psych explanations

cognitive explanations of schizophrenia

sz is characterised by disturbance in language attention, thought and perception.

this has led cognitive psychologists to explain the disorder as a result of dysfunctional thought processing - cognitive habits or beliefs that cause the individual to evaluate info inappropriately and produces undesirable consequences.

lower than usual levels of processing (possibly caused by bio factors) suggest that cognition is likely to be impaired.

cogn explanations - dysfunctional thinking

reduced thought processing in the ventral striatum is associated with negative symptoms.

ventral striatal activation during reward anticipation showed a strong negative correlation with apathy (avolition). 

reduced processing of info in the cingulate gyrus is associated with auditory hallucinations.

low levels of info processing suggests cognitive impairment.

cogn explanations - Frith et al. (1992)

suggested that schizophrenics fail to monitor their own thoughts correctly.

when a person hears voices, it’s actually their own inner voice being misinterpreted; but, sufferers may believe that someone or something in the external world is communicating with them.

such processing problems in people with sz are sometimes referred to as alien control symptoms cuz the sufferer feels as if external forces are influencing their thoughts and actions and they have no personal control. 

proposed two explanations: 
(1) metarepresentation - the cognitive ability to reflect on thoughts and behaviour which allows us insight into our own intentions and goals. dysfunction in this would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else. this explains auditory hallucinations and delusions like thought insertion.

(2) central control - this is the cognitive ability to suppress automatic response while we perform deliberate actions instead. dysfunction in this would lead to disorganised speech and thought disorder as we’re unable to suppress automatic thoughts and speech triggered by other thoughts. e.g. schizophrenics tend to experience derailment of thoughts and spoken sentences cuz each word triggers associations, and the patient can’t suppress automatic responses to them.

AO3 - evaluations of cognitive explanations of schizophrenia

strength: research support

limitation: a proximal explanation

limitation: psychological or biological?

cogn explanations - AO3 - strength of dysfunctional thought processing: research support

Stirling et al. (2006) compared performance on a range of cognitive tasks in 30 pps with sz and a control group of 30 pps without sz.

tasks included the Stroop task, in which pps have to name the font-colours of colour-words, so have to suppress the tendency to read the words aloud.

as predicted by Frith et al.’s central control theory, people with sz took longer – over twice as long on average – to name the font-colours.

this means that the cognitive processes of people with sz are impaired.

the Stroop test
the importance of the Stroop effect is that it appears to cast light into the essential operations of cognition, thereby offering clues to fundamental cognitive processes and their neuro-cognitive architecture.

Stroop effect is also utilised to investigate various psychiatric and neurological disorders.

cogn explanations - AO3 - limitation of cognitive explanations of sz: only explain the proximal origins of symptoms

cognitive explanations of sz are proximal explanations cuz they explain what’s happening currently to produce symptoms – as distinct from distal explanations which focus on what initially caused the condition.

possible distal explanations are genetic and family dysfunction explanations.

what’s currently unclear is how genetic variations or childhood trauma might lead to problems with metarepresentation or central control.

this means that cognitive theories on their own only provide partial explanations for sz.

cogn explanations - AO3 - psychological or biological?

genetic factors or adverse conditions in the womb can lead to a biological vulnerability and this can take the form of biochemical or neuroanatomical abnormalities.

the biological vulnerability can lead to psychological vulnerability such as an inability to process info appropriately.

cognitive processing deficits can lead to cognitive distortions. these cognitive difficulties can become exacerbated by stressful life events and thus could go on to produce some of the psychotic symptoms of sz such as delusions and hallucinations.

family dysfunction - schizophrenogenic mother

Fromm-Reichmann (1948) proposed a psychodynamic explanation for sz based on the accounts she heard from her patients about their childhoods. Fromm-Reichmann noted that many of her patients spoke of a particular type of parent, which she called the schizophrenogenic mother. 'Schizophrenogenic' meaning ‘schizophrenia-causing’.

the schizophrenogenic mother is cold, rejecting and controlling, and tends to create a family climate characterised by tension and secrecy. This leads to distrust that later develops into paranoid delusions (i.e. beliefs of being persecuted by another person), and ultimately schizophrenia.

family dysfunction - Bateson et al. (1972) - double blind theory

sz is the result of double-bind communication. parents who send out mutually contradictory signals.

this causes a state of internal conflict, when the individual is trapped in a situation where they fear doing the wrong thing, but receive mixed messages on what it is or how to ask for classification.

when they get it wrong, the child is often punished by withdrawal of love.

this leads to a mixed understanding of the world and can lead to symptoms such as disorganised thinking or delusions.

double blind is a risk factor.

family dysfunction - expressed emotion (EE)

is the level of emotion, in particular negative emotion, expressed towards a person with sz by their carers who are often family members. EE contains several elements:
- verbal criticism of the person, occasionally accompanied by violence.
- hostility towards the person, including anger and rejection.
- emotional over-involvement in the life of the person, including needless self-sacrifice.

These high levels of EE directed towards the individual are a serious source of stress for them. This is primarily an explanation for relapse in people with sz. but, it has also been suggested that it may be a source of stress that can trigger the onset of sz in a person who is already vulnerable, for example, due to their genetic make-up (diathesis-stress model).

AO3 - evaluations of family dysfunction

strength: research support

limitation: explanations lack support

limitation: socially sensitive research

Ao3 - strength of family dysfunction: research support

Indicators of family dysfunction include insecure attachment and exposure to childhood trauma, especially abuse. According to a review by Read et al. (2005) adults with sz are disproportionately likely to have insecure attachment, particularly Type C or D.

Read et al. also reported that 69% of women and 59% of men with sz have a history of physical and/or sexual abuse. In the Morkved et al. (2017) study, most adults with sz reported at least one childhood trauma, mostly abuse.

This strongly suggests that family dysfunction makes people more vulnerable to sz.

Ao3 - limitation of family dysfunction: explanations lack support

although there is plenty of evidence supporting the idea that childhood family-based stress is associated with adult sz, there’s almost none to support the importance of traditional family-based theories such as the schizophrenogenic mother and double bind.

Both these theories are based on clinical observation of people with sz and also informal assessment of their mothers' personalities, but not systematic evidence.

This means that family explanations haven’t been able to account for the link between childhood trauma and sz.

family dysfunction - AO3 - limitation of schizophrenic mother: socially sensitive research

research linking family dysfunction to sz is highly socially sensitive cuz it can lead to parent-blaming. Mothers seem to be particularly blamed. For parents already having to watch their child experience the symptoms of sz and take responsibility for their care, to be blamed adds insult to injury.