagh

Question 31

What is the double bind theory of communication?

Answer 31

1) Bateson suggested that disturbed patterns of communication might be a risk factor for schizophrenia.

2) children are given conflicting and mixed messages from parents and feel they cannot do the right thing.

3) this creates confusion, withdrawal and self doubt in children where they cannot create an internally coherent sense of reality.

4) if children do something wrong, the parents may punish them by withdrawing their love. They might develop schizophrenic symptoms like disorganised thinking, paranoia and delusions.

Question 32

What is a marital schism?

Answer 32

A marital schism is when parents may argue in front of their children and they might involve their children into the argument. This can cause distress and confusion for the children and they may develop schizophrenic symptoms.

Question 33

Strengths of the double bind theory?

Answer 33

1) Research conducted by Berger would support the double bind theory of schizophrenia. Berger found that schizophrenic patients reported a higher recall of double bind statements by their mothers, than did non schizophrenic patients.

2) Support for family dysfunction comes from psychodynamic theorists who recognised a schizophrenogenic mother who is typically cold, controlling and rejecting to her children which leads to excessive stress. This can be a main factor that helps develop schizophrenia.

Question 34

Weaknesses of the double bind theory ?

Answer 34

1) the double bind theory has been criticised because Bateson investigated his theory studying families retrospectively. This meant that families had to think back over a long period of time and identify traits of the double bind theory. Participants had to rely on their memories which could be faulty and inaccurate.

2) Bateson’s ideas can be criticised because he needs to investigate the element of cause and effect. Does family dysfunction cause schizophrenia to occur, or could it be that schizophrenia is caused by other factors which the development of the double bind theory.

Question 35

What is expressed emotion?

Answer 35

Negative emotional experiences in families may play a key role in helping cause and maintain the symptoms of schizophrenia. Expressed emotion is regarded as a set of traits whereby family members talk to the schizophrenic patient in a critical/hostile manner. Such traits include criticism,hostility, and emotional over involvement. This might aid relapse of a person recovering from schizophrenia.

Families with high EE talk more than they Listen and this causes schizophrenic patients to have a low tolerance of emotional stimuli. EE is more typical in developed countries.

Question 36

Strengths of expressed emotion?

Answer 36

1) Brown conducted research into expressed emotion and found results that agree and support that of kavanagh, in terms of high EE causing schizophrenia and found that schizophrenics living in families with high EE are 4x more likely to relapse.

2) expressed emotion is a well established maintenance model of schizophrenia. There is a lot of evidence to suggest that EE can cause relapse in schizophrenia and applies to a range of different cultures. This idea is so strong that families with high EE are encouraged to undergo training to reduce EE.

Question 37

Weaknesses of expressed emotion?

Answer 37

1) cause and effect needs to be established and is a major criticism of the EE model. Could it be that high EE can cause schizophrenia or that schizophrenia itself can cause family members to have high EE.

2) EE can be criticised because it ignores biological factors that might cause schizophrenia. When examining schizophrenia, the main causes of the illness tend to be biological eg genetics and dopamine. There is a lot of research to support biological causes of schizophrenia that can’t be ignored.

Question 38

What is the cognitive view of schizophrenia by Frith?

Answer 38

1) symptoms such as delusions of control and auditory hallucinations might occur because individuals have issues with self monitoring ans inadequate information processing. They cannot track thoughts properly.

2) schizophrenic patients claim their thoughts are “not their own” and they often have dysfunctional thought processes and are unable to recognise these cognitive distortions.

3) schizophrenic patients are poor at recognising their own out eg their own drawings. Schizophrenic patinet’s are poor at understanding their own thinking as distinct from environmental stimuli.

Question 39

What is metarepresentation?

Answer 39

The ability for a person to reflect on thoughts and experiences

Question 40

What 3 factors that schizophrenics tend to suffer from?

Answer 40

1) inability to generate voluntary action
2) inability to monitor voluntary action
3) inability to monitor the beliefs and intentions of others

Question 41

What was the research by Frith?

Answer 41

He gave schizophrenic and healthy participants a two choice task.
Participants had to guess whether the next card is a pack was red or black.
Schizophrenia patients tended to produce stereotypical choices like RRRRRRR or RBRBRBR
Healthy participants tended to produce more random choices like RRBRRRBB.
The research suggests that schizophrenic patients have problems generating immediate actions, and this supports the idea they have a lack of self-control, caused by cognitive impairments.

Question 42

Strengths of Frith’s work

Answer 42

1) the cognitive approach has the strength of providing a reasonable account of how the positive symptoms of schizophrenia develop. The cognitive approach highlights why schizophrenic patients develop symptoms of hallucinations and delusions; this is because they experience meta representation.

2) the psychological research is usually conducted as a labratory experiment, which means that it is highly controlled, scientific and objective. This allows psychologists to accurately manipulate the independent variable and see the affect on the dependent variable eg schizophrenia

Question 43

Weaknesses of Frith

Answer 43

1) Frith’s ideas about meta representation have been criticised for being reductionist. Frith is taking the complicated illness of schizophrenia and he is reducing it down to being caused be three basic ideas of meta representation which are at the level of individual cognitive symptoms.

2) the cognitive model can be criticised because it does not explain the underlying cause of schizophrenia which is mainly biological (genes and neural correlates). The cognitive model only explains some aspects of how people with schizophrenia think and ignored other approaches to the illness.

Question 44

What was Hemsley’s cognitive causes of schizophrenia?

Answer 44

1) Healthy people have a good combination of perception and memory, but schizophrenic patients have a poor combination of these.

2)Schizophrenic patients have a breakdown between stored information in their long term (schemas) and new incoming information.

3) They cannot access their schemas of aspects of the long term memory. They might experience sensory overload, and cannot decide what aspects to concentrate on and what to ignore. This may result in disorganised and delusional thinking and behaviour.

4) schizophrenic patients tend to have impaired executive functioning and central control, leading to problems in meta cognition. This explains disordered thinking and language deficits eg lack of fluency.

Question 45

Strengths of Hemsley’s theory

Answer 45

1) research by Stirling found evidence to support the idea that schizophrenic patients process information differently to healthy people. 30 schizophrenic patients were comapred to 18 controls and given cognitive tasks (stroop test). It was found that schizophrenic patients had a central control dysfunction and took twice as long to name colours in the test than the control group.

Question 46

Weaknesses of Hemsley’s theory?

Answer 46

1) one criticism of the research by Hemsley is that ethical issues need to be considered when using schizophrenia patients’ research. They may be unable to give their fully informed consent to take part in research. There is also the risk of psychological harm and patients might feel uncomfortable being observed and tested for their cognitive functioning.

2) the cognitive approach gives a good explanation of how dysfunctional thoughts can lead to schizophrenic symptoms developing. However, not all schizophrenics actually suffer from dysfunctional thoughts so therefore the cognitive approach is limited in explaining the causes of schizophrenia.

3) a disadvantage of the research is that beck and rector focused on a complex intercation of neurobiological, environmental and cognitive causes of schizophrenia. An abnormality in brain functioning (biological) could cause schizophrenia, which in turn can increase a person’s vulnerability to stressful experiences which leads to dysfunctional thought processes (cognitive causes). Cognitive causes alone, do not cause schizophrenia.

Question 47

What are typical anti-psychotic drugs?

Answer 47

1) common examples are Thorazine and chloropromazine. These drugs can be in tablet, syrup or injection form.
2) chlorpromazine acts as a sedative.
3) Typical drugs reduce positive symptoms of schizophrenia like delusions which are caused by high dopamine levels.
4) these drugs reduce dopamine levels in the brain by blocking dopamine receptors at the synapse.
5) the drugs must bind to 60-75% of the D2 receptors and block their activity in order to be effective.

Question 48

Strengths of typical drugs?

Answer 48

1) There is supporting evidence from Thornley that typical anti-psychotic drugs are effective in reducing symptoms of schizophrenia. Chloropromazine was compared to a placebo and found that schizophrenic patients had better functioning and reduced severity of symptoms when taking chloropromazine compared to a placebo, and the relapse rate was lower.

2) a strength of typical anti-psychotic drugs is that they are effective in minimising symptoms of schizophrenia, they are cheap to produce and administer, and helps patients lead a relatively normal life outside of an institution. Around 97% of schizophrenic patients live at home and this is because of the use of drug therapy.

Question 49

Weaknesses of typical anti-psychotic drugs?

Answer 49

1) one negative point about typical drugs is that they have terrible side effects which includes dizziness, agaitation, and in the long term patients may develop “tardive dyskinesia” whereby mouth muscles and their chin makes involuntary strange movement, which can lead to the patients stop taking the drug.

2) Research by Marder has found that typical anti-psychotics are good at reducing positive symptoms of schizophrenia such as delusions and hallucinations. However, they do not have any effect on negative symptoms of schizophrenia like apathy and speech poverty.

Question 50

What are atypical antipsychotic drugs?

Answer 50

1) some examples are clozapine and risperidone.
2) these drugs block the activity of dopamine receptors within the brain by acting on the D2 receptors to reduce dopamine levels.
3) Atypical drugs also increase serotonin activity in the brain and bind to dopamine receptors in order to improve mood.
4) atypical drugs tend to have less side effects and reduce both positive and negative symptoms of schizophrenia.

Question 51

What is Clozapine?

Answer 51

Clozapine is an atypical drug which bonds to dopamine receptors but a,so acts on serotonin and glutamate receptors too. This increases mood, reduces anxiety and depression and can improve cognitive functioning.

Question 52

Strengths of atypical drugs?

Answer 52

1) typical and atypical drugs have been proven to be the most effective treatment when compared to any form of therapy available for treating schizophrenia (biological and psychological).

2) Meltzer conducted research to support the idea that clozapine a more effective drug for treating schizophrenia than typical anti-psychotic drugs and alternative drugs. Clozapine was found to be 30-50% more effective in minimising schizophrenia symptoms compared to typical drugs.

Question 53

Weaknesses of atypical drugs?

Answer 53

1) drug therapy has the disadvantage that it treats the schizophrenia, but not the cause of it. Symptoms may return if the patient stops taking the drugs and this leads to the “revolving door phenomenon” whereby patients leave hospital and then return beacsye the drugs failed to work.

2) a problem with atypical drugs is that some schizophrenia patients are resistant to Clozapine as results from trials can sometimes be inconclusive about how effective they are. Some drugs will not be effective on some schizophrenic sufferers due to individual differences.

Question 54

Overview of cognitive behavioural therapy as treatment of schizophrenia?

Answer 54

1) can help schizophrenic patients identify irrational thoughts and change them.
2) the patient discusses with the therapist how likely that the beliefs are true, and evaluate the content of their delusions and make sense of them.
3) CBT dies not get rid of schizophrenia but allows the patient to cope more effectively.
4) CBT involves the patient being set homework assignments to improve functioning, such as strategies to counter irrational thoughts .
5) positive self talk is encouraged “I can cope with this, the voices are not real”.

Question 55

What are the stages of CBTp?

Answer 55

1) assessment- the schizophrenic patient expresses their thoughts and experienced to therapists and realistic goals are discussed.

2) engagement - the therapist empathises with the patient and their distress and explanations for distress can be developed.

3) ABC model- the therapist may dispute negative beliefs and rationalise them. The patient is set homework tasks and may need to engage in positive self talk and role plays.

4) normalisation - the therapist tells the schizophrenic patient that some “normal people” have unusual experiences when they’re stressed to make the patient less anxious.

5) critical collaboration analysis- therapist uses gentle questioning to help the patient understand illogical conclusions. “If the voices are real, why can’t other people hear them?”

6) develop alternative explanations- the schizophrenic patient develops alternative explanations for their unhealthy assumptions.

Question 56

Strengths of CBTp?

Answer 56

1) CBT has the advantage that it has less ethical issues compare to drug treatment. For CBT the patient is more in control if the treatment via the self help element. With drugs, the patient might feel that they are not in control of the treatment and it feels more like a “chemical straight jacket”. CBT also does not have any side effects like drug therapy and the patient has more free will.

2) Rathod found research evidence that CBT clinicians tend to be highly trained and effective. The most experienced, able and trained psychologists deliver CBT because they need to show empathy and positive regard to schizophrenic patients, so it is more likely to be helpful for schizophrenic patients.

Question 57

Weaknesses of CBTp?

Answer 57

1) a problem with CBT is that it is more expensive as a treatment for schizophrenia than drugs. Therefore, the NHS might be more willing ti issue medication to schizophrenic patients rather than CBT, because drugs are cheaper. Research by Haddock also found that CBTp is not usually offered in the UK and that many schizophrenic patients do not attend therapy sessions.

2) CBTp has the disadvantage of not being suitable for all schizophrenic patients, especially those that are too agitated, paranoid and are not able to communicate effectively. CBT works bebest for patients who refuse drug therapy however those who do not take drug treatment, tend to be more disturbed and find they cannot engage in drug treatment.