(9) Cognitive explanations of schizophrenia

According to the cognitive explanation of schizophrenia, the symptoms of schizophrenia are caused by

Dysfunctional mental processes such as attention and reasoning

What are the dysfunctional reasonings people with schizophrenia experience?

A tendency to assume something about a particular situation, based on very little evidence, is called a Jumping to conclusions bias.

A tendency to believe that you are being singled out and unfairly treated is called a persecution bias.

how do dysfunctional thought processes cause delusions?

Dysfunctional attention causes patients to overfocus on small irrelevant details of real events and coincidences

This lead to patients experiencing delusions because the patient tries to explain why coincidences keep happening, but their dysfunctional reasoning makes their explanation irrational, causing a delusional belief.

how do dysfunctional processes cause hallucinations

Due to dysfunctional attention, people overfocus on things that they imagine. Over focussing on imagined events causes the imagined events to begin to feel real.

People with schizophrenia struggle to tell the difference between things that they imagine and things that have actually happened.

How do dysfunctional processes lead to negative symptoms?

Patients start to become overwhelmed by their abnormal experiences, hallucinations or delusions.

Patients want to avoid their abnormal experiences, hallucinations or delusions

Patients isolate themselves from the outside world.

A03 for cognitive explanation: supporting evidence

O’Carroll reviewed studies that investigated mental dysfunction through studying people with schizophrenia aswell as people at risk of developing schizophrenia and found Dysfunctional mental processes may cause the symptoms of schizophrenia.

A03 for cognitive explanation: Limitations

It does not account for the role of biological factors in schizophrenia.

CBT as a treatment

CBT aims to treat the dysfunctional thought processes that the patient is having by challenging and correcting the biases in reasoning that cause the symptoms of schizophrenia

CBT steps

Explanation: The patient describes their experiences and beliefs.

Normalisation: The doctor normalises the patient’s experiences

Challenging: The doctor challenges beliefs and experiences.

Alternative explanations: The patient is asked to develop alternative explanations for beliefs and experiences

A03 for CBT: study support

NICE conducted a review of studies and compared the use of CBT combined with medical drugs, to medical drugs alone.

Treatments with CBT were found to be more effective at reducing symptoms of schizophrenia and were found to reduce the likelihood of a patient relapsing and having to go back into hospital.

However, Studies may have suffered from confounding variables so effectiveness of CBT may have been over exaggerated

A03 for CBT: cost

It requires lots of expensive sessions, which are usually one-to-one with a therapist limiting the availability of the treatment