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Psychological Explanations of Schizophrenia Approach Behavioural Psychodynamic Family Models Explanations Evidence Evaluation Schizophrenia often funs in families so symptoms are learnt through observing others. Positive reinforcement, e.g. attention, and negative reinforcement, e.g. avoiding behaviour, encourages schizophrenic symptoms. Time spent in institutions means that old symptoms are maintained and new symptoms are learnt of other schizophrenics. Abnormal upbringing (particularly if there is a cold, rejecting ‘schizogenic’ mother) leads to a weak and fragile ego, which can’t contain the id’s desires, therefore the ego in broken down leaving the id in overall control of the psyche. The person loses contact with reality as they can no longer distinguish between themselves and others, their desires and fantasies and reality (you need an ego to be able to do this). Regression to a state of ‘primary narcissism’ leads to hallucinating as a result of their basic inability to distinguish between their imaginations and reality. Paul and Lentz (1977) found that operant conditioning can be used to treat schizophrenia, by rewarding ‘normal behaviour’ P: This approach cannot fully account for core features of schizophrenia. Oltmanns et al (1999) found that parents of schizophrenic patients do behave differently from parents of other kinds of patients. P: There is a lack of reliable research to support this theory. Fromm-Reichmann (1948) suggests families who are overprotective, dominant and moralistic contribute to the development of schizophrenia. P: The psychodynamic approach is deterministic. Double-bind theory (Bateson, 1956) Contradictory signals by family members, usually the mother lead to internal conflict; therefore the schizophrenic symptoms are a result of trying to escape the double-bind. Berger (1965) found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. Expressed Emotion (Brown, 1972) Family members display high levels of expressed emotion (EE) , e.g. hostility, criticism or over concern. This increases stress levels in the patient beyond their coping mechanisms, triggering schizophrenic episodes. Tarrier et al (1988) found a strong relationship between relapse and living with a high EE relative. Brown et al (1966) found that relapse more likely (58% vs. 10%) where family is high in ‘expressed emotion’ P: Most schizophrenics suffer from similar symptoms. P: The approach is too simplistic as it fails to take into account biological explanations. P: Psychodynamic therapies have not been successful in treating schizophrenia. P: The psychodynamic approach isn’t falsifiable. P: The approach is too simplistic as it fails to take into account biological explanations. P: Research has not found a correlation between early childhood experiences and diagnosis P: There is some support for the double-bind theory for example Berger (1965) P: However the support may not be reliable. P: There is contradictory evidence against this theory for example Liem (1974). P: You cannot establish cause and effect. P: Studies looking into EE and mainly correlational. P: EE is not a defining characteristic of schizophrenia as it is also found in other disorders P: Measurement of EE only requires one observation or interview. Vaughn & Leff (1976) found that families high in criticism, hostility & over-involvement lead to more relapse. P: Most studies into family models are carried out after schizophrenia is diagnosed. P: Studies rarely used control groups. P: The approach is too simplistic as it fails to take into account biological explanations. Cognitive Frith Explains positive symptoms of schizophrenia, where patients are unable to distinguish between actions generated externally and those generated internally. Can be explained by 3 cognitive deficits: 1. Inability to generate willed action 2. Inability to monitor willed action 3. Inability to monitor beliefs and intentions of others Faulty operation is due to functional disconnection between frontal areas of the brain concerned with action and more posterior areas of the brain that control perception. Delusions and hallucinations are formed by a breakdown of the filter between conscious and preconscious processing. Helmsley (1993) Breakdown of relationship between information that has already been stored in memory (schema’s) and new, incoming information. Schizophrenic people do not know which information to pay attention to and which to ignore leading to sensory overload. Delusions: Superficial information appears relevant Hallucinations: Believe that their own internal thoughts are real Helmsley believed this is caused by abnormalities in the hippocampus. Meyer-Lindenberg at al (2002) found a link between the excess dopamine in the pre-frontal cortex and the working memory. P: An issue with this approach is that you cannot establish cause and effect. P: The models do combine neurological and cognitive explanations. P: There is a lot a scientific support for this theory, such as Meyer-Lindenberg et al (2002) P: Research support is far from conclusive and the theory is still regarded as speculative. P: The cognitive explanations have practical applications to improve the lives of schizophrenics, for example Yellowless et al (2002) P: Blaming the individual can make the disorder worse P: The cognitive explanations are deterministic, suggesting that cognitive deficits lead to schizophrenia. Labelling Theory Scheff (1999) Schizophrenic symptoms are seen as deviant from the rules of ‘normal behaviour’. If a person displays these behaviours they may be labelled schizophrenic leading to them diplaying more of the symptoms. Comer (2003) suggest that labelling causes a self-fulfilling prophecy, which promotes the development of other symptoms. P: Doesn’t explain the cause of the symptoms in the first place. P: There is scientific support by Scheff to support labelling theory. P: The approach is too simplistic as it fails to take into account biological explanations. Rosenhan (1973) found that once a label of schizophrenia had been applied it influenced that way the staff behaved towards the patient. Diathesis-stress Model Schizophrenics have a biological predisposition to the disorder then stressful life events trigger the psychotic symptoms. Biological predisposition Psychological vulnerability Faulty thinking Environmental triggers Psychotic symptoms Brown and Birley (1968) found that approximately 50% of people experienced a major life event in the 3 weeks prior to a schizophrenic episode, whereas only 12% reported one in the 9 weeks prior to that. Hirsch et al (1996) found life events made a significant cumulative contribution in the 12 months preceding relapse rather than having a more concentrated effect in the period just prior to the schizophrenic episode. P: This model poses more of a holistic approach to the explanation of schizophrenia.