Schizophrenia is a severe mental disorder that impairs contact with reality and insight, affecting 1% of the population. It involves positive symptoms like hallucinations and delusions as well as negative symptoms like lack of motivation. There is strong evidence for a genetic basis and biological explanations for schizophrenia, though environmental factors like childhood abuse and family dysfunction may also play a role. Treatment involves antipsychotic drugs to reduce dopamine activity as well as psychological therapies like CBT, though schizophrenia cannot be cured. Current models recognize that both biological and environmental factors likely interact to cause schizophrenia.

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2.  Schizophrenia is a severe mental disorder
where contact with reality and insight are
impaired. (Affects 1% of the population)
 Schizophrenia is a cluster of symptoms.
 DSM – Requires one positive symptom.
 ICD – Needs two or more negative symptoms.
 Positive symptoms are additional experiences
i.e. hallucinations and delusions.
 Negative Symptoms involve a loss of usual
abilities i.e. avolition (lack of motivation)
and poverty of speech.

3.  Reliability – Cheniaux et al (2009) one
psychiatrist diagnosed 26 with schizophrenia
using the DSM and 44 according to the ICD.
 Validity – Schizophrenia is much more likely
to be diagnosed using ICD than DSM.
 Co-morbidity – Buckley et al (2009) half of
schizophrenics also have depression.
 Symptom overlap – Both schizophrenia and
bipolar disorder involve positive symptoms
like delusions and negative symptoms like
avolition (lack of motivation).

4.  The genetic basis of schizophrenia –
Gottesman (1991) as genetic similarity
increases so does the probability of sharing
schizophrenia. Individual genes are believed
to be associated with risk of inheritance.
 The dopamine hypothesis – Dopamine is to do
with pleasure. Hyperdopaminergia = High
levels, hypodropaminergia = low levels.
 Neural correlates of schizophrenia –
measurements of the structure or function of
the brain that correlate with an experience.

5.  Strong evidence for genetic vulneralibility
(Gottesman)
 Mixed evidence for the dopamine hypothesis
 Neural correlates of schizophrenia do not tell
use whether they cause schizophrenia.
 Schizophrenia can take place in the absence
of a family history of the disorder (mutation)
 There is evidence to suggest an important
role for environmental factors, including
psychological ones such as family functioning
during childhood.

6.  Psychological explanations focus on the
environment, in the particular family.
 Family dysfunction (abnormal processes within a
family) – The schizophrenogenic mother who is
cold and controlling, double-bind theory that
suggests that the developing child receives
mixed messages and often punished with
withdrawal of love, and expressed emotion
which is the level of emotion (negative)
expressed towards a patient.
 Cognitive explanations – schizophrenia is linked
with several types of abnormal thinking.

7.  Read et al (2005) 69% of adult women
patients had a history of abuse in childhood.
(was 59% for men)
 No supporting evidence for the
schizophrenogenic mother and double-bind.
 Dysfunctional family explanations have also
led historically to parent-blaming.
 Stirling et al (2006) found that schizophrenics
took longer completing a stroop test (reading
coloured words)
 Strong evidence for biological explanations.

8.  Antipsychotics can be divided into two
typical (traditional) and newer atypical or
second-generation drugs.
 Typical antipsychotics like Chlorpromazine
work by acting as antagonists in the
dopamine system. (chemicals that reduce
action of a neurotransmitter)
 Clozapine binds to dopamine receptors in the
same way as Chlorpromazine, but Clozapine
also acts on serotonin and glutamate
receptors which helps improve mood.

9.  Evidence for effectiveness – Thornley et al
(2003) found that Chlorpromazine was
associated with better functioning and
reduced symptom severity.
 Typical antipsychotics come with side effects
and long term use can result in tardive
dyskinesia.
 Healy (2012) suggested that some successful
trails have had their data published multiple
times, exaggerating their evidence for
positive effects. (Publisher bias)

10.  CBT helps make sense of patients delusions
and hallucinations.
 Family therapy – Pharoah et al (2010)
identified a range of strategies by which
family therapists aim to improve the
functioning of a family with a member that’s
schizophrenic i.e. reducing stress and
reduction of anger etc.
 Token economies are reward systems used to
manage their behaviour. Tokens are given
when they perform a desirable behaviour,
and tokens can be exchanged for rewards.

11.  Jahaur et al (2014) found that CBT has a
significant effect on schizophrenics.
 All psychological therapies are worth doing,
but they do not cure schizophrenia, they only
reduce the symptoms.
 Ethical issues – token economy systems have
proved controversial. Privileges services
become more available to patients with mild
symptoms and less for those with severe
symptoms.
 Some supporting studies lack a control group.

12.  The interactionist approach acknowledges that
there are biological, psychological and societal
factors in the development of schizophrenia.
 The diathesis-stress model says that both a
vulnerability to schizophrenia and a stress-
trigger are needed in order to develop the
condition.
 In the original model, diathesis (vulnerability)
was entirely genetic. Now it’s clear that many
genes appear to increase genetic vulnerability
slightly.
 Stress was originally seen as psychological, now
it is anything that can trigger schizophrenia.
 Treatment- combine drugs with psychological
therapies.

13.  Tienari et al (2004) found that both genetic
vulnerability and family-related stress are
important in the development of
schizophrenia.
 The original model is too simple (single
schizogene and schizophrenic parenting
style)
 We do not yet fully understand the
mechanisms by which the symptoms of
schizophrenia appear and how both
vulnerability and stress produce them.