family dysfunction schizophrenia tutor2u

This suggests that gaining an insight into family relationships allows psychiatric professionals to help improve the quality of patients lives. Research evidence from autopsies has shown that schizophrenia sufferers have more dopamine receptors, which may lead to more neural firing and therefore an over production of messages. Imagined stimuli could involve any of the senses. with reference to co-morbidity, These refer to the latest editions of the two classification systems. Families can help minimize the damage to self of the schizophrenic that this entails. Treatment: In an interactionist approach, treatments will take more than one form. There is no such thing as a normal schizophrenic exhibiting the usual symptoms. There is evidence that people diagnosed as schizophrenic have difficulties in processing various types of information, for example visual and auditory information. Refer to one or more typesof family dysfunction in your answer. 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. The harmful effects on the child may go completely unacknowledged or be minimized. (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. Even newer antipsychotic drugs, such as risperidone and olanzapine are safer, and they also may be better tolerated. This raises practical and ethical issues when selecting different types of tretment. 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. The original dopamine hypothesis stated that schizophrenia suffered from an excessive amount of dopamine. CBT is rarely used without drug therapy, suggesting it is not enough on its own to treat schizophrenia. However they do not cure schizophrenia, rather they dampen symptoms down so that patients can live fairly normal lives in the community. 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? Response. The commonest diagnosis was schizophrenia (n = 23, 57.5%) followed by epileptic psychosis (n = 4, 10.0%) and general psychosis (n = 4, 10.0%) with one of psychotic depression and one psychosis secondary to general medical condition. Background: Social dysfunction is an important outcome for schizophrenia and can be measured by the evaluation of social skills. Broadcasting is a thought disorder whereby a person believes their thoughts are being broadcast to others, for example over the radio or through TV. Delusions: The most common delusion that people diagnosed with schizophrenia report is that others are trying to harm or kill them delusions of persecution. 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. Schizophrenia is a severe type of mental illness that affects a person's thoughts, perceptions, and behaviors. While schizophrenia has a strong genetic component, some individuals with genetic susceptibilities to the disorder nonetheless remain healthy. West Yorkshire, 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). ABC: Get the patients to understand what is really happening in their life: A: Antecedent what is triggering your problem ? Weak evidence for family based explanations, there is no evidence that supports the importance of double bind theory. 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. 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. With these particular questions there is a sizeable risk that people dont understand the difference between the questions, and then write about the wrong thing. 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 Al (2011) suggest many aspects of urban living ranging from life stressors to the use of drugs, can have an effect on human epigenetics. These include reduced levels of emotional expression, disorganised speech and delusions. Eg. 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%. 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. In other words, it doesnt cure schizophrenia, it just helps people get over it. Is it the cognitive deficits which causes the schizophrenic behavior or is the schizophrenia that causes the cognitive deficits? less effect on movement This suggests that the cognitive approach is oversimplistic when consider the explanation of schizophrenia. CSE aims to teach individuals to develop and apply effective coping strategies which will reduce the frequency, intensity and duration of psychotic symptoms and alleviate the accompanying distress. This supports a genetic link. It is one of the chemicals in the brain which causes neurons to fire. disputing techniques. Chlorpromazine and Haloperidol. Support for family research, Tienari et al (1994) adoption study found . 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. Requires self-awareness and willingness to engage Held back by the symptoms schizophrenics encounter It is an ineffective treatment likely to lead to disengagement. Schizophrenia Dysfunctional Family Dysfunctional Family Dysfunctional Family 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 As the drugs block dopamine activity, they tend to have (sometime severe) side-effects. Study notes, videos, interactive activities and more! In other words the illness only manifesters itself under appropriate environmental conditions, genetics was not enough on its own. Cultural bias African Americans and those of Afro-carribean descent are more likely to be diagnosed than their white counterparts but diagnostic rates in Africa and the West Indies is low Western over diagnosis is a result of cultural norms and the diagnosis lacks validity. The therapist wins the trust of the patient, so they can work together. Severe side effects Long term use can result in tardive dyskinesia which manifests as involuntary facial movements such as blinking and lip smacking While they may be effective, the severity of the side effects mean the costs outweigh the benefits therefore they are not an appropriate treatment. One biological explanation for schizophrenia is that it is passed on through the genes. Jack's experiences can be linked to the family dysfunction explanation. 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. Antipsychotic drugs are weakened by the fact that they have severe side-effects. There is other evidence to support difficult family relationships in childhood are associated with increased risk of schizophrenia in adulthood. Since the mid-1950s antipsychotic medications have greatly improved treatment. Berger (1965), however this evidence may be unreliable because the patients recall may be effected by the dis-order e.g. 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. Risperidone is another atypical antipsychotic, and is designed to be as effective as Clozapine without the risky side-effects. 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. The aim in modern forms of this therapy is to reduce the stress in the family environment so preventing relapse. 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. Social behavior depends, in part, on using other peoples actions as clues for understanding what they might be thinking. It can also reduce positive symptoms by not rewarding them, but rewarding desirable behavior instead. 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. Schizophrenia is a multi-factorial trait as it is the result of multiple genes and environmental factors. Researchers estimate up to 1 percent of adults worldwide have schizophrenia.. What . So environment does play a part in triggering the illness. A second weakness of the cognitive model is that it is reductionist. 2. a taxonomic category below an order and above a genus. Typical antipsychotics: Developed in the 1950s, for example Chlorpromazine. (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. 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. Having attempted to dispute faulty beliefs, patients may also be set behavioural assignments with the aim of improving their general level of functioning. It is now recognised that the vulnerability could be genetic or __environmental (for example, a traumatic event in early childhood). A final strength is that it takes on board the nurture approach to the development of schizophrenia. Psychomotor Disturbances: Stereotypyical Rocking backwards and forwards, twitches, & repetitive behaviors. Older antipsychotics like haloperidol or chlorpromazine may produce side effects The entire evaluation of Schizophrenia (AQA A-level Psychology) 33.39 5.49. Work out ways to recognise negative thoughts and test faulty beliefs when they arise, and then challenge and re-think them. Dopamine is a neurotransmitter. Family dysfunction - the double-bind theory Bateson et al. Preconscious thought (thought that occurs without awareness) contains a huge amount of information from our senses that would normally be filtered. Further support comes from the fact that dopamine agonists (e.g. this should enable a less biased/more varied/more representative sample OR this would allow the results to be generalised more widely, Wars of the Roses 6 - Henry VII 1485-1509. 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. For example hallucinations are a symptom of both schizophrenia and bipolar disorder. For example, it suggests that schizophrenic behavior is the cause of environmental factors such as cognitive factors. This suggests that there is a problem of the chicken and egg scenario in relation to expressed emotion causing schizophrenia. Usually the person has convinced him/herself that he/she is someone powerful or important, such as Jesus Christ, the Queen (e.g. Metaanalysis by Crossley Et Al (2010) suggested that Atypical antipsychotics are no more effective, but do have less side effects. (1972) described how a child may be regularly trapped in situations where they fear doing the wrong thing, but receive mixed messages about what counts as wrong. 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. David Rosenhan (1973) famous experiment involving Pseudopatients led to 8 normal people being kept in hospital despite behaving normally. 2002-2023 Tutor2u Limited. Atypical antipsychotics: Developed in the 1970s, as an attempt to find drugs with fewer severe side-effects than typical antipsychotics. This suggests that the dopamine hypothesis does not account for freewill. (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. Avolition: Lack of volition (i.e. But in fact some Schizophrenics are successfully treated whereas others are not. 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. A second weakness is the problem of nature-v-Nurture. 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. This means that the brains of schizophrenics are lighter than normal. amphetamines) can produce-schizophrenia like symptoms in non-sufferers. culture and gender bias and symptom overlap. Since their are problems with the validity of diagnois classification, unsuitable treatment may be administered, sometimes on an involuntary In the USA only 20% of psychiatric patients were classed as having schizophrenia in the 1930s but this rose to 80% in the 1950s . A quarter of people with schizophrenia (Total 4 marks) 11 Describe and evaluate biological explanations for schizophrenia. If diagnosis leads to successful treatment, the diagnosis can be seen as valid. 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. This suggests that if this research was tested and re-tested the same results would be achieved. It binds to dopamine receptors more strongly than Clozapine, and there is some evidence that it produces fewer side-effects. Gender bias: Loring and Powell (1988) found that some behavior which was regarded as psychotic in males was not regarded as psychotic in females. It is, therefore, very important to offer the most appropriate and effective type of treatment. This suggests that the research into gene mapping is oversimplistic as schizophrenia is not due to a single gene. Strategies are practised within a session and the client is helped through any problems in applying it. First, cognitive deficits which are impairments in thought processes such as perception, memory and attention. 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'. Refer to one or more types of family dysfunction in your answer. They are then given homework tasks to practice, and keep a record of how it worked. b) Explain one reason why there might be a problem of bias and generalisation in this study. Explain how family dysfunction might be involved in schizophrenia. 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. Central idea: Patients problems are based on incorrect beliefs and expectations. 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%. A. High dopamine activity leads to acute episodes, and positive symptoms which include: delusions, hallucinations, confused thinking. AQA maintains that 16-mark questions, or indeed, extended writing questions of other tariffs, could be asked on any part of any topic. Delusions of Grandeur). 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. 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. The idea of cognitive biases has been used to explain some of the behaviors which have been traditionally regarded as symptoms of schizophrenia. Book now . [4 marks], "Two years ago Jenny was diagnosed with schizophrenia. 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 Adults with an insecure attachement to their primary carere are also more likely to have schizophrenia (Berry et al 2008). EE is a family communication style that involves criticism, hostility and emotional over-involvement. Tienari Et. Even after stopping the use of the drug, this condition can persist. Therefore there is no need to feel stressed or ashamed about them. But if they have a supportive environment and/or good coping skills the illness may not develop. For example, an excess of dopamine receptors in Brocas area might be responsible for poverty of speech and auditory hallucinations. Gender bias is also an issue as the mother tends to be blamed the most, which means such research is highly socially sensitive. 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. Once the patient has had several sessions (often between 5 and 20), they should be able to recognise the fact that their beliefs are not based on reality. Tel: +44 0844 800 0085. Chronic schizophrenics achieved 3lbs of weight loss a week. Check out Adapt the A-level & GCSE revision timetable app. Describe the family dysfunction explanation for schizophrenia and explain how. Voices are usually heard coming from outside the persons head giving instructions on how to behave. a) Explain why a Mann-Whitney test is an appropriate choice of statistical test in this situation and a Spearman's test is not. Ethics do the benefits of classification (care, treatment, safety) outweigh the costs (possible misdiagnosis, mistreatment, loss of rights and responsibility, prejudice due to labelling). They found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics. Other side effects are potentially fatal, for example agranulocytosis and neuroleptic malignant syndrome (NMS). They cannot express their feelings about the unfairness of the situation. 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, Kazdin et al. Classification is the process of organising symptoms into categories based on which symptoms cluster together in sufferers. Words may become confused and sentences incoherent (so called word salad). This is a useful point to emphasise in any essay on the disorder. Schizophrenics returning to such a family were more likely to relapse into the disorder than those returning to a family low in EE. delusions. They involve modifying/interfering with the action of neurotransmitters, in order to increase (agonists) or decrease (antagonists) their activity. 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. they said an event was real but it was in their head. One strength of the double bind explanation comes from further empirical support provided by Berger (1965). Helping the patient to find logical reasons for the things which trouble them This causes the neurons that use dopamine to fire too often and transmit too many messages. Upper and Newton (1971) found that the weight gain associated with taking antipsychotics was addressed with token economy regimes. A weakness of the family relationsships appraoch is that there is a problem of cause and effect. There are two types of twins identical (monozygotic) and fraternal (dizygotic). 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. Carrying on a logical discussion till the patient begins to see where their ideas are going wrong and why they developed. Comorbidity occurs because the symptoms of different disorders overlap. If there is more than one individual in the scenario you must mention all of the characters to get to the top band. A final weakness of the dopamine hypothesis is that it is biologically deterministic. The aim in modern forms of this therapy is to reduce the stress in the family environment so preventing relapse. Symptom targeting: a specific symptom is selected for which a particular coping strategy can be devised It is therefore prescribed when the patient is at risk of suicide. 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? 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 . Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia 2. 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. For example parents who say they care whilst appearing critical or who express love whilst appearing angry. Refer to evidence in youranswer. Antipsychotic drugs (drugs used to reduce the intensity of the symptoms) are the most common treatment for schizophrenia. The ventricles of a person with schizophrenia are on average about 15% bigger than normal (Torrey, 2002). Cognitive biases refer to selective attention. Let the patient develop their own alternatives to their previous maladaptive behavior by looking at coping strategies and alternative explanations. Visual - Evaluation of the icd and dsm as tools to diagnose schizophrenia. Family studies find individuals who have schizophrenia and determine whether their biological relatives are similarly affected more often than non-biological relatives. The researchers found that the males had a genetic condition which became later known as "Brunner syndrome" (it is important to note that females only carry this condition, as it only affects the MAOA production gene on the single X chromosome in males). Saul Mcleod, Ph.D., is a qualified psychology teacher with over 18 years experience of working in further and higher education. [2 marks], Evaluate psychological explanations of schizophrenia [16 marks] and more. 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 limits the usefulness of token economies in treating schizophrenia. Conversely, antipsychotic drugs work by binding to dopamine receptors and reduce symptoms. Laing and others rejected the medical / biological explanation of mental disorders. 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. CBT aims to identify and alter irrational thinking including regarding: In theory, when the misunderstandings have been swept away, emotional attitudes will also improve. At least 73% of his sample reported that these strategies were successful in managing their symptoms. This suggests that there may be problems of demand characteristics. This weakens the interactionist explanation. Autopsies have found that there are generally a large number of dopamine receptors (Owen et al., 1987) and there was an increase in the amount of dopamine in the left amygdale (falkai et al. This helps improve the quality of life for schizophrenia sufferers. tutor2u is the leading support service for A-Level, GCSE, BTEC and IB students and teachers preparing for assessments, mocks and final exams. 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. MZ twins may have the same genetic vulnerability but can be triggered by different stressors. 2. In the 1950s and 60s nurses often rewarded patients with cigarettes. This requires honesty, patience and unconditional acceptance. Sometimes when people with schizophrenia become depressed, so it is common to prescribe anti-depressants at the same time as the anti-psychotics. This suggests that understanding the effects of cognitive deficits allows psychologists to create new initiatives for schizophrenics and improve the quality of their lives. 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. Read the model answers to get a clearer idea of what is needed. Boston Spa, Atypical antipsychotics such as Clozapine bind to dopamine, serotonin and glutamate receptors. basis. Cochrane (1977) reported that the incidence of schizophrenia in the West Indies and the UK is 1 %, but that people of Afro-Caribbean origin are seven times more likely to be diagnosed as schizophrenic when living in the UK. A final weakness of the genetic explanation of schizophrenia is that it is biologically reductionist. Liem (1974)measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families. CBT does seem to reduce relapses and readmissions to hospital (NICE 2014). 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. The biological basis for schizophrenia is therefore not addressed at all in the therapy, limiting its use. To teach patients and carers more effective stress management techniques. They did not believe that schizophrenia was a disease. They believed that schizophrenia was a result of social pressures from life. 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. For example, about 50% of people with schizophrenia are also diagnosed with depression. 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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