A second strength of the research into expressed emotion (EE) is that it has practical applications. Preliminary analysis: Through interviews and observation the therapist identifies strengths and weaknesses of family members and identifies problem behaviors. Hickling (1999) the stress of urban living made African-Carribean immigrants in Britain 8 to 10 times more likely to experience schizophrenia. Brown and Birley (1968) 50% people who had an acute schizophrenic episode had experienced a major life event in 3 weeks prior. At least 73% of his sample reported that these strategies were successful in managing their symptoms. B: behavior how do you react in these situations ? 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 . The harmful effects on the child may go completely unacknowledged or be minimized. 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. Some people who have been diagnosed as schizophrenic appear to have difficulties with this skill. 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. [4 marks], - Atypical and typical antipsychotics are equally effective against positive symptoms with more than half of patients responding well, Apart from effectiveness, briefly explain one limitation of drug therapy for schizophrenia. Although this study showed that children with a biological parent were still at greater risk even if they had been adopted into families with no history of schizophrenia, all reported cases of schizophrenia occurred in families rated as disturbed. disputing techniques. 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. They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. Laing believed that schizophrenia was a result of the interactions between people, especially in families. For example, it suggests that schizophrenic behavior is the cause of environmental factors such as cognitive factors. However they do not cure schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community. Antipsychotic drugs are highly effective as they are relatively cheap to produce, easy to administer and have a positive effect on many sufferers. In the USA only 20% of psychiatric patients were classed as having schizophrenia in the 1930s but this rose to 80% in the 1950s . For the classification system to be reliable, differfent clinicians using the same system (e.g. Example Answers for Schizophrenia: A Level Psychology, Paper 3, June 2019 (AQA) Exam Support. 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. Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them delusions of persecution. The stress-trigger could be environmental __or biological (for example, smoking cannabis is linked with schizophrenia). 3. Ethical issues Severely ill patients cant get privileges because they are less able to comply with desirable behaviors than moderately ill patients They may suffer from discrimination. Visual - Evaluation of the dopamine hypothesis for schizophrenia. First generation Antipsychotics are called Typical Antipsychotics 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. To improve how the family communicated and handled the situation. RWA Offering drugs can lead to an enhanced quality of life as patients are given independence Positive impact on the economy as patients can return to work and no longer need to be provided with institutional care. Abstract. This will not get rid of the symptoms of schizophrenia but it can make patients better able to cope with them. Since their are problems with the validity of diagnois classification, unsuitable treatment may be administered, sometimes on an involuntary The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly. Cognitive approaches examine how people think, how they process information. Drugs such as Chlorpromazine also have a sedative effect, meaning that they calm patients down and reduce anxiety. 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. Double bind is based on clinical observation the patients and early evidence involved assessing the personality of the mothers for 'crazy-making' characterists. b) Explain one reason why there might be a problem of bias and generalisation in this study. The diathesis-stress model states that both a vulnerability to SZ and a stress trigger are necessary to develop the condition. 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. The effect of this is, as well as reducing positive symptoms, the reduction of depression and anxiety, and the enhancement of mood. It is therefore prescribed when the patient is at risk of suicide. Melzer (2012) concluded that Clozapine is effective in 30-50% of cases where other drugs have failed, supporting its use in schizophrenia treatment. Research indicates their attention skills may be deficient they often appear easily distracted. Ethics do the benefits of classification (care, treatment, safety) outweigh the costs (possible misdiagnosis, mistreatment, loss of rights and responsibility, prejudice due to labelling). (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. Refer to one or more types of family dysfunction in your answer. less effect on movement Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49. 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. The schizophrenic twin generally had more enlarged ventricles and a reduced anterior hypothalamus. If family dynamics were the sole cause of schizophrenia, then all children raised in similar environments should be schizophrenic. They are also encouraged to evaluate the content of their delusions or of any internal voices they hear and to consider ways in which they might test the validity of their faulty beliefs. Since the mid-1950s antipsychotic medications have greatly improved treatment. How could the researchers modify their study to deal with this problem? A dysfunctional family is one that has at its core destructive and harmful parenting and a lack of concern for the child. Strategies are practised within a session and the client is helped through any problems in applying it. However she still suffers negative symptoms and side effects. As this is not the case family dysfunctions cannot be the sole cause ofthe illness. Pharaoh et al. Token economies raise ethical issues. Weak evidence for family based explanations, there is no evidence that supports the importance of double bind theory. 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. (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. Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics. [2 marks] Make sure you know which is which, for example do you understand the difference between genetic explanation and neural correlates explanation, and do you have a model essay for each? 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. Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . basis. Inherited factors that make some individuals more likely to develop a certain behaviour or mental disorder. Therefore there is no need to feel stressed or ashamed about them. The validity of schizophrenia as a single disorder is questioned by many. Positive symptoms are an excess or distortion of normal functions, for example hallucinations, delusions and thought disturbances such as thought insertion. However, one explanation for this is mutation in parental DNA. Gottesman (1991) found that MZ twins have a 48% risk of getting schizophrenia whereas DZ twins have a 17% risk rate. More receptors lead to more firing and an over production of messages. The focus of a token economy is on shaping and positively reinforcing desired behaviors and NOT on punishing undesirable behaviors. This is a useful point to emphasise in any essay on the disorder. 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. This suggests that gaining an insight into family relationships allows psychiatric professionals to help improve the quality of patients lives. A second explanation developed, which suggests that it is not excessive dopamine but that fact that there are more dopamine receptors. One criticism of the dopamine hypothesis is there is a problem with the chicken and egg. Family Dysfunction as an Explanation of Schizophrenia Miss Earle Psychology 3.57K subscribers Subscribe Share Save 2.4K views 3 years ago Family Dysfunction and Schizophrenia AO1 and AO3. Catatonia- staying in position for hours/days on end, cut off from the world. stress) may trigger the onset of schizophrenia, rather than individuals with schizophrenia moving down in social status. Most importantly, families can make the schizophrenic feel loved, accepted and valued. Check out Adapt the A-level & GCSE revision timetable app. However, those children from families schizophrenia were less likely to develop the illness if placed in a good family with kind relationships, empathy, security, etc. 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. 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 makes it more difficult to confidently diagnose schizophrenia. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. They did not believe that schizophrenia was a disease. To educate relatives about schizophrenia. Participants in Group B, the control group, were a volunteer sample of people who attended a community centre. A study by Anderson et al. This suggests that if this research was tested and re-tested the same results would be achieved. David Rosenhan (1973) famous experiment involving Pseudopatients led to 8 normal people being kept in hospital despite behaving normally. Drug therapy is a biological treatment for schizophrenia. Validity the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms. Dopamine is a neurotransmitter. Is the raised dopamine levels the cause of the schizophrenia, or is it the raised dopamine level the result of schizophrenia? 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). 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. Study with Quizlet and memorize flashcards containing terms like Explain how family dysfunction might be involved in schizophrenia. Briefly outline family dysfunction as an explanation for schizophrenia. This manages schizophrenia because it maintains desirable behavior and no longer reinforces undesirable behavior. 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. This is evidence that the higher the degree of genetic relativeness, the higher the risk of getting schizophrenia. The adoptive families were investigated thoroughly using joint and individual interviews and psychological tests. 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. Vasos (2012) Found the risk of schizophrenia was 2.37 times greater in cities than it was in the countryside, probably due to stress levels. Small doses given to people already suffering from schizophrenia tend to worsen their symptoms. Help the patient realise it is normal to have negative thoughts in certain situations. Families taught to have weekly family meetings solving problems on family and individual goals, resolve conflict between members, and pinpoint stressors. Just challenging the dysfunctional thoughts through disputing may not be enough to change them if the thoughts have a biological basis. Bruce Johnson is an A-level psychology teacher, and head of the sixth form at Caterham High School. Holistic Identifies that patients have different triggers, genes etc. But in fact some Schizophrenics are successfully treated whereas others are not. (2005) tested the reliability of the ICD-10 classification system in diagnosing schizophrenia. Upper and Newton (1971) found that the weight gain associated with taking antipsychotics was addressed with token economy regimes. Note: you may come across the terms DSM-IV and ICD-10. Toyokawa, Et. Combining treatments is most common in the UK, although it is also sometimes used in the USA. Cognitive deficits have been suggested as possible explanations for a range of behaviors associated with schizophrenia. Further support comes from the fact that dopamine agonists (e.g. Response. One weakness of the genetic explanation of schizophrenia is that there are methodological problems. [6 marks], ethical problems - parents feel responsible for their child's illness causing even greater stress and anxiety. Central idea: Patients problems are based on incorrect beliefs and expectations. Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia 2. 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. Kendler (1985) has shown that first-degree relatives of those with schizophrenia are 18 times more at risk than the general population. 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. One biological explanation for schizophrenia is that it is passed on through the genes. B.A., History and Educational Psychology, University of Exeter. This is not the case with schizophrenia: The causes may be one of biological or psychological or both. culture and gender bias and symptom overlap. They are then given homework tasks to practice, and keep a record of how it worked. Sweets and cigarettes. It is also important to note that two-thirds of people with schizophrenia have no relative with a similar diagnosis and therefore have no one to inherit it from. desire): in which a person becomes totally apathetic and sits around waiting for things to happen. Predictive validity. They believed that schizophrenia was a result of social pressures from life. A strength of the cognitive explanation is that it has practical applications. Additional communication skills are taught, such as compromise and negotiation, and requesting a time out . For men the figure was 59%. It is one of the chemicals in the brain which causes neurons to fire. 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. These may be risk factors for the development and maintenance of schizophrenia. Therefore, CBT has potential ethical issues. Liem (1974)measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families. (2004): Adopted children from families with schizophrenia had more chance of developing the illness than children from normal families. 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. Pathophysiology, evaluation and treatment of erectile dysfunction: review article Andrey Biff Sarris 1 , Maki Caroline Nakamura 1 Luiz Gustavo Rachid Fernandes 1 , Problems of validity: Are we really testing what we think we are testing? However, the concordance rate for MZ twins is not 100% which suggests that other factors must also be involved. 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. The original version suggested it was due to high levels or activity of dopamine in the subcortex (hyperdopaminergia). Eg. 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 It is difficult to keep this treatment going once the patients are back at home in the community. Conversely, antipsychotic drugs work by binding to dopamine receptors and reduce symptoms. The dopamine hypothesis is another biological explanation for schizophrenia. 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). Medications reduce positive symptoms particularly hallucinations and delusions; and usually allow the patient to function more effectively and appropriately. The researchers concluded that this is more important in maintaining schizophrenia than in causing it in the first place, (Brown et al 1958). Ventricles are fluid filled cavities (i.e. Comorbidities were also found with epilepsy being the . This demonstrates the high reliability of the clinical diagnosis of schizophrenia using up-to-date classification. where normal functions are limited: including speech poverty and avolition. Tel: +44 0844 800 0085. 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. VAT reg no 816865400. McMonagle and Sultana (2000) reviewed token economy regimes over a 15-year period, finding that they did reduce negative symptoms, though it was unclear if behavioral changes were maintained beyond the treatment programme. The differences were so large the schizophrenic twins could be easily identified from the brain images in 12 out of 15 pairs. Antipsychotic drugs (drugs used to reduce the intensity of the symptoms) are the most common treatment for schizophrenia. Of these, only 1 study showed improvement in symptoms and behavioural change in patients. So environment does play a part in triggering the illness. Therefore it appears that several neurotransmitters may be involved in the development of schizophrenia, meaning the dopamine hypothesis is too simplistic. 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 therefore, it is not appropriate to generalise their language ability to all people with schizophrenia (must be some application here) They cannot express their feelings about the unfairness of the situation. Company Reg no: 04489574. The aim in modern forms of this therapy is to reduce the stress in the family environment so preventing relapse. Diagnosis refers to the assigning of a label of a disorder to a patient. This suggests that understanding the effects of cognitive deficits allows psychologists to create new initiatives for schizophrenics and improve the quality of their lives. Eg. 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. In other words, it doesnt cure schizophrenia, it just helps people get over it. For the classification system to be valid it should be meaningful and classify a real pattern of symptoms, which result from a real underlying cause. Clozapine acts in a similar way to Chlorpromazine, but also acts on serotonin and glutamate receptors. Meehl suggested that the vulnerability is genetic (the result of a schizogene), causing a sensitive personality. 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. These machines take accurate readings of brain regions such as the frontal and pre-frontal cortex, the basil ganglia, the hippocampus and the amygdale. Family dysfunction refers to the workings of dysfunctional families, and the effects of being brought up in one, contributing to schizophrenia. Metaanalysis by Crossley Et Al (2010) suggested that Atypical antipsychotics are no more effective, but do have less side effects. (1972) described how a child may be regularly trapped in situations where they fear doing the wrong thing, but receive mixed messages about what counts as wrong. 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 entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49 3x sold 11 items 1. Culture One of the biggest controversies in relation to classification and diagnosis is to do with cultural relativism and variations in diagnosis. This suggests that there is wider academic credibility for the idea of contradictory messages causing 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. A final strength is that it takes on board the nurture approach to the development of schizophrenia. Typical antipsychotics: Developed in the 1950s, for example Chlorpromazine. There is no such thing as a normal schizophrenic exhibiting the usual symptoms. Researchers have focused on two factors which appear to be related to some of the experiences and behaviors of people diagnosed with schizophrenia. This suggests that there is a problem of the chicken and egg scenario in relation to expressed emotion causing schizophrenia. Gender bias is also an issue as the mother tends to be blamed the most, which means such research is highly socially sensitive. Chronic environmental stress, for example having a schizophrenogenic mother, results in the onset of schizophrenia. To teach patients and carers more effective stress management techniques. People with schizophrenia have abnormally large ventricles in the brain . A second weakness of the neuroanatomical explanations is that it is biologically deterministic. 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. Concordance rates are never 100% which suggests that environmental factors must also play a role in the development of SZ. CBT may involve challenging the validity of beliefs, which may interfere with freedom of thought. Slater & Roth (1969) say that hallucinations are the least important of all the symptoms, as they are not exclusive to schizophrenic people. 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. [4 marks], "Two years ago Jenny was diagnosed with schizophrenia. (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. Patients can receive different treatments for their SZ which will be more effective. Copyright Get Revising 2023 all rights reserved. In London the rate remained at 20%, suggesting neither group had a valid definition of schizophrenia. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. Assessment: The therapist encourages the patient to explain their concerns. CBT does seem to reduce relapses and readmissions to hospital (NICE 2014). Paul and Lentz (1977) Token economy led to better overall patient functioning and less behavioral disturbance, More cost-effective (lower hospital costs). 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? The intention is to show schizophrenics that their hallucinations are not real. The reason for this is because if the individual does have excessive amounts of dopamine then does it really mean that thy ey will develop schizophrenia? Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia. It could be that the problems caused by low neurotransmitters creates the cognitive deficits. Preconscious thought (thought that occurs without awareness) contains a huge amount of information from our senses that would normally be filtered. This suggests that there may be problems of demand characteristics. 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. The descriptions follow the same criteria; however you have to use the issues and debates effectively in your answers. Boston Spa, The understanding and treatment of schizophrenia have been greatly hampered by uncertainty about etiological factors and controversy about diagnostic boundaries. Example Answers for Section C Schizophrenia Topic Paper 3 June 2018 (AQA) . AQA maintains that 16-mark questions, or indeed, extended writing questions of other tariffs, could be asked on any part of any topic. Imagined stimuli could involve any of the senses. It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. If diagnosis leads to successful treatment, the diagnosis can be seen as valid. To form identical twins, one fertilised egg (ovum) splits and develops two babies with exactly the same genetic information.
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