Cognitive Explanations for Schizophrenia

Learning Outcomes Outline the cognitive explanations for Schizophrenia Explore the cognitive reasons for Psychotic symptoms Explore and evaluate the scientific model of delusional thinking Explore research which demonstrates a cognitive explanation

What’s going on inside the ‘black box’? People are laughing on the bus There’s something wrong with me

What’s going on inside the ‘black box’? My papers are not where I left them People are trying to sabotage my career

What’s going on inside the ‘black box’? I can’t hear what people are saying My family is plotting against me

http://www.youtube.com/watch?v=0vvU-Ajwbok

(Behavioural Outputs) Let’s remind ourselves of the Symptoms (Behavioural Outputs) POSITIVE SYMPTOMS – TYPE 1 Distortion of normal function NEGATIVE SYMPTOMS – TYPE 2 Lack of normal function Delusions, hallucinations, disorganised speech, under the control of an alien force, disordered thinking Apathy, no emotion, flat effect, social withdrawal, Alogia (Lack of Speech)

A RATIONAL PATH TO MADNESS (ZIMBARDO, 76) People turn to friends and relatives friends and relatives deny the reality of the sensations Sufferers conclude that the others are trying to hide the truth Reject all feedback and develop beliefs that they are being persecuted

Cognitive Explanation Hemsley (1993) suggested schizophrenics cannot distinguish between information that is already stored and new incoming information. As a result, schizophrenics are subjected to sensory overload and do not know which aspects of a situation to attend to and which to ignore. When schizophrenics first hear voices and experience any other worrying sensory experiences, they turn to their friends and relatives to confirm the validity of what they are experiencing. Some people fail to confirm the reality of these experiences, so the schizophrenic comes to believe they must be hiding the truth. Individuals then begin to reject feedback from those around them and develop delusional beliefs that they are being manipulated and persecuted. The role of biological factors is acknowledged in this explanation – it says that the condition has always existed, but is worsened by those around them

Maher model when we experience anything that is strange to us, we try to find an explanation for it We all experience relief when we come up with a logical explanation for something; even if we don’t like the explanation it is sometimes better to have one. But if we share our explanations with someone and they don’t agree with us, then logically that makes us either more special than them as we have access to more information than they do, or they are lying to us to prevent us from finding out the truth What we all do is to try and identify a cause of our experience, and if there is no obvious external cause then it is logical to assume invisible causes. This might explain why the person with psychosis develops fears of radio waves or aliens, or fears religious forces such as the devil, as these could be causes of their experiences.

So, someone suffering with schizophrenia… Sometimes agencies such as MI5 or the communist party might become the explanation for the strange event the person experienced. Maher stresses the rationality of these thoughts given are linked to the intensity of the experiences the person has For example, a person who perhaps feels guilty about childhood shoplifting might assume that he or she is being punished for this. A person who did not have psychosis might ask: ‘Who would be hunted by aliens for some minor fault?’, but this explanation would seem perfectly logical to some people with psychosis. On the other hand, the person may have unusually high self-esteem based on previous experiences and feel they have been chosen to save the world from a disaster, or fell that they may have enemies from the past who would logically be ‘out to get them’. Makes sense!!! A person suffering with schizophrenia will….. identify a strange event, identify who is the cause of it and decide that they are worthy of having been chosen to experience it. Finally, the patient has to identify why it should happen to them. Here they might look at guilty secrets from the past, or punishment for some minor indiscretion, which to the outsider only emphasises the apparent illogical nature of their thoughts.

Cut and stick Activity

Most symptoms of schizophrenia can be explained in three cognitive processes Inability to generate willed action (that is, any action that is under the voluntary control of the individual) Inability to monitor willed action Inability to monitor the beliefs and intentions of others

These three processes are all part of a general mechanism (called meta-representation) that allows us to be aware of our goals and our intentions and to understand the beliefs and intentions of others. Faulty operation of this mechanism is due to functional disconnection between frontal areas of the brain concerned with action and more posterior areas of the brain that control perception.

Cognitive explanation Frith (1992) attempted to explain the onset and maintenance of some of the positive symptoms of schizophrenia. This is called the faulty filter model. His idea is that people with schizophrenia are unable to distinguish between actions that are brought about by external forces and those that are generated internally. The filter between conscious and preconscious processing breaks down.

Frith and Done –learning task Use the worksheet to read about the 3 different experiments. APRC for the 3 experiments Complete the questions Evaluate as a group.

Frith has produced some evidence for his ideas by detecting changes in cerebral blood flow in the brains of people with schizophrenia when engaged in specific cognitive tasks Evaluation It has provided a comprehensive framework for explaining many of the symptoms in schizophrenia. Research support is far from conclusive and the theory is still regarded as speculative. reductionist, fails to take into account the role of environmental and biological factors.

Other research and evaluation Cognitive psychologists are attempting to find evidence for genetic links by examining whether malfunctioning cognitive processing is a family trait. Park et al. (1995) identified working memory deficits in people with schizophrenia in their first-degree non-schizophrenic relatives, Faraone et al. (1999), also found impairments in auditory attention Read the hand out with additional evidence / research Consider evaluation points… Reductionist? Nature? Nurture? Effective? Supporting research? Scientific?