Pick up & Frith - Explanations of Dysfunctional Behaviour

Question 1

Aim

Answer 1

To explore theory of mind impairments in patients with diagnosis of schizophrenia.

Question 2

Method

Answer 2

Laboratory experiment

Question 3

Sample

Answer 3

Clinical
41 patients diagnosed with schizophrenia 16-65
IQ: 70 +
No drug/alcohol abuse, neurological disability or leucotomy (brain surgery) history
All but one taking neuroleptic drugs to control schizophrenia although did not impair memory function.
2 control groups: 1 = 35 healthy people with no history of psychiatric problems, 2 = clinical control group 18 people with diagnosis of affective disorder eg. depression

Question 4

Procedure

Answer 4

1: Schizophrenics divided according to symptomology on day of testing eg. 16 behavioural signs group, 16 positive sign of paranoia, 1 showed passivity without behavioural signs, 8 no symptoms on the day
2: 2 second order and 1 first order false belief tests (deception task) of theory of mind were given to participants with schizophrenia and control groups
3: All given 3 ‘non-mental’ representation control tasks that were similar in structure of the Theory of Mind tasks but did not require theory of mind. Memory control questions also asked.
4: Tasks read aloud and enacted by experimenter using props
5: Most stories set in hospital or involved familiar objects in order to increase ecological validity for institutionalised patients.
6: Test question in each task was measure of representational understanding theory of mind.
7: Statistical analysis of relation between theory of mind and symptomatology was explored using regression analysis.

Question 5

Findings (6)

Answer 5

1: Schizophrenics with behavioural signs were impaired relative to controls on ToM.
2: Remittance patients and single case patients performed as well as controls.
3: Severity ratings of behavioural signs predicted there was impaired theory of mind in schizophrenics in regression analysis.
4: Weak evidence that subgroup with paranoid symptoms had ToM impairments associated with low IQ.
5: Schizophrenia patients only showed ToM deficits on second order task.
6: No impairments on matched control tasks which did not require theory of mind.

Question 6

Conclusions

Answer 6

1: Clear association between ToM impairment and behavioural signs in schizophrenia.
2: Deficits in paranoid patients were harder to detect. Deficits may have been compensated for by IQ dependent problem solving skills.
3: Theory of mind impairments in schizophrenia less severe than autism - although were specific to those with current symptoms of schizophrenia, not a reflection of general cognitive deficits.

Question 7

Point 1 - association

Answer 7

1: Schizophrenics with behavioural signs were impaired relative to controls on ToM.
2: Severity ratings of behavioural signs predicted there was impaired theory of mind in schizophrenics in regression analysis.
THEREFORE CONCLUDE…
There was an association between ToM impairment and behavioural signs in schizophrenia.
-Had more severe and complex symptoms, therefore most impaired because of these patients’ incapacity to represent the mental states of others as well as themselves.
-Mentalising abilities become impaired as the illness develops

Question 8

Point 2 - paranoid

Answer 8

1: Weak evidence that subgroup with paranoid symptoms had ToM impairments associated with low IQ.
THEREFORE CONCLUDE…
Deficits in paranoid patients were harder to detect. Deficits may have been compensated for by IQ dependent problem solving skills.
-Performed poorly because of their difficulties in monitoring other people’s intentions.

Question 9

Point 3 - thought disorder

Answer 9

Impairment of theory of mind is related to thought disorder, reflecting an executive functioning deficit.
Cognitive functioning = memory, language, reasoning, thought processing, language, attention.
COGNITIVE DEFICIT LEADING TO DYSFUNCTIONAL DISORDER SCHIZOPHRENIA.

Question 10

Point 4 - cognitive deficits

Answer 10

3: Theory of mind impairments in schizophrenia less severe than autism - although were specific to those with current symptoms of schizophrenia, not a reflection of general cognitive deficits.

• Problems with theory of mind seemed to occur only when specific symptoms of schizophrenia were present, suggesting there was not an underlying cognitive deficit but it is a result of something else.
  
  • – In remission, cognitive deficits only become apparent when individual showing sign of schizophrenia. Cognitive deficits only come out when having schizophrenic episodes. Indicating they are a consequence of rather than route cause for dysfunctional behaviour. May also be reversed eg. schizophrenic episode is a consequence of cognitive deficits.
• May have been cognitive deficits at early stage does not mean they cannot develop eg. mentalising abilities become impaired as the illness develops. Changes in thinking precede (i.e. come before) the onset.
• Developmental and psychotic disorder, also effects the personality so cognitive deficit is not a fixed thing.

Question 11

Point 5 - control task

Answer 11

No impairments on matched control tasks which did not require theory of mind.
THEREFORE valid

Question 12

Point 6 - remittance and passivity explanation

Answer 12

Remittance patients and single case patients performed as well as controls…
THEREFORE normal theory of mind (mentalising) abilities.

Question 13

Validity

• Well controlled
• Tests for children
• No behavioural signs on the day
• Control group

Answer 13

• Well controlled study shown to be valid in detecting theory of mind deficits in autism
• Tests devised for children, however tested on adults 16-65, therefore not valid as may have been too simple. May also explain why deficits only shown in second-order task because it was more difficult.
• Those with schizophrenia showing no signs of behavioural symptoms on the day did not have difficulty with the ToM tasks. THIS SUGGESTS the deficit is not consistent but only evident when symptoms are severe. LINK TO point 4 - cognitive deficits.
• Control group gives us validity as helps to prove that autism is present in schizophrenic patients

Question 14

Ecological Validity

Answer 14

Most stories set in hospital or involved familiar objects in order to increase ecological validity for institutionalised patients.

Question 15

Reliability

Answer 15

• sufficient age range of 16-65
• scientific, therefore reliable measure of differences
• not a true test of theory of mind as some people pass and some fail

Question 16

Ethics

Answer 16

• Given consent as clinical sample and over 16. Although schizophrenic, therefore are they in a sound state of mind to give consent (does schizophrenia mean you cannot give consent?)
• Embarrassment, especially if they fail, as asking adults to a childs task. However no more stress caused than everyday life situation therefore not an issue.

Question 17

Reductionist

Answer 17

Frith fails to take into account the role of environmental factors.

Question 18

Schizophrenia and cognitive approach

Answer 18

Characterised by profound thought disturbance.
Cognitive psychologists believe that disturbed thinking processes are the cause rather than the consequence of schizophrenia.

Question 19

Cognitive deficit

Answer 19

Impairment of individuals mental processes that lead to acquisition of information and knowledge, and drive how an individual understands and acts in the world.

Question 20

Cognitive explanation of schizophrenia

Answer 20

1 = mechanisms which filter and process information are defective. eg. cognitive deficit of memory
2 = schizophrenics can't filter information in the same way as normal people who can focus attention selectively. they have information overload and let in too much irrelevant information.
3 = This leads to them being inundated with external stimuli which is not interpreted appropriately therefore leads to functioning deficit explaining the dysfunctional disorder, schizophrenia as they experience the world differently. This is the effect of cognitive deficits.
4 = There are also physiological abnormalities associated with schizophrenia that lead to cognitive malfunctioning.

Explanation:
Unlike people with autism-spectrum disorders people with schizophrenia do not lack understanding that others have mental states, instead they over attribute knowledge to others or apply knowledge of mental states in an incorrect or biased way.

Changes in thinking precede (i.e. come before) the onset

Question 21

Limitation - question validity.

Answer 21

There is overlap between symptom clusters:
the subgrouping method used by Frith and colleagues is hierarchical, with the behavioural subgroup being the highest category.
This means that patients in that subgroup could also report paranoid symptoms, but those in the paranoid subgroup could not report behavioural symptoms.
However believe result is still valid.

Question 22

Usefulness 1

Answer 22

Cognitive explanations of schizophrenia can be easily combined with another model eg. behavioural to provide complete explanations.
Eg. as Frith is reductionist and fails to take into the account the role of environmental factors when concluding that schizophrenics with behavioural signs have theory of mind impairments, combination with behavioural approach would lead to complete explanation of this dysfunctional behaviour. May explain why those whose schizophrenia is not severe do not have cognitive deficits as there is another root cause, proving they are consequence rather than route cause of schizophrenia.

Question 23

Usefulness 2

Answer 23

There may be a role of mentalising impairment in the early detection and prediction of schizophrenia, therefore useful provides evidence for further areas of research examining theory of mind abilities in people at risk of developing schizophrenia, therefore useful for treatment.

Question 24

Determinism - schemas

Answer 24

Have biological production base however are also environmentally based and can accept/reject therefore have control over decisions.
Cognitive explanation therefore must have a biological impact… people with autism cannot develop physical schemas as don’t have physiological ability therefore deterministic. Autistic peoples behaviour is determined by cognitive and physiological ability.
Normal - decisions made based on past experiences, element of randomness eg. irrational behaviour that is free-will.