1. 28 th March – 15 April EASTER 26 15 April Explanations – Psychological 27 22 April Biological Treatments 28 29 April Psychological treatments 29 6 May Revision 30 13 May Revision 31 20 May Unit 4 Mock exam 28 th – 31st May HALF TERM 32 4 June A2 STUDY LEAVE 33 10 June Monday 10 th June (pm) PSYA-3 Unit 3 External Exam 34 17 June Monday 17 th June (am) PSYA-4 Unit 4 External exam

2. Psychological Explanations For Schizophrenia 1. Behavioural 2. Psychodynamic 3. Cognitive 4. Socio-cultural

3. Activity - Construct A3 mindmap to record this section..

4. Four key areas

5. 1.Behavioural 2.Psychodynamic 3.Cognitive 4.Socio-cultural

6. 1. Behavioural Theory  Behaviourists argue that schizophrenia is learnt through operant conditioning.  Someone may do something that gets a positive reaction or reward from others.  This encourages the person to repeat the behaviour- it reinforces it.

7. Behavioural Factors:  Behavioural explanations claim that a person behaves in a way that is expected of them and that psychotic behaviour can be a learnt response to given demands.  Scheff (1999) found that some children who were punished in early life retreat into a more satisfying inner world and were then labelled as ‘odd’.

8. Scheff’s labeling theory (1966)... The label then resulted in them behaving in a more peculiar way in an attempt to be rewarded by more attention and so a cycle developed. This became known as ‘labelling theory’ and schizophrenic behaviour in later life was seen an attempt to continue to be rewarded with attention and sympathy… So.. to summarise.. An individuals bizarre behaviour is rewarded with attention, it becomes more and more exaggerated and so schizophrenia develops.

9. Child is Punished Child retreats into inner world -Displays odd behaviour Child labelled as odd Child rewarded by attention/sympathy Labelling theory (Scheff, 1999) Child displays attention-seeking ’odd’ behaviour

10. Evaluation - Support Support for this theory comes from Liberman (1982) who suggests that if a child receives little or no social reinforcement early on in life (e.g. because of parental neglect), the child will, attend to inappropriate environmental cues (e.g. the sound of a word rather than its meaning). Although this has some face validity it is probably more relevant to the maintenance rather than the cause of the disorder.

11. More labelling support.. Remember ?? “I hear voices” “You are a schizophrenic”

13. Evaluation - Support  Rosenhan (1973) supports labelling theory when he found that psychiatric (diagnostic) labels tend to become ‘self-fulfilling prophecies’ whereby everything the patient says / does is interpreted in accordance with the label applied.

14. Evaluation - However  Gove (1982) argued that labels do not lead to long-term negative self-perceptions and instead increase the likelihood that those labelled as mentally ill or their families will seek and benefit from services and treatment.  However this could also be seen as attention seeking behaviour.

15. Evaluation:  These arguments may have face validity as it is almost impossible to deny, given both commonsense and research findings that labelling someone as “crazy” will not have some effect on them.  However.. schizophrenia may be the diagnosis of the labelled behaviour but not what the initial cause of the ‘odd’ behaviour was (Gove, 1999).

16. Evaluation - However..  Gross (2010) suggests that this explanation may be reductionist in proposing that a simple label explains such a complex mental illness as schizophrenia and therefore trivialises the illness.  In addition the behaviour of adult schizophrenics is not generally rewarded by others in fact it is often stigmatised and can result in a lack of privileges and attention not more.

17. 5 minute Activity - Questions… 1.Labelling Theory involves…. ? 2.Rosenhan’s research supports this theory because ….. ?

18. 2. Psychodynamic Theory  Freud claimed that schizophrenia is caused by over- whelming anxiety. It is a defence mechanism involving regression into early stage of development which he termed “primary narcissism”.

19. Psychic conflict: The structure of personality or “psyche” Id – Pleasure principle Selfish part of our personality, demands instant satisfaction of drives related to sex and aggression. Present from birth. Ego – Reality principle Conscious, rational part of our personality attempts to mediate between demands of id and superego Superego – Morality principle Moral part of our personality which is concerned with right and wrong (conscience) Id and Superego are in direct conflict with one another. ‘Psychic conflict’ The well-adjusted person develops a strong Ego that is able to control the other two components. Psychic conflict can occur at any time but particularly in early childhood, as the ego is not fully developed.

20. EGO Controlling the other two Moral conscience SUPEREGO “Naughty” pleasure seeking ID

21. Psychodynamic Theory  This results in the ego not being separated from the id which leads to a loss of contact with reality and an inability to deal with external reality. Therefore hallucinations are the ego’s attempt to restore contact with reality.

22. Critical Evaluation A03- However, there are major issues with this explanation; it is theoretical and is not supported by any experimental evidence. It therefore, lacks scientific rigour. A03 - Reductionist - ignores biological influences (Folens, 2009)

23. Critical Evaluation  The treatment used in this theory- ‘Psychoanalysis’ (dream analysis, hypnosis, etc.) is not an effective treatment, which therefore suggests that psychodynamic theory does not explain what causes schizophrenia (Lindenberg, 2000).

24. 3. Cognitive Theory  Cognitive psychologists argue that schizophrenia is caused by faculty information processing. This leads to … delusions, thought interference, language impairment and memory problems.

25. Evaluation - Support  Neufeld (1978) compared the cognitive processes of people with schizophrenia with a control group. The participants with schizophrenia took longer to encode stimuli and showed short-term memory problems. This would suggest that their ability to process information was impaired.

26. However.. Evidence against...  Biochemical research suggests that cognitive problems are caused by increased dopamine function rather than faulty information processing. (Davison & Neale 2000)

27. 4. Socio-Cultural Factors Socio-Economic Hypotheses Family Relationships

28.  There are two main socio-economic hypotheses, both relating to the status of the individual; 1.Social causation hypothesis  This states that people with low social status are more likely to suffer from schizophrenia than people with higher social status.  It is thought that factors like poverty and discrimination cause high stress levels and that this can cause schizophrenia. Socio-economic hypotheses

29. 2. Social drift hypothesis  This states that mental illness causes a decline or downward drift in social status.

30. Evaluation - Support  Several research studies have found a relationship between economic deprivation and inequality and the risk of schizophrenia. Boydell et al (2003) found that a positive correlation between incidence rates of schizophrenia and degree of inequality in deprived areas in London, even after adjusting for such variables as age, sex, absolute deprivation and ethnicity.  These findings support the social causation hypothesis.

31. Evaluation - Support  In further support of these 2 theories a British study by Cochrane and Stopes-Roe (1980) found that lower social status was associated with higher risk of developing schizophrenia. However…  Davison et al (2004) found that schizophrenia led to a decline in social status thus supporting the social drift hypothesis.

32. Evaluation - Support  In support of both socioeconomic hypotheses, Turner and Wagonfeld (1967) found that schizophrenics tended to be of lower social status overall than their fathers but that their fathers tended to be in the lower social classes in the first instance.

33. Evaluation  However, more disturbingly Johnstone (1989) found that patients from lower classes are more often diagnosed with severe conditions, such as schizophrenia, even when presenting similar symptoms to that of higher classes, further highlighting the problems with class differences and social bias in diagnosis.

34. Evaluation -Support  Harrison et al (2001) found that people who were born in deprived areas were more likely to develop schizophrenia. This suggests that factors like poverty, unemployment and crowding have an impact on schizophrenia.

35. Critical Evaluation Additional evidence against.... A03 - These results are correlational so they do not show cause and effect. The social drift hypothesis suggest that there are more people with schizophrenia in deprived areas because having schizophrenia gives them a lower social status e.g. because they might be unemployed.

36. Evaluation - Support  These findings have been replicated in many other studies of migrant groups, including Castle et al (1991) and Selten et al (2001) even accounting for other variables. This factor has strong scientific validity as a causal explanation for schizophrenia.

37. Critical Evaluation IDA Turner and Wagonfeld (1967) suggest that this approach may be deterministic in that it is too simplistic to claim that socioeconomic factors alone cause schizophrenia. They propose that a more combinational model is more appropriate as schizophrenia is more likely to be a complex interaction between genetic vulnerability and environmental stressors.

38. Other Socio-Cultural factors

39. Family Relationships  One of the most important family interaction factors is the mother and child relationship (Bateson, 1956).

40. Evaluation - Support A British longitudinal study that started in 1946 consisted of 5,362 participants, all born in that same week. By age 43 there were 30 cases of schizophrenia. The study found that one of the most powerful risk factors for the development of schizophrenia was the quality of the mother-child relationship at aged 4, as rated by health visitors. A poor relationship carried a six fold increase in risk for later Schizophrenia. (Folens, 2009).

41. Evaluation - Support  In a similar study carried out in New Zealand which followed 1000 children from birth to age 26 demonstrated that the mothers of children who developed schizophrenic symptoms were rated as having poorer attitudes and behaviours towards their children at age 3.

42. Critical evaluation.. A03 – Reductionist point “However these studies may be reductionist in that they fail to show whether the poor mother-child relationship is the result of bad parenting or the parent reacting to behaviour associated with schizophrenia displayed by the child ( Gross, 2010).

43. Evaluation - Support However..  Compelling evidence in support of the model by Myrhrman et al (1966) using the Northern Finland 1966 Birth Cohort (11,017 individuals) followed through to age 28, found that the risk of developing schizophrenia was considerably raised for the unwanted children even after adjusting for all social and demographic variables.

44. Evaluation Furthermore Agid et al (1999) observed a significant correlation between parental loss before the age of 8, particularly the loss of the mother through death, and the subsequent development of schizophrenia. Transition word

45. This correlation was further supported by… …. Mallett et al (2002) who suggests that the findings had high external validity as they were constant across different cultures, had large sample sizes and were well controlled longitudinal studies. A03

46. Other family relationships Double - bind theory.  Bateson et al (1956) argued that dysfunctional communication within family relationships can lead to schizophrenia.  The double-bind theory suggests that interactions with parents, i.e. contradictory messages sent by parents to children can cause confusion and therefore an inability to form a coherent construction of reality.  E.g. being told you are loved but then being ignored by the same parent- child then finds it hard to respond to the parent and  Schizophrenic symptoms can then result.

47. Other family relationships  The double-bind theory found that,for example, they may express love in an angry voice. Therefore, the child becomes confused but as these demands cannot be avoided or satisfied an individual’s schizophrenic symptoms become a learnt response to these impossible demands.

48. Critical Evaluation However.. the double-bind theory is only claiming a correlational relationship between family communication and the development of schizophrenia and there is very little scientific evidence to support the findings and conclusions of Bateson’s research (Gross, 2009).

49. In addition, the behaviour displayed by the parent may indicate that they were also suffering from schizophrenia. Therefore it might be argued that this correlation is reductionist in that the communication link could be genetic rather than psychological. A03-Reductionist

50. Essay question Discuss one or more psychological explanations of schizophrenia, including the evidence on which they are based (10+14marks)

51. Summary QUIZ Psychological explanations