disputing techniques. This is a useful point to emphasise in any essay on the disorder. They arrest dopamine production by blocking the D2 receptors in synapses that absorb dopamine, in the mesolimbic pathway thus reducing positive symptoms, such as auditory hallucinations. Schizophrenia seems to be polygenic, as a number of genes have been implicated. They engage in no self motivated behavior. Token economies aim to manage schizophrenia rather than treat it. Visual - Evaluation of the dopamine hypothesis for schizophrenia. It is therefore prescribed when the patient is at risk of suicide. A final weakness of the dopamine hypothesis is that it is biologically deterministic. There is evidence that people diagnosed as schizophrenic have difficulties in processing various types of information, for example visual and auditory information. Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics. Non-biological Explanation AO1 AO2 - PSYCHOLOGY WIZARD This is mainly aimed at lowering expressed emotion. 214 High Street, In addition, they can then predict the outcome of the disorder and suggest related treatment to help the patient. Kazdin et al. A second weakness of the double bind theory is that there are ethical issues. The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly. CBT aims to identify and alter irrational thinking including regarding: In theory, when the misunderstandings have been swept away, emotional attitudes will also improve. Another form of CBT: Coping Strategy Enhancement (CSE). It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. For example, an excess of dopamine receptors in Brocas area might be responsible for poverty of speech and auditory hallucinations. 1988) and increased dopamine in the caudate nucleus and putamen (Owen et al, 1978). West Yorkshire, The researchers used an inferential statistical test to see if there was a significant difference in language rating between the two groups. Noll (2009) also argues around one third of patients do not respond to drugs which block dopamine so other neurotransmitters may be involved. The differences were so large the schizophrenic twins could be easily identified from the brain images in 12 out of 15 pairs. It is, therefore, very important to offer the most appropriate and effective type of treatment. b) Explain one reason why there might be a problem of bias and generalisation in this study. Therefore there is no need to feel stressed or ashamed about them. To teach patients and carers more effective stress management techniques. There are two types of twins identical (monozygotic) and fraternal (dizygotic). [4 marks], "Two years ago Jenny was diagnosed with schizophrenia. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. They believed that schizophrenia was a result of social pressures from life. Bateson et al. However, the newer antipsychotic drugs affect other neurotransmitters such as serotonin and glutamate as well as dopamine. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002). Turkington et al. The aim in modern forms of this therapy is to reduce the stress in the family environment so preventing relapse. The effect of this is, as well as reducing positive symptoms, the reduction of depression and anxiety, and the enhancement of mood. Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them delusions of persecution. Tokens are secondary reinforcers, which are exchanged for rewards (primary reinforcers), for example food, being allowed to watch a film, and so on. They are a form of behavioral therapy where desirable behaviors are encouraged by the use of selective reinforcement and is based on operant conditioning. Upper and Newton (1971) found that the weight gain associated with taking antipsychotics was addressed with token economy regimes. Falloon et al (1996) stress such as divorce or bereavement, causes the brain to be flooded with neurotransmitters which brings on the acute episode. Combining treatments is most common in the UK, although it is also sometimes used in the USA. Example Answers for Section C Schizophrenia Topic Paper 3 June 2018 (AQA) . 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. Family Dysfunction as an Explanation of Schizophrenia Miss Earle Psychology 3.57K subscribers Subscribe Share Save 2.4K views 3 years ago Family Dysfunction and Schizophrenia AO1 and AO3. Risperidone is another atypical antipsychotic, and is designed to be as effective as Clozapine without the risky side-effects. At least 73% of his sample reported that these strategies were successful in managing their symptoms. 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. As this is not the case family dysfunctions cannot be the sole cause ofthe illness. For example Hogarty (1991) produced a type of therapy session, which reduced social conflicts between parents and their children which reduced EE and thus relapse rates. One of the biggest criticisms of the dopamine hypothesis came when Farde et al found no difference between schizophrenics levels of dopamine compared with healthy individuals in 1990. In order to explain schizophrenia effectively it would be better to take an interactionist approach, such as the diathesis stress model. Classification is the process of organising symptoms into categories based on which symptoms cluster together in sufferers. Schizophrenia Interactionist Approach Interactionist Approach Interactionist Approach 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 Thought disorder in which there are breaks in the train of thought and the person appears to make illogical jumps from one topic to another (loose association). Pathophysiology, evaluation and treatment of erectile dysfunction: review article Andrey Biff Sarris 1 , Maki Caroline Nakamura 1 Luiz Gustavo Rachid Fernandes 1 , BSc (Hons) Psychology, MRes, PhD, University of Manchester. Schizophrenia: Comorbidity | Psychology | tutor2u A number of researchers have suggested that difficulties in understanding other peoples behavior might explain some of the experiences of those diagnosed as schizophrenic. 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. Catatonia- staying in position for hours/days on end, cut off from the world. Slater & Roth (1969) say that hallucinations are the least important of all the symptoms, as they are not exclusive to schizophrenic people. Gender bias is also an issue as the mother tends to be blamed the most, which means such research is highly socially sensitive. Credit should be awarded for one type in some detail or for two (or more) done briefly. Families can help minimize the damage to self of the schizophrenic that this entails. Atypical antipsychotics: Developed in the 1970s, as an attempt to find drugs with fewer severe side-effects than typical antipsychotics. First generation Antipsychotics are called Typical Antipsychotics Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females. Psychological therapies are very rarely used alone, but sometimes patients may just take drugs without any other therapy. Family dysfunction - the double-bind theory Bateson et al. Conversely, antipsychotic drugs work by binding to dopamine receptors and reduce symptoms. Therapists may use logical (does it make sense? Due to the pivotal role of dopamine in schizophrenia this led to a culture of heavy smoking an nicotine addiction in psychiatric hospitals of the era. Comorbidities were also found with epilepsy being the . People with schizophrenia have abnormally large ventricles in the brain . 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. One criticism of the dopamine hypothesis is there is a problem with the chicken and egg. One weakness of the cognitive explanation is that there are problems with cause and effect. Ethics do the benefits of classification (care, treatment, safety) outweigh the costs (possible misdiagnosis, mistreatment, loss of rights and responsibility, prejudice due to labelling). Schizophrenogenic mother: Proposed by Fromm-Reichmann (1948), who noted that many of her patients with schizophrenia described a particular type of parent, which she termed 'schizophrenogenic'. Adverse drug reactions experienced by out-patients taking family dysfunction schizophrenia tutor2u Voices are usually heard coming from outside the persons head giving instructions on how to behave. The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49. an excess or distortion of normal functions: including hallucinations and Neuropsychologist Michael Foster Green suggests that neurocognitive deficits in basic functions such as memory, attention, central executive and problem solving skills may combine to have an outcome which we are labelling Schizophrenia as if it was the cause when in fact it is simply an umbrella term for a set of effects. So the stressors of modern living could cause increased schizophrenia in future generations. 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. laying out what they hope to achieve through the therapy. LS23 6AD However, those children from families schizophrenia were less likely to develop the illness if placed in a good family with kind relationships, empathy, security, etc. Hickling (1999) the stress of urban living made African-Carribean immigrants in Britain 8 to 10 times more likely to experience schizophrenia. Response. 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. PDF (Total 16 marks) - Psych205 Chronic schizophrenics achieved 3lbs of weight loss a week. In London the rate remained at 20%, suggesting neither group had a valid definition of schizophrenia. They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. Psychomotor Disturbances: Stereotypyical Rocking backwards and forwards, twitches, & repetitive behaviors. [4 marks], a) this study is about differences between two conditions/groups so the Mann-Whitney is appropriate it is not about correlation/relationship between two variables so Spearman's is not appropriate. A strength of the cognitive explanation is that it has practical applications. Paul and Lentz (1977) Token economy led to better overall patient functioning and less behavioral disturbance, More cost-effective (lower hospital costs). Concordance rates are never 100% which suggests that environmental factors must also play a role in the development of SZ. (2006) CBT is highly effective and should be used as a mainstream treatment for schizophrenia wherever possible. ', In a study of communication, researchers used a language rating scale to compare two groups of participants. 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. With these particular questions there is a sizeable risk that people dont understand the difference between the questions, and then write about the wrong thing. However they do not cure schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community. Evaluation of the family dysfunction explanation for schizophrenia - Stuvia 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. Having attempted to dispute faulty beliefs, patients may also be set behavioural assignments with the aim of improving their general level of functioning. The harmful effects on the child may go completely unacknowledged or be minimized. Note: you may come across the terms DSM-IV and ICD-10. Neural correlates are patterns of structure or activity in the brain that occur in conjunction with schizophrenia. 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. Cognitive biases refer to selective attention. For example, about 50% of people with schizophrenia are also diagnosed with depression. Getting dressed, tokens (in the form of coloured discs) are given immediately as secondary reinforcers which can be exchanged for rewards eg. These refer to the latest editions of the two classification systems. If family dynamics were the sole cause of schizophrenia, then all children raised in similar environments should be schizophrenic. We are committed to engaging with you and taking action based on your suggestions, complaints, and other feedback. As there is strong evidence that relapse is related to stress and expressed emotion within the family, it seems likely that CBT should be employed alongside family therapy in order to reduce the pressures on the individual patient. Keywords: psychosocial dysfunction, family burden, schizophrenia, OCD. 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%. tutor2u is the leading support service for A-Level, GCSE, BTEC and IB students and teachers preparing for assessments, mocks and final exams. Briefly outline family dysfunction as an explanation for schizophrenia. Words may become confused and sentences incoherent (so called word salad). This means that the brains of schizophrenics are lighter than normal. The intention is to show schizophrenics that their hallucinations are not real. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. 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. [2 marks] Antipsychotic drugs are weakened by the fact that they have severe side-effects. Some people who have been diagnosed as schizophrenic appear to have difficulties with this skill. Some sufferers only take a course of antipsychotics once, while others have to take a regular dose in order to prevent symptoms from reappearing. 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. , AQA A level Psychology paper 3 7182/3 14th June 2019 , AQA A Level Psychology Paper 3 7182/3 - 16 Jun 2022 [Exam Chat] , AQA A Level Psychology 2022 Predictions (Paper 3) . [4 marks]. Individual differences EE is associated with relapse but not all patients who live in high EE families relapse and not all patients in low EE families avoid relapse Family dysfunction is an incomplete explanation for schizophrenia. Last chance to attend a Grade Booster cinema workshop before the exams. Gottesman (1991) has found that schizophrenia is more common in the biological relatives of a schizophrenic, and that the closer the degree of genetic relatedness, the greater the risk. Company Reg no: 04489574. For men the figure was 59%. Schizophrenia is a severe type of mental illness that affects a person's thoughts, perceptions, and behaviors. LS23 6AD 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. The rate of relapse was particularly high if returning to a high EE family was coupled with no medication. Other side effects are potentially fatal, for example agranulocytosis and neuroleptic malignant syndrome (NMS). There is a sizeable minority who do not respond to drug treatment. Participants in Group A were a volunteer sample of people from a self-help group for people with schizophrenia. These might include things as simple as turning up the TV to drown out the voices they were hearing! Second, cognitive biases are present when people notice, pay attention to, or remember certain types of information better than other. 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. Problems of validity: Are we really testing what we think we are testing? Kahn et al. For example hallucinations are a symptom of both schizophrenia and bipolar disorder. The patients with the most severe symptoms are unable to access the tokens, as they are unable to perform the desirable behaviours. including dysfunctional thought processing. Alogia aka speech poverty is a thought disorder were correct words are used but with little meaning. Out-dated views that were once accepted are no longer tolerated by families and are now seen as destructive rather than productive, Briefly outline how cognitive behaviour therapy (CBT) is used to treat schizophrenia and explain one limitation of using CBT to treat schizophrenia. Predictive validity. They did not believe that schizophrenia was a disease. The focus of a token economy is on shaping and positively reinforcing desired behaviors and NOT on punishing undesirable behaviors. Schizophrenia Revisions Notes - Simply Psychology Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. 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. Pharoah et al (2010) suggest that the following techniques, in which all of the family are involved, are used: This is a behavioural treatment for schizophrenia, based on operant conditioning (learning through reinforcement). Evaluation of family therapy as a treatment for schizophrenia - Stuvia 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. They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity. Clozapine targets multiple neurotransmitters, not just dopamine, and has been shown to be more effective than other antipsychotics, although the possibility of severe side effects in particular, loss of the white blood cells that fight infection. Tarrier (2005) reviewed trials of CBT, finding evidence of reduced symptoms, especially positive ones, and lower relapse rates. this should enable a less biased/more varied/more representative sample OR this would allow the results to be generalised more widely, Wars of the Roses 6 - Henry VII 1485-1509. and pragmatic (how is the belief helpful?) [2 marks], - All drugs have side effects that can be severe and may lead to patients avoiding medication and hence to relapse, Outline and evaluate the use of antipsychotic drugs to treat schizophrenia [8 marks], 'Therapies can be time-consuming and, in some cases, uncomfortable for the client. They act as dopamine antagonists, attempting to reduce dopamine activity. The adoptive families were investigated thoroughly using joint and individual interviews and psychological tests. Genetic Explanations of Offending Behaviour | Psychology | tutor2u They cannot express their feelings about the unfairness of the situation. It also seems to be aetiologically heterogeneous as different studies have identified different candidate genes. Jakobsen et al. Ayllon and Azrin (1968) set up a token economy with schizophrenic patients in a psychiatric institution. Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . Researchers estimate up to 1 percent of adults worldwide have schizophrenia.. What . Sweets and cigarettes. Tel: +44 0844 800 0085. This limits the usefulness of token economies in treating schizophrenia. Preliminary analysis: Through interviews and observation the therapist identifies strengths and weaknesses of family members and identifies problem behaviors. Even after stopping the use of the drug, this condition can persist. stress) may trigger the onset of schizophrenia, rather than individuals with schizophrenia moving down in social status. Older antipsychotics like haloperidol or chlorpromazine may produce side effects It is more likely Cause and effect It remains unclear whether cognitive factors cause schizophrenia or if schizophrenia causes these cognitions Family dysfunction may not be a valid explanation for schizophrenia. This will not get rid of the symptoms of schizophrenia but it can make patients better able to cope with them. Medications reduce positive symptoms particularly hallucinations and delusions; and usually allow the patient to function more effectively and appropriately. They believed that schizophrenia was a result of social pressures from life. 3. Requires self-awareness and willingness to engage Held back by the symptoms schizophrenics encounter It is an ineffective treatment likely to lead to disengagement. A nationwide Finnish sample of schizophrenics' offspring given up for adoption was compared blindly with matched controls, who were adopted offspring of non-schizophrenic biological parents. This weakens the interactionist explanation. Their get up and go has got up and gone! [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. The basic assumption of CBT is that people often have distorted beliefs which influence their behaviour in maladaptive ways. There are serious ethical concerns in blaming the family, particularly as there is little evidence upon which to base this. Where two conditions are frequently diagnosed together it calls into question the . This suggests that understanding the effects of cognitive deficits allows psychologists to create new initiatives for schizophrenics and improve the quality of their lives. 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. 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). 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. All patients are in danger of relapsing but without medication the relapses are more common and more severe which suggests the drugs are effective. 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. Read et al (2005) reviewed 46 studies of child abuse and schizophrenia and found concluded that 69% of adult women in-patients with a diagnosis of schizophrenia had a physical abuse, sexual abuse or both during their childhood.
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