In the 1950s and 60s nurses often rewarded patients with cigarettes. (2008) found that antipsychotics are generally effective for at least one year, but second- generation drugs were no more effective than first-generation ones. Double bind is based on clinical observation the patients and early evidence involved assessing the personality of the mothers for 'crazy-making' characterists. It is one of the chemicals in the brain which causes neurons to fire. Keywords: psychosocial dysfunction, family burden, schizophrenia, OCD. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. This suggests that the cognitive approach is oversimplistic when consider the explanation of 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%. There is no such thing as a normal schizophrenic exhibiting the usual symptoms. (1991) found a relapse rate of almost 40% when patients had drugs only, compared to only 20 % when Family Therapy or Social Skills training were used and the relapse rate was less than 5% when both were used together with the medication. High dopamine activity leads to acute episodes, and positive symptoms which include: delusions, hallucinations, confused thinking. They act as dopamine antagonists, attempting to reduce dopamine activity. Is it the cognitive deficits which causes the schizophrenic behavior or is the schizophrenia that causes the cognitive deficits? However, group Bs scores suggest a positively skewed distribution as the mean (26) is higher than both the median (22.5) and the mode (16). 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. A hundred Danish patients with a history of psychosis were assessed using operational criteria, and a concordance rate of 98% was obtained. CBT may involve challenging the validity of beliefs, which may interfere with freedom of thought. disputing techniques. Communication skills training teach family to listen, to express emotions and to discuss things. Cognitive approaches examine how people think, how they process information. This suggests that the dopamine hypothesis does not account for freewill. 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. They are effectively discriminated against (in this case, denied rewards) for being more severely ill. A final weakness of the dopamine hypothesis is that it is biologically deterministic. However, one explanation for this is mutation in parental DNA. This suggests that one needs to be careful when establishing cause and effect relationships in schizophrenic patients. Just challenging the dysfunctional thoughts through disputing may not be enough to change them if the thoughts have a biological basis. Therapists may use logical (does it make sense? Schizophrenics returning to such a family were more likely to relapse into the disorder than those returning to a family low in EE. One weakness of the genetic explanation of schizophrenia is that there are methodological problems. Briefly outline family dysfunction as an explanation for schizophrenia. Brown and Birley (1968) 50% people who had an acute schizophrenic episode had experienced a major life event in 3 weeks prior. However, biological factors must have had a role to play as none of the adoptees with no family history of schizophrenia from disturbed families developed schizophrenia, Boston House, The Genome Project has increased understanding of the complexity of the gene. Atypical antipsychotics: Developed in the 1970s, as an attempt to find drugs with fewer severe side-effects than typical antipsychotics. delusions. double-bind, high expressed emotion - . 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. This suggests that the research therefore does not protect individuals from harm. In the USA only 20% of psychiatric patients were classed as having schizophrenia in the 1930s but this rose to 80% in the 1950s . 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. They are a form of behavioral therapy where desirable behaviors are encouraged by the use of selective reinforcement and is based on operant conditioning. The modern understanding of diathesis-stress is slightly different. Credit should be awarded for one type in some detail or for two (or more) done briefly. Family therapies may improve the quality of life for schizophrenia patients and their families, but do not provide a cure for schizophrenia, rather a management of the effects. 11 items. Older antipsychotics like haloperidol or chlorpromazine may produce side effects Aetiological validity for a diagnosis to be valid, all patients diagnosed as schizophrenic should have the same cause for their disorder. 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. By oversimplifying schizophrenia in terms of genes and neurotransmitters, the social context within which it develops has not been considered. But in fact some Schizophrenics are successfully treated whereas others are not. Validity the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms. 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. It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. When the families were rated as healthy, the likelihood of developing schizophrenia for those with a biological mother with schizophrenia fell to below 1%. For example, schizophrenia and depression are often found together. Lobban (2013) reports that other family members felt they were able to cope better thanks to family therapy. 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. [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. The original version suggested it was due to high levels or activity of dopamine in the subcortex (hyperdopaminergia). Berger (1965), however this evidence may be unreliable because the patients recall may be effected by the dis-order e.g. Chlorpromazine and Haloperidol. Describe the family dysfunction explanation for schizophrenia and explain how. This suggests that there is wider academic credibility for enlarged ventricles determining the likelihood of schizophrenia developing. At least 73% of his sample reported that these strategies were successful in managing their symptoms. Diagnosis refers to the assigning of a label of a disorder to a patient. Supporting evidence for the brain structure explanation comes from further empirical support from Suddath et al. Families can help minimize the damage to self of the schizophrenic that this entails. Meehl suggested that the vulnerability is genetic (the result of a schizogene), causing a sensitive personality. When desired behavior is displayed eg. This makes it more difficult to confidently diagnose schizophrenia. Results. This causes the neurons that use dopamine to fire too often and transmit too many messages. an excess or distortion of normal functions: including hallucinations and The patients with the most severe symptoms are unable to access the tokens, as they are unable to perform the desirable behaviours. David Rosenhan (1973) famous experiment involving Pseudopatients led to 8 normal people being kept in hospital despite behaving normally. For example, Ripke et al. The idea of pleasing her, shows that he does want to make . Cognitive deficits have been suggested as possible explanations for a range of behaviors associated with schizophrenia. They also have some effect on other neurotransmitters such as serotonin . Interactionist approaches attempt to explain schizophrenia as a combination of nature (biological) and nurture (environmental) factors. Patients went from performing 5 chores a day to around 40. In more extreme cases the patient might be unable to cope with the pressures of having to discuss their ideas and feelings and could become stressed by the therapy, or over-fixated with the details of their illness. Family dysfunction refers to the workings of dysfunctional families, and the effects of being brought up in one, contributing to schizophrenia. Bentalls meta-analysis (2012) shows that stress arising from abuse in childhood increases the risk of developing schizophrenia. Evidence suggests that the closer the biological relationship, the greater the risk of developing schizophrenia. The stress-trigger could be environmental __or biological (for example, smoking cannabis is linked with schizophrenia). Research suggests that these delusions are associated with specific biases in reasoning about and explaining social situations. To stabilize the social authority of the doctor and the family. This is mainly aimed at lowering expressed emotion. 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 . A strength is that the research into enlarged ventricles and neurotransmitter levels have high reliability. Assessment: The therapist encourages the patient to explain their concerns. But if they have a supportive environment and/or good coping skills the illness may not develop. Noll (2009) also argues around one third of patients do not respond to drugs which block dopamine so other neurotransmitters may be involved. 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) Group As scores suggest a normal distributed as the mean, median and mode are all almost the same (22). DSM) should arrive at the same diagnosis for the same individual. Falloon et al (1996) stress such as divorce or bereavement, causes the brain to be flooded with neurotransmitters which brings on the acute episode. Adoption studies have helped clarify both of these problems. Other side effects are potentially fatal, for example agranulocytosis and neuroleptic malignant syndrome (NMS). Benzel et al. This helps improve the quality of life for schizophrenia sufferers. Here are a series of suggested answers for the Schizophrenia topic questions in AQA A Level Psychology Paper 3 (Section B) in June 2018. First, cognitive deficits which are impairments in thought processes such as perception, memory and attention. The rate of relapse was particularly high if returning to a high EE family was coupled with no medication. less effect on movement Full Text. including dysfunctional thought processing. Family studies find individuals who have schizophrenia and determine whether their biological relatives are similarly affected more often than non-biological relatives. Prolonged exposure to such interactions prevents the development of an internally coherent construction of reality; in the long run, this manifests itself as typically schizophrenic symptoms such as flattening affect, delusions and hallucinations, incoherent thinking and speaking, and in some cases paranoia. Without this knowledge a person displaying overt emotional behavior in a Western culture might be regarded as abnormal. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. 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. They block dopamine receptors on post-synaptic neurons, meaning that less dopamine is transmitted across the synapse. 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 understanding and treatment of schizophrenia have been greatly hampered by uncertainty about etiological factors and controversy about diagnostic boundaries. [4 marks], Briefly outline family dysfunction as an explanation for schizophrenia. It is now recognised that the vulnerability could be genetic or __environmental (for example, a traumatic event in early childhood). Research using family studies have suggested a genetic vulnerability is inherited and this varies from those with a high . A second strength of the research into expressed emotion (EE) is that it has practical applications. 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. First, the adoptees study method, the index offspring of adopting-away schizo A strength of the cognitive explanation is that it has practical applications. However they do not cure schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community. Copyright Get Revising 2023 all rights reserved. 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. found 108 separate genetic variations were associated with increased risk of schizophrenia. (2003) studied DNA from human families affected by schizophrenia and found that those with the disease were more likely to have a defective version of a gene, called PPP3CC which is associated with the production of calcineurin which regulates the immune system. B: behavior how do you react in these situations ? Substance abuse: Amphetamine and Cannabis and other drugs have also been identified as triggers as they affect serotonin and glutamate levels. b) Explain one reason why there might be a problem of bias and generalisation in this study. 1. Chronic environmental stress, for example having a schizophrenogenic mother, results in the onset of schizophrenia. If there is more than one individual in the scenario you must mention all of the characters to get to the top band. Jack's experiences can be linked to the family dysfunction explanation. Response. How could the researchers modify their study to deal with this problem? Kazdin et al. Faris and Dunham (1939) found clear pattern of correlation between inner city environments and levels of psychosis. It is also important to note that two-thirds of people with schizophrenia have no relative with a similar diagnosis and therefore have no one to inherit it from. To teach patients and carers more effective stress management techniques. This is not the case with schizophrenia: The causes may be one of biological or psychological or both. [2 marks], Evaluate psychological explanations of schizophrenia [16 marks] and more. Concordance rates are never 100% which suggests that environmental factors must also play a role in the development of SZ. Objectives: To compare social skills in patients with schizophrenia classified according the degree of treatment response and severity of psychopathology with normative controls by using the Del Prette Social Skills Inventory (SSI). They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. 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. For men the figure was 59%. Preconscious thought (thought that occurs without awareness) contains a huge amount of information from our senses that would normally be filtered. 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 Catatonia- staying in position for hours/days on end, cut off from the world. 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. [4 marks]. 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. Predictive validity. 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. Jakobsen et al. Book now . So the stressors of modern living could cause increased schizophrenia in future generations. Clozapine, Olazapine and Risperidone. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. 2002-2023 Tutor2u Limited. Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . Further support comes from the fact that dopamine agonists (e.g. The fact that the concordance rates are not 100% means that schizophrenia cannot wholly be explained by genes and it could be that the individual has a pre-disposition to schizophrenia and simply makes the individual more at risk of developing the disorder. culture and gender bias and symptom overlap. However, the fact that these people were on medication and having regular meetings with doctors would be expected to have that effect anyway. This suggests that the biological account cannot give a full explanation of the disorder. To educate relatives about schizophrenia. 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? Carrying on a logical discussion till the patient begins to see where their ideas are going wrong and why they developed. The severity of the side-effects is a weakness as patients will be reluctant to take them, or may even die as a result of the effect. Vasos (2012) Found the risk of schizophrenia was 2.37 times greater in cities than it was in the countryside, probably due to stress levels. 3x sold. Effectively means that it needs to be clearly linked and explained in the context of the answer. 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. CBT does seem to reduce relapses and readmissions to hospital (NICE 2014). 3. Preliminary analysis: Through interviews and observation the therapist identifies strengths and weaknesses of family members and identifies problem behaviors. They believed that schizophrenia was a result of social pressures from life. where normal functions are limited: including speech poverty and avolition. This raises practical and ethical issues when selecting different types of tretment. Registered office: International House, Queens Road, Brighton, BN1 3XE, Psychology Schizophrenia Family Dysfunction. Broadcasting is a thought disorder whereby a person believes their thoughts are being broadcast to others, for example over the radio or through TV. Imagined stimuli could involve any of the senses. Most importantly, families can make the schizophrenic feel loved, accepted and valued. To improve how the family communicated and handled the situation. (2003) studied DNA from human families affected by schizophrenia and found that those with the disease were more likely to have a defective version of a gene, called PPP3CC which is associated with the production of calcineurin which regulates the immune system. Liem (1974)measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families. with reference to co-morbidity, Since their are problems with the validity of diagnois classification, unsuitable treatment may be administered, sometimes on an involuntary Book now . [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. Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia. Heather (1976) there is only a 50% chance of predicting what treatment a patient will receive based on diagnosis, suggesting that diagnosis is not valid. A final weakness of the genetic explanation of schizophrenia is that it is biologically reductionist. Conversely, antipsychotic drugs work by binding to dopamine receptors and reduce symptoms. Newer drugs, called atypical antipsychotics attempt to target D2 dopamine activity in the limbic system but not D3 receptors in other parts of the brain. Culture One of the biggest controversies in relation to classification and diagnosis is to do with cultural relativism and variations in diagnosis. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. A. Essentially due to . Cognitive biases refer to selective attention. Tarrier (1987) used detailed interview techniques, and found that people with schizophrenia can often identify triggers to the onset of their psychotic symptoms, and then develop their own methods of coping with the distress caused. Last chance to attend a Grade Booster cinema workshop before the exams. Ethical issues Antipsychotics have been used in hospitals to calm patients and make them easier for staff to work with rather than for the patients benefit Can lead to the abuse of the Human Rights Act (no one should be subject to degrading treatment). Central idea: Patients problems are based on incorrect beliefs and expectations. 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). Pills are not as helpful with other symptoms, especially emotional problems. Holistic Identifies that patients have different triggers, genes etc. 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. Copyright Get Revising 2023 all rights reserved. Visual - Evaluation of the dopamine hypothesis for schizophrenia. 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. 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. Classification and diagnosis does have advantages as it allows doctors to communicate more effectively about a patient and use similar terminology when discussing them. Kahn et al. There are serious ethical concerns in blaming the family, particularly as there is little evidence upon which to base this. The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine. Fox (1990): It is more likely that factors associated with living in poorer conditions (e.g. System overlap refers to the way that disorders have shared symptoms. Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia 2. 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.
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