Download Behavioural explanation and treatment

Psychological explanations of
schizophrenia and therapies
Behavioural explanation
Assumption: schizophrenia
like any other behaviour is
learnt from the environment
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Operant conditioning: if the behaviour is
positively
then the behaviour will be
How isreinforced
schizophrenic
repeated.
If it ispositively
punished then the frequency of
behaviour
the behaviour
will decrease.
reinforced?
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Psychological Explanations;
Behavioural approach
 Behaviourists argue that learning plays a key role in
the development of schizophrenia. One suggestion is
that early experience of punishment may lead the
child to retreat into a rewarding inner world. Others
then label them as ‘odd’ or ‘strange’.
 Scheff’s (1966) labelling theory suggests that
individuals labelled in this way may continue to act in
ways that conform to this label. Bizarre behaviour is
rewarded with attention, and becomes more and
more exaggerated in a continuous cycle before being
labelled as ‘schizophrenic’
Psychological Explanations;
Behavioural approach
 Behaviourists have attempted to explain schizophrenia
as the consequences of faulty learning.
 If a child receives little or no social reinforcement early
on in life, the child will attend to inappropriate and
irrelevant environmental cues, instead of focusing on
social stimuli in the normal way.
 Behaviourists explain the fact that schizophrenia runs
in families as a function of social learning. Bizarre
behaviour by parents is copied by children. Parents
then reinforce this behaviour and the behaviour
becomes progressively more unusual, until eventually
the child acquires the label of being ‘schizophrenic’
There is another way....
Social learning theory
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If an individual observes the
schizophrenic behaviour being reinforced
in another person i.e. parent (vicarious
reinforcement) the individual might
reproduce the behaviour to obtain the
same reinforcements.
Social learning and operant
conditioning combine
An individual starts imitating schizophrenic
behaviour observed in another then this is
maintained and developed through operant
conditioning.
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Evaluation
The disorder tends to run
in families so it is
possible that people may
learn to exhibit
symptoms through
observing other people who
do and want to imitate
these people to get the
same reinforcements.
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This approach cannot
really account for the core
features of schizophrenia:
hallucinations, delusions
and disorganization of
thinking.
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• It cannot explain why
• Experiments with
so many people with
behaviour modification
schizophrenia exhibit
for schizophrenia have
similar symptoms
indicated that, whilst
regardless of where
symptoms can be
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they originate.
modified, the
accompanying
• It cannot explain why
experiences tend to
an individual who has
persist, which suggests
never had contact with
that the cause cannot
a schizophrenic display
be only the learning
symptoms of
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of the behaviour. AO2
schizophrenia.
Wilder et al. (2001) Every
time a Sz patient made a
statement unrelated to the
topic being discussed, the
therapist would ignore the
statement and ask to take
a break, then look away for
30 seconds. The sessions
lasted for 10 mn and took
place 2-3 times a week. The
patients’ bizarre
vocalisations reduced
dramatically over 30
sessions. Which shows
that?????
Ayllon and Haughton
(1964) trained hospital staff
to ignore an inpatient' s
delusional remarks . The
staff responded normally to
non-delusional speech. There
was a large reduction of
delusional speech.
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Although these studies seem to
suggest a significant improvement
we do not know whether there was
an improvement of the delusion
itself or whether the patients felt
they could not speak about them.
Also it is likely as they were in
hospital that they were on
medication so the improvement
could have been due to medications
rather than the therapy
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Gender bias
Reductionism
• is the theory based on research carried out on an
unrepresentative sample?
• does the theory/approach attempts to explain
phenomena in terms of basic elements?
Ethnocentrism
• is the theory based on research carried out in one
particular type of culture (i.e. Individualistic culture) ?
Nature/Nurture
• Does the theory/approach explain phenomena in
terms of nature i.e. genetics neglecting other factors
i.e. social factors?
Approach
• Situate the theory in one approach (biological,
behavioural, cognitive, psychodynamic)
Determinism
• Does the theory/approach acknowledge a sense of
individual free-will or does it argue that our behaviour
is determined by a particular set of factors?
Ethics
• Does the theory/approach propose/research issues
which could be socially controversial ? (i.e. correlation
between race and IQ)
Scientific
method
• Is the theory based on evidence which is objective/
valid/ reliable?
Behavioural therapy
Token economy
Link the therapy with the explanation
According the behavioural
approach, schizophrenia, like
any other behaviour is learnt
from the environment through
operant conditioning or social
learning
The behaviour can be unlearnt
and replaced by a more
adaptive behaviour using the
same processes
Token economy
It is based on operant
conditioning therefore it is
called a behaviour modification
technique
The aim is to modify
directly observable
behaviours
It involves three main steps
•Identifying the undesirable or maladaptive behaviour
•Identifying the reinforcers that maintain such behaviour
•Restructuring the environment so that the undesirable
behaviour is no longer reinforced
How it works ....
Undesirable behaviour is
repeated because it is
being reinforced
Desired behaviour is
displayed
Remove reinforcers (behaviour then
becomes less likely to be repeated)
Punishment will also decrease the
likelihood of the behaviour being
repeated
Positive reinforcement is given
i.e. token
The tokens then can be exchanged
for privileges i.e. Watching TV,
listening to music, sports activity.
Basic commodities like food, water
and sleep are human rights they
cannot be withheld from patients
Evaluation
• It changes only
observable behaviours but
does it change delusions,
hallucinations?
• Ayllon and Azrin
(1968) found that
tokens were effective in
eliminating undesired
behaviours and
maintaining desired
behaviours.
• Kazdin & Bootzin
(1972) have claimed
that the token economy
does not lead to
permanent behavioural
change, and that once
the reinforcement is
removed, the
undesirable behaviours
return to their initial
level.
• The token economy
system is only effective
if the tokens are given
immediately after the
desired behaviour has
occurred. The longer the
interval between the
behaviour and the token
the less likely it is that
learning will take place.
• There ethical problems
(i.e. punishments).
• It requires an
environment where the
therapist is in total
control. It might not
work when the patient
goes back in the
community.
• When the tokens are
stopped the undesirable
behaviours are displayed
again leading to
rehospitalisation.
• Patients in psychiatric
hospitals are also on
drugs so it is difficult to
say what lead to the
improvement.
• It fails to address the
underlying causes of
schizophrenia.
• It does not have serious
side-effects unlike
drugs.
• It require consistency so
staff have to be trained.
• It is expensive as it
requires a lot of input
from the staff
Psychological Treatment;
Behavioural
 Implosion- Extinguishing anxiety by inducing the client to imagine
intensely anxiety-provoking scenes that, because they produce no
harmful consequences, lose their power to induce fear.
 Flooding- Extinguishing anxiety by exposing the clients to actual fearproducing situations that, because they produce no harmful
consequences, lose their power to induce fear.
 Modeling- Exposing clients to desired behaviour that is modeled by an
other person, and rewarding the client for imitating that behaviour.
Evaluation
 The validity of the behavioural model is moderately
supported by the success of behavioural therapies used
with schizophrenic patients.
 Social skills training techniques have been used to help
schizophrenics acquire useful social skills (Rodger et
al.,2002). Allyon & Azrin (1968) have shown that
schizophrenics have learned to make their own beds,
comb their own hair etc. when given rewards for doing
so.
 Finally Roder et al. (2002) has demonstrated that social
skills training techniques have been used to help
schizophrenics acquire social skills.
Evaluation
 The success of such programmes in teaching new
skills and reintegrating schizophrenics back into the
community suggests that these are skills that
schizophrenics failed to learn in the first place.
 Overall this research can explain how schizophrenia
symptoms are maintained but it does not
adequately explain where they came from in the
first place.
 Critics claim that labelling theory ignores strong
genetic evidence and trivialises a serious disorder.
In what ways could it be argued that the behaviourist approach to schizophrenia is
reductionist?
Potential Exam Questions
Describe two psychological explanations of the Schizophrenia
Evaluate these explanations of Schizophrenia
“Psychologists believe that Schizophrenia can be explained solely by biological factors”
Discuss this claim with reference to the above quotation.
Describe and evaluate at least two issues in classifying or diagnosing schizophrenia
a) Explain issues relating to classifying schizophrenia as a mental disorder (5)
b) Discuss two explanations of schizophrenia from different perspectives in psychology
Describe and evaluate two psychological treatments of Schizophrenia
Describe the clinical characteristics of Schizophrenia
Explain and evaluate issues relating to the diagnosis of Schizophrenia as a mental disorder
Discuss the extent to which biological therapies can be used to treat Schizophrenia.