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What is schizophrenia (sz)?
· Psychosis is the general term for disorders that involve a
loss of contact with reality. It covers many disorders, which
may involve delusions (hallucinations that cause a person to
lose their sense of what is really happening in their life).
Understandably it can lead to withdrawal from the outside
world as the person becomes more confused and
disorientated.
· Psychotic disorders tend to be characterised by delusions
and disorganised speech or behaviour. They include all types
of sz and symptoms tend to be both positive, and negative,
where normal behaviours are missing, such as emotional
reactions or fluent speech.…read more

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Behavioural explanation
· Behaviourism might be considered one of the least effective
explanations for psychotic disorders such as sz. The idea
that people might learn to suffer delusions or hallucinations
seems ludicrous, but there is evidence that people with sz
can learn less maladaptive behaviours. Logically, if people
can unlearn behaviours, it might be reasonable to suggest
that the behaviours were learnt in the first place.
· Liberman's study is based on the behaviourists' belief that
social skills in people are rewarding, thereby fulfilling a
need. As they are rewarded by having affiliative needs for
love and esteem met, the social skills will be repeated. In
patients diagnosed with sz there is no reinforcement for
showing/developing social skills and so their social skills are
not maintained. The resulting behaviours could lead to a
diagnosis of a psychotic disorder such as sz.…read more

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Liberman ­ assessment of
social skills
· Aim: To identify social skills psychotic patients may lack.
· Methodology: Review of methods of assessing social skills and
identifying problems psychotic patients may have in behaving
appropriately in social situations, which results in a lack of social
reinforcers.
· Pp's: Research looked at patients with sz and other psychotic
illnesses.
· Procedure: This review article identified key features of social
skills analysis in previous research. Methods include role-
playing of social skills, behavioural assessment of observable
behaviour, and biological data. The skills are monitored in novel
situations to see durability.
· Findings: Individual sz patients lack appropriate social learning
from past experiences. Institutionalisation can lead to loss of
social skills. Excessive anxiety impedes social performance.
Cognitive deficits may also lead to faulty perception of other
people's actions, or the situation leading to inappropriate social
behaviours.
· Conclusions: Sz patients lack social skills necessary to function…read more

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Biological explanation
· Probably the most common explanation for sz is the
biological one. Of course this might be because it is seen as a
medical condition which requires drug therapy and if we are
treating it with drugs there must be a biological cause. This
biological cause on its own seems to be too simplistic.
· Gottesman and Shields' review shows a clear link, but with
concordance rates of only 58% at best, it is clear that their
conclusion that genetics plays only a part in explaining sz is
true.
· Many social theories go hand in hand with the genetic
disposition, such as the stress diathesis model, which
suggests a disposition that becomes apparent when
stressed, or the sz mother, which suggests that a particular
personality in a parent is linked with the development of sz.…read more

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Gottesman and Shields ­ a review of recent adoptive twin and family
studies of sz
· Aim: To review research on genetic transmission of sz.
· Methodology: A review of adoption and twin studies into sz
between 1967 and 1976. Studies reviewed: 2 adoption and 5 twin
studies.
· Procedure: In the adoptive studies, biological parents and
siblings were compared and adoptive parents and siblings. In the
twin studies the concordance rate for monozygotic and dizygotic
twins were compared.
· Findings: All three adoption studies found an increased incidence
of sz in adopted children with a schizophrenic biological parents,
whereas normal children fostered to schizophrenic parents and
adoptive parents of schizophrenic children showed little
evidence of sz.
All twin studies found a higher concordance rate for sz in
monozygotic twins than dizygotic twins. In Gottesman and
Shields' own study this was 58% in monozygotic twins, meaning
that if one twin had sz then there a 58% chance the other would
have it, compared with a 12% concordance rate for dizygotic
twins.
· Conclusions: There is obviously a significant genetic input into
the onset of sz, but with concordance rates less than 100% there…read more

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