Psychological Explanation & Treatments of Schizophrenia L Psychological Explanation & Treatments of Schizophrenia L.O: Describe and evaluate BEHAVIOURAL explanations and treatments of schizophrenia

Psychological Explanations Psychological explanations: Psychodynamic, Behavioural, Cognitive Sociocultural factors: The role of social and family relationships  life events, double bind, Expressed Emotion

Behaviourist EXPLANATION Explain schizophrenia as a consequence of faulty learning Little or no social reinforcement early in life (parental disinterest), may lead child to attend inappropriate & irrelevant environmental cues e.g. sound of a word instead of meaning. Result – child’s verbal or other behavioural responses will become bizarre and those who observe it will either avoid the child or respond erratically, thereby reinforcing the bizarre behaviour. This cycle will eventually deteriorate into a psychotic state.

Evaluation of Approach Moderately supported by success of behavioural therapies in helping re-integration Social skills training Roder et al., 2002 Patients acquire useful social skills Reintegrate into community Suggests skills were not learned in first place BUT Sz symptoms too complex to be all learned, though Sz may have partly led to failure to learn those skills.

Behaviourist TREATMENT - Token Economy Programmes Generally used in long-term care setting such as long-stay inpatient units. Based on ........................... and ............................ principles, participants receive reinforcers (such as tokens or points) for performing clearly defined target behaviours such as ..................... These reinforcers then exchanged at a later time for rewards or privileges such as ..................

Token Economy Programmes Cochrane, 2000: T.E effective when targeting negative symptoms, such as poor socialisation, poor motivation, and poor activities of daily living  teaching skills! Roder et al, 2002: Can help Sz patients gain useful social skills to help re-integrate *call back* - what is the behaviourist ‘downward spiral’ of schizophrenia?

Evaluation of TREATMENT HOWEVER: Many patients with Sz go in and out of hospital, so the drop out rate from token economy programmes is high. Ongoing active intervention needs to be maintained to avoid deterioration of skills T.E. has low ecological validity (esp. once incentives are removed)