Schizophrenia
,Schizophrenia
Describe and evaluate the diagnosis and classification of schizophrenia
AO1
Schizophrenia doesnt have one defining characteristic, can be defined by many
symptoms, 2 major systems for the classification of it are ICD-10 and the DSM-5 in
america, in DSM-5 one of the positive systems like delusions, hallucinations or
speech disorganisation must be present whereas 2 or more negative systems need to
be present in ICD-10, Dsm-5 doesn’t recognise subtypes of schizophrenia but ICD-10
does.
Positive symptoms are additional experiences added on to ordinary existence, like
hallucinations, where it can be auditory or visual, like hearing voices or distortion.
Delusions are paranoia and are irrational, commonly involve being persecuted by
government or aliens. people with delusions might believe they are under external
control. can change a way u behave like make u aggressive.
Negative symptoms involve the loss of ordinary abilities, avolition or apathy is the
loss of motivation, people with schizophrenia lose motivation to carry out normal
things, Andreason identified 3 signs of avolition, poor hygiene, lack of work or
education and lack of energy, speech poverty is the reduction in the amount and
quality of speech. This is accompanied by a delay in the person’s verbal responses.
AO3
The two measures of schizophrenia lack consistency, low inter rater reliability, Elie
Cheniaux et al had 2 psychiatrists diagnose 100 people using both DSM and ICD
criteria, one psychiatrist diagnosed 26 with schizophrenia according to DSM and 44
according to ICD, the other psychiatrist diagnosed 13 according to DSM and 24
according to ICD. poor reliability, This links to cultural bias as it is interpreted
differently across different cultures. However it used a small sample of 2 people so it
cant be generalised.
Gender bias in diagnosis as Julia Longnecker reviewed studies and concluded that
since the 1980s men have been diagnosed with schizophrenia more often then
women, this may be because men are more genetically vulnerable to developing
schizophrenia then women or that there is gender bias in the diagnosis,
It appears that women function better than men, being more likely to work and have
good family relationships. This high functioning may explain why women might not
have been diagnosed with schizophrenia as much as men, their better interpersonal
functioning may bias practitioners to under-diagnose them either because they mask
symptoms better or their case is too mild to warrant a diagnosis. This links to gender
bias in psychology and the under diagnosis for women shows how the diagnosis
lacks validity. However, research has shown that men have a higher biological
vulnerability to schizophrenia.
There is symptom overlap between the symptoms of schizophrenia and other
conditions. For example, both schizophrenia and bipolar disorder involve positive
symptoms like delusions and negative symptoms like avolition. this again calls into
question the validity of both the classification and diagnosis of schizo. Under icd a
person might be diagnosed with schizophrenia, however the same individual will
receive a diagnosis of bipolar disorder according to dsm criteria. this could suggest
,that schizo and bpd could be the same. This suggests that mental illness may not fit
into clear cut categories, challenging reductionist classification systems.
Describe and evaluate biological explanations for schizophrenia
AO1
Schizo runs in families, genetic similarities between family members is associated
with the likelihood of developing schizo. We share 100% of our genes qiith an
identical twin 50% with a sibling or parent. strong relationship with genetic similarity
and shared risk of schizo. Candidate genes, different genes that are believed to be
associated with risk of inheritance, schizo is polygenic. studies identified different
canidate genes (aetiologically heterogenous) Stephern Ripke et al carried out a study
combining data from genome wide studies of schizo, found genetic make up of 37000
schizos was compared to 112,000 controls, 108 genetic variations were associated
with the risk of schizo.
neurotransmitters, brain chemical messengers, work differently for those with schizo.
dopamine is involved, may be implicated in the symptoms of schizo,
hyperdopaminergia, high levels of dopamine in the brocas area for example may be
associated with poverty of speech and auditory hallucinations. hypodopaminergia,
low levels of dopamine plays a role in the negative symptoms for schizo.
Neural correlates are patterns of structure of activity in the brain that occur with an
experience and may be implicated in the origins of that experience. Avolition involves
loss of motivation, motivation involves anticipation of a reward and ventral striatum
are believed to be involved with this anticipation, therefore juckel said that ventral
striatum is a neural correlate of negative symptoms of schizo, reduced activity in
superior temporal gyrus and anterior cingulate gyrus is a neural correlate of auditory
hallucination.
AO3
Multiple research support for genetic susceptibility, Adoption studies cleary show that
children of people with schizo if adopted into families with no history of schizo has a
heightened risk of schizo. evidence of genetic variations significantly increasing the
risk of schizo. shows how genetic factors make people much more vulnerable to
schizo then others. Genetic explanation supports nature, inherited vulnerability.
However, environmental influences plays a crucial role, factors like trauma and
dysfunction can trigger schizo alongside genetic vulnerability, supports the diathesis
stress model.
Correlation between levels of activity in the ventral striatum and negative symptoms
of schizo does not mean causation as it may be something wrong in the striatum
which is causing the negative symptoms but it is possible that the negative
symptoms itself mean that less info passes through the striatum resulting in the
reduced activity. neural correlates in schizo therefore tells us little. Neural correlates
are correlational so they cant prove cause and effect. However, neural correlates has
real world applications even without proving cause and effect as there are drugs that
target the dopamine pathways linked to the striatum.
Evidence supporting role of biological factors is overwhelming as there is evidence to
suggest that there is an important role for environmental factors including
psychological ones such as family functioning during childhood. after all the
, probability of developing schizo even if ur identical twin has it is less then 50%.
shows how biological explanitions are reductionist. However, environmental
explanations such as family dysfunction may be criticised for lacking clear casual
evidence.
Describe and evaluate psychological theories of schizophrenia.
AO1
Psychologists attempt to link schizo to childhood and adult experiences of living with
a dysfunctional family, ie the schizophrenogenic mother, according to Fromm
reichman the schizophrenogenic mother is cold rejecting and controlling, and tends
to creat tension and secrecy, this leads to distrust that later leads to paranoia and
delusions and ultimately schizo. the double blind theory by Gregory bateson (1972)
agreed that family climate is important in the development of schizophrenia,
emphasises the role of communication style within a family. if a child receives mixed
signals when they did something wrong or if they are punished by withdrawal of love
they get confused about the understanding of the world, which leads to disorganised
thinking and paranoid delusions. Expressed emotion is the negative emotions
expressed towards a schizo by their carers, verbal criticism with violence, hostility,
emotional over involvement, are a source of stress, leads to relapse with schizo.
Christopher Frith et al identified 2 kinds of dysfunctional thought processing,
metarepresentation is the ability to reflect thoughts and behaviour, it also allows u to
interpret the actions of others, dysfunction in metarepresentation disrupts ability of
thoughts carried out by ourselves and recognise our own actions, explains
hallucinations and delusions.
AO3
Research support for family dysfunction. Read et al reviewed 46 studies of child
abuse and schizo and concluded that 69% of adult women with a diagnosis of
schizophrenia had a history of pphysical abuse in childhood. for men it was 59%.
Supports family dysfunction. Supports nurture in the nature vs nurture debate as it
shows environmental causes. However, cant generalise findings to everyone as 41%
of men and 31% of women go against the findings
Psychological explanations for schizo can be hard to reconcile with biological
explanations. It could be that both psychological and biological factors can separately
produce the same symptoms which raises the question of whether both outcomes are
really schizophrenia, we can view this in terms of the diathesis stress model where
the diathesis may be biological or psychological. Shows they are both reductionist.
However, treatments that combine biological approach and psychological approach
(CBT) are more effective.
remains unclear what causes what, including whether cognitive factors are a cause or
a result of the neural correlates and abnormal levels seen in schizophrenia.
combining both is interactionist as neural correlates is nature and cognitive is
nurture. However both have practical explanations, biological treatments eg
antipsychotics and psychological therapies like CBT are effective suggesting bith are
meaningful targets.
,Schizophrenia
Describe and evaluate the diagnosis and classification of schizophrenia
AO1
Schizophrenia doesnt have one defining characteristic, can be defined by many
symptoms, 2 major systems for the classification of it are ICD-10 and the DSM-5 in
america, in DSM-5 one of the positive systems like delusions, hallucinations or
speech disorganisation must be present whereas 2 or more negative systems need to
be present in ICD-10, Dsm-5 doesn’t recognise subtypes of schizophrenia but ICD-10
does.
Positive symptoms are additional experiences added on to ordinary existence, like
hallucinations, where it can be auditory or visual, like hearing voices or distortion.
Delusions are paranoia and are irrational, commonly involve being persecuted by
government or aliens. people with delusions might believe they are under external
control. can change a way u behave like make u aggressive.
Negative symptoms involve the loss of ordinary abilities, avolition or apathy is the
loss of motivation, people with schizophrenia lose motivation to carry out normal
things, Andreason identified 3 signs of avolition, poor hygiene, lack of work or
education and lack of energy, speech poverty is the reduction in the amount and
quality of speech. This is accompanied by a delay in the person’s verbal responses.
AO3
The two measures of schizophrenia lack consistency, low inter rater reliability, Elie
Cheniaux et al had 2 psychiatrists diagnose 100 people using both DSM and ICD
criteria, one psychiatrist diagnosed 26 with schizophrenia according to DSM and 44
according to ICD, the other psychiatrist diagnosed 13 according to DSM and 24
according to ICD. poor reliability, This links to cultural bias as it is interpreted
differently across different cultures. However it used a small sample of 2 people so it
cant be generalised.
Gender bias in diagnosis as Julia Longnecker reviewed studies and concluded that
since the 1980s men have been diagnosed with schizophrenia more often then
women, this may be because men are more genetically vulnerable to developing
schizophrenia then women or that there is gender bias in the diagnosis,
It appears that women function better than men, being more likely to work and have
good family relationships. This high functioning may explain why women might not
have been diagnosed with schizophrenia as much as men, their better interpersonal
functioning may bias practitioners to under-diagnose them either because they mask
symptoms better or their case is too mild to warrant a diagnosis. This links to gender
bias in psychology and the under diagnosis for women shows how the diagnosis
lacks validity. However, research has shown that men have a higher biological
vulnerability to schizophrenia.
There is symptom overlap between the symptoms of schizophrenia and other
conditions. For example, both schizophrenia and bipolar disorder involve positive
symptoms like delusions and negative symptoms like avolition. this again calls into
question the validity of both the classification and diagnosis of schizo. Under icd a
person might be diagnosed with schizophrenia, however the same individual will
receive a diagnosis of bipolar disorder according to dsm criteria. this could suggest
,that schizo and bpd could be the same. This suggests that mental illness may not fit
into clear cut categories, challenging reductionist classification systems.
Describe and evaluate biological explanations for schizophrenia
AO1
Schizo runs in families, genetic similarities between family members is associated
with the likelihood of developing schizo. We share 100% of our genes qiith an
identical twin 50% with a sibling or parent. strong relationship with genetic similarity
and shared risk of schizo. Candidate genes, different genes that are believed to be
associated with risk of inheritance, schizo is polygenic. studies identified different
canidate genes (aetiologically heterogenous) Stephern Ripke et al carried out a study
combining data from genome wide studies of schizo, found genetic make up of 37000
schizos was compared to 112,000 controls, 108 genetic variations were associated
with the risk of schizo.
neurotransmitters, brain chemical messengers, work differently for those with schizo.
dopamine is involved, may be implicated in the symptoms of schizo,
hyperdopaminergia, high levels of dopamine in the brocas area for example may be
associated with poverty of speech and auditory hallucinations. hypodopaminergia,
low levels of dopamine plays a role in the negative symptoms for schizo.
Neural correlates are patterns of structure of activity in the brain that occur with an
experience and may be implicated in the origins of that experience. Avolition involves
loss of motivation, motivation involves anticipation of a reward and ventral striatum
are believed to be involved with this anticipation, therefore juckel said that ventral
striatum is a neural correlate of negative symptoms of schizo, reduced activity in
superior temporal gyrus and anterior cingulate gyrus is a neural correlate of auditory
hallucination.
AO3
Multiple research support for genetic susceptibility, Adoption studies cleary show that
children of people with schizo if adopted into families with no history of schizo has a
heightened risk of schizo. evidence of genetic variations significantly increasing the
risk of schizo. shows how genetic factors make people much more vulnerable to
schizo then others. Genetic explanation supports nature, inherited vulnerability.
However, environmental influences plays a crucial role, factors like trauma and
dysfunction can trigger schizo alongside genetic vulnerability, supports the diathesis
stress model.
Correlation between levels of activity in the ventral striatum and negative symptoms
of schizo does not mean causation as it may be something wrong in the striatum
which is causing the negative symptoms but it is possible that the negative
symptoms itself mean that less info passes through the striatum resulting in the
reduced activity. neural correlates in schizo therefore tells us little. Neural correlates
are correlational so they cant prove cause and effect. However, neural correlates has
real world applications even without proving cause and effect as there are drugs that
target the dopamine pathways linked to the striatum.
Evidence supporting role of biological factors is overwhelming as there is evidence to
suggest that there is an important role for environmental factors including
psychological ones such as family functioning during childhood. after all the
, probability of developing schizo even if ur identical twin has it is less then 50%.
shows how biological explanitions are reductionist. However, environmental
explanations such as family dysfunction may be criticised for lacking clear casual
evidence.
Describe and evaluate psychological theories of schizophrenia.
AO1
Psychologists attempt to link schizo to childhood and adult experiences of living with
a dysfunctional family, ie the schizophrenogenic mother, according to Fromm
reichman the schizophrenogenic mother is cold rejecting and controlling, and tends
to creat tension and secrecy, this leads to distrust that later leads to paranoia and
delusions and ultimately schizo. the double blind theory by Gregory bateson (1972)
agreed that family climate is important in the development of schizophrenia,
emphasises the role of communication style within a family. if a child receives mixed
signals when they did something wrong or if they are punished by withdrawal of love
they get confused about the understanding of the world, which leads to disorganised
thinking and paranoid delusions. Expressed emotion is the negative emotions
expressed towards a schizo by their carers, verbal criticism with violence, hostility,
emotional over involvement, are a source of stress, leads to relapse with schizo.
Christopher Frith et al identified 2 kinds of dysfunctional thought processing,
metarepresentation is the ability to reflect thoughts and behaviour, it also allows u to
interpret the actions of others, dysfunction in metarepresentation disrupts ability of
thoughts carried out by ourselves and recognise our own actions, explains
hallucinations and delusions.
AO3
Research support for family dysfunction. Read et al reviewed 46 studies of child
abuse and schizo and concluded that 69% of adult women with a diagnosis of
schizophrenia had a history of pphysical abuse in childhood. for men it was 59%.
Supports family dysfunction. Supports nurture in the nature vs nurture debate as it
shows environmental causes. However, cant generalise findings to everyone as 41%
of men and 31% of women go against the findings
Psychological explanations for schizo can be hard to reconcile with biological
explanations. It could be that both psychological and biological factors can separately
produce the same symptoms which raises the question of whether both outcomes are
really schizophrenia, we can view this in terms of the diathesis stress model where
the diathesis may be biological or psychological. Shows they are both reductionist.
However, treatments that combine biological approach and psychological approach
(CBT) are more effective.
remains unclear what causes what, including whether cognitive factors are a cause or
a result of the neural correlates and abnormal levels seen in schizophrenia.
combining both is interactionist as neural correlates is nature and cognitive is
nurture. However both have practical explanations, biological treatments eg
antipsychotics and psychological therapies like CBT are effective suggesting bith are
meaningful targets.
