Faris and Dunham (1939) found clear pattern of correlation between inner city environments and levels of psychosis. This is not the case with schizophrenia: The causes may be one of biological or psychological or both. But in fact some Schizophrenics are successfully treated whereas others are not. Schizophrenia is a multi-factorial trait as it is the result of multiple genes and environmental factors. It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. Pills are not as helpful with other symptoms, especially emotional problems. A nationwide Finnish sample of schizophrenics' offspring given up for adoption was compared blindly with matched controls, who were adopted offspring of non-schizophrenic biological parents. The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly. Central idea: Patients problems are based on incorrect beliefs and expectations. Chronic environmental stress, for example having a schizophrenogenic mother, results in the onset of schizophrenia. This means that the brains of schizophrenics are lighter than normal. Broadcasting is a thought disorder whereby a person believes their thoughts are being broadcast to others, for example over the radio or through TV. Pharaoh et al. [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. 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). MZ twins share 100% of their genes, compared to DZ twins who only share 50% of their genes, so this suggests that genes must have some influence on the development of schizophrenia. Lobban (2013) reports that other family members felt they were able to cope better thanks to family therapy. Interactionist Approach: Definition, Evaluation & Example - StudySmarter US Let the patient develop their own alternatives to their previous maladaptive behavior by looking at coping strategies and alternative explanations. less effect on movement 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. So environment does play a part in triggering the illness. 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? One strength of the double bind explanation comes from further empirical support provided by Berger (1965). When desired behavior is displayed eg. Schizophrenics returning to such a family were more likely to relapse into the disorder than those returning to a family low in EE. Cognitive approaches do not explain the causes of cognitive deficits where they come from in the first place. Help the patient realise it is normal to have negative thoughts in certain situations. Carrying on a logical discussion till the patient begins to see where their ideas are going wrong and why they developed. A second explanation developed, which suggests that it is not excessive dopamine but that fact that there are more dopamine receptors. Patients can receive different treatments for their SZ which will be more effective. (2002) developed a machine that produced virtual hallucinations, such as hearing the television telling you to kill yourself or one persons face morphing into anothers. 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. Schizophrenia: Positive Symptoms of Schizophrenia | Psychology - tutor2u This has the effect of reducing dopamine production, and reduces positive symptoms such as hallucinations. Tarrier (2005) reviewed trials of CBT, finding evidence of reduced symptoms, especially positive ones, and lower relapse rates. 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 generally have fewer side effects eg. Book now . Delusions are false beliefs. Interactionist approaches attempt to explain schizophrenia as a combination of nature (biological) and nurture (environmental) factors. Heather (1976) there is only a 50% chance of predicting what treatment a patient will receive based on diagnosis, suggesting that diagnosis is not valid. Family dysfunction - the double-bind theory Bateson et al. Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females. Family therapy is based on the theory that schizophrenia is associated with schizophrenogenic mothers, double bind communication, expressed emotion, or other dysfunction in the family. Kendler (1985) has shown that first-degree relatives of those with schizophrenia are 18 times more at risk than the general population. The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49. This suggests that there is wider academic credibility for enlarged ventricles determining the likelihood of schizophrenia developing. Desirable behavior includes self-care, taking medication, work skills, and treatment participation. Validity the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms. 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. A second weakness of the cognitive model is that it is reductionist. For example, an excess of dopamine receptors in Brocas area might be responsible for poverty of speech and auditory hallucinations. They engage in no self motivated behavior. First generation Antipsychotics are called Typical Antipsychotics The adoptive families were investigated thoroughly using joint and individual interviews and psychological tests. where normal functions are limited: including speech poverty and avolition. Scheff (1966) points out that diagnosis classification labels the individual, and this can have many adverse effects, such as a self-fulfilling prophecy (patients may begin to act how they are expected to act), and lower self-esteem. A dysfunctional family is one that has at its core destructive and harmful parenting and a lack of concern for the child. Note: you may come across the terms DSM-IV and ICD-10. Adults with an insecure attachement to their primary carere are also more likely to have schizophrenia (Berry et al 2008). Typical antipsychotics: Developed in the 1950s, for example Chlorpromazine. 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. They assumed the bogus patients were schizophrenic with no real evidence. This limits the usefulness of token economies in treating schizophrenia. It is more likely THE DYSFUNCTIONAL FAMILY - Institute Of Counseling Example Answers for Schizophrenia: A Level Psychology, Paper 3, June 2019 (AQA) Exam Support. It is not a cure. stress) may trigger the onset of schizophrenia, rather than individuals with schizophrenia moving down in social status. It also seems to be aetiologically heterogeneous as different studies have identified different candidate genes. 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). Token economies are only likely to work in a clinical setting, where patients can be constantly monitored and the system of rewards is closely controlled. The basic assumption of CBT is that people often have distorted beliefs which influence their behaviour in maladaptive ways. delusions. Schizophrenia is a severe mental illness where contact with reality and insight are impaired, an example of psychosis. This makes it more difficult to confidently diagnose schizophrenia. They did not believe that schizophrenia was a disease. This suggests that there are problems with the chicken and egg problem. These refer to the latest editions of the two classification systems. 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. 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. Assessment: The therapist encourages the patient to explain their concerns. 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. b) Explain one reason why there might be a problem of bias and generalisation in this study. DSM) should arrive at the same diagnosis for the same individual. 11 items. Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them delusions of persecution. Tel: +44 0844 800 0085. The stress-trigger could be environmental __or biological (for example, smoking cannabis is linked with schizophrenia). (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. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. The rate of relapse was particularly high if returning to a high EE family was coupled with no medication. Treatment: In an interactionist approach, treatments will take more than one form. Adoption studies of schizophrenia - PubMed 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 double-bind, high expressed emotion - . The validity of schizophrenia as a single disorder is questioned by many. In other words, it doesnt cure schizophrenia, it just helps people get over it. These may be risk factors for the development and maintenance of schizophrenia. She has been taking a typical antipsychotic drug and there have been improvements in her positive symptoms. LS23 6AD CBT does seem to reduce relapses and readmissions to hospital (NICE 2014). In more extreme cases the patient might be unable to cope with the pressures of having to discuss their ideas and feelings and could become stressed by the therapy, or over-fixated with the details of their illness. Gottesman reports that while the rate of schizophrenia in the general population is 1%, if one parent has schizophrenia there is a 12% likelihood their child will develop it and if both parents have schizophrenia, it increases to 40%. The technique alleviates negative symptoms such as poor motivation, and nurses subsequently view patients more positively, which raises staff morale and has beneficial outcomes for patients. Registered office: International House, Queens Road, Brighton, BN1 3XE, Psychology Schizophrenia Family Dysfunction. Tokens are secondary reinforcers, which are exchanged for rewards (primary reinforcers), for example food, being allowed to watch a film, and so on. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002). schizophrenia psychology aqa question help - The Student Room We are committed to engaging with you and taking action based on your suggestions, complaints, and other feedback. Briefly outline family dysfunction as an explanation for schizophrenia. In a follow up study they rejected genuine patients whom they assumed were part of the deception. In other words the illness only manifesters itself under appropriate environmental conditions, genetics was not enough on its own. Schizophrenia Revisions Notes - Simply Psychology David Rosenhan (1973) famous experiment involving Pseudopatients led to 8 normal people being kept in hospital despite behaving normally. Family Dysfunction as an Explanation of Schizophrenia - YouTube They act as dopamine antagonists, attempting to reduce dopamine activity. PDF Title: Psychological Explanations - WordPress.com It is very difficult to separate out the influence of nature-v-nurture. disputing techniques. VAT reg no 816865400. 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. Newer drugs, called atypical antipsychotics attempt to target D2 dopamine activity in the limbic system but not D3 receptors in other parts of the brain. If the distress caused to the child is severe and long-lasting, he/she may . Family Therapy aims to reduce levels of expressed emotion, and reduced the likelihood of relapse. Another form of CBT: Coping Strategy Enhancement (CSE). Having attempted to dispute faulty beliefs, patients may also be set behavioural assignments with the aim of improving their general level of functioning. For the classification system to be reliable, differfent clinicians using the same system (e.g. A weakness of the family relationsships appraoch is that there is a problem of cause and effect. A second weakness is the problem of nature-v-Nurture. Chlorpromazine and Haloperidol. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. The focus of a token economy is on shaping and positively reinforcing desired behaviors and NOT on punishing undesirable behaviors. Negative symptoms are a diminution or loss of normal functions such as psychomotor disturbances, avolition (the reduction of goal-directed behavior), disturbances of mood and thought disorders. (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. He used MRI (magnetic resonance imaging) to obtain pictures of the brain structure of MZ twins in which one twin was schizophrenic. Voices are usually heard coming from outside the persons head giving instructions on how to behave. Laing and others rejected the medical / biological explanation of mental disorders. Family dysfunction refers to the workings of dysfunctional families, and the effects of being brought up in one, contributing to schizophrenia. 2002-2023 Tutor2u Limited. A co-operative, trusting relationship with the family is established, Therapist provides information about schizophrenia, Family members contribute, all contributions valued, Family is provided with practical coping skills to help deal with the disorder (to anticipate and solve problems), More constructive ways of interaction and communication encouraged (to avoid expressed emotion), Training to detect any signs of relapse in the patient. Positive symptoms are an excess or distortion of normal functions, for example hallucinations, delusions and thought disturbances such as thought insertion. By oversimplifying schizophrenia in terms of genes and neurotransmitters, the social context within which it develops has not been considered. 806 8067 22 Kahn et al. Dopamine is a neurotransmitter. The biological basis for schizophrenia is therefore not addressed at all in the therapy, limiting its use. People with schizophrenia have abnormally large ventricles in the brain . Drug therapy is a biological treatment for schizophrenia. Cognitive deficits have been suggested as possible explanations for a range of behaviors associated with schizophrenia. This suggests that one needs to be careful when establishing cause and effect relationships in schizophrenic patients. However, evidence may not be reliable as patients recall may be affected by their schizophrenia. Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. Benzel et al. Full Text. In London the rate remained at 20%, suggesting neither group had a valid definition of schizophrenia. Further support comes from the fact that dopamine agonists (e.g. Diagnosis refers to the assigning of a label of a disorder to a patient. This suggests that biological factors predispose someone to schizophrenia, but this has to be triggered by some sort of experience or stressor. Outline and evaluate the diathesis-stress model of schizophrenia Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia. 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. 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. The commonest diagnosis was schizophrenia (n = 23, 57.5%) followed by epileptic psychosis (n = 4, 10.0%) and general psychosis (n = 4, 10.0%) with one of psychotic depression and one psychosis secondary to general medical condition. In the 1950s and 60s nurses often rewarded patients with cigarettes. Without this knowledge a person displaying overt emotional behavior in a Western culture might be regarded as abnormal. Ethical issues Antipsychotics have been used in hospitals to calm patients and make them easier for staff to work with rather than for the patients benefit Can lead to the abuse of the Human Rights Act (no one should be subject to degrading treatment). 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. This is mainly aimed at lowering expressed emotion. Schizophrenia | Psychology | tutor2u PDF (Total 16 marks) - Psych205 Even newer antipsychotic drugs, such as risperidone and olanzapine are safer, and they also may be better tolerated. These symptoms may leave them fearful and withdrawn. The aim in modern forms of this therapy is to reduce the stress in the family environment so preventing relapse. [6 marks], ethical problems - parents feel responsible for their child's illness causing even greater stress and anxiety. For example, about 50% of people with schizophrenia are also diagnosed with depression. VAT reg no 816865400. Eg. The schizophrenic twin generally had more enlarged ventricles and a reduced anterior hypothalamus. Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . BSc (Hons) Psychology, MRes, PhD, University of Manchester. To teach patients and carers more effective stress management techniques. One area where the model has had considerable success is schizophrenia, a disease with both genetic and environmental causes. Found that changes in behavior achieved through token economies do not remain when tokens are withdrawn, suggesting that such treatments address effects of schizophrenia rather than causes. Bruce Johnson is an A-level psychology teacher, and head of the sixth form at Caterham High School. . The idea of pleasing her, shows that he does want to make . Toyokawa, Et. Laing believed that schizophrenia was a result of the interactions between people, especially in families. In order to explain schizophrenia effectively it would be better to take an interactionist approach, such as the diathesis stress model. The intention is to show schizophrenics that their hallucinations are not real. This suggests that gaining an insight into family relationships allows psychiatric professionals to help improve the quality of patients lives.