Download Cognitive Explanations for Psychotoc disorders Cognitive

Psychological explanations for Sz
Spec states:
Psychological explanations for
schizophrenia:
- family dysfunction
- cognitive explanations, including
dysfunctional thought processing
Learning Outcomes
• Outline and describe the family dysfunctional
explanation to Sz
• Evaluation the explanation looking at research
• Outline the cognitive explanations for Schizophrenia
• Explore the cognitive reasons for Psychotic
symptoms
• Explore and evaluate the scientific model of
delusional thinking
• Explore research which demonstrates a cognitive
explanation
Family Relationships
• biological processes are clearly important in both
the origins and symptoms of schizophrenia
• psychological processes are also important
• impact of family relationships has been put
forward as a possible explanation for
schizophrenia.
• Psychologists have attempted to link
schizophrenia to childhood and adulthood
experiences of living in a dysfunctional family
3 key characteristics research has
suggested is evident in Sz in relation to
their family
Criticism
Conflict
Breakdown in
communication
Fun fact!
Early theorists influenced by Freudian ideas,
thought that a ‘schizophrenogenic mother’, who
was cold, dominant and created conflict, caused
schizophrenia to emerge in the child (1948)
These mothers were said to be rejecting,
overprotective, self-sacrificing, moralistic
about sex and fearful of intimacy
The distrust, resentfulness and instability
caused by such a parent was thought to
induce a schizophrenic reaction.
By the 1980s research had concluded
that there was no such thing as a
‘schizophrenogenic mother’
It had become apparent that only a small
percentage of women who might arguably fit
the criteria of schizophrenogenic mother had
actually produced schizophrenic children.
Conversely, many schizophrenics were found
to have mothers who did not fit the criteria
The theory has been criticised for
hindering progress in psychiatry and
understanding of this complex disorder
‘Double Bind’
• This was termed ‘double bind’ –
– the children are ‘punished’ for doing what was asked
(giving a hug, then being pushed away)
– then punished again when the parent gives no reason
for pushing them away.
• theory suggests children will become confused
and lose their grip on reality.
• Negative symptoms of social withdrawal and flat
affect may be an appropriate and logical
response to such situations
‘Double Bind’
Bateson (1904 – 1980) - a British anthropologist
and social scientist, one of the first researchers
to look at the family dynamic of Sz pateints
• stated if children receive mixed messages
from parents
– e.g. being asked for a hug and then being pushed
away,
• then they learn that they cannot trust the
messages they receive from others.
• Resulting in lack of trust their own feelings
and perceptions
Expressed Emotion (EE)
Family communication style that involves:
• Critical comments through both tone and content,
occasionally accompanied by violence
• Hostility towards the patient, including anger and
rejection
• Emotional over-involvement in the life of the patient,
including needless self-sacrifice
If these factors are high, risk of a relapse is high
Using your text books and other
resources, complete an evaluation
for Family Dysfunction
• Use pg 20 in pack to help
• 15mins
Support for family dysfunction as a risk factor
• There is evidence to suggest that difficult family
relationships in childhood are associated with increased
risk of schizophrenia in adulthood
• For example, Read (2005) reviewed 46 studies of child
abuse and schizophrenia in adulthood and concluded
that 69% of adult in-patients with a diagnosis of
schizophrenia had a history of child abuse - for men the
figure was 59%
• Adults with insecure attachments to their primary carer
are also more likely to develop schizophrenia
Weak evidence for family based explanations
• Information about childhood experiences is gathered after the
symptoms have developed, therefore the schizophrenia may
have distorted the patients’ recall of these childhood
experiences – this creates a serious problem of validity
• Dysfunctional family explanations for schizophrenia have
historically led to parent-blaming. Parents, who have already
suffered at seeing their child’s descent into schizophrenia
underwent further trauma by receiving blame for the
condition
• In the 1980s there was a shift from hospital to community
care (often involving parental care), and this possibly added to
a decline of the schizophrenogenic mother and double-bind
theories
PSYB3
Summary of explanation
• Psychological explanations look to the person’s
environment to explain schizophrenia
• Families can influence both the onset (through
socialisation) and the maintenance (through high EE)
of schizophrenia
• The diathesis-stress model of schizophrenia is where
biological factors cause a predisposition to develop
schizophrenia
the stress factors in the
environment may well be to do with family
dysfunction
PSYB3
Cognitive Explanations for
Schizophrenia
So…lets recap the cog approach
What does the Cognitive approach assume?
1. assumes that the key to understanding people is understanding
how the mind works
2. primarily concerned with investigating internal mental processes
like thinking, problem solving and memory.
3. It explains behaviour in terms of how the mind processes
information
4. The underlying idea is that the mind works like a computer –
information is inputted, stored and retrieved.
5. As information processors our minds actively organise and
manipulate the information we receive – we do not merely
passively respond to our environment
So in terms of schizophrenia we are interested in the processes and
the way information is organised / processed
What’s going on inside the ‘black box’?
People
are
laughing
on the
bus
There’s
something
wrong with
me
What’s going on inside the ‘black box’?
My
papers
are not
where I
left them
People are
trying to
sabotage
my career
What’s going on inside the ‘black box’?
I can’t
hear
what
people
are
saying
My family is
plotting
against me
http://www.youtube.com/watch?v=0vvU-Ajwbok
Let’s remind ourselves of the Symptoms
(Behavioural Outputs)
• POSITIVE SYMPTOMS – TYPE 1
– Distortion of normal function
Delusions, hallucinations, disorganised speech, under the
control of an alien force, disordered thinking
• NEGATIVE SYMPTOMS – TYPE 2
– Lack of normal function
Apathy, no emotion, flat effect, social withdrawal, Alogia (Lack of Speech)
Beck & Roger (2005) – cognitive model
Abnormal brain functioning
Neurobiological
Vulnerability to stress…
Environmental
…the environment (e.g.
home)
Cognitive
Dysfunctional beliefs…
Behavioural
Dysfunctional behaviours
Using this model, can you explain why positive
and negative symptoms occur?
Why might delusions occur?
What about hallucinations?
Flat effect?
Lack of social withdrawal?
Frith et al (1992) has conducted lots of
research into the cog explanation
2 key terms that you need to refer to:
1. Metarepresentation: ability to reflect on our
own thoughts… do you think a Sz has this
ability? Why?
2. Central control: ability to supress automatic
reponses. Does a Sz have this? Why?
Positive symptoms:
Thinking irrationally would lead to….
Such as…. Delusions … specifically
of persecution
(everyone is out to get
me)
The individual not
thinking clearly and
potentially
‘exaggerating’
If the information is not correct (dysfunctional)
this could also lead to deficits in their ability to
process the real world…. This could lead to
symptoms such as ….
Hallucinations
Negative symptoms:
There is the idea that a Sz experiences a
heighten sense of mental stimulation and it is
the strategy that they use that is the
symptom... Can you think of an example?
Social withdrawal could
be the strategy of
dealing with an
overwhelming mental
stimulation.. Can deal
with the mental
stimulation in public
No emotion could be the
strategy used to control
the amount of emotion
they do actually
experience
Using your text books and notes, complete
pg 21 in your pack – 10mins
Evaluation of Cognitive Approach





Focuses on the current cognitions - A
Plenty of research into the idea – S
Influential and popular model - A
Includes biological and the psychological
Empowers the individual to change - A





Ignores the environmental influences - L
Unscientific - T
Blaming the individual can make the disorder worse – L / A
Is thinking irrational? - A
Which is the cause? Which is the effect? - L
Exam Questions
- Pg 22 in your packs
Please complete Q1 and Q5 for homework – hand in for
Lesson 3 of this week