psychological explanations of sz

the sz mother put forward by frieda argues that controlling rejecting parenting can lead to the dev of sz. The role of the father is often passive.

Double bind theory put forward by bateson argues that parents who are contradictory in their messages and whos signals are mixed confuse the child and create distrust, this causes confussion, paranoia, disorganised thinking, being 'flat' and a loss of girp of reality. These symptoms are commonly associated with the negative symptoms of sz.

expressed emotion referres to family enviroment where parents are controlling, hostile critical and overly envolved of patients with sz, thiese factors have a mojir influence of relapse rates. Brown found that patients returining to famillies with high levels of expressed emotion are 4x more likley to relapse compared to those which a low ee family enivorment.

there is supporting evidance which comes from patino, patino established 7 problems which influence the chance of a sz patient relapsing, these include hostiility, overprotection etc. these 7 issues are of high resemblance to those of EE and patino found that if ony 3 are present in szpatients the chance of relape is 4x greater. this supports that high ee in family environment increase patients chance of relapse.

however family dysfunction doesnt meet full scientific criteria and in facts lacks validity. this is as patients who have been interviewed about their childhood relationships with parents have been interviewed after their symptoms took place, meaning that the symptoms may undermime the credibiltiy and thus validity of the statements made by the ppt. symptoms may have an effect on the memory of patients. therefore this explanation lacks validity. 

there is also supporting evidence from kavagnah. kavagnah found that high ee rates compared to low ee rates have a huge impact on relapse rates he found that those returning to enviroments with high have a 48% of relapse compared with those with low levels who only have a 21% chace of relapse thus showing that family dysfunction is critical in patients relapse of sz.

focus on dysfunctional thought processing, including faulty interpretation of internal/ external perceptions and the inhabity to process information correctly.

frith- patients with sz fail to internally moniter their thoughts effectively:

lack of meta cognition is the inibility to distinguish between internally produced stimili and external stimuli or sensory based perceptions. this results in auditory hallucinations due to the misinterpretation of own internal thoughts.

lack of central controll is the inibility to supress automatic responses this may be triggered by external or internal stimuli.This can involve derailment (loss of concentration when speaking) as parcticuar words trigger automatic associations and can be the cause symptoms such as disorganised speech and thought disorder.  

The cognative approach is hollisitc. this is because its ideas of faulty though processes such as the misinterpretation of internally produced speech can be due to biological faults. This explanation takes into account aspects of the biological approach such as that a high amount of dopamine in the brocas area in causing disorganised speech. therfore the cognative approach can be credited for taking different explanations into accound whilst looking for causes of sz. 

the cognative approach has supporting evidance, stirling carried out a stroop test using an experimental group of sz patients and a control of non sz patients. both groups were timed whiclst reading the colour of a word written on a page and not the word itself. stirling found that sz patients took twice as long perfoming this task and that this can be linked to derailemt. therfore this provides evidance cognative factos such as lack of central control help to explain sz symptoms. 

CBT- based on cognative and behavioural techniques a held discussion between therapist and patient whcih can take 5-20 sessions. the aim of cbt is to help the patient identify their irrational thougts and try to chanage them as well as help them to stop acting on these thougts through a process of normalisation. CBT helps patinets better able to understand their thoughts ans symptoms. cbt helps people with sz better able to cope and understand their symptoms, patients are helped to make sense of how their feelings impact their thoughts and how this imapct their actions. by understanding these sympotoms it can be beneficial of patients as the offer of a psychological eplanation helps reduce anxiety levels. cbt also helps people understand that their delusions are not based on reality. turkington conducted a case study on a man with paranoid sz who believed the mafia was out to get him, through cbt he was able to come up with less threatening possibilities.

family therapy- carried out with famillies rather than individaul sz patients, can take up to 6 months. the aim is to reduce expressed emotion and improve communication between family memebers. a discussion is held as a group of communication techniques and support techniques aswel as guidence of how to solve issues which could be the cause of sz or relapse. Pharoah argues family therapy helps by adressing certain factors including: improving the famillies ability to anticipate/solve issues, improve the stigma around sz, reduce anger/guilt, reduce stress. aswell as reducing stress and ee it helps the patient comply with medication.

evidance for its effectivness comes form juahar who reviewed 34 studies of cbt and found  significant evidance for its effectivness, aswell as this pontillo found reductions in hallucinations after patentis underwent cbt. and thurther clinical advice recomends cbt as a form of treatment for cbt.

however a weakness is that although cbt helps impove symptoms it doesnt cure them. CBT is a prosess which helps patients understand their symptoms and better cope with anxiety surrounding these symptoms however although delusions and hallucinations may be better understood they will still be present in those who have sz as from a biopsychologist point of view it doesnt tackle the root cause therby although it imroves quality of life it is overoptimistic and doesnt cure the symptoms only lessens the anxiety surrounding symptoms.

a strngth is that family therapy is beneficial for the whole family, because the family is understanding hope to cope with their loved ones suffering with a mental disorder their anxiety is lessened. it is also helpful as harmful feelings of anger and guilt are helped by this which would more than likely improve the whole famillies mental health, and thurthermore it is not ambigious to assume that other memebers who live with the patient may have developed some sort of anxiety or depression themselves as it is a hard situation to deal with. and thus has implications on the ecomony too.

token economies are a form of behaviour management stratogies which use the ideo of operant conditioning to condition patients to perform desired behavioiurs. behaviours are encouraged using selective reinforcement and manages sz by shaping sz through reinforcement.

patients are given token which act as secondary reinforcers, these are only rewarded when patients act in desirable ways such as being social, keeping clean etc. these token can then be exchanged for items or privallges which the patients want and these are primary reinforces. these can include visitation, sweets, time outside etc. 

token economies are a form of behaviour management stratogies which use the ideo of operant conditioning to condition patients to perform desired behavioiurs. behaviours are encouraged using selective reinforcement and manages sz by shaping sz through reinforcement.

patients are given token which act as secondary reinforcers, these are only rewarded when patients act in desirable ways such as being social, keeping clean etc. these token can then be exchanged for items or privallges which the patients want and these are primary reinforces. these can include visitation, sweets, time outside etc. 

Matson identified 3 catagories of institutional behaviour which can be tackled through token enconomies : personal care, condition related behaviour and social behaviour.

there are two major benefits on these behaviours, it improves quality of life and normalises behaviour.

support for its effectivness from Glowacki identified 7 high quality studies published between 199 and 2013 on the effectivness of token economies in hospital settings. all studies showed that token economies worked in making behaviour desirable, this therfore supportrs that token economies work in controlling behaviour.

however ther are ethical issues concearning proffesionals power to control vunerable participants with sz. these professionals can inflict power and their wn norms on these people who are vunerable and have no way of defending their own selves. the imposition of peoples norms in some way goes against their human rights. but in many cases the very vunerable are extreamly limited in what enjoyable things they can do in these institutions as they struggle to progress which leads to a decrease in mental health and a worse quality of life. 

another weakness is that evidance is very small scale and therfore limits gennerasibility, the findings of token encominies cannot be generalised to different poeple in different countries ages and genders. there is also possibility of researcher bias in these studies as there is so little of them.

most commom treatment of sz is through the use of antipsychotics these can be used either short or long term to reduce symptoms of sz.

typical 1st generation antipsychotics- these include chroropazine and were developed in the 50s, they work to reduce positive symptoms such as hallucinations and delusions, but have little effect on negative symptoms. they work by tightly binding to dopamine receptor ites which decreases the amount of domapine crossing theough the the post synaptic gab as blocking the receptors stops summation from occuring. howver these have been assosiated with side effects which include issues with movement deficited as dopamines has an effect on motor control.

atypical 2nd generation antipsychotics- these include clozipine and were developed in the 70's, they work to reduce both positive and negative symptoms such as delusion, hallucinations, feeling flat, avolition. these work by loosing blinding to dopamine and seretonin receptors which decrease the amount of neurotransmitter going through whilst some still gets to reach summation. they slowily deflect ans the amount of neurotransmittter is regulated. however side effects including issues with white blood cells can occur, this effects the amount of white blood cells produced and therfore increases chane of infection. due to this life risking side effect dosage is kep low.

one strength of psychotics for treating sz is that they are effective- thornely reviewed data from 13 trials and found chlorprozimine was associated with better functioning and reduced symptoms compared with placebos, however it could be argued those patients who took the placebos were subjected to unfair treatment as they were experiment subject rather than people trying to be treated.

one wekness of antipsychotics is that they have extream side effects, both first and second generation versions of the drug have extream side effects which affect the patients haelth and wellbeing, first generation antipsychotics cause issues with motor movement and in 15% of cases uncontrollable jaw movement, although patients are helped by reducing potive symptoms their subjected to a lessened quality of life as they can be by some defined to be in a 'zombie state'. atypical psychotics have a chance of giving the user a blood condition, 1% of sz patients white blood cells decrease when taking the drug this makes them more prone to infection and evev death. therfore psychotics have to be carefully looked into to see whether the benefits will outweigh the negatives in helping someone with sz. 

there are also ethical issues to be considered when it comes to antipsychotic use in mental hospitals, in some cases patients who are seen as hard work may be administered drugs that they dont need in order to make the life of doctors easier, this violates human rights.

sz can be explained by interactionists as the reaction of a predisposition with a stressfull life situation, the stress diathesis model is used to show this:

the diathesis model consists of the diathesis and stress, a combination between both results in a disorder like sz. 

diathesis, was previosly thought to be polygenic and the COMPT gene predisposes individuals to sz, a child would inherit this gene from their parents which causes the predisposition. joseph 2004- mz twins 40% cocordance rate and dz twins 7% cocordance rate showing sz must have genetic basis.the updated modern model argues that the deiathesis isnt only genetic, the deiathesis could be psychological, neurological or due to improper brain development eg during child abuse the HPA system changes .

stress, any negative experience in life which can act as a trigger to the diathesis/predisposition. Environmental factors such as a stressful life eg childhood abuse may trigger the activation of the gene and cause sz. therfore it is the interaction between both that explains sz.

there is support from tienari 2004 which supports the diathesis model, family rearing styles were measured to see if they contributed in the development of sz, children who were adopted into famillies and had biological mothers with sz were studies to see their envirorments and genetic affects on the child. different adoptee families had different styles however he found that famillies whos styles was critical, high levels of stress and conflict wer the most involved with the development of sz in the children. this suppots that it is in fact a reaction between the diathesis and the stress which causes sz.

the original diathesis model assumes stress factors have to be negative psychological experiences, however there is evidance to support this isnt true. the new modern verision however aknowledges risk factors such as cannabis use and early childhood abuse which creates nerological damage abd their role in the development of sz. 

a strength of the model is that it has free will, the explanation of the disorder as a predispotion combined with a stressor may help those who are aware they are genetically predisposed avoid triggering factors such as cannabis use. therfore this approach gives people the free will to have control over their own predisposition.

the interactionis approach belives that sz should be treated by using a combination of both antipsychotics and a talking therapy such as cbt. this is eclectic therapy as it takes an idiographic way of thinking and caters the therapy towards each indiviuals needs.

the eclectic therapy is more expensive than just using psychotics on their own. this puts a strain on the nhs and thus is not available to everyone, its also proven that psychotics on their own work very simaliry clearing the symptoms of sz and therefore due to the price and need for a qualified therapist many doctors wont refer patients for this therapy. however there is evidance from anderson which supports that a combination works a lot better than just one treatmenet he found relapse rates fell to less than 5%.

a strenght is that it is catered towards the individual, different people have diferent symptoms and need a different tailored experience to treat their symptoms, this therapy does just this as it is based on the idographic approach. for some the fear of side effects from taking drugs for a long time may put somoene off and the idea of a combination may work better. therfore this therapy opens up more options for patients and creates a better experiance.

an advantage of using a combination comes from tarriere, he had participants randomly alocated to either a mediacation and cbt group, medication and supportive counelling group or a controll group , participarts in the two combination groups showed lower symptom levels than those in the control group which shows that a combination is a form of superior treatment.