Explanations and Therapies for Schizophrenia

Key:

Sz: schizophrenia

MZ: monozygotic

DZ: diozygotic

APM: antipsychotic medication

Caps: conventional antipyschotics

Aaps: atypical antipsychotics

ECT: electroconvulsive therapy

CBT: cognitive behavioural therapy

EE: expressed emotion

DB: double bind

FI: family intervention

SFP: self fulfilling prophecy

Biological Explanations of Sz:

Family – Gottesman found that Sz is more common amongst biological relatives of a person with Sz, children with two Sz parents had a 46% concordance rate.

Twin – investigate contributions of genetic and social influences. Joseph found a concordance rate of 40% with MZ twins whilst DZ twins had a concordance rate of 7%. Blind studies found that the rates were slightly lower but MZ rate was still considerably higher than the DZ rate.

Adopt – Tienari found that of 164 adoptees with Sz biological mothers, 11 also had Sz compared to 4 in the control group.

Evaluation:

• ·         Family – other factors such as EE may trigger Sz symtoms.
• ·         Twin – MZ may be treated more similarly so the higher concordance rate may be due to environment.
• ·         Adopt – adoptees are not selectively placed but in the earlier studies parents knew of the Sz biological parents
• ·         Evolutionary – Sz caused division after optimum group size had been reached due to some following the psychotic symptoms of Sz.
• Dopamine – neurotransmitters fire too easily or too often leading to Sz symptoms, there is evidence from amphetamines which cause flooding of dopamine and lead to Sz symptoms. Antipsychotics block dopamine and alleviate the symptoms of Sz whilst Parkinsons sufferers who took L-Dopa to raise dopamine levels had Sz symptoms.

Evaluation:

• ·         Drugs which aim to block dopamine can actually increase it as neurons struggle to compensate for the deficiency. Haracz found that post-mortems of Sz who had received antipsychotics actually showed elevated dopamine levels after their deaths.
• ·         At present, neuroimaging studies fail to provide any conclusive evidence of altered dopamine activity.

Psychological Explanations:

Psychodynamic – Freud suggested that Sz was the result of regression to a pre-ego state and attempts to re-establish ego control.

Cognitive – Biological factors cause initial sensory experiences of Sz, further features of Sz appear as individuals try to understand their situation.

Evaluation:

·         There is no specific evidence to support Freud’s ideas, subsequent psychoanalysts have claimed he is accurate. Parents of Sz sufferers do act differently but this is a consequence not a cause.

·         Yellowlees developed a machine that produces virtual hallucinations, such as one person’s face morphing into another. The aim to show Sz that their hallucinations are not real.

Socio-Cultural Factors:  

Life events – higher stress levels have been linked to a higher Sz risk, Burley found that prior to a Sz episode patients reported a higher number of stressful life events compared to a control…