Psychological explanations for sz.

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  • Psychological explanations for sz.
    • Cognitive Models
      • Frith explained sz symptoms came from: Poor self monitoring, failure to keep track of own intentions, preconcious/concious filtering breaks down, and lack of theory of mind.
        • Metarepresenation: the ability to reflect on our own thoughts, behaviour and experiences. Allows self awareness of our own intentions and goals. Also allows us to interpret the intentions of others.
          • + symptoms such as thought incersion occurs as sz patients are unable to distinguish whether what they have heard is their own internal thoughts of if it an external voice.
          • Benthall et al: found sz patients struggled to distinguish between words they had read, new words and words they had come up with compared to a control group. Concluded they have an inability to recognise own actions.
        • Central Control: the ability to supress our automatic response to stimuli while we perform actions that reflect our wishes or intentions.
          • - symptoms such as the speech defecit clanging occur due to a failure to supress stimuli-driven behaviour.
          • Baker et al: found sz patients found it difficult to take medication at the right time and of the right dose, concluded they have a cognitive difficulty in willed behaviour.
        • Hemsley contrasts Friths model and explained misinterpretation is due to a breakdown of the relationship between perception and memory.
    • Social-Cultural Models.
      • Patients more likely to experience life events just prior to onset of illness due to stress.
        • Life events effect emotional response to daily hassles leavings patients vulnerable to relapse/
        • However life events could be a result of the onset of illness.
      • Lower social classes are more likely to be diagnosed with sz.
        • Could be due to issues with diagnosis.
        • Social Causation Hypothesis: lower classes experience more poverty, poor physical health, stress and discrimination.
        • Social Drift Hypothesis: individuals who develop sz more likely to loose job and therefore social status reduces.
      • Institutionalisation can cause apathy, social withdrawal and other negative symptoms.
        • Wing & Brown: found negative symptoms scale significantly correlated with understimulating social environments of hospitals. Conluded poor environments are generally detrimental to sz patients.
    • Psychodynamic Approach & Family Models.
      • Psy.dyn. Approach believes sz is due to a harsh childhood & sz patients regress to early stages of emotional development.
        • Little evidence for this approach however Family Models developed from this idea.
      • Family Models believe early experiences drastically affect the way a child percieves and interacts with the world.
        • Fromm-Rechmann: proposed idea of Schizophrenogenic Mother. A cold, controlling mother who creates a family climate of tension & secrecy.
          • Does not explain why siblings do not always share sz if this was sole explanation.
        • Bateson proposed Double-Bind hypothesis. Contradicting messages from a parent increase risk of developing sz.
          • Berger: found sz patients reported higher recall of double-bind messages from mothers.
            • Data is retrospective so unreliable.
            • Recall may be affected by sz so unreliable.
          • Liem: found no difference of double-bind messages between families with sz and normal families.
          • Hypothesis not stood up to experimental scrutiny.
        • EE linked with the maintenance of sz.EE is a family communication style that involves criticism, hostility and emotional over-envolvment, Negative emotional climate aroses patient & leads to stress triggering sz episode.
          • Theory has led to an effective therapy where EE families are shown how to reduce EE.
            • Hegarty et al: found therapy reduces relapse rates but not clear if this is down to reduction of EE or family intervention.
            • Linszen et al: found patient returning to high EE family is 4x more likely to relapse than patient returnng to low EE family.
          • Explains cultural differences in relapse rates.
            • Kalafi & Torabit: found higher prevelance of EE in Indian culture was one of the main causes of sz relapse.
    • Diathesis-Stress Model.
      • Factors such as genetic vulnerability and stress should be drawn together.
      • The interaction between biological and environmental factors need to take place together.
      • Theory less reductionist as it takes into account bioliical and psychological factors. Nature and nurture working together.


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