psychological: cognitive explanations of schizophrenia

dysfunctional thought processing (DTP)

• Dysfunctional thought processing refers to how a person with schizophrenia understands, perceives and interprets the world and other people around them

• An individual with schizophrenia may struggle to differentiate between the typical internal dialogue that most people experience - such as mentally reading words, rehearsing a to-do list, or daydreaming - and what they interpret as external voices directed at them, which they perceive as originating outside of themselves

• DTP, as suggested by Frith (1992), involves the mechanism of metarepresentation

  • Metarepresentation involves:

    • The ability to reflect on one’s thoughts and behaviours and to know what one’s intentions, goals and motivations are

    • The ability to interpret the behaviour of others and to understand that another person’s actions/thoughts are particular to that person and not to oneself

      • This representation is a type of Theory of Mind (TOM), and so to lack metarepresentation means to lack TOM

      • Frith (1992) claims that the lack of both TOM and metarepresentation can produce paranoid schizophrenia, which involves extreme delusions

attentional biases

• Attentional bias refers to the tendency to pay attention to specific stimuli and to ignore other types of stimuli

• Someone who is suffering from a mental illness may prioritise what they perceive to be threat or danger-related stimuli over benign, harmless stimuli

• The perceived threat may not present any real danger or threat at all, but to a person with schizophrenia (particularly the more extreme form of paranoid schizophrenia), the harmless actions of others may be viewed from a biased perspective involving misinterpretation of others’ actions and intentions

• The schizophrenic person may be unable to exercise self-monitoring

• The schizophrenic person may lack the ability to recognise benign stimuli and signs that the world is not an entirely dangerous place, which contributes to the positive symptom of delusion

research which investigates cognitive explanations

• Scherzer et al. (2012)

  • Found that paranoid schizophrenics who did not pass a TOM test were unable to distinguish between their mental state and that of others when compared to a normal control group

  • Navalón et al. (2021)

    • Found that schizophrenic patients displayed an attentional bias towards threatening scenes on video, showing a ‘late avoidance’ of sad scenes and increased attention to scenes containing threats

strengths of cognitive explanations of schizophrenia

• Schizophrenia is a condition that is marked by a misperception of reality, which means that cognitive explanations have good validity in their assumptions

• The link between dysfunctional thought processing  and TOM can be tested using standardised TOM false-belief tasks, which can be replicated to test for reliability

weaknesses of cognitive explanations of schizophrenia

• Cognitive explanations lack cause-and-effect conclusions:

  • Does schizophrenia cause dysfunctional thought processing, or does that dysfunctional thought processing lead to schizophrenia symptoms?

• There may be issues with the validity of cognitive explanations e.g. a person’s thought processing is likely to be highly subjective, regardless of whether they have schizophrenia or not

  • It is difficult to know how to judge and assess what is dysfunctional or biased when it comes to idiosyncratic (pertaining to the individual) cognitions

links of cognitive explanations of schizophrenia to issues & debates

• The theory implies that schizophrenia symptoms are caused by automatic cognitive dysfunctions, which supports a soft determinist view

  • This has implications for treatment and responsibility, as it suggests symptoms arise from underlying cognitive deficits, not from conscious choice