Schizophrenia AO3s Flashcards
Psychological explanations of schizophrenia
Support for family dysfunction as a risk factor
Read et al
Evidence suggests family dysfunction in childhood is associated with increased risk of schizophrenia in adulthood.
Read et al reviewed 46 studies of child abuse and schizophrenia and concluded 69% adult women in-patients with diagnosis has history of physical abuse, sexual abuse or both. For men figure was 59%.
Adults with insecure attachments to primary career more likely to have schizophrenia. Most evidence shares weakness. Info about childhood experiences was gathered after development of symptoms, and schizophrenia may have distorted patients recall. =Validity problems.
Psychological explanations of schizophrenia
Strong evidence for dysfunctional information processing
Stirling et al
Support for idea that info is processed differently in mind of schizophrenia sufferer
Stirling et al compared 30 patients with diagnosis with 18 non patient controls on range of cognitive tasks including Stroop Test, in which ppts name ink colours of colour words, suppressing impulse to read words in the task.
In line with Frith’s theory of central control dysfunction, patients took over twice as long to name ink colour than control group.
Although the links between symptoms and faulty cognition is clear this doesn’t tell us about origins of cognitions or of schizophrenia. Cognitive theories can’t explain the distal causes e.g. origins of condition
Psychological explanations of schizophrenia
Evidence for biological factors is not adequately considered
ü Psychological explanations for schizophrenia can be hard to reconcile with biological explanations. Could be that both biological and psychological factors can separately produce the same symptoms, which questions whether both outcomes are schizophrenia
- Alternatively, we can view this in terms of diathesis-stress model where diathesis may be biological or psychological
Biological therapies for schizophrenia – drug therapy
Evidence for effectiveness
Ben Thornley et al
Ben Thornley et al reviewed studies comparing effects of Chlorpromazine to control conditions (patients received placebo)
Data from 1121 ppts showed Chlorpromazine was associated with better functioning and reduced symptoms severity. Data from 512 ppts showed relapse rate was also lower when Chlorpromazine was taken. In addition, there is support for benefits of atypical antipsychotics
Herbert Meltzer concluded Clozapine is more effective than typical antipsychotics and other atypical antipsychotics., it’s effective in 30-50% of treatment-resistant cases where typical antipsychotics have failed.
Biological therapies for schizophrenia – drug therapy
Serious side effects
Typical antipsychotics associated with range of side effects including dizziness, sleepiness, weight gain
Most serious side effect of typical antipsychotics is neuroleptic malignant syndrome (NMS). Believed to be caused because drug blocks dopamine action in hypothalamus. NMS results in high temps, delirium and coma
Atypical antipsychotics were developed to reduce frequency of side effects. Successful, but side effects exist which is -ve of antipsychotic drugs.
Biological therapies for schizophrenia – drug therapy
Human rights abuse
Widely believed that antipsychotic have been used to calm patients in hospital situations, rather than for benefits to patients themselves
Although short-term use of antipsychotics to calm agitated patients is recommended, this is seen as some as human rights abuse.
Psychological therapies for schizophrenia
Evidence of effectiveness
Jauhar et al
Pharoah et al
Jauhar et al reviewed results of 34 studies of CBT for schizophrenia
Concluded CBT has significant but small effect on both +ve and -ve symptoms. Pharoah et al reviewed evidence for effectiveness of family therapy for families of sufferers. Concluded there moderate evidence to show family therapy reduces hospital readmission over course of year and improves quality of life for patients and families
However the evidence overall is not enough to make conclusions.
Psychological therapies for schizophrenia
Treatment improves quality of life not cure
All psychological treatment for schizophrenia discussed aim to make it more manageable and improve the quality of a patient
CBT helps by allowing patients make sense of and challenge their symptoms. Family therapy helps by reducing stress of living with sufferers. Token economies help by making patients more socially acceptable so they can better reintegrate into society
However, these treatments don’t cure schizophrenia
Psychological therapies for schizophrenia
Ethical issues
Token economy systems have proved controversial.
Major issue is that privileges and services become more available to patients with mild symptoms and less to those with severe ones that prevent them complying with desirable behaviours
This means that most severely ill patients suffer discrimination alongside symptoms, and some families have challenged the legality of this. This has reduced use of token economies in psychiatric systems
The interactionist approach to schizophrenia
Evidence for the role of vulnerability and triggers
Tienari et al
There is evidence for vulnerability and triggers.
Tienari et al investigated genetic vulnerability and parenting style (trigger) Children adopted from 19,000 Finnish mothers with schizophrenia were followed up
Rates of schizophrenia were compared to control group of adoptees without genetic risk
Child-rearing style of high-level criticism and conflict and low levels empathy implicated in the development of schizophrenia but only for children with high genetic risk not control group.
Suggests both genetic vulnerability and family-related stress are vital in development of schizophrenia
The interactionist approach to schizophrenia
Support evidence for effectiveness of combination treatments
Turkington et al
Tarrier et al
Turkington et al point out it’s not really possible to use combination treatments without adopting an interactionist approach
Studies show an advantage to using combinations of treatments for schizophrenia. E g. in study by Tarrier et al 315 patients were randomly allocated to medication + CBT group, medication+ supportive counselling or control group
Patients in two combinations showed lower symptom levels than those in control. Shows there is clear practical advantage to adopting interactionist approach in form of superior treatment outcomes
The interactionist approach to schizophrenia
Treatment causation fallacy
Turkington et al
Turkington et al argue that there is a good logical fit between interactionist approach and using combination treatments
However, fact that combined biological and psychological treatments are more effective than either on their own does, doesn’t mean interactionist approach to schizophrenia is correct
Similarly, fact that drugs helps does not mean schizophrenia is biological in origin. This error of logic = treatment-causation fallacy
