Schizophrenia

Question 1

Who does schizophrenia affect in the population?

Answer 1

It affects about 1% of the population and is equally common in men and women.

Question 2

At what age does schizophrenia occur in men and women?

Answer 2

In men it begins in the mid-20s and in women it occurs in early 30s.

Question 3

What are the different types of schizophrenia?

Answer 3

Paranoid
Disorganised
Catatonic 
Residual 
Undifferentiated

Question 4

What are positive symptoms?

Answer 4

Refer to excesses of normal behaviour that are present.

E.g. Hallucinations

Question 5

What are negative symptoms?

Answer 5

Refer to normal behaviour this is missing.

E.g. Social withdrawal

Question 6

How is schizophrenia diagnosed?

Answer 6

Diagnosis by the DSM requires 1 month of 2 or more positive symptoms.

Question 7

Describe the dopamine hypothesis

Answer 7

Schizophrenia may be caused by an imbalance of these chemicals with regards to the receptors on the neurones.
An increase in dopamine in one site of the brain (mesolimbic pathway) contributes to positive symptoms.
A decrease in dopamine in another site (mesocortical pathway) contributes to negative symptoms.
Excess dopamine receptors may arise from genetic inheritance or brain lesioning.

Question 8

State 3 examples of positive symptoms

Answer 8

Hallucinations: Seeing or hearing things that do not exist, e.g. Voices that are often harsh and critical.
Delusions: False beliefs that remain even when shown not to be true or beliefs that are not logical.
Disordered thinking: a failure to be able to think straight and thoughts may come and go rapidly. The patient may not be able to concentrate on one thought for very long and may be easily distracted, unable to focus attention.

Question 9

State 3 negative symptoms

Answer 9

Social withdrawal: no longer interacts with family and friends.
Lack of energy and apathy: no motivation to do daily chores.
Flatness of emotions: face is emotionless and voice is dull with no rise and fall.

Question 10

State a strength and weakness of positive symptoms

Answer 10

👍🏼Positive symptoms tend to have greater weight when diagnosing schizophrenia, however they can be affected by cultural differences.
👎🏼Positive symptoms are more subjective and difficult to measure empirically e.g. It would be difficult if not impossible to measure objectively the voice a patient hears in their head.

Question 11

State two strengths of negative symptoms

Answer 11

👍🏼Negative symptoms are less affected by cultural differences and it has been suggested that they can be measured more objectively.
👍🏼Lack of energy, flatness of emotions or social withdrawal are more easily monitored than positive symptoms.

Question 12

State two strengths of the dopamine hypothesis

Answer 12

👍🏼Supporting evidence comes from drug studies. A group of drugs called phenothiazines block dopamine receptors and alleviate the symptoms of schizophrenia. If the receptors are blocked then less dopamine will be taken up so the effects of excess dopamine are avoided. This suggests the hypothesis is valid.
👍🏼Further supporting evidence comes from drug studies. Drugs such as L-dopa, which increases dopamine production in sufferers from Parkinson’s disease (caused by too little dopamine) can cause symptoms similar to schizophrenia as a side effect. Suggests it is valid.

Question 13

State two weaknesses of the dopamine hypothesis

Answer 13

👎🏼The explanation is reductionist as it ignores social and environmental factors. The social approach would argue that there is a link between social class and schizophrenia. Perhaps stressful life events can trigger the production of excess dopamine rather than the excess being purely biological. This suggests it is not a full explanation of the illness.
👎🏼Opposing evidence comes from drug studies. Anti schizophrenia drugs block the dopamine receptors almost immediately but any calming effect is not noticed for several days. This suggests that something other than excess dopamine is causing psychotic symptoms.

Question 14

Describe genetic factors as an explanation for schizophrenia

Answer 14

There is evidence from twin and family studies for a genetic factor in schizophrenia.
The closer a person is genetically to someone with schizophrenia.
For example the concordance rate for MZ twins is 48%, DZ twins is 17% and siblings is 9%.
The common view is schizophrenia is caused by a number of genes rather than one specific gene.

Question 15

State two strengths of genetic factors as an explanation for schizophrenia

Answer 15

👍🏼Supporting evidence for a genetic link in schizophrenia comes from Gottesman (1991) who pooled data from 41 different European studies. He found 1% of the general population had schizophrenia, but percentage of having it increased closer you were genetically to someone who had it, increasing to 45% for identical twins.
👍🏼Great deal of objective data to support biological explanations of schizophrenia. Evidence from brain scans, blood tests and genetic testing are conducted using reliable equipment meaning the data gather is credible.

Question 16

State a weakness of genetic factors as an explanation for schizophrenia

Answer 16

👎🏼Family studies upon which genetic explanations have been based upon can be criticised for failing to acknowledge the role of environmental influences and are therefore reductionist. For example research into dysfunctional family communication patterns and schizophrenia relapse rates indicate schizophrenia may be a result of stress caused by negative emotions within families.

Question 17

Describe social causation as an explanation of schizophrenia

Answer 17

Social causation theory suggests that people who live with high levels of stress are more vulnerable to schizophrenia.
The source of stressors is often found in migrant populations trying to adapt to new ways of living. Particularly if they were in a minority in their new community or if they are in a vulnerable financial state.
Those in lower social classes suffer from a lot of stress due to their poor environment such as having no job and little money.

Question 18

State two strengths of social causation as an explanation of schizophrenia

Answer 18

👍🏼Supporting evidence for a social link comes from Faris et al. They studied the rates of schizophrenia in various areas of Chicago. They found a higher rate in working class areas with poor housing, overcrowding and high crime rates than in more middle class areas. This suggests that social class may be a crucial factor in determining who suffers from schizophrenia.
👍🏼Supporting evidence for a social link to ethnicity comes from Veling et al (2008) who found that in The Hague, there were more schizophrenic people living in a place where their ethnic group was not predominant compared with places where their ethnic group did predominate.

Question 19

State two weaknesses of social causation as an explanation of schizophrenia

Answer 19

👎🏼A weakness of this explanation is that it ignores elements of bias in the diagnosis process. Psychiatrists are more likely to diagnose those in working class and black people with schizophrenia. This is because of the social distance between psychiatrists and the patient in terms of education and background. This suggests it is a diagnosis problem.
👎🏼It is very hard to establish cause and effect. This is because it is difficult to separate environmental factors to see if they cause schizophrenia, as they could be the result of schizophrenia. Schizophrenia may result in social drift, which suggests that schizophrenics become lower class because of the difficulties that arise from having the disorder e.g. Problems in adolescence and difficulties keeping a job.

Question 20

Describe the dopamine hypothesis as an explanation for schizophrenia

Answer 20

Schizophrenia can be cause by an imbalance of chemical neurotransmitters in regards to the receptors on the neurones.
The presence of an excess number of dopamine receptors in the brain contributed to schizophrenia.
Increase of dopamine in one site of the brain (mesolimbic pathway) contributes to positive symptoms and in another site (mesocortical pathway) contributes to negative symptoms when dopamine is decreased.

Question 21

Describe drug therapy as a treatment of schizophrenia

Answer 21

Antipsychotic drugs aim to affect the faulty neurotransmitter functioning (dopamine) that causes the symptoms.
They fit into the dopamine receptors in the brain blocking the dopamine and stopping it being picked up.
Most antipsychotic drugs work to suppress hallucinations and delusions.
Each patient is only put on one antipsychotic drug at a time but antidepressants and anticonvulsants might also be prescribed.
Drugs are taken on a regular basis and it takes about 10 days before the drug starts to show an effect and symptoms reduce.

Question 22

State two strengths of drug therapy as a treatment of schizophrenia

Answer 22

👍🏼Drugs allow the patient to live and function in society as they control the symptoms of schizophrenia. This means the patient avoids being institutionalised by a long term stay in a hospital.
👍🏼It is more ethical, effective and quicker to take effect than pre 1950s treatment for schizophrenia such as insulin shock therapy (where patients were repeatedly injected with large doses of insulin in order to produce daily comas over several weeks)

Question 23

State two weaknesses of drug therapy as a treatment of schizophrenia

Answer 23

👎🏼Antipsychotic drugshave sode effects. Including shaking and muscle spasms, dry mouth and tar dive dyskinesia. Theses side effects may be enough to put people off taking the drug or result in compliance problems (degree to which the he patient follows medical advice)
👎🏼It is estimated that 50% of schizophrenic patients do not continue to take the drugs that are prescribed for them. This can lead to rotating door syndrome (continual relapsed and readmissions to hospital). It might be that problems with functioning mean someone with schizophrenia is not competent enough to take their medication regularly without close monitoring.

Question 24

Describe cognitive behaviour therapy as a treatment of schizophrenia

Answer 24

The therapist builds up a strong trusting relationship with the patient so that the patient will feel confident and comfortable in therapy.
The therapist engaged with the patient in identifying the sources of distress for the individual such as hearing voices.
The therapist will challenge the patients beliefs while being supportive.
The patient is encouraged to develop new, rational and alternative explanations for their experiences.

Question 25

State 2 aims of Carlsson et al’s (2000) contemporary study

Answer 25

To investigate further chemical explanations for schizophrenia beyond the dopamine hypothesis.
To review studies into the relationship between levels of neurotransmitters in particular dopamine and glutamine.

Question 26

State 3 method points of Carlsson et al’s (2000) contemporary study

Answer 26

Completed a literature review using research investigating neurochemical levels in patients diagnosed with schizophrenia, as well as studies into drugs known to induce symptoms of psychosis using animals. Extensively used research using PET scans which support the dopamine hypothesis.
The many drug studies used recreational drugs known to induce psychosis such as amphetamines and phencyclidine both have been linked to symptoms of psychosis.
Researchers drew on evidence from studies into the effectiveness of drugs used to treat schizophrenia.

Question 27

State the result of Carlsson et al’s (2000) contemporary study

Answer 27

The evidence suggests there are two main neurotransmitters explanations of schizophrenia:

1) hyperdopaminergia - ‘hyper’ means active and refers to the excess of dopamine hypothesis.
2) hypoglutamatergia - ‘hypo’ means under active and refers to the inhibited glutamine explanation.

Question 28

State two strengths of Carlsson et al’s (2000) contemporary study

Answer 28

👍🏼Good credibility as they used a wide variety of studies using rodents, people with Parkinson’s and people with schizophrenia both acute and in remission. This means that the findings gathered about the role of low levels of glutamine plays in the development of the disorder can be trusted.
👍🏼Practical advantages as they used a large amount of secondary data, gathering many studies into schizophrenia quickly and providing a core overview of findings in this area. As a result the mass of information gathered increases the validity of the conclusions.

Question 29

State two weaknesses of Carlsson et al’s (2000) contemporary study

Answer 29

👎🏼We can question the validity and reliability of Carlsson’s review as they used a great deal of secondary data from a variety of different studies, there is no way of knowing how valid or reliable the original studies were. Therefore basing further therapeutic options for schizophrenia on the conclusions of this review will be problematic.
👎🏼Low credibility due to the animal studies included as there are many differences between animals and humans in terms of genes, CNS and brain structure. They researchers themselves suggested that animal studies show ambiguous results when making claims about excess dopamine activity. This means the conclusions about schizophrenia are undermined when discussing in relation to human development.

Question 30

State state a conclusion about Carlsson et al’s (2000) contemporary study

Answer 30

The review has benefits for society because through the review process it is clear that psychology has relied upon the dopamine hypothesis for far too long as an explanation of schizophrenia meaning some patients have had to cope with ineffective treatment.
However it is clear that more research needs to be completed in this area to ensure more credible primary data is gathered, specifically related to the development of schizophrenia in people to allow results to be formed about future treatments.