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This limits the usefulness of token economies in treating schizophrenia. But they tended to block ALL types of dopamine activity, (in other parts of the brain as well) and this caused side effects and may have been harmful. It is therefore prescribed when the patient is at risk of suicide. Boston Spa, 1. Central idea: Patients problems are based on incorrect beliefs and expectations. DSM) should arrive at the same diagnosis for the same individual. Delusions are false beliefs. 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. Conversely, antipsychotic drugs work by binding to dopamine receptors and reduce symptoms. Schizophrenia and Dopamine: Links and Connections - Healthline Eg. They are a form of behavioral therapy where desirable behaviors are encouraged by the use of selective reinforcement and is based on operant conditioning. They may or may not treat the illness as well as clozapine, however. One biological explanation for schizophrenia is that it is passed on through the genes. 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. 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. Schizophrenia: Comorbidity | Psychology | tutor2u However, one explanation for this is mutation in parental DNA. Evidence to support this view comes from the prospective adoption study by Tienari et al. In other words, it doesnt cure schizophrenia, it just helps people get over it. 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. Other side effects are potentially fatal, for example agranulocytosis and neuroleptic malignant syndrome (NMS). 2. Essentially due to . They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity. Research by Miyakawa et al. (1956) suggested the double bind theory, which suggests that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia. Company Reg no: 04489574. Last chance to attend a Grade Booster cinema workshop before the exams. Given that a much lower number of genes exist than anticipated, it is now recognised that genes have multiple functions and that many genes behavior. The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine. 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. 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. This suggests that there may be problems of demand characteristics. Read the model answers to get a clearer idea of what is needed. Effectively means that it needs to be clearly linked and explained in the context of the answer. Example Answers for Section C Schizophrenia Topic Paper 3 - tutor2u 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. (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. The Genome Project has increased understanding of the complexity of the gene. However the difference only emerged in situations where the adopted family was rated as disturbed. tutor2u is the leading support service for A-Level, GCSE, BTEC and IB students and teachers preparing for assessments, mocks and final exams. 2002-2023 Tutor2u Limited. Antipsychotic drugs are highly effective as they are relatively cheap to produce, easy to administer and have a positive effect on many sufferers. culture and gender bias and symptom overlap. There is evidence that people diagnosed as schizophrenic have difficulties in processing various types of information, for example visual and auditory information. Copyright Get Revising 2023 all rights reserved. Melzer (2012) concluded that Clozapine is effective in 30-50% of cases where other drugs have failed, supporting its use in schizophrenia treatment. Some sufferers only take a course of antipsychotics once, while others have to take a regular dose in order to prevent symptoms from reappearing. Note: you may come across the terms DSM-IV and ICD-10. Kendler (1985) has shown that first-degree relatives of those with schizophrenia are 18 times more at risk than the general population. Classification and diagnosis does have advantages as it allows doctors to communicate more effectively about a patient and use similar terminology when discussing them. For the classification system to be reliable, differfent clinicians using the same system (e.g. 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. They cannot express their feelings about the unfairness of the situation. A dysfunctional family is one that has at its core destructive and harmful parenting and a lack of concern for the child. Family, twin and adoption studies must be considered cautiously because they are retrospective, and diagnosis may be biased by knowledge that other family members who may have been diagnosed. This is not the case with schizophrenia: The causes may be one of biological or psychological or both. The intention is to show schizophrenics that their hallucinations are not real. (Total 16 marks) 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 Schizophrenia is a severe type of mental illness that affects a person's thoughts, perceptions, and behaviors. Refer to one or more types of family dysfunction in your answer. These symptoms may leave them fearful and withdrawn. 806 8067 22, Registered office: International House, Queens Road, Brighton, BN1 3XE, psychological explanation for schizophrenia, psychological explanations for schizophrenia, Schizophrenia - SS2 - Explanations - Socio-Cultural - Research, I need help on this A Level AQA psychology 16 marker please , A-Level Psychology Revision Tips and Tricks , comparing biological explanation of SZ with family dysfunction , Family dysfunction model of schizophrenia , aqa alevel psychology paper 3 2022 predictions? 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'. This will not get rid of the symptoms of schizophrenia but it can make patients better able to cope with them. Strategies are practised within a session and the client is helped through any problems in applying it. Last chance to attend a Grade Booster cinema workshop before the exams. 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. There is no such thing as a normal schizophrenic exhibiting the usual symptoms. Of these, only 1 study showed improvement in symptoms and behavioural change in patients. Aetiological validity for a diagnosis to be valid, all patients diagnosed as schizophrenic should have the same cause for their disorder. Get Revising is one of the trading names of The Student Room Group Ltd. Register Number: 04666380 (England and Wales), VAT No. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. The basic assumption of CBT is that people often have distorted beliefs which influence their behaviour in maladaptive ways. (2004): Adopted children from families with schizophrenia had more chance of developing the illness than children from normal families. This means that the brains of schizophrenics are lighter than normal. This suggests that the research into gene mapping is oversimplistic as schizophrenia is not due to a single gene. Christopher Frith (1979) argues schizophrenia is the result of a faulty attention system. Inherited factors that make some individuals more likely to develop a certain behaviour or mental disorder. ABC: Get the patients to understand what is really happening in their life: A: Antecedent what is triggering your problem ? LS23 6AD Preconscious thought (thought that occurs without awareness) contains a huge amount of information from our senses that would normally be filtered. Social behavior depends, in part, on using other peoples actions as clues for understanding what they might be thinking. Clozapine acts in a similar way to Chlorpromazine, but also acts on serotonin and glutamate receptors. Information transfer teaching the patient and the family the actual facts about the illness, its causes, the influence of drug abuse, and the effect of stress and guilt. Double bind is based on clinical observation the patients and early evidence involved assessing the personality of the mothers for 'crazy-making' characterists. The Diathesis Stress model of schizophrenia is part of the interactionist approach that see's schizophrenia developing due to an interaction between the biological (diathesis) and the environmental (stress) influences. However they do not cure schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community. This makes it more difficult to confidently diagnose schizophrenia. Catatonia- staying in position for hours/days on end, cut off from the world. Make sure you know which is which, for example do you understand the difference between genetic explanation and neural correlates explanation, and do you have a model essay for each? The Interactionist approach acknowledges that there are a range of factors (including biological and psychological) which are involved in the development 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. They generally have fewer side effects eg. These may be risk factors for the development and maintenance of schizophrenia. There are also delusions of being paranoid, worrying that people are out to get them. The Finnish Adoptive Family Study of Schizophrenia A strength is that the research into enlarged ventricles and neurotransmitter levels have high reliability. Evaluation of family therapy as a treatment for schizophrenia - Stuvia Check out Adapt the A-level & GCSE revision timetable app. 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. Noll (2009) also argues around one third of patients do not respond to drugs which block dopamine so other neurotransmitters may be involved. Benzel et al. 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 NICE review of family therapy studies demonstrated that it was associated with significant cost savings when offered to patients alongside the standard care Relapse rates are also lower which suggests the savings could be even higher. Often, little or nothing is done to rectify the situation or to alleviate its adverse effects upon the child. They are effectively discriminated against (in this case, denied rewards) for being more severely ill. It binds to dopamine receptors more strongly than Clozapine, and there is some evidence that it produces fewer side-effects. Both aspect of diathesis-stress must be present to develop the disorder. 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%. Assessment: The therapist encourages the patient to explain their concerns. Laing believed that schizophrenia was a result of the interactions between people, especially in families. Zubin and Spring suggest that a person may be born with a predisposition towards schizophrenia which is then triggered by stress in everyday life. A final strength is that it takes on board the nurture approach to the development of schizophrenia. However, evidence may not be reliable as patients recall may be affected by their schizophrenia. Sweets and cigarettes. Abstract. The validity of schizophrenia as a single disorder is questioned by many. 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. Family Therapy aims to reduce levels of expressed emotion, and reduced the likelihood of relapse. Study notes, videos, interactive activities and more! Metaanalysis by Crossley Et Al (2010) suggested that Atypical antipsychotics are no more effective, but do have less side effects. Evidence to support the genetic explanation comes from Gottesman and Shields, who found a concordance rate of 42% for MZ and 9% for DZ. In the USA only 20% of psychiatric patients were classed as having schizophrenia in the 1930s but this rose to 80% in the 1950s . Ayllon and Azrin (1968) set up a token economy with schizophrenic patients in a psychiatric institution. There are two types of twins identical (monozygotic) and fraternal (dizygotic). Describe and evaluate family dysfunction as an explanation for Schizophrenia: Genetics - A Level Psychology AQA Revision - Study Rocket VAT reg no 816865400. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. 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. Non-biological Explanation AO1 AO2 - PSYCHOLOGY WIZARD 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). [4 marks], Briefly outline family dysfunction as an explanation for schizophrenia. 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. Liem (1974)measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families. Combining treatments is most common in the UK, although it is also sometimes used in the USA. 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. Desirable behavior includes self-care, taking medication, work skills, and treatment participation. Just challenging the dysfunctional thoughts through disputing may not be enough to change them if the thoughts have a biological basis. It also seems to be aetiologically heterogeneous as different studies have identified different candidate genes. Family therapy is a form of therapy carried out with members of the family with the aim of improving their communication and reducing the stress of living as a family. Side effects are less severe where patients are taking a reduced dose, as many do today, but this can reduce the effectiveness of the drug as well. There have also been ethical concerns as such a process is seen to be dehumanising, subjecting the patient to a regime which takes away their right to make choices. Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. For example, an excess of dopamine receptors in Brocas area might be responsible for poverty of speech and auditory hallucinations. Cognitive biases refer to selective attention. There is a sizeable minority who do not respond to drug treatment. CBT aims to identify and alter irrational thinking including regarding: In theory, when the misunderstandings have been swept away, emotional attitudes will also improve. For men the figure was 59%. Family dysfunction refers to the workings of dysfunctional families, and the effects of being brought up in one, contributing to schizophrenia. Research by Miyakawa et al. 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. where normal functions are limited: including speech poverty and avolition. The reason for this is because the approach does not consider other factors such as genes. Education and rapport training: therapist and client work together to improve the effectiveness of the clients own coping strategies and develop new ones. This has the effect of reducing dopamine production, and reduces positive symptoms such as hallucinations. 2002-2023 Tutor2u Limited. Example Answers for Section C Schizophrenia Topic Paper 3 June 2018 (AQA) . Psychological therapies are very rarely used alone, but sometimes patients may just take drugs without any other therapy. West Yorkshire, Communication skills training teach family to listen, to express emotions and to discuss things. Comorbidity describes people who suffer from two or more mental disorders. Further support comes from the fact that dopamine agonists (e.g. Medication can be taken as pills, syrups or injections, and may be taken over a short or long-term. The idea of pleasing her, shows that he does want to make . Dopamine is a neurotransmitter. Some people who have been diagnosed as schizophrenic appear to have difficulties with this skill. Token economies aim to manage schizophrenia rather than treat it. 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. B: behavior how do you react in these situations ? Boston Spa, The therapist wins the trust of the patient, so they can work together. 11 Explain how family dysfunction might be involved in schizophrenia. Drug therapy is a biological treatment for schizophrenia. Is the raised dopamine levels the cause of the schizophrenia, or is it the raised dopamine level the result of schizophrenia? Words may become confused and sentences incoherent (so called word salad). This weakens the interactionist explanation. 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, Delusions of Grandeur). Gottesman (1991) found that MZ twins have a 48% risk of getting schizophrenia whereas DZ twins have a 17% risk rate. But in fact some Schizophrenics are successfully treated whereas others are not. The researchers used an inferential statistical test to see if there was a significant difference in language rating between the two groups. It is not clear which comes first. Typical antipsychotics: Developed in the 1950s, for example Chlorpromazine. The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49. The stress-trigger could be environmental __or biological (for example, smoking cannabis is linked with schizophrenia). Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia 2. This suggests that there is a problem of the chicken and egg scenario in relation to expressed emotion causing schizophrenia. A number of researchers have suggested that difficulties in understanding other peoples behavior might explain some of the experiences of those diagnosed as schizophrenic. Is it the cognitive deficits which causes the schizophrenic behavior or is the schizophrenia that causes the cognitive deficits? This is a useful point to emphasise in any essay on the disorder. (2006) CBT is highly effective and should be used as a mainstream treatment for schizophrenia wherever possible. Evidence for this comes from that fact that amphetamines increase the amounts of dopamine . For example, it suggests that schizophrenic behavior is the cause of environmental factors such as cognitive factors. A final weakness of the genetic explanation of schizophrenia is that it is biologically reductionist. 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. [6 marks], ethical problems - parents feel responsible for their child's illness causing even greater stress and anxiety. As this is not the case family dysfunctions cannot be the sole cause ofthe illness. Since the mid-1950s antipsychotic medications have greatly improved treatment. [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. First generation Antipsychotics are called Typical Antipsychotics This suggests that the biological account cannot give a full explanation of the disorder. Usually the person has convinced him/herself that he/she is someone powerful or important, such as Jesus Christ, the Queen (e.g. b) Explain one reason why there might be a problem of bias and generalisation in this study. THE DYSFUNCTIONAL FAMILY - Institute Of Counseling They believed that schizophrenia was a result of social pressures from life. , 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) . Having attempted to dispute faulty beliefs, patients may also be set behavioural assignments with the aim of improving their general level of functioning. Therefore it appears that several neurotransmitters may be involved in the development of schizophrenia, meaning the dopamine hypothesis is too simplistic. B.A., History and Educational Psychology, University of Exeter. basis. Chronic schizophrenics achieved 3lbs of weight loss a week. Older antipsychotics like haloperidol or chlorpromazine may produce side effects In a token economy, tokens are given to reward people in psychiatric institutions for performing socially desirable behaviours, the aim being to encourage self-care. 214 High Street, The patients with the most severe symptoms are unable to access the tokens, as they are unable to perform the desirable behaviours. They block dopamine receptors on post-synaptic neurons, meaning that less dopamine is transmitted across the synapse. CBT is rarely used without drug therapy, suggesting it is not enough on its own to treat 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. In other words the illness only manifesters itself under appropriate environmental conditions, genetics was not enough on its own. 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. Even newer antipsychotic drugs, such as risperidone and olanzapine are safer, and they also may be better tolerated. When desired behavior is displayed eg. Does the low motivation reflect depression or schizophrenia, or both? 806 8067 22 The rate of relapse was particularly high if returning to a high EE family was coupled with no medication. However, the newer antipsychotic drugs affect other neurotransmitters such as serotonin and glutamate as well as dopamine. A second weakness of the neuroanatomical explanations is that it is biologically deterministic. 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. 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. That said, please be assured that question paper development involves a rigorous and robust process during which experienced colleagues determine whether or not, for any specific content, within a . The therapist needs to accept that the illusions may seem real to the patient at the time and should be dealt with accordingly. 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. Refer to one or more types of family dysfunction in your answer. (1990). Family therapy for families of adolescents or young adults who have developed schizophrenia tends currently to emphasize psychoeducation (guidance about schizophrenia and its treatment) and aims at enhancing recovery rather than the discovery of pathogenic patterns of child-rearing (McFarlane 2016 ). Berger (1965), however this evidence may be unreliable because the patients recall may be effected by the dis-order e.g. In addition, they can then predict the outcome of the disorder and suggest related treatment to help the patient. Diathesis-Stress Model - Simply Psychology Let the patient develop their own alternatives to their previous maladaptive behavior by looking at coping strategies and alternative explanations. Psychology Schizophrenia Family Dysfunction - Advantages and Token economies raise ethical issues. Schizophrenia seems to be polygenic, as a number of genes have been implicated. A Level Psychology Schizophrenia exam questions Flashcards 11 items. Pathophysiology, evaluation and treatment of erectile dysfunction: review article Andrey Biff Sarris 1 , Maki Caroline Nakamura 1 Luiz Gustavo Rachid Fernandes 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. 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) [4 marks]. Research suggests that these delusions are associated with specific biases in reasoning about and explaining social situations.