schizophrenia

Question 1

diagnosis and classification of schizophrenia AO1

Answer 1

Classification = ICD-10 and the DSM-5

DSM-5 states there must be at least one positive symptom present whereas the ICD accepts two or more negative symptoms for a diagnosis

positive symptom= additional experiences beyond normal experience
Eg: hallucinations are unusual sensory experiences (auditory or visual) such as hearing voices or seeing people that are not there

Delusions = irrational beliefs that someone may have, such as grandiosity or persecution

Negative symptoms = loss of usual abilities and experiences.
eg: avolition - difficulty of keeping up with goal-directed activities as a result of reduced motivation
-> poor hygiene and grooming

Speech poverty= reduction in the amount and quality of speech, such as long pauses between words or one-word responses

Schizophrenia’s symptomatology, ranging from hallucinations to motivational deficits, profoundly impacts individuals’ lives, necessitating comprehensive diagnosis and classification that is reliable and valid

Question 2

diagnosis and classification of schizophrenia - reliable not valid

Answer 2

Osório investigated whether different diagnosis clinicians would reach the same diagnosis
and whether the same clinicians would reach the same diagnosis for the same individual on two occasions
results showed excellent inter-rater reliability (+.97) and test-retest reliability (+.92) for the diagnosis of schizophrenia using the DSM-5

suggests that clinicians consistently reach the same diagnosis for individuals with schizophrenia, indicating a high level of consistency in its application.

BUT studies have shown different clinicians arrive at different diagnoses for the same patient
two psychiatrists independently d the same 100 patients using ICD-10 and DSM-V criteria
found that 68 were diagnosed under ICD-10 while 39 were diagnosed using the DSM-V

Lack of consistency undermines validity of diagnosis
diagnosis of schizophrenia may not accurately assess the condition it intends to measure

Question 3

diagnosis and classification of schizophrenia - comorbidity

Answer 3

A review revealed the comorbidity rates for schizophrenia and other conditions, such as depression (50%), substance abuse (47%), PTSD (29%) and OCD (23%)
This means that if depression and schizophrenia occur simultaneously so often, it might be better seen as a single condition
Or clinicians struggle to distinguish between the 2
implies that schizophrenia may not exist as a distinct condition and highlights challenges in accurately diagnosing it due to its association with other disorders

Question 4

diagnosis and classification of schizophrenia - symptom overlap

Answer 4

Eg: positive symptoms like delusions and negative symptoms like avolition can be observed in both schizophrenia and bipolar disorder
a person might be diagnosed with schizophrenia under the ICD classification, but receive a diagnosis of bipolar disorder according to DSM criteria
highlights the complexity of diagnosing schizophrenia accurately and suggests potential limitations in its classification as a distinct disorder

Question 5

diagnosis and classification of schizophrenia - cultural variability

Answer 5

Although ICD/DSM have standardised criteria for consistency in results
Ignoring cultural factors may oversimplify the diagnosis - failing to capture the complexity of schizophrenia
Certain auditory hallucinations may be interpreted as spiritual communication in other cultures.
ICD/DSM are westernised and ethnocentric tests leading to possible misdiagnosis if universalied

Question 6

diagnosis and classification of schizophrenia - gender bias

Answer 6

Women are less likely to be diagnosed with schizophrenia due to presenting more subtle symptoms than men
Stigma of hysterical women means practitioners often disregard female cases
Therefore, the diagnosis of schizophrenia may not be as effective as it seems

Question 7

drug treatments of schizophrenia AO1

Answer 7

Antipsychotic drugs are the most common biological treatment for schizophrenia, and can be divided into typical and atypical.

Typical antipsychotics were first developed in the 50s, such as chlorpromazine.
Typical antipsychotics act as a dopamine antagonist, reducing the action of dopamine by blocking dopamine receptors in the synapses. Normalises neurotransmissions in key brain areas, thereby reducing symptoms like hallucinations

Chlorpromazine = sedative, reduces dopamine, syrup/tablet, short or long term treatment, antagonist, reduces psychosis, decline in use

Atypical antipsychotics have been used since the 70s and were developed to reduce side effects but have similar effectiveness

Eg: Clozapine,a dopamine antagonist, targeting serotonin and glutamate receptors too.

helps improve mood, reduce depression and anxiety and may improve cognitive functioning prescribed to suicidal schizophrenics (30-50% of people)
Risperidone is another atypical antipsychotic, which works similar to Clozapine but binds more strongly to dopamine receptors, which is believed to lead to fewer side effects and lower dosage

Clozapine = requires regular blood tests and can lead to agranulocytosis (affects immune system), affects serotonin+dopamine+glutamate

Risperidone = fewer side effects, lower dosage

Question 8

drug treatments of schizophrenia - research support + use alongside CBT

Answer 8

it is reasonably effective
Eg: a review compared Chlorpromazine with a placebo and found that the typical antipsychotic was associated with reduced symptom severity as well as lower relapse rates
Research also found Clozapine to be more effective than other atypical antipsychotics and is effective in 30-50% of cases where patients failed to respond to typical antipsychotics
suggests that antipsychotics are at least moderately effective and can be used to treat schizophrenia and improve patients’ quality of life to a certain extent

+ Use alongside CBT:

Research suggests that combining pharmacological treatments with psychological therapies can yield better outcomes than either treatment alone

CBT can address negative symptoms and improve coping strategies, reducing the likelihood of relapse
This indicates that while drug therapy has its place, a more integrative approach could enhance treatment efficacy

Publication bias - drug trial research inflated by pharma companies

Question 9

drug treatments of schizophrenia - ethical issues

Answer 9

critics have referred to antipsychotics as ‘chemical straitjackets’ as they reduce patients to a calm, zombie-like state due to calming influences

This means they don’t have therapeutic value and fail to cure symptoms as they are used primarily to calm patients and make them easier to work with for staff

this suggests that antipsychotics are not actually for the benefit of the patients themselves and they may not even be in a position (psychotic state) to consent to such treatment in the first place

Question 10

drug treatments of schizophrenia - reductionist

Answer 10

This reductionist perspective oversimplifies the complex nature of schizophrenia which is influenced by psychosocial factors such as stress, trauma, and family dynamics.
Critics argue that solely addressing biological factors ignores holistic treatment opportunities that incorporate therapy and social support, which could lead to more comprehensive care and better long-term outcomes.

Question 11

drug treatments of schizophrenia - side effects + stigma

Answer 11

side effects can potentially be life threatening in some cases

typical antipsychotics could result in dizziness, sleepiness, weight gain and even tardive dyskinesia which can lead to involuntary facial movements such as blinking and lip smacking

more severe cases of typical antipsychotic use can lead to neuroleptic malignant syndrome which can manifest as high temperature, delirium and coma, and can be fatal

antipsychotics can reduce symptoms but also negatively affect people’s quality of life and result in them stop taking medication altogether

Studies indicate that up to 50% of patients may stop taking their medication within the first year
Results in relapse rates that undermine initial treatment successes, suggesting that while medication can be effective, its overall practicality is limited by these challenges

Cultural practices where drug therapies have a stigma may lead to reluctance in seeking treatment

Question 11

biological explanations of schizophrenia AO1

Answer 11

Gottesman - greater genetic similarity between family members = greater likelihood of both developing schizophrenia
concordance rate (sharing similar traits) for schizophrenia in identical twins (100% genetic similarity) = 50% compared to concordance rate with schizophrenic parents (50% genetic similarity), which is 9%
45? For DZ

no single candidate gene which is associated with risk of developing schizophrenia
So schizophrenia is polygenic (multiple genes work in combination)
Schizophrenia = aetiologically heterogeneous so different combinations of factors can lead to the condition (over 108 genetic variations have been found to be associated with increased risk of schizophrenia)

Most of these genes are responsible for the functioning of neurotransmitters (dopamine) leading to the dopamine hypothesis

hyperdopaminergia occurs in the subcortex, for example excess dopamine receptors in Broca’s area have been linked to auditory hallucinations

Hypodopaminergia occurs in the cortex, with low levels of dopamine in the prefrontal cortex associated with negative symptoms

Question 12

biological explanations of schizophrenia - supporting evidence + counter

Answer 12

Family studies found increased genetic similarity is linked to an increased vulnerability to develop schizophrenia

adoption studies also demonstrated that people with biological schizophrenic parents are at an increased risk of developing schizophrenia, even if their adopted family has no history of schizophrenia - disproving the environmental approach

studies show that genes play an important role and explains why some people are more likely to develop schizophrenia than others
Increases validity

BUT although genetic predispositions are a strong influence it is not deterministic
Many predisposed individuals do not develop schizophrenia indicating environmental influence
67% of people with schizophrenia reported at least one childhood trauma compared to 38% of a non-psychotic mental illness matched group +several studies indicate that environmental factors such as birth complications and cannabis use contribute to the risk of schizophrenia

Need for diathesis stress model instead?

Question 13

biological explanation of schizophrenia - supporting research for dopamine hypothesis

Answer 13

Research demonstrates that amphetamines that increase dopamine, worsen symptoms in schizophrenia
antipsychotic drugs reduce dopamine activity and alleviates symptoms

some candidate genes for schizophrenia are linked to dopamine production or receptors

supports the dopamine hypothesis as a plausible explanation for schizophrenia symptoms

Question 14

biological explanation of schizophrenia - challenging evidence

Answer 14

consistently found elevated levels of glutamate in the brains of individuals with schizophrenia
candidate genes for schizophrenia are implicated in glutamate production or processing
not all individuals with schizophrenia respond to these medications, suggesting a more complex neurochemical model may be needed

(but glutamate in depression too - comorbidity?)

suggests that schizophrenia may involve complex interactions between multiple neurotransmitters, challenging the dopamine-centric view of the disorder

Question 15

biological explanations of schizophrenia - differences in brain structures + counter

Answer 15

Neuroimaging studies have shown that individuals with schizophrenia have brain abnormalities like enlarged ventricles and reduced grey matter in prefrontal cortex and temporal lobe
Supports biological basis of schizophrenia

BUT are not universal in all patients
Implies structural abnormalities alone are not enough to fully explain the disorders onset and interactions + individual differences should be considered
Brain differences may be a result of the disorder rather than cause so longitudinal studies lead to a more causal relationship

Question 16

biological explanation of schizophrenia - reductionist

Answer 16

Sole biological approach overlooks social, psychological and contextual factors contributing to the disorder
Eg: providing community support alongside medical treatment
Or diathesis stress model more accurate by using an interactionist approach between biology and the environment

Question 17

drug treatment eval - research support

Answer 17

Research support:

it is reasonably effective
Eg: a review compared Chlorpromazine with a placebo and found that the typical antipsychotic was associated with reduced symptom severity as well as lower relapse rates
Research also found Clozapine to be more effective than other atypical antipsychotics and is effective in 30-50% of cases where patients failed to respond to typical antipsychotics
suggests that antipsychotics are at least moderately effective and can be used to treat schizophrenia and improve patients’ quality of life to a certain extent

Question 17

drug treatments AO1

Answer 17

Antipsychotic drugs are the most common biological treatment for schizophrenia, and can be divided into typical and atypical.

Typical antipsychotics were first developed in the 50s, such as chlorpromazine.
Typical antipsychotics act as a dopamine antagonist, reducing the action of dopamine by blocking dopamine receptors in the synapses. Normalises neurotransmissions in key brain areas, thereby reducing symptoms like hallucinations

Chlorpromazine = sedative, reduces dopamine, syrup/tablet, short or long term treatment, antagonist, reduces psychosis, decline in use

Atypical antipsychotics have been used since the 70s and were developed to reduce side effects but have similar effectiveness.
Eg: Clozapine,a dopamine antagonist, targeting serotonin and glutamate receptors too.

helps improve mood, reduce depression and anxiety and may improve cognitive functioning prescribed to suicidal schizophrenics (30-50% of people)
Risperidone is another atypical antipsychotic, which works similar to Clozapine but binds more strongly to dopamine receptors, which is believed to lead to fewer side effects and lower dosage

Clozapine = requires regular blood tests and can lead to agranulocytosis (affects immune system), affects serotonin+dopamine+glutamate

Risperidone = fewer side effects, lower dosage

Question 17

drug treatment eval - research support for use of drugs with CBT BUT publication bias

Answer 17

Use alongside CBT:

Research suggests that combining pharmacological treatments with psychological therapies can yield better outcomes than either treatment alone

CBT can address negative symptoms and improve coping strategies, reducing the likelihood of relapse
This indicates that while drug therapy has its place, a more integrative approach could enhance treatment efficacy

Publication bias - drug trial research inflated by pharma companies

Question 18

drug treatment eval - ethical issues

Answer 18

Ethical issues:

critics have referred to antipsychotics as ‘chemical straitjackets’ as they reduce patients to a calm, zombie-like state due to calming influences

This means they don’t have therapeutic value and fail to cure symptoms as they are used primarily to calm patients and make them easier to work with for staff

this suggests that antipsychotics are not actually for the benefit of the patients themselves and they may not even be in a position (psychotic state) to consent to such treatment in the first place

Question 19

drug treatment eval - reductionist

Answer 19

Reductionist:

This reductionist perspective oversimplifies the complex nature of schizophrenia which is influenced by psychosocial factors such as stress, trauma, and family dynamics.
Critics argue that solely addressing biological factors ignores holistic treatment opportunities that incorporate therapy and social support, which could lead to more comprehensive care and better long-term outcomes.

Question 20

drug treatment - side effects

Answer 20

Side effects:
side effects can potentially be life threatening in some cases

typical antipsychotics could result in dizziness, sleepiness, weight gain and even tardive dyskinesia which can lead to involuntary facial movements such as blinking and lip smacking

more severe cases of typical antipsychotic use can lead to neuroleptic malignant syndrome which can manifest as high temperature, delirium and coma, and can be fatal

antipsychotics can reduce symptoms but also negatively affect people’s quality of life and result in them stop taking medication altogether

Studies indicate that up to 50% of patients may stop taking their medication within the first year
Results in relapse rates that undermine initial treatment successes, suggesting that while medication can be effective, its overall practicality is limited by these challenges

Cultural practices where drug therapies have a stigma may lead to reluctance in seeking treatment

Question 21

psychological explanations of schizophrenia AO1

Answer 21

dysfunctional family: Fromm-Reichmann explained how the ‘schizophrenogenic mother’ is cold, rejecting and controlling, creating tension and secrecy within the family, which can lead to distrust that can develop into paranoid delusions

The double-bind theory focuses on communication style within the family. This is a communication dilemma that comes from a conflict between two or more messages, which can leave people with a confusing understanding of the world, developing into symptoms like disorganised thinking and paranoid delusions.

Expressed emotion refers to the negative emotions expressed towards a person with schizophrenia by their carers, such as verbal criticism and emotional over-involvement. This can cause a lot of stress and may explain relapse rates for people with schizophrenia.

Another part of the psychological explanation emphasises the mind and the abnormal information processing. For example, dysfunctional metarepresentation (interpreting your own and others’ intentions and actions) could explain voice hallucinations.
disrupts ability to recognise own actions from external stimuli/others -> auditory hallucinations
Likewise, dysfunctional central control (suppressing automatic thoughts) could result in disorganised speech as they are unable to suppress thoughts triggered by speech.

Question 22

psychological explanations of schizophrenia eval - Supporting evidence of family's influence on schizophrenia: (dysfunction)

Answer 22

Supporting evidence of family's influence on schizophrenia: (family dysfunction explanation) A strength of the family dysfunction explanation is that there is research evidence to support the link between difficult family relationships and schizophrenia a review revealed that 69% of female patient with schizophrenia (59% for men) had a history of physical abuse, sexual abuse or both Furthermore, another study showed people with schizophrenia were more likely to have insecure attachments to their primary caregiver this supports the idea that family dysfunction is a risk factor and makes people more vulnerable to schizophrenia

Question 22

psychological explanations of schizophrenia eval - not enough evidence to support any of the explanations of family dysfunction:

Answer 22

not enough evidence to support any of the explanations of family dysfunction: there is little evidence to support the schizophrenogenic mother or the double-bind theory as these were originally based on patient observations and flawed personality assessments of their mothers Theory devised from correlations blaming mother These explanations have led to parent-blaming, with parents receiving the blame for the condition which potentially could be traumatic lack of evidence and negative consequences of these seriously question the validity and usefulness of such family explanations

Question 22

psychological explanations of schizophrenia eval - Support for the link between dysfunctional information processing and schizophrenia: (cognitive)

Answer 22

Support for the link between dysfunctional information processing and schizophrenia: (cognitive) Comparison of people with schizophrenia with controls on the Stroop found that people with schizophrenia took twice as long to name the ink colour compared to the control group This is because people with schizophrenia had trouble suppressing the tendency to read the word out loud, which is the goal of the Stroop Test this confirms that people with schizophrenia have impaired cognitive processes and adds validity to the explanation (proves why CBT works) BUT ignores biological explanations eg: neurochemical imbalances/dopamine may lead to cognitive distortions rather than occur as a result of them (not a causal relationship) Only a partial explanation as it doesnt explain root cause like family dysfunction theory

Question 23

psychological explanations of schizophrenia eval - idea that psychodynamic or behaviourist explanations may explain better?

Answer 23

idea that psychodynamic or behaviourist explanations may explain better: Behaviourists = social withdrawal etc occur due to reinforcement. Withdraw due to anxiety and reinforces symptoms BUT ignores biology and psychological processes Psychodynamic = schizophrenia occurs due to regression of earlier developmental stages resulting from anxiety of unresolved conflicts Fragmented version of self (id etc) so leads to hallucinations BUT doesnt have empirical support

Question 24

psychological treatment of schizophrenia AO1

Answer 24

CBT - identifies irrational thoughts and challenges them Patients understand how their hallucinations/delusions affect their feelings and actions 5-20 sessions Therapist provides alternative reasons for delusions Normalisation techniques eg explaining that voices are a common extension of thought, can alleviate fear Family therapy - helps improve quality of communication/interaction and reduce negative emotions within the family unit Helps family balance care for the individual with maintaining their own lives Aims to prevent relapse Token economies used to maintain improvements in schizophrenia rather than treat Reducing maladaptive behaviours -> tokens to be swapped for tangible/intangible rewards via reinforcement - operant conditioning

Question 25

psychological treatment of schizophrenia eval- family therapy benefits all the family

Answer 25

Benefits all family members: Research concluded that family therapy strengthens the functioning of the entire family, who provide the bulk of care for people with schizophrenia This means that by enhancing family functioning, family therapy lessens the negative impact of schizophrenia on other family members and strengthens the family’s ability to support the person with schizophrenia Link to psychological explanations of schizophrenia that blame the parents for the child's disorder - provides motivation to provide the care again This suggests that family therapy has wider benefits beyond the obvious positive impact on the identified patient

Question 25

psychological treatment of schizophrenia eval- evidence of effectiveness of CBt

Answer 25

Evidence for effectiveness of CBT: A review of 34 studies on CBT for schizophrenia found small but significant effects on both positive and negative symptoms Other studies found reductions in the frequency and severity of auditory hallucinations Research indicates that CBT can help patients reinterpret and rationalize their experiences, leading to reduced distress this suggests that both research and clinical experience support the benefits of CBT for managing schizophrenia symptoms integration of drug treatments Holistic approach CBT more effective with drugs so interactionist approach Meta analysis proved CBT works best with drug therapy

Question 25

psychological treatment of schizophrenia eval- evidence for effectiveness of family therapy

Answer 25

evidence for effectiveness of family therapy: McFarlane concluded that family therapy is one of the most consistently effective treatments for schizophrenia, particularly in reducing relapse rates by 50-60% this suggests that family therapy is effective in both reducing relapse rates and beneficial in early stages of mental health decline Reduces expressed emotion and strengthens support systems BUT places undue stress on family members coping with the challenges of the disorder and may prefer treatment directed at the patient instead Family therapy may not be a universal treatment and depending on family dynamics could be counter productive (need for culturally sensitive adaptations)

Question 26

psychological treatment of schizophrenia eval- Integration of CBT with family therapy

Answer 26

Integration of CBT with family therapy: Could argue CBT alone only manages symptoms so should be combined with family treatments Dual approach = more comprehensive understanding of disorder so reduces relapse rate BUT CBT expensive and difficult to manage schedules between both types of therapy Patients family may give up and leave patient untreated Differing therapeutic interventions may lead to conflict in treatment focus confusing the patients Could be counterproductive Family therapy only efficient with skilled therapists so not accessible treatment for all Treatment only effective if stable and ongoing despite fluctuations in symptoms so ongoing support essential for maintaining benefits of therapeutic interventions

Question 27

management of schizophrenia AO1

Answer 27

Token economies- originally, tokens were awarded for tasks, redeemable for privileges, significantly improving task completion Although declining in the UK due to community care growth and ethical concerns, they remain a global standard for managing schizophrenia Institutionalisation fosters maladaptive behaviours so addressed by token economies, enhancing quality of life and facilitating community reintegration behaviour categories commonly tackled = personal care, condition-related behaviours, and social conduct While not curing schizophrenia, modifying behaviours offers immediate rewards, improving hospital life and easing community transition Tokens hold no inherent value but are exchanged for real rewards, reinforcing operant conditioning principles Tokens = secondary reinforcers that gain value through association with primary reinforcers Initially paired, tokens and primary reinforcers reinforce desired behaviours By customising target behaviours, token economies optimise effectiveness

Question 28

management of schizophrenia eval - small evidence basis supporting the effectiveness of token economies:

Answer 28

small evidence basis supporting the effectiveness of token economies: The limited number of studies raises concerns about the file drawer problem, where positive findings may be overrepresented due to publication bias This means that there is uncertainty regarding the overall effectiveness of token economies due to the potential bias in the available evidence this raises questions about the reliability of the evidence supporting the use of token economies for managing schizophrenia

Question 28

management of schizophrenia eval - evidence for effectiveness

Answer 28

Evidence for effectiveness: Glowacki reviewed seven high-quality studies that investigated the effectiveness of token economies for people with chronic mental health issues like schizophrenia in a hospital setting results showed a reduction in negative symptoms and unwanted behaviours in patients this suggests that token economies have demonstrated value in reducing symptoms and managing behaviours associated with schizophrenia

Question 28

management of schizophrenia eval - ethical issues

Answer 28

Ethical issues: Imposing norms and restricting personal freedoms can raise ethical concerns, particularly when considering the impact on the quality of life for individuals with schizophrenia Eg restricting the availability of rewards (e.g. seeing films) to those who don’t behave as desired could be even worse for someone already experiencing severe symptoms Reduces adults to childlike principles Could lower self esteem once they leave an institution as they realise others don't use these this means that the benefits of token economies may be outweighed by their negative impact on personal freedom and well-being Risk of exploitation if the system prioritises attainment of tokens over patient wellbeing BUT does empower patients to change and earn rewards based on their efforts

Question 28

management of schizophrenia eval -Don't address the underlying issues contributing to social withdrawal

Answer 28

Does Not treat issues like paranoia or negative symptoms like flattened affect Patients might engage in social interactions for tokens but lack genuine understanding and emotional investment as to why the system is effective Patients could become dependent on external validation for social participation rather than developing intrinsic motivation for relationships and socialisation Leaving an institutional setting may lead to relapse into their old ways leaving the token economy improvement redundant Families may not implement the token economy system effectively as they may not adhere to the rewards they promise or the patient grows tired of the same reward Therefore its unclear how effective token economy systems are in the long term

Question 29

interactionist approach to schizophrenia AO1

Answer 29

The interactionist approach explains how biological, psychological and societal factors interact - diathesis-stress model, where vulnerability and stress are both necessary for the disorder to develop. The original model explained how diathesis was purely genetic (a single ‘schizogene’), without which schizophrenia would not develop. Chronic childhood and adolescence stress (i.e. schizophrenogenic mother) could result in the development of the disorder (meehl) Our improved understanding of diathesis is that there are actually many genes that increase genetic vulnerability. Diathesis can even include psychological trauma as it can alter the developing brain in ways that can make a person more vulnerable to later stress (trauma the diathesis not stress) stress has changed to include anything that risks triggering schizophrenia, such as cannabis use which can increase the risk of up to seven times depending on the dose. Treatment = the interactionist approach combines antipsychotics with psychological therapies (CBT) In the UK, it is unusual to treat schizophrenia using psychological treatments alone as they are usually used alongside antipsychotics

Question 30

interactionist approach to schizophrenia eval -Original diathesis-stress model is too simple:

Answer 30

Original diathesis-stress model is too simple: original model explained diathesis as a single schizophrenic gene and stress was portrayed as schizophrenogenic parenting; both had a single source current understanding is more complex and shows how vulnerability can be both genetic make-up as well as early trauma and factors such as cannabis use can be seen as a stressor which can trigger the onset of schizophrenia questions the validity of the original diathesis-stress model which has since been updated to include more factors

Question 30

interactionist approach to schizophrenia eval - Supporting evidence of diathesis stress model

Answer 30

Supporting evidence of diathesis stress model A strength of the interactionist approach is that there is supporting evidence for the dual role of vulnerability and stress in developing schizophrenia eg: Tineari compared 19,000 Finnish children who had a schizophrenic mothers with controls (no genetic risk) and investigated the impact of both genetic vulnerabilities and psychological influences (dysfunctional parenting of adopted mother) Results showed that child-rearing style (high levels of criticism and low levels of empathy) was associated with development of schizophrenia, but only for those children with high genetic risks and not for the control group = diathesis stress Suggests genetically vulnerable children are more sensitive to parenting behaviour which adds validity to the interactionist explanation of schizophrenia

Question 30

interactionist approach to schizophrenia eval - treatment causation fallacy

Answer 30

Treatment causation fallacy: the fact that combined treatments are more effective than either on their own does not necessarily mean that the interactionist approach is correct. unsure whether the treatment actually deals with the underlying root cause of schizophrenia or just suppresses the symptoms Therefore, while a combination of biological and psychological treatments is superior in producing better outcomes, it doesn’t tell us exactly what the origin of schizophrenia is

Question 31

interactionist approach to schizophrenia eval - real world applications

Answer 31

Real world applications: has real world applications, in terms of effectiveness of interactionist treatment options Tarrier randomly allocated people with schizophrenia into one of three groups; medication + CBT, medication + supportive counselling, or medication only (control group) results showed combination groups displayed lower symptoms levels compared to control group highlights the importance of adopting an interactionist approach by combining drug treatment and psychological therapies allows patients to address both the biological and psychological aspects of their condition, leading to a more well-rounded approach to treatment BUT could become dependent on medication without developing coping skills leading to decreased motivation for CBT engagement Less likely to have access based on socio economic backround or stigma unsure whether the treatment actually deals with the underlying root cause of schizophrenia or just suppresses the symptoms (doesnt explain origins

Question 32

psychological explanations - cognitive AO1

Answer 32

cognitive explanation emphasises the mind and the abnormal information processing. For example, dysfunctional metarepresentation (interpreting your own and others’ intentions and actions) could explain voice hallucinations. people with schizophrenia are poor at understanding their own thinking (metacognition) as distinct from environmental stimuli Likewise, dysfunctional central control (suppressing automatic thoughts) could result in disorganised speech as they are unable to suppress automatic thoughts from associations triggered by speech.

Question 33

psychological explanations - cognitive eval explains positive symptoms better than negative

Answer 33

the cognitive approach is limited because it can only explain the positive symptoms experienced by schizophrenics, but offers no explanation for negative symptoms, such as avolition. Therefore, it is likely that there are other factors that play a role in causing schizophrenia that account for the presence of the negative symptoms. incomplete explanations

Question 34

psychological explanations cognitive eval - reductionist - ignores biology

Answer 34

does not explain the underlying cause which is probably biological, only explains some aspects of how people with schizophrenia think * does not address the underlying cause, so any therapeutic attempts based on the cognitive explanation might just deal with some symptoms rather than treat from the root