However, evidence may not be reliable as patients recall may be affected by their schizophrenia. One weakness of the cognitive explanation is that there are problems with cause and effect. [4 marks], Briefly outline family dysfunction as an explanation for schizophrenia. A co-operative, trusting relationship with the family is established, Therapist provides information about schizophrenia, Family members contribute, all contributions valued, Family is provided with practical coping skills to help deal with the disorder (to anticipate and solve problems), More constructive ways of interaction and communication encouraged (to avoid expressed emotion), Training to detect any signs of relapse in the patient. Imagined stimuli could involve any of the senses. LS23 6AD The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49 3x sold 11 items 1. So in this context it is the occurrence of two illnesses or conditions together; for example, a person has both schizophrenia and a personality disorder. Copyright Get Revising 2023 all rights reserved. tutor2u's AQA Knowledge Books are designed to help students recap and revise the essential specification knowledge by providing retrieval activities and exam skills development - View resources New for 2023 | Online CPD Courses for AQA A-Level Psychology Teachers CPD (Online) Requires self-awareness and willingness to engage Held back by the symptoms schizophrenics encounter It is an ineffective treatment likely to lead to disengagement. It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. It is therefore prescribed when the patient is at risk of suicide. They cannot express their feelings about the unfairness of the situation. The basic assumption of CBT is that people often have distorted beliefs which influence their behaviour in maladaptive ways. For the classification system to be valid it should be meaningful and classify a real pattern of symptoms, which result from a real underlying cause. Clozapine, Olazapine and Risperidone. Both aspect of diathesis-stress must be present to develop the disorder. To improve how the family communicated and handled the situation. Yellowless et al. Turkington et al. Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. A strength is that the research into enlarged ventricles and neurotransmitter levels have high reliability. Biological explanations for schizophrenia can be criticised for being biologically reductionist. West Yorkshire, AQA maintains that 16-mark questions, or indeed, extended writing questions of other tariffs, could be asked on any part of any topic. Atypical antipsychotic drugs work on negative symptoms, improving mood, cognitive functions and reducing depression and anxiety. They engage in no self motivated behavior. The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly. [4 marks]. Schizophrenia Dysfunctional Family Dysfunctional Family Dysfunctional Family Addiction Addiction Treatment Theories Aversion Therapy Behavioural Interventions Drug Therapy Gambling Addiction Nicotine Addiction Physical and Psychological Dependence Reducing Addiction Risk Factors for Addiction Six Stage Model of Behaviour Change Autopsies have found that there are generally a large number of dopamine receptors (Owen et al., 1987) and there was an increase in the amount of dopamine in the left amygdale (falkai et al. Research suggests that these delusions are associated with specific biases in reasoning about and explaining social situations. This suggests that the dopamine hypothesis does not account for freewill. Family Dysfunction refers to any forms of abnormal processes within a family such as conflict, communication problems, cold parenting, criticism, control and high levels of expressed emotions. When desired behavior is displayed eg. Antipsychotic drugs (drugs used to reduce the intensity of the symptoms) are the most common treatment for schizophrenia. Schizophrenia is a multi-factorial trait as it is the result of multiple genes and environmental factors. Although this study showed that children with a biological parent were still at greater risk even if they had been adopted into families with no history of schizophrenia, all reported cases of schizophrenia occurred in families rated as disturbed. 3. Usually the person has convinced him/herself that he/she is someone powerful or important, such as Jesus Christ, the Queen (e.g. A final weakness of the genetic explanation of schizophrenia is that it is biologically reductionist. CBT may involve challenging the validity of beliefs, which may interfere with freedom of thought. (2003) meta analysis found family interventions help the patient to understand their illness and to live with it, developing emotional strength and coping skills, thus reducing rates of relapse. they said an event was real but it was in their head. David Rosenhan (1973) famous experiment involving Pseudopatients led to 8 normal people being kept in hospital despite behaving normally. Parents who have already suffered their child going through the dis-order and have to look after them with care go into more trauma by being blamed for the condition. This can lead to problems with reliability of diagnosis as one doctor might diagnose the person as having schizophrenia while another might diagnose bipolar disorder. Some sufferers only take a course of antipsychotics once, while others have to take a regular dose in order to prevent symptoms from reappearing. b) identifying source of bias - EITHER people volunteer so their behaviour might be atypical/unrepresentative OR they all attend self-help group so their behaviour may be atypical/unrepresentative eg volunteers may be better communicators, more verbal Support for family research, Tienari et al (1994) adoption study found those adopted children who had schizophrenic parents were more likely to become ill themselves than those children with non-biological parents. Ventricles are fluid filled cavities (i.e. They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. For example, schizophrenia and depression are often found together. This suggests the doctors had no valid method for detecting schizophrenia. Economic Benefits: Family therapy is highly cost effective because it reduces relapse rates, so the patients are less likely to take up hospital beds and resources. Medication can be taken as pills, syrups or injections, and may be taken over a short or long-term. Typical antipsychotic drugs are used to reduce the intensity of positive symptoms, blocking dopamine receptors in the synapses of the brain and thus reducing the action of dopamine. Since the mid-1950s antipsychotic medications have greatly improved treatment. They generally have fewer side effects eg. Research in Hampshire, by Kingdon and Kirschen (2006) found that CBT is not suitable for all patients, especially those who are too thought disorientated or agitated, who refuse medication, or who are too paranoid to form trusting alliances with practitioners. Research evidence from autopsies has shown that schizophrenia sufferers have more dopamine receptors, which may lead to more neural firing and therefore an over production of messages. He used MRI (magnetic resonance imaging) to obtain pictures of the brain structure of MZ twins in which one twin was schizophrenic. A final strength is that it takes on board the nurture approach to the development of schizophrenia. Work out ways to recognise negative thoughts and test faulty beliefs when they arise, and then challenge and re-think them. Meehl suggested that the vulnerability is genetic (the result of a schizogene), causing a sensitive personality. However the difference only emerged in situations where the adopted family was rated as disturbed. Dopamine is a neurotransmitter. They block dopamine receptors on post-synaptic neurons, meaning that less dopamine is transmitted across the synapse. Therefore there is no need to feel stressed or ashamed about them. Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms. stress) may trigger the onset of schizophrenia, rather than individuals with schizophrenia moving down in social status. [2 marks], - Characteristics of dysfunction eg difficulties in communication, high levels of interpersonal conflict, Evaluate psychological explanations of schizophrenia [16 marks], Briefly discuss two limitations of the family dysfunction explanation for schizophrenia. In addition, they can then predict the outcome of the disorder and suggest related treatment to help the patient. Eg. This is mainly aimed at lowering expressed emotion. One biological explanation for schizophrenia is that it is passed on through the genes. Cochrane (1977) reported that the incidence of schizophrenia in the West Indies and the UK is 1 %, but that people of Afro-Caribbean origin are seven times more likely to be diagnosed as schizophrenic when living in the UK. Book now . Eg. The focus of a token economy is on shaping and positively reinforcing desired behaviors and NOT on punishing undesirable behaviors. However she still suffers negative symptoms and side effects. For the classification system to be reliable, differfent clinicians using the same system (e.g. One area where the model has had considerable success is schizophrenia, a disease with both genetic and environmental causes. Researchers have focused on two factors which appear to be related to some of the experiences and behaviors of people diagnosed with schizophrenia. In order to explain schizophrenia effectively it would be better to take an interactionist approach, such as the diathesis stress model. The biological basis for schizophrenia is therefore not addressed at all in the therapy, limiting its use. It is difficult to keep this treatment going once the patients are back at home in the community. Drugs such as Chlorpromazine also have a sedative effect, meaning that they calm patients down and reduce anxiety. If diagnosis leads to successful treatment, the diagnosis can be seen as valid. Help the patient realise it is normal to have negative thoughts in certain situations. The modern understanding of diathesis-stress is slightly different. Avolition: Lack of volition (i.e. (1956) suggested the double bind theory, which suggests that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia. Gottesman reports that while the rate of schizophrenia in the general population is 1%, if one parent has schizophrenia there is a 12% likelihood their child will develop it and if both parents have schizophrenia, it increases to 40%. Research using family studies have suggested a genetic vulnerability is inherited and this varies from those with a high . amphetamines) can produce-schizophrenia like symptoms in non-sufferers. This suggests that there is wider academic credibility for enlarged ventricles determining the likelihood of schizophrenia developing. McMonagle and Sultana (2000) reviewed token economy regimes over a 15-year period, finding that they did reduce negative symptoms, though it was unclear if behavioral changes were maintained beyond the treatment programme. In CBT, patients may be taught to recognise examples of dysfunctional or delusional thinking, then may receive help on how to avoid acting on these thoughts. A strength of the cognitive explanation is that it has practical applications. Diathesis-stress model: Meehl (1962) originally proposed that both a vulnerability to schizophrenia and a stress-trigger are necessary in order to develop the condition. While schizophrenia has a strong genetic component, some individuals with genetic susceptibilities to the disorder nonetheless remain healthy. It binds to dopamine receptors more strongly than Clozapine, and there is some evidence that it produces fewer side-effects. Registered office: International House, Queens Road, Brighton, BN1 3XE, Psychology Schizophrenia Family Dysfunction. Token economies aim to manage schizophrenia rather than treat it. Classification is the process of organising symptoms into categories based on which symptoms cluster together in sufferers. LS23 6AD Scheff (1966) points out that diagnosis classification labels the individual, and this can have many adverse effects, such as a self-fulfilling prophecy (patients may begin to act how they are expected to act), and lower self-esteem. Communication skills training teach family to listen, to express emotions and to discuss things. Family therapy is based on the theory that schizophrenia is associated with schizophrenogenic mothers, double bind communication, expressed emotion, or other dysfunction in the family. To educate relatives about schizophrenia. Last chance to attend a Grade Booster cinema workshop before the exams. The reason for this is because the research is carried out in highly controlled environments, which specialist, high tech equipment such as MRI and PET scans. Another form of CBT: Coping Strategy Enhancement (CSE). Antipsychotic drugs are highly effective as they are relatively cheap to produce, easy to administer and have a positive effect on many sufferers. Pills are not as helpful with other symptoms, especially emotional problems. Al (2011) suggest many aspects of urban living ranging from life stressors to the use of drugs, can have an effect on human epigenetics. They assumed the bogus patients were schizophrenic with no real evidence. Keywords: psychosocial dysfunction, family burden, schizophrenia, OCD. This will not get rid of the symptoms of schizophrenia but it can make patients better able to cope with them. Their get up and go has got up and gone! By oversimplifying schizophrenia in terms of genes and neurotransmitters, the social context within which it develops has not been considered. including dysfunctional thought processing. The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine. Comorbidity describes people who suffer from two or more mental disorders. Antipsychotic medication will often be used alongside CBT, acknowledging the role that biological and psychological factors play in the disorder. why some children in such dysfunctional families often do not go on to develop schizophrenia. However, the newer antipsychotic drugs affect other neurotransmitters such as serotonin and glutamate as well as dopamine. It is, therefore, very important to offer the most appropriate and effective type of treatment. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. There is a sizeable minority who do not respond to drug treatment. Also, research by Sherrington et al. There are serious ethical concerns in blaming the family, particularly as there is little evidence upon which to base this. with reference to co-morbidity, This suggests that the research into gene mapping is oversimplistic as schizophrenia is not due to a single gene. Even newer antipsychotic drugs, such as risperidone and olanzapine are safer, and they also may be better tolerated. Schizophrenia is a severe type of mental illness that affects a person's thoughts, perceptions, and behaviors. Response. Mischler & Waxler (1968) found significant differences in the way mothers spoke to their schizophrenic daughters compared to their normal daughters, which suggests that dysfunctional communication may be a result of living with the schizophrenic rather than the cause of the disorder. The understanding and treatment of schizophrenia have been greatly hampered by uncertainty about etiological factors and controversy about diagnostic boundaries. 2. A dysfunctional family is one that has at its core destructive and harmful parenting and a lack of concern for the child. Company Reg no: 04489574. delusions. Visual - Evaluation of neural correlates for schizophrenia 4. 214 High Street, Bruce Johnson is an A-level psychology teacher, and head of the sixth form at Caterham High School. CBT aims to identify and alter irrational thinking including regarding: In theory, when the misunderstandings have been swept away, emotional attitudes will also improve. Delusions are false beliefs. [2 marks], Evaluate psychological explanations of schizophrenia [16 marks] and more. This suggests that one needs to be careful when establishing cause and effect relationships in schizophrenic patients. Jakobsen et al. Even after stopping the use of the drug, this condition can persist. Addington and Addington (2005) claim that CBT is of little use in the early stages of an acute schizophrenic episode, but perhaps more useful when the patient is more calm and beginning to worry about how life will be after they recover. Ethical issues Severely ill patients cant get privileges because they are less able to comply with desirable behaviors than moderately ill patients They may suffer from discrimination. Last chance to attend a Grade Booster cinema workshop before the exams. They believed that schizophrenia was a result of social pressures from life. Family therapy is based on the theory that schizophrenia is associated with schizophrenogenic mothers, double bind communication, expressed emotion, or other dysfunction in the family. It could be that the problems caused by low neurotransmitters creates the cognitive deficits. Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them delusions of persecution. In order to diagnose Schizophrenia the Mental Health Profession developed the DSM (Diagnostic and Statistical Manual) still used today as a method of classifying mental disorders (particularly in the USA). West Yorkshire, More recent versions have included hypodopaminergia, where low levels of dopamine in the prefrontal cortex are believed to be responsible for some of the negative symptoms of schizophrenia. Support for family research, Tienari et al (1994) adoption study found . The rate of relapse was particularly high if returning to a high EE family was coupled with no medication. For example, trying to persuade an individual that the government is not watching or monitoring them in any way may interfere with their (possibly justifiable) fear of an over-controlling government. Gottesman reports that while the rate of schizophrenia in the general population is 1%, if one parent has schizophrenia there is a 12% likelihood their child will develop it and if both parents have schizophrenia, it increases to 40%. use a different sampling method, such as random or systematic OR a sample of people with schizophrenia who do not go to a self-help group. Pharaoh et al. A final weakness of the dopamine hypothesis is that it is biologically deterministic. [2 marks] Comorbidities were also found with epilepsy being the . Here are a series of suggested answers for the Schizophrenia topic questions in AQA A Level Psychology Paper 3 (Section B) in June 2018. However they do not cure schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community. They are also encouraged to evaluate the content of their delusions or of any internal voices they hear and to consider ways in which they might test the validity of their faulty beliefs. Last chance to attend a Grade Booster cinema workshop before the exams. DSM) should arrive at the same diagnosis for the same individual. Comorbidity refers to more than one disorders or diseases that exist alongside a primary diagnosis, which is the reason a patient gets referred and/or treated. Found that changes in behavior achieved through token economies do not remain when tokens are withdrawn, suggesting that such treatments address effects of schizophrenia rather than causes. Upper and Newton (1971) found that the weight gain associated with taking antipsychotics was addressed with token economy regimes. Of these, only 1 study showed improvement in symptoms and behavioural change in patients. 1. Liem (1974)measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families. In most cases the original typical antipsychotics have more side effects, so if the exam paper asks for two biological therapies you can write about typical anti-psychotics and emphasise the side effects, then you can write about the atypical antipsychotics and give them credit for having less side effects. Last chance to attend a Grade Booster cinema workshop before the exams. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. Helping the patient to find logical reasons for the things which trouble them In CBT, schizophrenia patients are encouraged to trace back the origins of their symptoms in order to get a better idea of how the symptoms might have developed. Credit should be awarded for one type in some detail or for two (or more) done briefly. Check out Adapt the A-level & GCSE revision timetable app. A number of researchers have suggested that difficulties in understanding other peoples behavior might explain some of the experiences of those diagnosed as schizophrenic. Visual - Evaluation of the dopamine hypothesis for schizophrenia. Abstract. This suggests that gaining an insight into family relationships allows psychiatric professionals to help improve the quality of patients lives. Evidence to support this view comes from the prospective adoption study by Tienari et al. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. To stabilize the social authority of the doctor and the family. For example, about 50% of people with schizophrenia are also diagnosed with depression. Refer to one or more types of family dysfunction in your answer. Participants in Group B, the control group, were a volunteer sample of people who attended a community centre. The legality of this has been challenged, and the use of token economies has declined as a result. 1. a group of people related by blood or marriage or a strong common bond, such as those descended from a common ancestor, or a husband, wife, and their children. A second strength of the research into expressed emotion (EE) is that it has practical applications. Kahn et al. Study notes, videos, interactive activities and more! culture and gender bias and symptom overlap. Small doses given to people already suffering from schizophrenia tend to worsen their symptoms. Pharoah identified examples of how family therapy works: It helps family members achieve a balance between caring for the individual and maintaining their own lives, it reduces anger and guilt, it improves their ability to anticipate and solve problems and forms a therapeutic alliance. However, the fact that these people were on medication and having regular meetings with doctors would be expected to have that effect anyway. Treatment: In an interactionist approach, treatments will take more than one form. [4 marks], - Atypical and typical antipsychotics are equally effective against positive symptoms with more than half of patients responding well, Apart from effectiveness, briefly explain one limitation of drug therapy for schizophrenia. MZ twins may have the same genetic vulnerability but can be triggered by different stressors. This is not the case with schizophrenia: The causes may be one of biological or psychological or both. Getting dressed, tokens (in the form of coloured discs) are given immediately as secondary reinforcers which can be exchanged for rewards eg. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. Additional communication skills are taught, such as compromise and negotiation, and requesting a time out . There is no such thing as a normal schizophrenic exhibiting the usual symptoms. Another problem is the theory led's to parent blaming. CBT does seem to reduce relapses and readmissions to hospital (NICE 2014). Company Reg no: 04489574. First, cognitive deficits which are impairments in thought processes such as perception, memory and attention. This suggests that the cognitive approach is oversimplistic when consider the explanation of schizophrenia. desire): in which a person becomes totally apathetic and sits around waiting for things to happen. In other words, it doesnt cure schizophrenia, it just helps people get over it. [8 marks] The fact that jack could never talk to his mum shows a symptom of schizophrenia, that fact that he displays lack of speech. Therefore, the evidence supporting token economies is very weak. However, the concordance rate for MZ twins is not 100% which suggests that other factors must also be involved. The commonest diagnosis was schizophrenia (n = 23, 57.5%) followed by epileptic psychosis (n = 4, 10.0%) and general psychosis (n = 4, 10.0%) with one of psychotic depression and one psychosis secondary to general medical condition. Fox (1990): It is more likely that factors associated with living in poorer conditions (e.g. The technique alleviates negative symptoms such as poor motivation, and nurses subsequently view patients more positively, which raises staff morale and has beneficial outcomes for patients. Negative symptoms are a diminution or loss of normal functions such as psychomotor disturbances, avolition (the reduction of goal-directed behavior), disturbances of mood and thought disorders. This has the effect of reducing dopamine production, and reduces positive symptoms such as hallucinations. Social behavior depends, in part, on using other peoples actions as clues for understanding what they might be thinking. Ethics do the benefits of classification (care, treatment, safety) outweigh the costs (possible misdiagnosis, mistreatment, loss of rights and responsibility, prejudice due to labelling). The harmful effects on the child may go completely unacknowledged or be minimized. Boston House, Zubin and Spring suggest that a person may be born with a predisposition towards schizophrenia which is then triggered by stress in everyday life. Conversely, antipsychotic drugs work by binding to dopamine receptors and reduce symptoms. Those who do not have the schizogene would not develop schizophrenia, even if they experienced a chronically stressful upbringing. Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females. Her psychiatrist wants to change her medication from typical antipsychotics to one of the atypical antipsychotics and has also suggested cognitive behavioural therapy", What do the data in Table 1 seem to show about the effectiveness of typical and atypical antipsychotics in the treatment of schizophrenia? Psychological therapies are very rarely used alone, but sometimes patients may just take drugs without any other therapy. These might include things as simple as turning up the TV to drown out the voices they were hearing! Token economies raise ethical issues. A quarter of people with schizophrenia (Total 4 marks) 11 Describe and evaluate biological explanations for schizophrenia. It is not clear which comes first. (2004): Adopted children from families with schizophrenia had more chance of developing the illness than children from normal families. The patients with the most severe symptoms are unable to access the tokens, as they are unable to perform the desirable behaviours. Family studies find individuals who have schizophrenia and determine whether their biological relatives are similarly affected more often than non-biological relatives. Tokens are secondary reinforcers, which are exchanged for rewards (primary reinforcers), for example food, being allowed to watch a film, and so on. For example in some Asian countries people are not expected to show emotional expression, whereas in certain Arabic cultures public emotion is encouraged and understood. The aim in modern forms of this therapy is to reduce the stress in the family environment so preventing relapse. . An example is Clozapine which is used when other drugs have failed, due to the risk of agranulocytosis (a potentially fatal blood condition). The family dysfunction explanation is an explanation that sees maladaptive relationships and patterns of communication as a source of stress which influences the development of schizophrenia The researchers found that the males had a genetic condition which became later known as "Brunner syndrome" (it is important to note that females only carry this condition, as it only affects the MAOA production gene on the single X chromosome in males). Preliminary analysis: Through interviews and observation the therapist identifies strengths and weaknesses of family members and identifies problem behaviors. This suggests that there is wider academic credibility for the idea of contradictory messages causing schizophrenia. Twenty-six of forty patients (65.0%) were taking haloperidol and 14 (35.0%) chlorpromazine. basis. Does the low motivation reflect depression or schizophrenia, or both? Large doses of amphetamine given to people with no history of psychological disorders produce behavior which is very similar to paranoid schizophrenia. Simply Scholar Ltd. 20-22 Wenlock Road, London N1 7GU, 2023 Simply Scholar, Ltd. All rights reserved, Section 1 Diagnosis and Classification of Schizophrenia, Section 2 Biological Explanations for Schizophrenia, Section 3 Psychological Explanations for Schizophrenia, Section 4 Drug Therapy typical and atypical antipsychotics, Section 5 Psychological Therapies for Schizophrenia, Effective use of terminology (use the technical terms).

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