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Psy. explanation SZ
AQA A-level psychology explanations for schizophrenia year 13
| Term | Definition |
|---|---|
| Double bind theory | An individual is given two conflicting mutually exclusive choices by an authority figure in their relationship and whatever option they pick they will be blamed for it leading to emotional distress & higher risk of SZ |
| Schizophrenogenic mother | Psychodynamic (debunked) theory that states the mother can contribute to the development of SZ in her child by being cold, overprotective, and emotionally distant |
| Expressed emotions | Emotional environment created by family and caregivers of SZ individuals characterised by high levels of criticism, hostility, and emotional overinvolvement |
| Frith et al. cognitive explanations for schizophrenia | Believed that dysfunctional thought processes in meta-representation and central control led to the development of SZ |
| Dysfunctional thought processes | Faults in our thought processes leading to development of the disorder, Frith highlights the correlation between cognitive issues and impairment of Theory of Mind |
| Theory of Mind | Understanding the mental state of others |
| Metarepresentation | Ability to understand ourselves and others, reflect on thoughts and behaviours. Allows us insight into our own intentions and goals and those of others |
| Central control | The ability to suppress our automatic responses and perform deliberate actions |
| Stirling et al. (2006) theory of central dysfunction | 30 SZ patients and 18 non-patients on a range of cognitive tasks (e.g., Stroop test) and found that SZ patients took twice as long to complete the tasks compared to the control group which supports the theories of Frith et al. |
| Family dysfunction | Abnormal and problematic processes within the family such as poor Communication or excess Criticism, Control, & Conflict |
| Cognitive explanations | Explanations that focus on mental processes such as thinking, language, & attention |
| Dysfunction thought processing | Faulty information processing which can cause undesirable consequences p |
| Bateson et al. (1972) double bind communication | He believed that double bind communication sends mixed messages to children about how to behave and they learn that the world is a confusing and dangerous place, this can lead to paranoid delusions and speech poverty |
| Butzlaff & Hooley (1998) high expressed emotions | They found that when there is an environment of high EE, the relapse rate of schizophrenia is doubled |
| Read et al. (2005) childhood abuse | Reviewed 46 studies, more than 2/3 women and more than 1/2 men with SZ diagnosis had experience physical or sexual abuse during childhood, proves family relationships can contribute to SZ. However, positive SZ symptoms can make memories unreliable |
| Egocentric bias | Cognitive tendency to rely heavily on our own perspective when interpreting events, making judgements, or attributing meaning to situations |
| NICE - National Institute for health and Care Excellence (2014) CBT | Found that CBT was effective at reducing rehospitalisation rates for up to 18 months |
| CBT - talking therapy (patient-therapist collaboration) | 1 hour sessions, 16 normally needed, prescribed by NICE with drugs, patients identify irrational beliefs which are challenged & provided with alternative explanations and goals for how to improve & empirical & logical disputes |
| SIGN (Scottish) approach to therapy | Recommends against CBT siting the positive effects as too little and instead focuses on just antipsychotic medication |
| Tarrier et al. | Found that combination treatment worked better than just medication alone |
| Jauhar et al. (2004) effect of CBT | Meta-analysis of 34 studies & found that while CBT did improve symptoms, it was only in a small range |
| Overall aim of family therapy | To improve family function by reducing stress and expressed emotion to reduce relapse rates and hospitalisation as well as improving family communication |
| Pharoah et al. (2010) family therapy effects | Meta analysis of 53 studies which found family therapy reduced hospital readmissions and quality of life over the course of a year, however, not all studies supported this |
| Pharoah et al. Beliefs | Family therapy reduces stress for people caring for relative with SZ, improves family’s ability to anticipate & solve problems, reduces anger and guilt for contributing towards SZ, helps family understand SZ behaviour |
| Pharoah et al. Counterpoint | Results could be due to the fact family is being supportive by reminding SZ patient to take medication which is improving the symptoms |
| How family therapy benefits the economy | Reduces relapse rates and makes family better equipped to provide SZ care rather than using government funded facilities and services. Significant therapeutic benefits to patient and family so they can work to support the economy |
| Token economies | Reward systems that manage behaviours based on principles of operant conditioning, used in institutions for patients with maladaptive habits |
| Why token economies are referred to as “management of schizophrenia” | This is because it normalises behaviours which improve the general quality of life of patients however, it doesn’t cure their condition so it isn’t a cure. It may be referred to on exams as “management of SZ” rather than token economies |
| How token economies help schizophrenic patients | Target behaviours are immediately rewarded with tokens to help negative symptoms such as avolition & speech poverty by making motivation based and sociable behaviours more likely by rewarding them |
| Delayed discounting | The tendency of individuals to devalue the worth of a reward based on the delay in receiving it |
| Primary reinforcer | A tangible reward which can provide instant gratification |
| Secondary reinforcer | A reward with no inherent value except it’s association with a tangible reward |
| Dickerson et al. (2005) | Meta-analysis of 13 studies into token economies. 11 found they were directly beneficial. However, a lot had methodological problems & so should be treated with caution |
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