SCHIZOPHRENIA

SCHIZOPHRENIA

SYMPTOMS
1. POSITIVE
  1. Any change in behaviour or thoughts
  2. Delusions
    1. Beliefs held by the individual that despite not being true
2. NEGATIVE
  1. A reduction in normal behaviour
  2. Lack of concentration, not wanting to leave the house, and changes in sleeping patterns
BIOLOGICAL EXPLANATION
1. Excess dopamine is associated with positive symptoms
  1. EVIDENCE: Research study raised levels of dopamine in the brains of rats by injecting them with amphetamine. They became more aggressive and isolated = psychotic-type behaviour
2. Amphetamine increases the level of dopamine
  1. EVIDENCE: Research found that 75% of patients with schizophrenia showed new symptoms or an increase in psychosis after using amphetamine
3. STRENGTHS
  1. Drugs that bind to D2 receptors and prevent dopamine from being absorbed into neurons in large quantities, reducing the effect of dopamine. Antipsychotic medications which act in this way are found to be effective.
4. WEAKNESS
  1. It is not known whether an increase in dopamine causes schizophrenia or if schizophrenia alters brain chemistry
    1. Cannot gather evidence of brain chemistry before a diagnosis has been made
  2. Can be seen as a reductionist explanation
    1. Schizophrenia has many complex features, by only looking at an imbalance of one neurotransmitter, the theory ignores other biological, psychological and social factors
GENETIC EXPLANATION
1. The greater the degree of relatedness, the higher the risk of developing the disorder
  1. If a first degree relative (parent, sibling) chance increases to 6 - 17%
2. STRENGTHS
  1. Twin studies and adoption studies show clear evidence of a genetic aspect to schizophrenia. This is because schizophrenia is more common in people who are related to schizophrenics than in the general population.
3. WEAKNESS
  1. Concordance rate between MZ twins is 48%. So,cannot be seen as solely a genetic cause as not 100%
COGNITIVE EXPLANATION
1. Starts by agreeing with the biological explanation that positive symptoms have a biological cause, e.g. increased dopamine.
  1. Other symptoms develop when the individual struggles to make sense of their experiences of the symptoms
    1. EVIDENCE: Frith (1979) published work focusing on a person’s heightened ‘self-awareness’ causing schizophrenia
2. WEAKNESS
  1. Still believe that the underlying cause is biological despite focusing on involvement of cognitive processing.
  2. No easy way to measure whether the cognitive deficits in a patient has caused the disorder or the effect of having schizophrenia.
BIOLOGICAL TREATMENT: DRUG THERAPY
1. ANTIPSYCOTIC MEDICATION
  1. Treat psychotic symptoms e.g. hallucinations
  2. The first antipsychotic drugs (1950s) are called ‘typical’ antipsychotics - Known to have many side effects.
    1. Led to development of ‘atypical’ antipsychotics in the 1990s which have far fewer side effects.
  3. Antipsychotic drugs help to reduce level of dopamine in areas of the brain associated with the symptoms by blocking dopamine receptors.
    1. In the form of tablets or injections
2. WEAKNESS
  1. Drug treatment has been described as a "chemical straitjacket" because it only tackles the symptoms, not the cause.
  2. Severe side effects has been found to stop patients from completing course of medication.
    1. Clozapine is one of the most effective atypical antipsychotic drugs – this may be because it has fewer side effects than other similar drugs. However, it has been found to increase the risk of developing agranilosytosis
3. STRENGTHS
  1. There are short-term benefits from drug therapy,life can become more manageable if symptoms are under control
BEHAVIOURAL TREATMENT: FAMILY THERAPY
1. Provides a support network for family
  1. Why? Reasons such as understanding that there is no blame and education on the illness
  2. Encourages family to talk openly with one another
    1. This makes patient feel more supported in the home which increases success rate of treatment.
2. STRENGTHS
  1. Evidence: Goldstein & Miklowitz (1995) Reviewed studies into effectiveness of family therapy. Found a lot of evidence suggesting that family interventions combined with medication were much more effective in reducing relapse rates than medication alone.
3. WEAKNESS
  1. Not a treatment/cure for the disorder – a therapy to help families cope
PSYCHOLOGICAL TREATMENT: CBT
1. CBT is based on the idea that how we think (cognition), how we feel (emotion) and how we act (behavior) all interact together.
  1. Specifically, our thoughts determine our feelings and our behavior.
  2. Therefore, negative and unrealistic thoughts can cause us distress and result in problems
  3. Cognitive therapy helps people to develop alternative ways of thinking and behaving which aims to reduce their psychological distress.
2. STRENGTHS
  1. EVIDENCE: Tarrier et al. (1998) investigated 87 patients with schizophrenia, some receiving treatment as usual (TAU, antipsychotic drugs) and some receiving CBT (problem solving and enhanced coping skills) alongside TAU. 83% completed the treatment. 3 months after the treatment ended, the CBT-group showed fewer symptoms and time in hospital but the TAU-group showed more symptoms and time in hospital.
3. WEAKNESS
  1. Many patients with schizophrenia drop out of CBT. Patients need to be highly motivated because the treatment requires effort and commitment

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	Created by Molly Burns over 6 years ago