Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . Bateson et al. therefore, it is not appropriate to generalise their language ability to all people with schizophrenia (must be some application here) To teach patients and carers more effective stress management techniques. 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. C: Consequences what impact does that have on your relationships with others? Of these, only 1 study showed improvement in symptoms and behavioural change in patients. An example is Clozapine which is used when other drugs have failed, due to the risk of agranulocytosis (a potentially fatal blood condition). It is therefore prescribed when the patient is at risk of suicide. Just challenging the dysfunctional thoughts through disputing may not be enough to change them if the thoughts have a biological basis. CBT may involve challenging the validity of beliefs, which may interfere with freedom of thought. It could be that the problems caused by low neurotransmitters creates the cognitive deficits. 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. [4 marks]. The diathesis-stress model states that both a vulnerability to SZ and a stress trigger are necessary to develop the condition. 1. a group of people related by blood or marriage or a strong common bond, such as those descended from a common ancestor, or a husband, wife, and their children. EE is a family communication style that involves criticism, hostility and emotional over-involvement. This is mainly aimed at lowering expressed emotion. They block dopamine receptors on post-synaptic neurons, meaning that less dopamine is transmitted across the synapse. Antipsychotic drugs are used to reduce the intensity of symptoms (particularly positive symptoms). (2005) tested the reliability of the ICD-10 classification system in diagnosing schizophrenia. He used MRI (magnetic resonance imaging) to obtain pictures of the brain structure of MZ twins in which one twin was schizophrenic. A hundred Danish patients with a history of psychosis were assessed using operational criteria, and a concordance rate of 98% was obtained. While schizophrenia has a strong genetic component, some individuals with genetic susceptibilities to the disorder nonetheless remain healthy. why some children in such dysfunctional families often do not go on to develop schizophrenia. Positive symptoms are an excess or distortion of normal functions, for example hallucinations, delusions and thought disturbances such as thought insertion. One of the biggest criticisms of the dopamine hypothesis came when Farde et al found no difference between schizophrenics levels of dopamine compared with healthy individuals in 1990. Double bind is based on clinical observation the patients and early evidence involved assessing the personality of the mothers for 'crazy-making' characterists. Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics. Credit should be awarded for one type in some detail or for two (or more) done briefly. Bruce Johnson is an A-level psychology teacher, and head of the sixth form at Caterham High School. This suggests that the biological account cannot give a full explanation of the disorder. In CBT, patients may be taught to recognise examples of dysfunctional or delusional thinking, then may receive help on how to avoid acting on these thoughts. Melzer (2012) concluded that Clozapine is effective in 30-50% of cases where other drugs have failed, supporting its use in schizophrenia treatment. This suggests that the research into gene mapping is oversimplistic as schizophrenia is not due to a single gene. holes) in the brain that supply nutrients and remove waste. So in this context it is the occurrence of two illnesses or conditions together; for example, a person has both schizophrenia and a personality disorder. Requires self-awareness and willingness to engage Held back by the symptoms schizophrenics encounter It is an ineffective treatment likely to lead to disengagement. Another problem is the theory led's to parent blaming. They generally have fewer side effects eg. Patients went from performing 5 chores a day to around 40. It is difficult to keep this treatment going once the patients are back at home in the community. A final strength is that it takes on board the nurture approach to the development of schizophrenia. This suggests that there are problems with the chicken and egg problem. 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. 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. Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. System overlap refers to the way that disorders have shared symptoms. First, the adoptees study method, the index offspring of adopting-away schizo ), empirical (where is the evidence?) Berger (1965), however this evidence may be unreliable because the patients recall may be effected by the dis-order e.g. Older antipsychotics like haloperidol or chlorpromazine may produce side effects (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 Dysfunctional Family Dysfunctional Family Dysfunctional Family 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 806 8067 22 Family therapies may improve the quality of life for schizophrenia patients and their families, but do not provide a cure for schizophrenia, rather a management of the effects. Schizophrenia is a severe mental illness where contact with reality and insight are impaired, an example of psychosis. This supports a genetic link. The modern understanding of diathesis-stress is slightly different. For example, trying to persuade an individual that the government is not watching or monitoring them in any way may interfere with their (possibly justifiable) fear of an over-controlling government. Read the model answers to get a clearer idea of what is needed. ABC: Get the patients to understand what is really happening in their life: A: Antecedent what is triggering your problem ? including dysfunctional thought processing. Voices are usually heard coming from outside the persons head giving instructions on how to behave. The researchers used an inferential statistical test to see if there was a significant difference in language rating between the two groups. B: behavior how do you react in these situations ? 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. 3x sold. A quarter of people with schizophrenia (Total 4 marks) 11 Describe and evaluate biological explanations for 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. Where two conditions are frequently diagnosed together it calls into question the . Even newer antipsychotic drugs, such as risperidone and olanzapine are safer, and they also may be better tolerated. 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 severity of the side-effects is a weakness as patients will be reluctant to take them, or may even die as a result of the effect. This requires honesty, patience and unconditional acceptance. Economic Benefits: Family therapy is highly cost effective because it reduces relapse rates, so the patients are less likely to take up hospital beds and resources. The reason for this is because the approach does not consider other factors such as genes. Study with Quizlet and memorize flashcards containing terms like Explain how family dysfunction might be involved in schizophrenia. 2. 2002-2023 Tutor2u Limited. They act as dopamine antagonists, attempting to reduce dopamine activity. VAT reg no 816865400. The harmful effects on the child may go completely unacknowledged or be minimized. they said an event was real but it was in their head. BSc (Hons) Psychology, MRes, PhD, University of Manchester. Avolition: Lack of volition (i.e. Drugs such as Chlorpromazine also have a sedative effect, meaning that they calm patients down and reduce anxiety. This suggests that the dopamine hypothesis does not account for freewill. This suggests that biological factors predispose someone to schizophrenia, but this has to be triggered by some sort of experience or stressor. Social behavior depends, in part, on using other peoples actions as clues for understanding what they might be thinking. Neuropsychologist Michael Foster Green suggests that neurocognitive deficits in basic functions such as memory, attention, central executive and problem solving skills may combine to have an outcome which we are labelling Schizophrenia as if it was the cause when in fact it is simply an umbrella term for a set of effects. It is also used as a basis for the ICD (International Classification of Diseases) used by the World Health Organisation in classifying all disorders (mental and physical). a) Explain why a Mann-Whitney test is an appropriate choice of statistical test in this situation and a Spearman's test is not. 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 ). This creates problems of reliability. Without this knowledge a person displaying overt emotional behavior in a Western culture might be regarded as abnormal. This raises practical and ethical issues when selecting different types of tretment. 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. They believed that schizophrenia was a result of social pressures from life. Copyright Get Revising 2023 all rights reserved. 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. Imagined stimuli could involve any of the senses. 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. These symptoms may leave them fearful and withdrawn. Here are a series of suggested answers for the Schizophrenia topic questions in AQA A Level Psychology Paper 3 (Section B) in June 2018. Falloon et al (1996) stress such as divorce or bereavement, causes the brain to be flooded with neurotransmitters which brings on the acute episode. Evidence to support the genetic explanation comes from Gottesman and Shields, who found a concordance rate of 42% for MZ and 9% for DZ. Preconscious thought (thought that occurs without awareness) contains a huge amount of information from our senses that would normally be filtered. Visual - Evaluation of neural correlates for schizophrenia 4. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. They did not believe that schizophrenia was a disease. The intention is to show schizophrenics that their hallucinations are not real. Note: you may come across the terms DSM-IV and ICD-10. CBT aims to identify and alter irrational thinking including regarding: In theory, when the misunderstandings have been swept away, emotional attitudes will also improve. with reference to co-morbidity, [2 marks] The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49 3x sold 11 items 1. Comorbidity occurs because the symptoms of different disorders overlap. However she still suffers negative symptoms and side effects. 214 High Street, Drug therapy is a biological treatment for schizophrenia. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. 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. Psychological therapies are very rarely used alone, but sometimes patients may just take drugs without any other therapy. They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity. Research indicates their attention skills may be deficient they often appear easily distracted. Adoption studies have helped clarify both of these problems. Desirable behavior includes self-care, taking medication, work skills, and treatment participation. Refer to one or more typesof family dysfunction in your answer. They engage in no self motivated behavior. One area where the model has had considerable success is schizophrenia, a disease with both genetic and environmental causes. It is not a cure. Atypical antipsychotics such as Clozapine bind to dopamine, serotonin and glutamate receptors. However, the newer antipsychotic drugs affect other neurotransmitters such as serotonin and glutamate as well as dopamine. 2. a taxonomic category below an order and above a genus. In application questions, examiners look for effective application to the scenario which means that you need to describe the theory and explain the scenario using the theory making the links between the two very clear. Evidence to support this view comes from the prospective adoption study by Tienari et al. There are also delusions of being paranoid, worrying that people are out to get them. [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. Another family variable associated with schizophrenia is a negative emotional climate, or more generally a high degree of expressed emotion (EE). Antipsychotic medication will often be used alongside CBT, acknowledging the role that biological and psychological factors play in the disorder. Families taught to have weekly family meetings solving problems on family and individual goals, resolve conflict between members, and pinpoint stressors. Culture One of the biggest controversies in relation to classification and diagnosis is to do with cultural relativism and variations in diagnosis. Cognitive approaches examine how people think, how they process information. Research by Miyakawa et al. 2002-2023 Tutor2u Limited. Chronic environmental stress, for example having a schizophrenogenic mother, results in the onset of schizophrenia. First generation Antipsychotics are called Typical Antipsychotics There are two types of twins identical (monozygotic) and fraternal (dizygotic). Tel: +44 0844 800 0085. Cognitive biases refer to selective attention. stress) may trigger the onset of schizophrenia, rather than individuals with schizophrenia moving down in social status. 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. Kazdin et al. Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia. They arrest dopamine production by blocking the D2 receptors in synapses that absorb dopamine, in the mesolimbic pathway thus reducing positive symptoms, such as auditory hallucinations. Further support comes from the fact that dopamine agonists (e.g. Laing believed that schizophrenia was a result of the interactions between people, especially in families. Recovery may be due to psychological factors The placebo effect is when patients symptoms are reduced because they believe that it should. This helps improve the quality of life for schizophrenia sufferers. The stress-trigger could be environmental __or biological (for example, smoking cannabis is linked with schizophrenia). Family therapy is based on the premise that nurture (upbringing) is a significant factor in schizophrenia. Response. The original version suggested it was due to high levels or activity of dopamine in the subcortex (hyperdopaminergia). But in fact some Schizophrenics are successfully treated whereas others are not. The researchers found that the males had a genetic condition which became later known as "Brunner syndrome" (it is important to note that females only carry this condition, as it only affects the MAOA production gene on the single X chromosome in males). Classification and diagnosis does have advantages as it allows doctors to communicate more effectively about a patient and use similar terminology when discussing them. Medication can be taken as pills, syrups or injections, and may be taken over a short or long-term. Psychomotor Disturbances: Stereotypyical Rocking backwards and forwards, twitches, & repetitive behaviors. 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. Chronic schizophrenics achieved 3lbs of weight loss a week. In the 1950s and 60s nurses often rewarded patients with cigarettes. So environment does play a part in triggering the illness. Tarrier (1987) used detailed interview techniques, and found that people with schizophrenia can often identify triggers to the onset of their psychotic symptoms, and then develop their own methods of coping with the distress caused. In the USA only 20% of psychiatric patients were classed as having schizophrenia in the 1930s but this rose to 80% in the 1950s . Explain how family dysfunction might be involved in schizophrenia. Boston House, Tokens are secondary reinforcers, which are exchanged for rewards (primary reinforcers), for example food, being allowed to watch a film, and so on. The dopamine hypothesis is another biological explanation for schizophrenia. Zubin and Spring suggest that a person may be born with a predisposition towards schizophrenia which is then triggered by stress in everyday life. Jakobsen et al. Faris and Dunham (1939) found clear pattern of correlation between inner city environments and levels of psychosis. They assumed the bogus patients were schizophrenic with no real evidence. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002). A second strength of the research into expressed emotion (EE) is that it has practical applications. Therefore, CBT has potential ethical issues. 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 other words the illness only manifesters itself under appropriate environmental conditions, genetics was not enough on its own. This means it cannot be used to treat schizophrenia by itself. 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%. 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'. This suggests that the cognitive approach is oversimplistic when consider the explanation of schizophrenia. 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. The schizophrenic twin generally had more enlarged ventricles and a reduced anterior hypothalamus. Research using family studies have suggested a genetic vulnerability is inherited and this varies from those with a high . Getting dressed, tokens (in the form of coloured discs) are given immediately as secondary reinforcers which can be exchanged for rewards eg. Antipsychotic drugs are weakened by the fact that they have severe side-effects. For example Hogarty (1991) produced a type of therapy session, which reduced social conflicts between parents and their children which reduced EE and thus relapse rates. b) Explain one reason why there might be a problem of bias and generalisation in this study. Diagnosis of schizophrenia is difficult as the practitioner has no physical signs but only symptoms (what the patient reports) to make a decision on. It is very difficult to separate out the influence of nature-v-nurture. With these particular questions there is a sizeable risk that people dont understand the difference between the questions, and then write about the wrong thing. Delusions are false beliefs. Research by Miyakawa et al. The rate of relapse was particularly high if returning to a high EE family was coupled with no medication. The idea of cognitive biases has been used to explain some of the behaviors which have been traditionally regarded as symptoms of schizophrenia. David Rosenhan (1973) famous experiment involving Pseudopatients led to 8 normal people being kept in hospital despite behaving normally. This suggests that there is wider academic credibility for the idea of contradictory messages causing schizophrenia. 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. Typical antipsychotic drugs are used to reduce the intensity of positive symptoms, blocking dopamine receptors in the synapses of the brain and thus reducing the action of dopamine. Ayllon and Azrin (1968) set up a token economy with schizophrenic patients in a psychiatric institution. For men the figure was 59%. There are serious ethical concerns in blaming the family, particularly as there is little evidence upon which to base this. Those who do not have the schizogene would not develop schizophrenia, even if they experienced a chronically stressful upbringing. Turkington et al. Boston Spa, Symptom targeting: a specific symptom is selected for which a particular coping strategy can be devised (2004): Adopted children from families with schizophrenia had more chance of developing the illness than children from normal families. Clozapine targets multiple neurotransmitters, not just dopamine, and has been shown to be more effective than other antipsychotics, although the possibility of severe side effects in particular, loss of the white blood cells that fight infection. There is a lack of understanding and explanation of how the diathesis-stress model works- it is known that both have to be present to lead to schizophrenia, but not how the mechanisms of schizophrenia symptoms develop. A second weakness is the problem of nature-v-Nurture. Communication skills training teach family to listen, to express emotions and to discuss things. 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. Family studies find individuals who have schizophrenia and determine whether their biological relatives are similarly affected more often than non-biological relatives. Benzel et al. 1. Addington and Addington (2005) claim that CBT is of little use in the early stages of an acute schizophrenic episode, but perhaps more useful when the patient is more calm and beginning to worry about how life will be after they recover. CBT is rarely used without drug therapy, suggesting it is not enough on its own to treat schizophrenia. Small doses given to people already suffering from schizophrenia tend to worsen their symptoms. [4 marks], "Two years ago Jenny was diagnosed with schizophrenia. Pederson and Mortensen (Denmark 2001) found Scandanavian villages have very LOW levels of psychosis, but 15 years of living in a city increased risk. Cochrane (1977) reported that the incidence of schizophrenia in the West Indies and the UK is 1 %, but that people of Afro-Caribbean origin are seven times more likely to be diagnosed as schizophrenic when living in the UK. Does the low motivation reflect depression or schizophrenia, or both? and pragmatic (how is the belief helpful?) The Genome Project has increased understanding of the complexity of the gene. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia. characteristics of iq levels, average male shoe size by height,

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