But in fact some Schizophrenics are successfully treated whereas others are not. Individual differences EE is associated with relapse but not all patients who live in high EE families relapse and not all patients in low EE families avoid relapse Family dysfunction is an incomplete explanation for schizophrenia. Refer to evidence in youranswer. Visual - Evaluation of the dopamine hypothesis for schizophrenia. The focus of a token economy is on shaping and positively reinforcing desired behaviors and NOT on punishing undesirable behaviors. For example, schizophrenia and depression are often found together. Refer to one or more typesof family dysfunction in your answer. As there is strong evidence that relapse is related to stress and expressed emotion within the family, it seems likely that CBT should be employed alongside family therapy in order to reduce the pressures on the individual patient. Hallucinations are usually auditory or visual perceptions of things that are not present. Registered office: International House, Queens Road, Brighton, BN1 3XE, Psychology Schizophrenia Family Dysfunction. Research evidence from autopsies has shown that schizophrenia sufferers have more dopamine receptors, which may lead to more neural firing and therefore an over production of messages. Comorbidity describes people who suffer from two or more mental disorders. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. Symptom targeting: a specific symptom is selected for which a particular coping strategy can be devised The fact that the concordance rates are not 100% means that schizophrenia cannot wholly be explained by genes and it could be that the individual has a pre-disposition to schizophrenia and simply makes the individual more at risk of developing the disorder. Chronic schizophrenics achieved 3lbs of weight loss a week. However, biological factors must have had a role to play as none of the adoptees with no family history of schizophrenia from disturbed families developed schizophrenia, Boston House, Interactionist approaches attempt to explain schizophrenia as a combination of nature (biological) and nurture (environmental) factors. In order to diagnose Schizophrenia the Mental Health Profession developed the DSM (Diagnostic and Statistical Manual) still used today as a method of classifying mental disorders (particularly in the USA). Schizophrenia is a severe mental illness where contact with reality and insight are impaired, an example of psychosis. b) identifying source of bias - EITHER people volunteer so their behaviour might be atypical/unrepresentative OR they all attend self-help group so their behaviour may be atypical/unrepresentative eg volunteers may be better communicators, more verbal ), empirical (where is the evidence?) This is mainly aimed at lowering expressed emotion. The biological basis for schizophrenia is therefore not addressed at all in the therapy, limiting its use. Pederson and Mortensen (Denmark 2001) found Scandanavian villages have very LOW levels of psychosis, but 15 years of living in a city increased risk. Social behavior depends, in part, on using other peoples actions as clues for understanding what they might be thinking. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. This means that the brains of schizophrenics are lighter than normal. The dopamine hypothesis is another biological explanation for schizophrenia. Words may become confused and sentences incoherent (so called word salad). People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. Since their are problems with the validity of diagnois classification, unsuitable treatment may be administered, sometimes on an involuntary The ICD-10 (only negative symptoms need to be present) is used worldwide and the DSM-5 (only positive symptoms need to be present) is used in America. [8 marks] The fact that jack could never talk to his mum shows a symptom of schizophrenia, that fact that he displays lack of speech. Lengthy It takes months compared to drug therapy that takes weeks which leads to disengaged treatment as they dont see immediate effects A patient who is very distressed and perhaps suicidal may benefit better in the short term from antipsychotics. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia. This helps improve the quality of life for schizophrenia sufferers. Benzel et al. Token economies raise ethical issues. [2 marks], Evaluate psychological explanations of schizophrenia [16 marks] and more. Medications reduce positive symptoms particularly hallucinations and delusions; and usually allow the patient to function more effectively and appropriately. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002). A strength is that the research into enlarged ventricles and neurotransmitter levels have high reliability. disputing techniques. Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia 2. Ayllon and Azrin (1968) set up a token economy with schizophrenic patients in a psychiatric institution. Those who do not have the schizogene would not develop schizophrenia, even if they experienced a chronically stressful upbringing. Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females. Essentially due to . A hundred Danish patients with a history of psychosis were assessed using operational criteria, and a concordance rate of 98% was obtained. Al (2011) suggest many aspects of urban living ranging from life stressors to the use of drugs, can have an effect on human epigenetics. How could the researchers modify their study to deal with this problem? Note: you may come across the terms DSM-IV and ICD-10. More recent versions have included hypodopaminergia, where low levels of dopamine in the prefrontal cortex are believed to be responsible for some of the negative symptoms of schizophrenia. The diathesis-stress model states that both a vulnerability to SZ and a stress trigger are necessary to develop the condition. This raises practical and ethical issues when selecting different types of tretment. (2003) meta analysis found family interventions help the patient to understand their illness and to live with it, developing emotional strength and coping skills, thus reducing rates of relapse. [2 marks], - Characteristics of dysfunction eg difficulties in communication, high levels of interpersonal conflict, Evaluate psychological explanations of schizophrenia [16 marks], Briefly discuss two limitations of the family dysfunction explanation for schizophrenia. they said an event was real but it was in their head. It is one of the chemicals in the brain which causes neurons to fire. Diathesis-stress model: Meehl (1962) originally proposed that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition. Schizophrenia 16-marker Plans (AQA A Level Psychology) Description AQA A Level Schizophrenia: 16-marker plans for the explanations and treatments of schizophrenia aqa a level psychology schizophrenia a2 psychology aqa a level psychology- 16-mark question plans as level Note by Grace Fawcitt, updated more than 1 year ago 2915 8 0 Resource summary Bateson et al. Even after stopping the use of the drug, this condition can persist. The descriptions follow the same criteria; however you have to use the issues and debates effectively in your answers. Support for family research, Tienari et al (1994) adoption study found those adopted children who had schizophrenic parents were more likely to become ill themselves than those children with non-biological parents. To educate relatives about schizophrenia. Tokens are secondary reinforcers, which are exchanged for rewards (primary reinforcers), for example food, being allowed to watch a film, and so on. Broadcasting is a thought disorder whereby a person believes their thoughts are being broadcast to others, for example over the radio or through TV. Given that a much lower number of genes exist than anticipated, it is now recognised that genes have multiple functions and that many genes behavior. B: behavior how do you react in these situations ? Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms. In most cases the original typical antipsychotics have more side effects, so if the exam paper asks for two biological therapies you can write about typical anti-psychotics and emphasise the side effects, then you can write about the atypical antipsychotics and give them credit for having less side effects. Objectives: To compare social skills in patients with schizophrenia classified according the degree of treatment response and severity of psychopathology with normative controls by using the Del Prette Social Skills Inventory (SSI). They did not believe that schizophrenia was a disease. Patients can receive different treatments for their SZ which will be more effective. CBT may involve challenging the validity of beliefs, which may interfere with freedom of thought. Thought disorder in which there are breaks in the train of thought and the person appears to make illogical jumps from one topic to another (loose association). This suggests that there are problems with the chicken and egg problem. Kahn et al. Help the patient realise it is normal to have negative thoughts in certain situations. Research in Hampshire, by Kingdon and Kirschen (2006) found that CBT is not suitable for all patients, especially those who are too thought disorientated or agitated, who refuse medication, or who are too paranoid to form trusting alliances with practitioners. (1991) found a relapse rate of almost 40% when patients had drugs only, compared to only 20 % when Family Therapy or Social Skills training were used and the relapse rate was less than 5% when both were used together with the medication. Schizophrenia Interactionist Approach Interactionist Approach Interactionist Approach Addiction Addiction Treatment Theories Aversion Therapy Behavioural Interventions Drug Therapy Gambling Addiction Nicotine Addiction Physical and Psychological Dependence Reducing Addiction Risk Factors for Addiction Six Stage Model of Behaviour Change This suggests that if this research was tested and re-tested the same results would be achieved. Last chance to attend a Grade Booster cinema workshop before the exams. Evidence suggests that the closer the biological relationship, the greater the risk of developing schizophrenia. Copyright Get Revising 2023 all rights reserved. The reason for this is because if the individual does have large ventricles then does it really mean that they will develop schizophrenia? To improve how the family communicated and handled the situation. basis. Another form of CBT: Coping Strategy Enhancement (CSE). Cause and effect It remains unclear whether cognitive factors cause schizophrenia or if schizophrenia causes these cognitions Family dysfunction may not be a valid explanation for schizophrenia. Cognitive deficits have been suggested as possible explanations for a range of behaviors associated with schizophrenia. To stabilize the social authority of the doctor and the family. laying out what they hope to achieve through the therapy. It also seems to be aetiologically heterogeneous as different studies have identified different candidate genes. Schizophrenogenic mother: Proposed by Fromm-Reichmann (1948), who noted that many of her patients with schizophrenia described a particular type of parent, which she termed 'schizophrenogenic'. Another problem is the theory led's to parent blaming. First, the adoptees study method, the index offspring of adopting-away schizo However, Thornley et al carried out a meta-analysis comparing the effects of Chlorpromazine to placebo conditions and found Chlorpromazine to be associated with better overall functioning Drug therapy is an effective treatment for SZ. Communication skills training teach family to listen, to express emotions and to discuss things. These machines take accurate readings of brain regions such as the frontal and pre-frontal cortex, the basil ganglia, the hippocampus and the amygdale. Last chance to attend a Grade Booster cinema workshop before the exams. Company Reg no: 04489574. Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. During CBT, the therapist lets the patient develop their own alternatives to previous maladaptive beliefs, ideally by looking for alternative explanations and coping strategies that are already present in the patients mind. Substance abuse: Amphetamine and Cannabis and other drugs have also been identified as triggers as they affect serotonin and glutamate levels. We are committed to engaging with you and taking action based on your suggestions, complaints, and other feedback. Noll (2009) also argues around one third of patients do not respond to drugs which block dopamine so other neurotransmitters may be involved. Abstract. Gottesman (1991) has found that schizophrenia is more common in the biological relatives of a schizophrenic, and that the closer the degree of genetic relatedness, the greater the risk. Gender bias is also an issue as the mother tends to be blamed the most, which means such research is highly socially sensitive. For the classification system to be reliable, differfent clinicians using the same system (e.g. They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity. The intention is to show schizophrenics that their hallucinations are not real. Read et al (2005) reviewed 46 studies of child abuse and schizophrenia and found concluded that 69% of adult women in-patients with a diagnosis of schizophrenia had a physical abuse, sexual abuse or both during their childhood. The therapist wins the trust of the patient, so they can work together. Twenty-six of forty patients (65.0%) were taking haloperidol and 14 (35.0%) chlorpromazine. LS23 6AD Response. They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. The Interactionist approach acknowledges that there are a range of factors (including biological and psychological) which are involved in the development of schizophrenia. This can lead to problems with reliability of diagnosis as one doctor might diagnose the person as having schizophrenia while another might diagnose bipolar disorder. However, evidence may not be reliable as patients recall may be affected by their schizophrenia. and pragmatic (how is the belief helpful?) Atypical antipsychotics: Developed in the 1970s, as an attempt to find drugs with fewer severe side-effects than typical antipsychotics. As the drugs block dopamine activity, they tend to have (sometime severe) side-effects. When the families were rated as healthy, the likelihood of developing schizophrenia for those with a biological mother with schizophrenia fell to below 1%. Upper and Newton (1971) found that the weight gain associated with taking antipsychotics was addressed with token economy regimes. In a token economy, tokens are given to reward people in psychiatric institutions for performing socially desirable behaviours, the aim being to encourage self-care. Eg. Mischler & Waxler (1968) found significant differences in the way mothers spoke to their schizophrenic daughters compared to their normal daughters, which suggests that dysfunctional communication may be a result of living with the schizophrenic rather than the cause of the disorder. Antipsychotic drugs are used to reduce the intensity of symptoms (particularly positive symptoms). There is a sizeable minority who do not respond to drug treatment. In other words, it doesnt cure schizophrenia, it just helps people get over it. Melzer (2012) concluded that Clozapine is effective in 30-50% of cases where other drugs have failed, supporting its use in schizophrenia treatment. Often, little or nothing is done to rectify the situation or to alleviate its adverse effects upon the child. Company Reg no: 04489574. Further support comes from the fact that dopamine agonists (e.g. Culture One of the biggest controversies in relation to classification and diagnosis is to do with cultural relativism and variations in diagnosis. Autopsies have found that there are generally a large number of dopamine receptors (Owen et al., 1987) and there was an increase in the amount of dopamine in the left amygdale (falkai et al. They are effectively discriminated against (in this case, denied rewards) for being more severely ill. Imagined stimuli could involve any of the senses. In London the rate remained at 20%, suggesting neither group had a valid definition of schizophrenia. (Total 4 marks) 12 Describe and evaluate biological explanations for schizophrenia. These include reduced levels of emotional expression, disorganised speech and delusions. Chronic environmental stress, for example having a schizophrenogenic mother, results in the onset of schizophrenia. Group As scores suggest a normal distributed as the mean, median and mode are all almost the same (22). They assumed the bogus patients were schizophrenic with no real evidence. Jack's experiences can be linked to the family dysfunction explanation. Antipsychotic drugs are weakened by the fact that they have severe side-effects. They are a form of behavioral therapy where desirable behaviors are encouraged by the use of selective reinforcement and is based on operant conditioning. Study with Quizlet and memorize flashcards containing terms like Explain how family dysfunction might be involved in schizophrenia. Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics. Read et al (2005) reviewed 46 studies of child abuse and schizophrenia and found concluded that 69% of adult women in-patients with a diagnosis of schizophrenia had a physical abuse, sexual abuse or . A final strength is that it takes on board the nurture approach to the development of schizophrenia. One biological explanation for schizophrenia is that it is passed on through the genes. This suggests that there may be problems of demand characteristics. Pharoah et al (2010) suggest that the following techniques, in which all of the family are involved, are used: This is a behavioural treatment for schizophrenia, based on operant conditioning (learning through reinforcement). The validity of schizophrenia as a single disorder is questioned by many. desire): in which a person becomes totally apathetic and sits around waiting for things to happen. (2003) studied DNA from human families affected by schizophrenia and found that those with the disease were more likely to have a defective version of a gene, called PPP3CC which is associated with the production of calcineurin which regulates the immune system. Delusions of Grandeur). This weakens the interactionist explanation. Laing believed that schizophrenia was a result of the interactions between people, especially in families. Helping the patient to find logical reasons for the things which trouble them Token economies aim to manage schizophrenia rather than treat it. That said, please be assured that question paper development involves a rigorous and robust process during which experienced colleagues determine whether or not, for any specific content, within a . 1. They cannot express their feelings about the unfairness of the situation. Prolonged exposure to such interactions prevents the development of an internally coherent construction of reality; in the long run, this manifests itself as typically schizophrenic symptoms such as flattening affect, delusions and hallucinations, incoherent thinking and speaking, and in some cases paranoia. In CBT, schizophrenia patients are encouraged to trace back the origins of their symptoms in order to get a better idea of how the symptoms might have developed. Check out Adapt the A-level & GCSE revision timetable app. Family Dysfunction refers to any forms of abnormal processes within a family such as conflict, communication problems, cold parenting, criticism, control and high levels of expressed emotions. This has the effect of reducing dopamine production, and reduces positive symptoms such as hallucinations. Comorbidity occurs because the symptoms of different disorders overlap. One criticism of the dopamine hypothesis is there is a problem with the chicken and egg. Aetiological validity for a diagnosis to be valid, all patients diagnosed as schizophrenic should have the same cause for their disorder. It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. Weak evidence for family based explanations, there is no evidence that supports the importance of double bind theory. A second weakness of the cognitive model is that it is reductionist. This supports a genetic link. For example, an excess of dopamine receptors in Brocas area might be responsible for poverty of speech and auditory hallucinations. Therapists may use logical (does it make sense? In a follow up study they rejected genuine patients whom they assumed were part of the deception. Family therapy for families of adolescents or young adults who have developed schizophrenia tends currently to emphasize psychoeducation (guidance about schizophrenia and its treatment) and aims at enhancing recovery rather than the discovery of pathogenic patterns of child-rearing (McFarlane 2016 ). These symptoms may leave them fearful and withdrawn. Full Text. The reason for this is because the research is carried out in highly controlled environments, which specialist, high tech equipment such as MRI and PET scans. (Total 16 marks) Desirable behavior includes self-care, taking medication, work skills, and treatment participation. , AQA A level Psychology paper 3 7182/3 14th June 2019 , AQA A Level Psychology Paper 3 7182/3 - 16 Jun 2022 [Exam Chat] , AQA A Level Psychology 2022 Predictions (Paper 3) . Therefore there is no need to feel stressed or ashamed about them. Requires self-awareness and willingness to engage Held back by the symptoms schizophrenics encounter It is an ineffective treatment likely to lead to disengagement. Antipsychotic drugs are highly effective as they are relatively cheap to produce, easy to administer and have a positive effect on many sufferers. Her psychiatrist wants to change her medication from typical antipsychotics to one of the atypical antipsychotics and has also suggested cognitive behavioural therapy", What do the data in Table 1 seem to show about the effectiveness of typical and atypical antipsychotics in the treatment of schizophrenia? This suggests that one needs to be careful when establishing cause and effect relationships in schizophrenic patients. These refer to the latest editions of the two classification systems. Out-dated views that were once accepted are no longer tolerated by families and are now seen as destructive rather than productive, Briefly outline how cognitive behaviour therapy (CBT) is used to treat schizophrenia and explain one limitation of using CBT to treat schizophrenia. b) Explain one reason why there might be a problem of bias and generalisation in this study. There are also delusions of being paranoid, worrying that people are out to get them. Bruce Johnson is an A-level psychology teacher, and head of the sixth form at Caterham High School. 806 8067 22, Registered office: International House, Queens Road, Brighton, BN1 3XE, psychological explanation for schizophrenia, psychological explanations for schizophrenia, Schizophrenia - SS2 - Explanations - Socio-Cultural - Research, I need help on this A Level AQA psychology 16 marker please , A-Level Psychology Revision Tips and Tricks , comparing biological explanation of SZ with family dysfunction , Family dysfunction model of schizophrenia , aqa alevel psychology paper 3 2022 predictions? Schizophrenia is a severe type of mental illness that affects a person's thoughts, perceptions, and behaviors. CBT is rarely used without drug therapy, suggesting it is not enough on its own to treat schizophrenia. Due to the pivotal role of dopamine in schizophrenia this led to a culture of heavy smoking an nicotine addiction in psychiatric hospitals of the era. Slater & Roth (1969) say that hallucinations are the least important of all the symptoms, as they are not exclusive to schizophrenic people. The family dysfunction explanation is an explanation that sees maladaptive relationships and patterns of communication as a source of stress which influences the development of schizophrenia 2002-2023 Tutor2u Limited. Other side effects are potentially fatal, for example agranulocytosis and neuroleptic malignant syndrome (NMS). The differences were so large the schizophrenic twins could be easily identified from the brain images in 12 out of 15 pairs. (2007) three genes: COMT, DRD4, AKT1 have all been associated with excess dopamine in specific D2 receptors, leading to acute episodes, positive symptoms which include delusions, hallucinations, strange attitudes. Preliminary analysis: Through interviews and observation the therapist identifies strengths and weaknesses of family members and identifies problem behaviors. Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . Supporting evidence for the brain structure explanation comes from further empirical support from Suddath et al. Family therapy is a form of therapy carried out with members of the family with the aim of improving their communication and reducing the stress of living as a family. Credit should be awarded for one type in some detail or for two (or more) done briefly. Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia. Families can help minimize the damage to self of the schizophrenic that this entails. Both aspect of diathesis-stress must be present to develop the disorder. including dysfunctional thought processing. 2002-2023 Tutor2u Limited. DSM) should arrive at the same diagnosis for the same individual. The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine. The legality of this has been challenged, and the use of token economies has declined as a result. A strength of the cognitive explanation is that it has practical applications. Many people who experience feelings of persecution have a general tendency to assume that other people cause the things that go wrong with their lives. To teach patients and carers more effective stress management techniques. As this is not the case family dysfunctions cannot be the sole cause ofthe illness. Severe side effects Long term use can result in tardive dyskinesia which manifests as involuntary facial movements such as blinking and lip smacking While they may be effective, the severity of the side effects mean the costs outweigh the benefits therefore they are not an appropriate treatment. A second weakness of the double bind theory is that there are ethical issues. This is not the case with schizophrenia: The causes may be one of biological or psychological or both. The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly. A weakness of the family relationsships appraoch is that there is a problem of cause and effect. A final weakness of the dopamine hypothesis is that it is biologically deterministic. Dopamine is a neurotransmitter. Therefore it appears that several neurotransmitters may be involved in the development of schizophrenia, meaning the dopamine hypothesis is too simplistic. LS23 6AD This suggests that the dopamine hypothesis does not account for freewill. AQA maintains that 16-mark questions, or indeed, extended writing questions of other tariffs, could be asked on any part of any topic. This suggests that the research therefore does not protect individuals from harm. Therefore, CBT has potential ethical issues. Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them delusions of persecution. There is no such thing as a normal schizophrenic exhibiting the usual symptoms. 214 High Street, Evidence to support this view comes from the prospective adoption study by Tienari et al. The adoptive families were investigated thoroughly using joint and individual interviews and psychological tests. The harmful effects on the child may go completely unacknowledged or be minimized. Medication can be taken as pills, syrups or injections, and may be taken over a short or long-term. Does the low motivation reflect depression or schizophrenia, or both? Problems of validity: Are we really testing what we think we are testing? A second weakness of the neuroanatomical explanations is that it is biologically deterministic. [2 marks], - All drugs have side effects that can be severe and may lead to patients avoiding medication and hence to relapse, Outline and evaluate the use of antipsychotic drugs to treat schizophrenia [8 marks], 'Therapies can be time-consuming and, in some cases, uncomfortable for the client. In order to explain schizophrenia effectively it would be better to take an interactionist approach, such as the diathesis stress model.