Psychology A2 - Schizophrenia:

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  • Created by: Samantha
  • Created on: 17-01-13 14:25

Schizophrenia Overview:

Schizophrenia is a severe mental disorder characterised by a deep disruption of cognition and emotion.

  • This affects a person's language, thought, perception and even their sense of self. The schizophrenic tends to believe things that cannot be true - Delusions - and/or hears voices or sees visions when there is no present stimuli to create them - Hallucinations.
  • Contrary to popular beliefs, schizophrenic people do not have 'split personalities', neither are they constantly incoherent or constantly displaying psychotic symptoms.
  • However, displaying one of the characteristics (symptoms) of schizophrenia could be enough to land a person with a diagnosis for life.
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Clinical Characteristics of Schizophrenia:

+ Symptoms - An excess of normal function

  • Delusions 
  • Experiences of control - Person believes they are under control of some paranormal force
  • Hallucinations
  • Disordered thinking

- Symptoms - A loss of normal function

  • Affective flattening - Reduction in range + intensity of emotion
  • Alogia - Reduction in range of volcabulary
  • Avolition - Inability to persist in goal-directed behaviour
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Biological Explanation of Schizophrenia:

Genetic Factors:

Family studies - Are biological relatives more similarly affected than non-biological = More common among biological. Closer the genetic material = greater the risk of developing.

Twin Studies - Contributions of genetic material vs. environmental = Monozygotic concordance rate higher than dizygotic = Supports genetic position.

Adoption studies - Genetically related individuals raised apart = Genetic role confirmed.

Dopamine Hypothesis: (Symptoms of S are caused by excess of dopamine in the brain)

For some schizophrenics too much of the neurotransmitter dopamine is present. May account for some symptoms (Eg. Hallucinations  + strange motor movements) - as dopamine circuit is involved in perception + motor control + limbic system = Emotion changes.                             ...Amphetamines, Antipsychotic drugs + Parkinson's disease can all lead to dopamine overload = Schizophrenic symptoms.                 

(Think of D2 receptors as Bowls filling up with dopamine, sometimes schizophrenics have too many bowls = Too much dopamine being taken in = Symptoms)

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Evaluation of Biological Explanations:

Genetic Factors:

Family studies - Schizophrenia appears to run in families. However could be due to environmental/common rearing factors rather than heredity.

Twin studies - MZs treated more similarly than DZs - reflecting environmental differences.

Adoption studies - ??

Dopamine Hypothesis:

Excess dopamine could be a result of having schizphrenia as opposed to the cause.

Studies have shown that this hypothesis also only applies to a certain sub-group of schizophrenics - suggesting that not all Ss produce excess dopamine.

This reinforces the idea that schizophrenics are not all suffering from the same disorder.

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Psychological Explanations of Schizophrenia:

Psychological Theories:

Psychodynamic - World of S been harsh = Regress to early stage before ego + realistic view of world developed. Infantile state - Symptoms are attempts to control ego.

Cognitive - Acknowledges biology but features of disorder develop as S begins to experience symptoms - Friends not confirming reality of them = S rejects feedback = Delusional beliefs.

Socio-Cultural Factors:

Life events - Major stress factor associated with episodes = Stressful life events. Eg. Death

Family relationships - 1. Double-bind theory - Conflicted messages = Confusion + misinterpreting. Eg. Mother says love while turning head in disgust. 2. Expressed emotion = - emotional climate = Impaired coping mechanisms

Labelling theory - Social groups make rules for members - Symptoms are deviant from rules = Label of schizophrenia applied. Label becomes self-fulfilling prophecy = other symptoms. (If called schizophrenic, treated as + then acts like)

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Evaluation of Psychological Theories:

Psychological Theories:

Psychodynamic explanations - No support except for other psychoanalysists claiming, like him, that disordered family patterns can cause S. Eg. Schizophrenogenic mothers.

Cognitive explanations - Much evidence of physical nature for cognitive deficits linked.

Socio-Cultural factors:

Life events - Not all evidence supports + evidence that does suggest link could be only correlational. Eg. Beginnings of disorder = Cause of major life event.

Family relationships - Importance supported. 1 - Some evidence only. 2 - Much more universal support. However, not sure if EE is cause or effect of S. Either way has led to effective form of therapy where high-EE relatives are shown how to reduce levels of EE. EE + culture = Much less common in families outside West - Less individualist - Less responsibility - Less likely to blame S for their actions.

Labelling theory - Lots of evidence support.

Diathesis Stress Model - Likely that only predisposed Ss are affected by these factors.

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Biological Therapies for Schizophrenia + Evaluatio

Anti-Psychotic Medication:

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Biological Therapies for Schizophrenia + Evaluatio

Electroconvulsive Therapy:

Idea very new in early 20th century - followed reports that S was rare in epileptic people + seizures reduced S symptoms. First studies - Disappointing + low recovery rates.

What Happens in ECT?

Unconscious in procedure, given nerve-blocking agent to paralyse muscles against shock + prevent breakages. Small amount of electric current passes through brain for 1/2 second via 2 scalp electrodes - Seizure lasts for minute, affects entire brain. Requires 3-15 treatments

Effectiveness of ECT:

Reveiw - ECT produced results no different or worse than antispychotic drugs. However, Indian study showed no symptom reduction in either ECT or simulated ECT - Ineffective?

Appropriateness of ECT:

Significant brain risks associated - Use of treatment has declined significantly in UK.

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Psychological Therapies for Schizophrenia: CBT:

Cognitive-Behavioural Therapy (CBT):

  • Basic assumption - Patients have distorted beliefs which influence their behaviour in maladaptive ways. Delusions thought to result from faulty interpretations of events. CBT goal = Help the patient identify + correct these.
  • In CBT - Patients encouraged to trace back origins of symptoms to get better idea of how they might have developed. Encouraged to evaluate content of delusions + consider ways in which they might test validity of faulty beliefs. Might also be set behavioural assignments with aim of improving level of function.
  • During CBT therapist lets patient develop own alternatives to previous maladaptive beliefs - Ideally by looking for the techniques already present in patient's mind.
  • Outcome studies - Suggest patients who recieve CBT experience fewer hallucinations + delusions + recover functioning to greater extent than those who recieve drugs alone.
  • Reduction of + symptoms + 25-50% recovery rate for patients given combination of CBT + antipsychotic drugs.
  • Follow up - Confirmed above advantages + noted there were also lower patient drop- out rates + greater patient satisfaction rates when CBT was used in conjunction with antipsychotic medication.
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Biological Therapies for Schizophrenia: Psychoanal

Psychodynamic Therapy: Psychoanalysis:

  • Assumes that all symptoms are meaningful + a product of life history of patient.
  • Based on assumption that individuals are often unaware of influence of unconscious conflicts on current psychological state. 
  • Aim - Bring into awareness conflicts where they can be dealt with.
  • Therapist attempts to create alliance with patient by offering real help for percieved problem of patient.
  • Freud believed schizophrenics could not be analysed because they could not form a transference with their analyst.
  • However, other forms of psychodynamic therapy have been found successful in treating schizophrenia.
  • These have in common with Freud's psychoanlysis - First task of any psychodynamic therapy is to win trust of of patient + to build relationship with them.
  • Therapist achieves this by replacing the harsh + punishing conscience (often based on parents) with one that is less destructive + more supportive.
  • As patient gets healthier they take more active role -and therefore therapist takes less active role- in own recovery.
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Evaluation of Psychological Therapies:

CBT Psychodynamic Therapy:

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