(1990). The ICD-10 (only negative symptoms need to be present) is used worldwide and the DSM-5 (only positive symptoms need to be present) is used in America. Kahn et al. One weakness of the cognitive explanation is that there are problems with cause and effect. Ethical issues Severely ill patients cant get privileges because they are less able to comply with desirable behaviors than moderately ill patients They may suffer from discrimination. Last chance to attend a Grade Booster cinema workshop before the exams. 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 . Lobban (2013) reports that other family members felt they were able to cope better thanks to family therapy. (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. Broadcasting is a thought disorder whereby a person believes their thoughts are being broadcast to others, for example over the radio or through TV. Comorbidity describes people who suffer from two or more mental disorders. Group As scores suggest a normal distributed as the mean, median and mode are all almost the same (22). A second weakness of the cognitive model is that it is reductionist. Tarrier (2005) reviewed trials of CBT, finding evidence of reduced symptoms, especially positive ones, and lower relapse rates. Found that changes in behavior achieved through token economies do not remain when tokens are withdrawn, suggesting that such treatments address effects of schizophrenia rather than causes. Company Reg no: 04489574. and pragmatic (how is the belief helpful?) For example hallucinations are a symptom of both schizophrenia and bipolar disorder. Reliability is the level of agreement on the diagnosis by different psychiatrists across time and cultures; stability of diagnosis over time given no change in symptoms. Liem (1974)measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families. It is therefore prescribed when the patient is at risk of suicide. Visual - Evaluation of neural correlates for schizophrenia 4. B: behavior how do you react in these situations ? [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. Note: you may come across the terms DSM-IV and ICD-10. Does the low motivation reflect depression or schizophrenia, or both? 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 application questions, examiners look for effective application to the scenario which means that you need to describe the theory and explain the scenario using the theory making the links between the two very clear. They act as dopamine antagonists, attempting to reduce dopamine activity. They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity. For example parents who say they care whilst appearing critical or who express love whilst appearing angry. 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. Full Text. Communication skills training teach family to listen, to express emotions and to discuss things. Classification and diagnosis does have advantages as it allows doctors to communicate more effectively about a patient and use similar terminology when discussing them. found 108 separate genetic variations were associated with increased risk of schizophrenia. (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. Even after stopping the use of the drug, this condition can persist. ), empirical (where is the evidence?) Researchers estimate up to 1 percent of adults worldwide have schizophrenia.. What . It is not a cure. 11 items. There is no such thing as a normal schizophrenic exhibiting the usual symptoms. (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. CBT aims to identify and alter irrational thinking including regarding: In theory, when the misunderstandings have been swept away, emotional attitudes will also improve. 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). Support for family research, Tienari et al (1994) adoption study found those adopted children who had schizophrenic parents were more likely to become ill themselves than those children with non-biological parents. Older antipsychotics like haloperidol or chlorpromazine may produce side effects Helping the patient to find logical reasons for the things which trouble them Therapists may use logical (does it make sense? (Total 16 marks) 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 is not the case with schizophrenia: The causes may be one of biological or psychological or both. These symptoms may leave them fearful and withdrawn. 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. Antipsychotic drugs (drugs used to reduce the intensity of the symptoms) are the most common treatment for schizophrenia. holes) in the brain that supply nutrients and remove waste. 2002-2023 Tutor2u Limited. Biological explanations for schizophrenia can be criticised for being biologically reductionist. The intention is to show schizophrenics that their hallucinations are not real. In other words the illness only manifesters itself under appropriate environmental conditions, genetics was not enough on its own. AQA maintains that 16-mark questions, or indeed, extended writing questions of other tariffs, could be asked on any part of any topic. Fox (1990): It is more likely that factors associated with living in poorer conditions (e.g. Another form of CBT: Coping Strategy Enhancement (CSE). Study notes, videos, interactive activities and more! Family Dysfunction refers to any forms of abnormal processes within a family such as conflict, communication problems, cold parenting, criticism, control and high levels of expressed emotions. tutor2u is the leading support service for A-Level, GCSE, BTEC and IB students and teachers preparing for assessments, mocks and final exams. Research indicates their attention skills may be deficient they often appear easily distracted. For example, about 50% of people with schizophrenia are also diagnosed with depression. ABC: Get the patients to understand what is really happening in their life: A: Antecedent what is triggering your problem ? [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. 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. 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 . Atypical antipsychotic drugs work on negative symptoms, improving mood, cognitive functions and reducing depression and anxiety. Effectively means that it needs to be clearly linked and explained in the context of the answer. If the distress caused to the child is severe and long-lasting, he/she may . Refer to one or more types of family dysfunction in your answer. Berger (1965), however this evidence may be unreliable because the patients recall may be effected by the dis-order e.g. Drugs such as Chlorpromazine also have a sedative effect, meaning that they calm patients down and reduce anxiety. In a follow up study they rejected genuine patients whom they assumed were part of the deception. Psychologists use the DSM and ICD to diagnose a patient with schizophrenia. Validity the extent to which schizophrenia is a unique syndrome with characteristics, signs and symptoms. Alogia aka speech poverty is a thought disorder were correct words are used but with little meaning. Avolition: Lack of volition (i.e. 214 High Street, Symptom targeting: a specific symptom is selected for which a particular coping strategy can be devised For example, schizophrenia and depression are often found together. To stabilize the social authority of the doctor and the family. Words may become confused and sentences incoherent (so called word salad). A number of researchers have suggested that difficulties in understanding other peoples behavior might explain some of the experiences of those diagnosed as schizophrenic. Falloon et al (1996) stress such as divorce or bereavement, causes the brain to be flooded with neurotransmitters which brings on the acute episode. Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics. (Total 4 marks) 12 Describe and evaluate biological explanations for schizophrenia. 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). B.A., History and Educational Psychology, University of Exeter. Therefore there is no need to feel stressed or ashamed about them. 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. less effect on movement MZ twins share 100% of their genes, compared to DZ twins who only share 50% of their genes, so this suggests that genes must have some influence on the development of schizophrenia. Very important to note genetics are only partly responsible, otherwise identical twins would have 100% concordance rates. Noll (2009) also argues around one third of patients do not respond to drugs which block dopamine so other neurotransmitters may be involved. 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. [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. Ventricles are fluid filled cavities (i.e. Melzer (2012) concluded that Clozapine is effective in 30-50% of cases where other drugs have failed, supporting its use in schizophrenia treatment. [2 marks] Additional communication skills are taught, such as compromise and negotiation, and requesting a time out . In order to explain schizophrenia effectively it would be better to take an interactionist approach, such as the diathesis stress model. 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. Research by Miyakawa et al. A final strength is that it takes on board the nurture approach to the development of schizophrenia. Credit should be awarded for one type in some detail or for two (or more) done briefly. Sweets and cigarettes. 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, They generally have fewer side effects eg. amphetamines) can produce-schizophrenia like symptoms in non-sufferers. One biological explanation for schizophrenia is that it is passed on through the genes. Pathophysiology, evaluation and treatment of erectile dysfunction: review article Andrey Biff Sarris 1 , Maki Caroline Nakamura 1 Luiz Gustavo Rachid Fernandes 1 , In CBT, patients may be taught to recognise examples of dysfunctional or delusional thinking, then may receive help on how to avoid acting on these thoughts. Keywords: psychosocial dysfunction, family burden, schizophrenia, OCD. Benzel et al. Schizophrenia seems to be polygenic, as a number of genes have been implicated. Many people who experience feelings of persecution have a general tendency to assume that other people cause the things that go wrong with their lives. Most importantly, families can make the schizophrenic feel loved, accepted and valued. disputing techniques. Paul and Lentz (1977) Token economy led to better overall patient functioning and less behavioral disturbance, More cost-effective (lower hospital costs). First generation Antipsychotics are called Typical Antipsychotics Preconscious thought (thought that occurs without awareness) contains a huge amount of information from our senses that would normally be filtered. Classification is the process of organising symptoms into categories based on which symptoms cluster together in sufferers. The schizophrenic twin generally had more enlarged ventricles and a reduced anterior hypothalamus. Visual - Evaluation of the dopamine hypothesis for schizophrenia 3. Boston House, Help the patient realise it is normal to have negative thoughts in certain situations. A. If there is more than one individual in the scenario you must mention all of the characters to get to the top band. 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. Family dysfunction - the double-bind theory Bateson 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. Example Answers for Schizophrenia: A Level Psychology, Paper 3, June 2019 (AQA) Exam Support. People with schizophrenia often suffer terrifying symptoms such as hearing internal voices not heard by others, or believing that other people are reading their minds, controlling their thoughts, or plotting to harm them. The reason for this is because the approach does not consider other factors such as genes. These may be risk factors for the development and maintenance of schizophrenia. Voices are usually heard coming from outside the persons head giving instructions on how to behave. Company Reg no: 04489574. For example, an excess of dopamine receptors in Brocas area might be responsible for poverty of speech and auditory hallucinations. We are committed to engaging with you and taking action based on your suggestions, complaints, and other feedback. 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. 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). Weak evidence for family based explanations, there is no evidence that supports the importance of double bind theory. RWA Offering drugs can lead to an enhanced quality of life as patients are given independence Positive impact on the economy as patients can return to work and no longer need to be provided with institutional care. Inherited factors that make some individuals more likely to develop a certain behaviour or mental disorder. The effect of this is, as well as reducing positive symptoms, the reduction of depression and anxiety, and the enhancement of mood. There is a lack of understanding and explanation of how the diathesis-stress model works- it is known that both have to be present to lead to schizophrenia, but not how the mechanisms of schizophrenia symptoms develop. Having attempted to dispute faulty beliefs, patients may also be set behavioural assignments with the aim of improving their general level of functioning. Family therapy is based on the premise that nurture (upbringing) is a significant factor in schizophrenia. The harmful effects on the child may go completely unacknowledged or be minimized. Psychological therapies are very rarely used alone, but sometimes patients may just take drugs without any other therapy. By oversimplifying schizophrenia in terms of genes and neurotransmitters, the social context within which it develops has not been considered. Refer to one or more typesof family dysfunction in your answer. why some children in such dysfunctional families often do not go on to develop schizophrenia. (2008) found that antipsychotics are generally effective for at least one year, but second- generation drugs were no more effective than first-generation ones. When the families were rated as healthy, the likelihood of developing schizophrenia for those with a biological mother with schizophrenia fell to below 1%. Lengthy It takes months compared to drug therapy that takes weeks which leads to disengaged treatment as they dont see immediate effects A patient who is very distressed and perhaps suicidal may benefit better in the short term from antipsychotics. In the 1950s and 60s nurses often rewarded patients with cigarettes. 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).
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