Schizophrenia - Psychological explanations & treatment (Cognitive)

Question 1

Dysfunctional thinking

Answer 1

Disruption to normal thought processing & the inability to filter preconscious thoughts

Question 2

Meta representation dysfunction

Answer 2

Inability to reflect on thoughts as their own & recognise own actions (thought insertion -> put there by someone else -> delusions)

Question 3

Central control dysfunction

Answer 3

Issues with ability to suppress automatic responses during deliberate actions (disorganised speech)

Question 4

Attention deficit/selective attention dysfunction

Answer 4

Inability to deny preconscious thoughts and provide too much attention to them (more if threatening)

Question 5

Supporting study of cognitive explanation: Beech

Answer 5

Examined attention deficit through negative priming -> impaired ability to inhibit distracting information with Schz

Question 6

Supporting study of cognitive explanation: Bentall

Answer 6

1991 - Identify words given to them that were previously provided, had suggested themselves and new ones -> meta representation meant they could not

1994 - Abnormal attention given to persecutory delusions & have a bias towards threatening stimuli

Question 7

Supporting study of cognitive explanation: Hemsley

Answer 7

Trouble with activating schemas leads to lack of understanding the world

Question 8

Contradictory study of cognitive explanation: Firth

Answer 8

Used PET scans on Schz patients -> reduced blood flow and increased activity in temporal lobe -> backs up partial or full biological explanation

Question 9

Strengths of cognitive explanation

Answer 9

+ Practical application (CBT & AI - production of virtual hallucinations help to show that theirs are not real)

Question 10

Limitations of cognitive explanations

Answer 10

• Reductionism (common symptoms & is overly simplistic reducing them to meta representation)
• Not underlying cause (correlation with biology)
• Social sensitivity (blaming individual’s cognition for their disorder)
• Cause & effect (unable to determine if cognitions cause symptoms or if symptoms cause faulty cognition)

Question 11

Treatment: CBT

Answer 11

• Identify & change faulty cognitions using logic to dispute delusion & challenge cognitions
• 1st stage: engaging client & forming a therapeutic alliance that enables collaborative approach
• ABC(DE) strategy: understand source & provide process to restructure delusions

Question 12

Strengths of CBT (Schz)

Answer 12

+ Affects both + & - symptoms (Jauhar et al - small but significant [p<0.001] results)
+ Reduces auditory hallucinations (Pontillo et al)
+ Reduces relapse rates (NICE - improved social functioning, lowers severity of symptoms)

Question 13

Limitations of CBT (Schz)

Answer 13

• Issues with availability (NICE - 1/10, only 7% offered)
• Requires interactionist approach (NICE may onlu work in combination with other treatments)
• Unreliable (Thomas - different techniques and sampling means its harder to gauge how symptoms are impacted)