Tuesday, 28 October 2014

MEDIA AQA PSYCHOLOGY

MEDIA PSYCHOLOGY

SYNOPTIC TOOL KIT

MAID – D (DEBATES)
SCIENTIFIC VS NON SCIENTIFIC
NATURE VS NURTURE
HOLISM VS REDUCTIONIST
FREE WILL VS DETERMINISM
BIOLOGICAL
BING
SCIENTIFIC
Because it considers bing
Also uses empirical evidence. The research is objective. It is falsifiable and has a testable hypothesis
NATURE
It is a matter of genetics. Nurture could also influence the way you think
REDUCTIONIST
It doesn’t consider other approaches such as environmental influence or social situations
DETERMINISTIC
Things that you can’t change..based on your genetics
BEHAVIOURIST
SLT
SCIENTIFIC
Uses empirical evidence. Can test the hypothesis. You can question its objectivity
NURTURE
It looks at your environment. There is also a biological basis
REDUCTIONIST
Reduces study to behaviour which is environmentally based. SLT could have biological predisposition
ENVRONMENTAL DETERMISM
It suggests you learn from your surroundings. Adults could have free will but it is case dependent.
COGNITIVE
ABC
SCIENTIFIC
Because it deals with the brain. It has a testable hypothesis, also uses empirical evidence
IT DEPENDS
Nature because you are born with your brain but nurture because friends can influence the way you see things.
REDUCTIONISM
Focuses on brain and mental processing – ignores all other elements E.G environment
FREE WILL
You decide how you think. Free will in treatment but determinism in basis.
PSYCHODYNAMIC
ID EGO SUPEREGO
NON SCIENTIFIC
Hypothesis cannot be proven. There is no objectivity. It is based on individual case studies.
NURTURE
Based  upon childhood experiences
REDUCTIONIST
Simplifies behaviour to childhood experiences
DETERMISISM
Based on childhood experiences



APPROACHES:
1.       Cognitive
2.       Behaviourist
3.       Psychodynamic
4.       Biological
 
M= methodology
A= approaches
I= issues
D = debates


BIOLOGICAL = BING
·         B = brain (neuroautonomy, structure of brain)
·         I= injury / infection (Kilve wearing, influenza)
·         N= neurotransmitters (dopamine, serotonin, adrenaline)
·         G=genetics (hereditary, DNA)
BEHAVIOURIST (BORN AS BLANK SLATE = TABULA RASA)
·         all behaviour is learnt
·         classical conditioning – learning through association
·         operant conditioning – learning through reinforcement
·         SLT social learning theory – learn by observing – reinforcement and repetition
PSYCHODYNAMIC
·         Freud tripartite personality
·         Stages of development = oral, anal, phallic, latent, genital
·         ID, EGO, SUPERERGO.
·         Ice berg structure, unconscious desires, pleasure principle
COGNITIVE
·         Thought processes. Input – process – output. Input = environmental stimuli, process = rational/irrational thoughts, output = behaviour
·         ELLIS ABC MODEL
·         A= activating event, B= belief rational or irrational, C= consequence


DEBATES:
1 .NATURE VS NURTURE
Born vs learned, biology vs environment
Were you born that way or did your environment influence you?
2 .REDUCTIONISM VS HOLISM
Reduce complex behaviour into base components. It has a clear focus.
Holistic therapy. Holism takes everything into account
3 .FREE WILL VS DETERMINISM
Free will = you make your own choices
Determinism = pre programmed controlled by your environment.
4 .SCIENTIFIC VS NON SCIENTIFIC
Does it encounter science into it?


SOCIAL LEANRING THEORY:
·         Developed by Albert Bandura in 1977
·         States that behaviour is learned from your environment through observational learning
·         Children copy models regardless if it is gender appropriate or not
·         Child is more likely to imitate behaviour that is gender appropriate or if its imitated with reinforcement or punishment.
·         Positive and negative reinforcement has little impact if reinforcement offered externally does not match with individual needs
·         Vicarious reinforcement = when you see someone else get positive feedback so the child is more likely to copy the behaviour.


External = if child wants approval from friends or peers
Internal = Feeling happy about actions

Bandura 1986 Bobo Doll Study
Children observed aggressive or non aggressive adult models; they were tested for imitative learning. Participants were ages between 3-5 years old. They observed adults interacting with the doll. Children in the aggressive condition reproduced a good deal of physical and verbal aggression. Children in the non aggressive condition exhibited no aggression to the doll.

+ This experiment shows that aggressive behaviour can be learned even with the absence of direct reinforcement.

-Demand characteristics. Child was quoted saying ‘’look mummy that’s the doll we have to hit’’ this means that if the child knew the aim of the study they may act in a certain way, making the results biased.

3 types of model –
1.       Live model (person performing behaviour)
2.       Verbal instruction model (details of behaviour)
3.       Symbolic model  (real or fictional character demonstrating behaviour EG on Tv show)

External reinforcement = reward and punishment
Intrinsic reinforcement = form of internal reward / better feeling 

Modelling process=

1.       Attention – watch model
2.       Retention- absorb it so that you can imitate it
3.       Reproduction- copy behaviour
4.       Motivation or reinforcement – positive or negative reinforcement. Reward, punishment, approval

Cognitive Priming = watching violence leads to people to store the acts as memories/scripts then later retrieve these and activate them in real life situations

Arousal = physiological response happens when you watch violence this is called increased arousal. Zillmans excitation theory argues that arousal produced is transferred to real life situation that involves conflict. If person is provoked and they are already in a heightened state they can misinterpret this resulting in an aggressive response.

Imitation = this explanation comes from SLT and Banduras Bo Bo doll study. Children observe behaviour of people they may admire and they later imitate this

Desensitisation = this explanation leads on from increased arousal. When a person regularly watches violent media they become used to it, decreasing arousal. When faced with real life violence watchers are desensitised and do not experience a stress response.

Huesmann et al 2003
Longitudinal study of 557 boys and girls in Chicago in 1977 when they were aged 5-8. They were asked about their favourite tv shows and characters. They were asked which character they most identified with. In 1991 398 were followed up in their early 20s, they were asked the same questions again. They also interviewed 3 people who knew them well; they had to common on how often the ppt looses their temper and if they were violent. Criminal records were also analysed. The viewing of violent tv shows when children were aged 6-9 correlated with violence in later life. Men classified as high violence viewers had three times the criminal conviction rate of low violence viewers.

Gunter et al 2002

Studied introduction of tv to remote community of st Helena. 23 boys and 23 girls 2 years before introduction of tv. Their teachers were asked to comment of their levels of antisocial behaviour using a checklist. Gunter returned 3 years after the introduction of tv, he asked the children to keep a 3 day diary of the tv that they watched. They were assessed by their teachers again. He found that children watched on average 3 hours of tv per day and were exposed to 95 acts of violence. Boys saw more violence and rated more antisocial. There was no overall increase in aggressive behaviour post tv. Children with higher antisocial score were more likely to watch cartoons.

Topic 2: Media influences on pro-social behavior
On average people watch 25 hours of television per week. It increases rapidly from 7 hours per week in two year olds, to 20 hours by the age of six. This declines in teenagers, and then rises again through adulthood. All viewers are exposed to large amounts of pro social behavior.

Explanations for media influence on pro-social behavior

1.       Exposure. As well as being exposed to violence, people are also exposed to pro-social behavior. Greenberg et al 2002 found that among the favorite TV shows of 8-12 year olds there was an average of 42 acts of anti-social behavior and 44 acts of pro-social behavior.
Howards and Roberts 2002 studied toddlers watching the teletubies. Responses included joining in with the actions, interacting with viewing companions, pointing to the screen and answering the questions of the characters.
2.       Social Learning Theory Banduras social learning theory suggests that children learn through observing behavior, then later imitating it if the expectation of a reward is greater than expectation of a punishment. This process is the same for pro-social acts, as it is for anti-social acts, however pro-social acts are likely to be in accordance with social norms, so they are associated with the expectation of reinforcement.  This reward acts as a motivation to repeat the action.
3.       Developmental factors child development research has shown that pro-social behavior is dependent on the developmental stage of the child. Perspective, empathy and moral reasoning develop through childhood and adolescence. Young children are less able to recognize emotional state of others and how to help. They may also not be able to understand complex pro-social messages portrayed in media.
4.       Parental meditation Many children watch TV alone, however they sometimes have a co-viewer. Parents who watch their children and discuss the themes and content can enhance the learning experience.

Rosenkoetter 1999 suggested that with parental mediation, children as young as 7 were able to understand complex moral messages.

Mares 1996
Meta-analysis studying 4 different categories of prosocial behavior spread over 39 different studies.
·         Positive interactions – children saw positive interactions acted more positively in their own interactions with others compared to those who viewed neutral or antisocial content. The effect size was found to be moderate.
·         Altruism – This included sharing, donating, offering help and comforting. Children who viewed altruistic behavior acted altruistically than the ones who viewed neutral or antisocial content. When altruism was not explicitly modelled the effect size was much smaller.
·         Anti-stereotyping – Looked at the effects of counter stereotypical portrayals and ethnicity and attitudes and beliefs. Children who viewed counter stereotypical themes showed less evidence of stereotyping and prejudice in their own beliefs. The effect size was moderate, but was larger when exposure to counter stereotypical themes in the context of the school classroom was accompanied by extra classroom activities designed to expand on the issues viewed.
·         Self-control – this included resistance to temptation, obedience to rules, ability to work independently and persistence at a task. Children who were observed models exercising self-control tended to show more self-control in their own behavior, particularly compared with those who saw a model behaving anti-socially. The effect size was moderate when compared with a neutral group, but large when compared with anti-social content.

Cole et al 2003
Cole investigated if Sesame Street taught mutual respect and understanding between Palestinian and Israeli children.  Before watching there were few negative comments, after watching there was an increase in positive attributes noted. Males and females were equally positively affected by pro-social content and there were no ethnic or racial differences, however effects were stronger among higher socio-economic groups where parental mediation was higher.

Fogel 2007
Fogel researched the effects of parental mediation. In condition 1children watched a 30minute clip of ‘hang time’ then had a 15 minute discussion about the clip with an adult. In condition 2 children watched the same clip, but did not have a discussion. Those who discussed it with an adult (parental mediation) scored higher in measures of pro-social behaviour including tolerance and friendship.
Negative effects of games and computers
Guo 2007
Guo identified the main effects of playing violent video games. He said that as physiological arousal and aggressive behaviours increase, helping behaviour decrease. Research has also pointed out de-sensitisation effect of computer games to both gaming and real life violence.

Carnagey, Anderson and Bushman 2007
They examined the effects of playing violent computer games on later responses to real life violence. A sample of participants were asked about their gaming habits and then randomly allocated to one of two conditions: playing a randomly selected violent game for 20 minutes, or playing a non-violent randomly selected game for 20 minutes. They then all watched a film with real life violence whilst wired to measure physiological response of heart rate and skin response. Those who played a violent game had lower heart rate and skin response.

GAM = General aggression model
Input variables which include individual factors (such as personality and gender) and situational variables (such as provocation) can influence reaction to playing violent games. Exposure to games is said to increase aggression through three pathways:
·         Arousal: playing violent games leads to increased arousal. A high level of arousal can lead to aggressive behaviour.
·         Cognition: Playing violent video games leads to priming of aggressive thoughts
·         Affective: Playing violent games increases aggressive or hostile feelings.

Karpinsky 2009
Found a strong relationship between Facebook use and academic under achievement. Majority of people who use Facebook every day underachieved by a whole grade. Facebook users spent between one and five hours a week studying, while non Facebook users spent between 11 and 15 hours per week. The link between Facebook and non Facebook users was even seen in graduate students.

Charles 2011
Charles used a focus group and interview techniques to investigate the Facebook habits of 200 undergraduates in Scotland. 12% experienced anxiety related to their use of Facebook. The more friends they had, the more anxiety they had. They reported stress from deleting unwanted contacts and the pressure to be humorous. 32% stated that rejecting friend requests made them feel guilty and 10% disliked receiving friend requests.

Positive effects of games and computers on behaviour

Greitemeyer and Ozzwald 2010
They gave participants one of three games to play: lemmings (where you ensure safety), an aggressive game and Tetris and a neutral game for 8 minutes. The researcher then accidently knocked over a pot of pencils. 67% people who played Lemmings helped 28% people who were lamers and 33% who played Tetris.

REAL WORLD APPLICATION = HOLMES ET AL 2010
They showed volunteers traumatic images of personal injury. 30 minutes later some participants played Tetris for 10 minutes, some did nothing. Those who played Tetris had fewer flashbacks. When the gap between images and game was increased to 4 hours, the effect was still noted. The researchers concluded that game interferes with the way traumatic memories are formed.

Hyper personal model – Walther 1996 this can explain the link between Facebook and positive self esteem. We self select information to represent our selves; we pick it to make us look good. This acts as positive feedback as nice messages are left by our friends and family.



Peter et al 2005
They studied 493 adolescents in Denmark using questionnaires and interviews to study the relationship between personality types and online friendship formation. They found that introverted adolescents were strongly motivated to communicate online.

Gonzales and Hancock 2011
They argue that Facebook walls can have positive influence on self esteem. Feedback can be very positive. Students were given three minutes to 1) use their Facebook page, 2) look at themselves in the mirror, or 3) do nothing. Those who had interacted with their Facebook page gave much more positive feedback than the two other groups.

Media and Persuasion
The Hovland Yale model
The hovland yale model argues that persuasions is dependent on several factors: the source, the message and the target.

·         The source – Experts are more effective at persuasion as they have knowledge. This could also be a celebrity endorsement as they are attractive.
·         The message- Messages are more persuasive if we think we are not being persuaded.  A message can be more effective if it creates a moderate level of fear, and if it is repeated.
·         Audience – Low and high intelligence audiences are easily persuaded than those with moderate intelligence. Intelligent audiences like to evaluate both sides of the argument. The argument needs to be clear enough for low intelligence people to understand it.

Evaluation of Hovland Yale model
·         Attractive sources are not most influential O’mahony and meenagan 1997 showed that celebrities are not convincing or believable. Hume 1992 = celebrity endorsement fails as people remember the celebrity and not the actual product
+ Fear appeals do work. Appeals can be persuasive if they do not petrify the audience and if they are informed of how to avoid the danger
-Gender bias in persuasive research Women are more susceptible to persuasive communications. Eagly and carli 1981 explained this in terms of socialisation differences- women socialised to conform. Sistrunk and McDavid 1971 claimed that studies find women more easily persuaded.
Elaboration Likelihood model – Petty and cacioppo (central and peripheral routes to persuasion
Message – central route – audience motivated to think about message – focus on quality of argument – lasting attitude change
Message- Peripheral route – audience not motivated to think about message – focus on peripheral factors – temporary attitude change

·         Central route = message is important; the focus is placed upon the quality of the argument, as the audience has a high need for cognition. This is likely to result in attitude changes.
·         Peripheral route = Audience focus is on context, not the actual message hidden in it. Focus is placed upon the contextual cues such as celebrity endorsement or the mood created. The final attitude change is likely to be temporary. This is most commonly used.
An important factor in the ELM is the need for cognition. The degree to which they enjoy thinking about the information they receive and analysing problems. Need for cognition is an individual difference. People with a high need for cognition can reflect on information well so that they have a good understanding of the world.

Evaluation of elaboration Likelihood model

-          Influence from peripheral route is only temporary although the peripheral route influence can be considerable, there is a strong likelihood that any change produced by this route is temporary – Penner and Frizsche 1993.

-          Most humans are cognitive misers Friske and Taylor 1984 Humans rely on simple time efficient strategies when evaluating and making time efficient decisions. If the content of a message  is not personally important then we are more influenced by contextual cues such as celebrity endorsement. When content is important they are better motivated to process message carefully.

+Support for the temporary attitude change of the peripheral route comes from Penner and Fritzche US basketball player Johnson Jr announced he was HIV positive. Penner and Friztche were psychologists collecting data about people’s willingness to help people with AIDS. After basketball player came out, helping rate rose to 83%.

Media and persuasiveness of television advertising
Pester power
Especially in the run up to Christmas adverts are aimed at children with the intention that they will go and pester their parents to buy the product for them. In Sweden it is illegal to aim an advert at a child under 12, this is to stop pester power. Pine and nash 2001 found a positive correlation between television exposure and Christmas gift request increases.

Evaluation = to measure persuasiveness researchers use data from how much viewers liked the product after viewing. However for an advert to be persuasive it should lead to an actual purchase.  

Does celebrity endorsement work? Martin et al 2008
He found that student participants were more convinced by a television endorsement from a fictional character when buying a digital camera than one from a celebrity. The researchers claimed that young people like to make sure the product is fashionable among people who resemble them, rather than approved by celebrities.

Methodological limitations – Erfgen 2011
He claims that research on the persuasiveness of celebrity endorsement has focussed on the characteristics of the celebrity and less on the message communicated. Celebrities endorse a product in several ways: implicitly (I use this product), explicitly (I endorse this product), in co-present mode (celebrity and product are depicted simultaneously).

Attraction of celebrity social psychological explanation
s
Parasocial relationship = where an individual is attracted to another who’s is unaware of the existence of the person who created the relationship
Attachment theory suggests that the tendency to develop parasocial relationships starts in childhood. Insecurely attached children are more likely to form parasocial relationships. These relationships are seen as desirable because there is no chance of being rejected.

Schiappa et al 2007
Schiappa examined research on parasocial relationships to predict factors that lead to that type of relationship. The predictors found were attractiveness, similarity and real. If the character discloses personal information we feel intimate with them.

Evaluation = Derrick et al 2008
Derrick examined the relationship between self esteem and identification with a parasocial relationship. Those with low self esteem saw their favourite celebrity as similar to themselves. Benefits unique to parasocial relationships are not experienced in real life situations.
Absorption Addiction Model
This model explains how a compromised identity structure can lead to a psychological absorption with a celebrity in attempt to establish an identity. Giles and Maltby 2006 identified this process:
·         Entertainment social – fans are attracted to a celebrity because of their ability to entertain, act as gossip and social interaction.
·         Intense-personal- This reflects intense and compulsive feelings about the celebrity. For example fans may believe they are soul mates.
·         Borderline pathological- This includes uncontrollable behaviours and fantasies about their celebrity.

How fans move through these stages: MCutcheon et al 2002
He argues that people have parasocial relationships due to lacks in their real life; they use parasocial relationships as an escape to reality. People may follow celebrities to gain a sense of identity and fulfilment. Motivational forces driving this absorption can become addictive.
Evaluation = social desirability bias, based on questionnaire = not accurate

Persuasive techniques =
·         Hard and soft cell – hard cell is the central route e.g. face to face sell where you present the factors of the product. Soft cell is the peripheral route where you create a feeling about the product.
·         Product endorsement – Hovland Yale model ‘source factors’ we develop parasocial relationships where we trust their judgement as we want to be like them. Product endorsement is similar to a stamp of approval.
·         Pester power – Advertising aimed at children with the idea they pester their parents. This has been made illegal to aim adverts at under 12s in Sweden.

·          Sex and violence – Advertisers are interested in the age group 18-34 as they have a disposable income and have no regular spending habits such as children or a mortgage.  They put adverts in programs where the TV show also has a high level of sex and violence.

Tuesday, 7 October 2014

Psychology AQA A - Schizophrenia


Schizophrenia
Positive symptoms
Positive symptoms are a change in behaviour or thoughts. It is when something is gained such as delusions (bizarre beliefs that seem real to the person), hallucinations (unreal perceptions of surroundings), or experiences of control E.G thinking an alien is controlling them.

Negative symptoms
Negative symptoms represent a withdrawal or lack of something E.G motivation. Negative symptoms include apathy (lack of interest or emotion), social withdrawal, alogia (poverty of speech no fluency slowed thoughts), avolition (cant initiate goal directed behaviour) , flat effect (having  no emotion).

Clinical Characteristics
·         Chronic onset – slow and gradual deterioration. Most commonly seen in younger people aged 18-25.  They can often experience more obvious symptoms such as hallucinations.
·         Acute onset – Obvious symptoms occur quickly can be after a stressful life event. Most usually known in older people. This is the least common way.



 DSM-IV-TR
®       Text revision version of DSM-IV published in July 2000.  

®       Diagnostic and statistical manual of mental disorder
®       Produced by the American psychiatric association
®       Most widely used diagnostic tool worldwide.

ICD
®       International classification of diseases.
®      Produced by world health organization (WHO)


Classification systems for diagnosing Sz are the ICD and DSM. To be diagnosed the patient has to have had the symptoms for at least 6 months.


Sub types listed in DSM but removed from DSM5:  paranoid Sz, Hebephrenic Sz, Catatonic Sz, undifferentiated Sz, and Residual Sz. = these had a negative impact upon validity. DSM 5 updated in 2013.

Cormorbidty = presence of one or more disorders. E.G Having depression as well as bipolar.

Issues with diagnosis and classification of Schizophrenia:
·         Psychological harm to patient if they receive wrong diagnosis or no diagnosis.
·         It’s a waste of money and resources if a patient is treated with therapy and drugs and then turns out not to have the disorder.
·         You want to diagnose it correctly as it helps psychologists to becoming closer to understanding what causes Sz.
·         Is Sz actually a mental health issue?
·         Reliability of diagnostic manuals
·         Inter-rater reliability (extent to which psychiatrists agree on diagnosis)
·         Validity
·         Co-morbidity ( when Sz sufferer has 1 or more disorders E.G Depression and Sz)
·         Cultural differences

·         Advantages and disadvantages of labelling 

-Advantages of labelling = help communicate better between clinicians, help research cause of Sz
-Disadvantages of labelling= can become a self fulfilling prophecy and Goffman 1968 said labelling had negative consequences and that people react badly to it.

Cultural differences:
·         Could genuinely be more likely to have Sz.
·         Environmental factors EG Stress of living in poverty, or diet or unemployment
·         Social factors such as cannabis smoking.
·         Genetic pre-disposition to get the disorder.

Criticism of diagnosis of Sz:
ROSENHAN ET AL 1973 :
Rosenhan did a study showing that 8 healthy ‘pseudopatients’ could gain admissions to 12 psychiatric hospitals in America by pretending to have auditory hallucinations such as the word ‘empty, thud, hollow’. When admitted they behaved normally. All wanted to be discharged so they behaved very well and followed all instructions from staff. They remained in the hospital from 7-52 days. Follow up study completed where Rosenhan warned hospitals he was sending people out, 21% of them were found out… yet Rosenham didn’t actually send anyone out!!

ESSAY Q = DISCUSS THE ISSUES SURROUNDING THE CLASSIFICATION AND DIAGNOSIS OF SZ
AO1  8 MARKS A03 = 16 MARKS

·         Explanation of how reliability affects diagnosis
·         Inter rater reliability tests
·         Reliability improved since rosenhams landmark study
·         Copelands study
·         Does sz exist? If experts cant agree then maybe it has no objective truth behind it Thomas Szasz said that mental illnesses are a myth.

CULTRAL DIFFERENCES:
®      Copeland et al (1971) gave a description of a patient to 134 US psychiatrists and 194 British psychiatrists.
®      69% of US psychiatrists diagnosed schizophrenia, but only 2% of British psychiatrists gave same diagnosis.

®      Harrison et Al said that afro-Caribbean people are 8x more likely to get Sz. Could be due to environmental factors such as stress of unemployment, or cannabis smoking. Could be due to how they were bought up to show their emotions.

Type 1 = positive symptoms
Type 2 = negative symptoms

Inter rater reliability = getting the same result regardless of who you ask. For example Copeland demonstrated that the inter rate reliability between British and American psychologists is very low.


Copenhagen High Risk Study 1994 family and Sz (genetic causes)
Kety et al study in Denmark 207 offspring with mothers who have Sz Condition 1 = high risk group condition 2 = low risk group. All kids ages 10-18. Matched pairs design, matched on age, gender, socio economic factors.
Follow up in 1974 . 16.2% high risk diagnosed with Sz. 1.9% low risk diagnosed.  Schizotypal personality disorder was diagnosed in 18.8% of group 1 and in 5% of group 2.
+ prospective not retrospective study
+natural experiment high ecological validly. Also longitudinal study with 2 follow ups
-          Population bias done in Denmark can’t be generalised to different cultures e.g. Africa
-           Natural experiment extraneous variables could affect the IV
+ new York high risk study is a supporting study showed same resilts.
-          Could also use nature VS nurture debate could be copying behaviour

Biological explanations of Sz include: genes (DNA), biochemical (dopamine) and anatomical (structure of brain). 






Carlson 1991 = Claims that the DSM has become more reliable as it has been updated, however a review in 2001 showed that it has an inter-rater reliability of 0.11

Klosterkotter 1994 = Assessed nearly 500 admissions to a psychiatric unit in Germany and found that positive symptoms are more useful in diagnosis.

Cromer 2003 = dopamine neurons play key role in attention, perception and thought.

Test retest reliability = repeating the test and making sure you get the same findings 


BIOCHEMICAL EXPLANATION OF SZ:
·         This is the most supported explanation of Sz.
·         Sz sufferers have high levels of dopamine binding
·         The drug LSD can imitate symptoms of Sz
·         Neurotransmitters DRD1, DRD2 have been linked to Sz.
·         Neurons send messages via electrical impulses over the synapse.
·         Neurotransmitters released fit onto dopamine receptors. The receptors are shaped specially to fit.
·         In Sz sufferers messages from neurons transmit dopamine fire too easily
·         Symptoms of Sz have been observed in Parkinson’s patients who took ‘levodopa’

EVALUATION OF BIOCHEMICAL:
+ supports idea dopamine plays key role, anti psychotic drugs block the activity of dopamine in the brain so they are dopamine antagonists. By reducing binding they eliminate symptoms such as hallucinations.
+Post mortem studies support biochemical explanation. Autopsies of patients with Sz revealed increase in dopamine in left dopamine receptor. This was confirmed with  PET scan.
  
-Mixed results of drug treatments, drugs that work on  dopamine do not benefit all Sz suffers E.G not very effective at treating negative symptoms (type 2)
-Clonazapine most effective drug in Sz treatment it works with serotonin and not dopamine
- We don’t know if dopamine is the cause or effect of Sz. However it wouldn’t explain LSD
Giving Sz like symptoms.


GENETIC EXPLANATION OF SZ:
The closer the biological link with a Sz suffer, the greater the link of  child or relative developing Sz.
KENDLER 1995 showed that 1st degree relatives are 18 x more at risk than general population.
Cousins = 2%, Siblings = 9%, Children = 13% = average risks for developing Sz = 1%
Kety 94(Copenhagen high risk study), Erlenmeyer kimling 97( new York high risk study) = LONGITUDINAL STUDIES BOTH  CARRIED OUT OVER 25 YEARS + = STRONG FAMILIAL LINK IN SZ

TWIN STUDIES:
Gottseman 1991 Meta analysis of 40 studies. Found 48% concordance rate for Mz twins and 17% for Dz twins, = large genetic component with environmental link.

Jospeh 2004 meta analysis concordance rate for identical twins = 40.4% and 7.4% for non identical twins.

EVALUATION OF META ANALYSIS:
+ gather large amount of data from meta analysis can infer cause and effect
+gives more weight to conclusions
-          Suffer from publication and cultural bias
-          May have reduced reliability as dissimilarities in methods used in studies.

ADOPTION STUDIES:
Finnish adoption study 2000 = 7% adopted children of mothers with Sz developed the disorder. Compared to 1.5% of the control group.
Danish adoption study = high rates of chronic Sz in adopted children of biological parents with Sz.

EVALUATION OF GENETIC EXPLANATION:
-         Family studies are often inconclusive because they are retrospective. Prospective longitudinal studies EG Copenhagen and NY provide better quality data
-         Difficult to isolate genetic factors as environmental factors also play a key role.
-         The fact Sz runs in families could be nurture and not nature
-         Scientists cannot find the specific gene that causes it
-         Genetic explanation been criticised for being reductionist
-         Adoption studies have advantage of separating environmental +genetic factors more clearly

NEURO ANATOMICAL EXPLANATIONS:
MRI studies E.G Brown 96, Flaum 95 show definite anatomical abnormalities in Sz patients especially those with negative symptoms. In the past structural differences had been noticed but all evidence is from post mortem studies.
Structural changes could be a consequence not a cause of Sz, MRI allows you to see brain of living Sz patient.
Such anatomical abnormalities have been found more often in patients with negative/chronic symptoms, supporting the division between Type I and Type II.
Szesko et al found that the ‘asymmetry’ found in normal brains in the prefrontal cortex is absent in people with schizophrenia.
However L researchers do not agree on which areas of the brain are affected.

·         DECREASED BRAIN WEIGHT
·         ENLARGED VENTRICLES
·         ABNORMALITIES IN FRONTAL CORTEX (SZESKO FOUND THIS)
VIRAL INFECTIONS AND SCHIZOPHRENIA:

Measles, scarlet fever, polio and influenza A contracted either during pregnancy or in early childhood have been suggested as explanations of Sz.
Jones and Cannon 98 = children who suffered viral infections are 5 times more likely to develop Sz.
Torrey 88 and 96 = If the mother suffers Type A flu between weeks 25 and 30 of pregnancy (phase of major brain development) the viral infection enters the brain of the foetus.  There it stays until activated at puberty (hpth 1) or cause a slow and gradual degeneration of the brain that eventually results in S (hpth 2)  
EVALUATION OF VIRAL:
L    Correlational data therefore may not establish cause and effect.
L    Obsolete diagnostic criteria.
L    Difficulty in isolating contributory factors in pregnancy.
J  Historically flu epidemics are linked with an increase in S cases.  L Not all researchers agree on this conclusion from evidence.


PSYCHOLOGICAL EXPLANATIONS FOR SZ:
Psychosocial factors:
  • Socio economics = Sz is more common among people with lower socio-economic status. Living in poorer conditions with financial worries brings a number of stressors that can trigger the onset of the condition.
  • Migrant populations. Migrants who move into a new environment are at higher risk. In the UK Sz is more frequent among African Caribbean groups. However this might reflect racial bias in diagnosis  
Family relationships
  • Double blind theory. Contradictory messages from parents may result in the development of schizophrenic symptoms such as flat effect and withdrawal. Conflicting messages from a parent prevent the development of a coherent model of reality. Families with high emotional tension have been described as ‘schizophrenogenic.’  
  • Expressed emotion a negative emotional climate at home has been linked to Sz. In particular high levels of expressed emotion (hostility, criticism but also over involvement)
LIFE EVENTS
A specific stressful life event, such as bereavement or divorce, can trigger a schizophrenic episode.
Brown and Birley reported that 50% of people experience a stressful life event in the 3 weeks before a schizophrenic episode (a control group of healthy people reported low levels of traumatic experiences).  The people they studied had previously experienced S and the stressful event caused a relapse.
However not all evidence supports the role of life events.  Van Os (94) reported no link between life events and the onset of S.  Also supporting evidence tends to be correlational.

COGNITIVE EXPLANATIONS
The disorganised and disordered thinking characteristic of S is the cause rather than the consequence of the disorder.
Attention deficit theory (Frith 79)
The mechanisms that operate in ‘normal’ brains to filter incoming information are defective in people with S.  They let in too much irrelevant information, because they are unable to select what is relevant. Frith tested the hpth and found that S sufferers have reduced cerebral blood flow in  certain areas of the brain (indicating reduced activity) during certain cognitive tasks.
Neuropsychological theories = Physiological abnormalities lead to cognitive malfunctioning:
        i.            Failure to activate schemas (Hemsley 93)
The main problem in S is the breakdown in the relationship    between stored information and new sensory input.  Schemas are knowledge packages in our memory built from experience that we use to make sense of reality and interpret new events.  Hemsley suggests that schemas are not activated in S.  This has been used to explain positive symptoms such as delusions and auditory hallucinations.
      ii.            Faulty cognitive processes (Frith 92)
This is an explanation of how some of the positive symptoms develop. 
A disconnection between frontal areas of the brain regulating action and posterior areas controlling perception causes a fault in a mechanism which he calls ‘meta-representation’.  This is what regulates cognitive processes that allow us to have goals and to pursue them and to understand the intentions of others.

Genetic links
Cognitive psychologists are trying to find out whether cognitive malfunctioning is hereditary.  There is some evidence that first degree relatives of S sufferers have various cognitive deficits such as working memory malfunctioning (Park 95) or an impaired auditory attention (Faraone 99).  These would be an indication of the presence of the gene that predisposes to S and even causes S.

EVALUATION.

 It is not clear why some members of the family with malfunctioning cognitive processes don’t develop the disorder.  It could be that it depends on the degree to which one has the gene(s) or on the presence of environmental triggers.

EVALUATION OF COGNITIVE EXPLANATIONS
L  Cognitive explanations describe S symptoms in terms of cognitive processes rather than finding the causes.  They may help however J to explain how such symptoms develop.
L    They need to be combined with biological factors such as genes or physiological abnormalities to give a full explanation.
L   Hemsley’s theory has little supporting evidence, although recently J the results of animal research offer some support.
L    Frith’s faulty processes theory has been criticised as reductionist, though it does offer a useful framework J  for explaining many of the symptoms of S.

THE PSYCHODYNAMIC EXPLANATION

Freud saw the distorted beliefs characteristic of SZ as the regression of the ego into a pre-ego state.  This may be caused by an excessively critical and uncaring mother (or parent).  The unrealistic picture of the world typical of SZ (e.g. delusions) is similar to that of early childhood.  The ego attempts to regain control are the cause of auditory hallucinations.

EVALUATION OF THE PSYCHODYNAMIC EXPLANATION

J  Later psychodynamic psychologists (such as Fromm-Reichmann) found that SZ sufferers do tend to have what they call ‘schizophrenogenic’ mothers.
J  Observational studies of how parents behave in the presence of their SZ children support the theory.  However L is such observed parental behaviour cause or effect?  We would need evidence that parents behaved coldly and uncaringly in the early stage of the child’s life for the Freudian explanation to be supported.
L  The theory has no scientific research support.
L  This explanation leads to parental blame.
L  Even Freud regarded his psychoanalytic theory as unsatisfactory to explain psychoses.

THERAPIES
BIOLOGICAL THERAPIES
DRUG THERAPY
Conventional antipsychotic drugs such as phenothiazines are dopamine antagonists - they reduce the amount of available dopamine or the number of dopamine receptor sites. By doing this they can stop hallucinations and delusions experienced by the patient. 
Among the serious side effects of conventional antipsychotic drugs are symptoms similar to those of Parkinson’s disease, as well as low blood pressure and blurred vision. Tardive dyskinesia is a serious condition probably caused by phenothiazines destroying parts of the brain. Around 30% of those taking phenothiazines develop tardive dyskinesia.

Atypical antipsychotic drugs such as clozapine work mainly by blocking serotonin receptors. Clozapine has been shown by research to be more effective than conventional antipsychotic drugs. The immune system can be damaged by prolonged use of clozapine.

One problem with long term drug therapies is that outpatients may stop taking them because of their side effects or simply because they forget. One way to overcoming this problem is to provide depot medication.  Depot injections release the drug slowly, so they only need to be given at intervals of a week or more.
Another promising strategy that has been introduced to help sufferers to carry on taking their prescribed drug therapy is motivational interviewing.  This non-coercive technique aims at making the patient feel that he/she is in control of the decision of following the therapy voluntarily.
ECT
Electroconvulsive Therapy has received some bad press as a result of what the treatment used to be. Yet "ECT has a higher success rate for severe
depression than any other form of treatment
." It has also been shown to be an effective form of treatment for certain types of schizophrenia (those accompanied by catatonia, extreme depression, mania and other affective components). In recent years there has been a resurgence of interest in ECT because it has evolved into a safe option.
ECT has a higher success rate on severe depression and certain cases of catatonic SZ than any other form of treatment.  Although its benefits in treating SZ are not as impressive as for depression, it can bring about a rapid cure in cases of alogia and catatonic unresponsivenessIt is particularly useful for people who suffer from psychotic depressions or other severe psychoses and cannot take medication due to problems of health or lack of response & pregnant women.
·         When a patient is intent on harming themselves or others, ECT is a good option because it works rapidly.  Suicide attempts are very rare after ECT.
·         Today the method is painless, & with modifications in technique it bears little relationship to the unmodified treatments of the 1940s.
·         Side effects:  short term memory loss.
·         In some cases, after the initial success, the patient relapses into the condition.
images[2]PSYCHOLOGICAL THERAPIES
CBT
People may have distorted beliefs and these make their behaviour maladaptive.  This is often the case with S.  The therapy aims at replacing disordered and delusional thoughts with thoughts that are more constructive and more in line with reality.  Patients are encouraged to find a rational explanation for the origin of their symptoms and evaluate the content of their beliefs.  They are also set behavioural tasks aimed at making their behaviour more adaptive.

J  A consistent body of research evidence has shown that CBT is effective in relieving both negative and positive symptoms of S.
J   Research shows that CBT has positive effects fairly soon into the treatment programme.
L   CBT is generally conducted on patients who also receive drug treatment.  Its effectiveness has therefore not been assessed independently.

FAMILY INTERVENTIONS
The type of communication within a family can cause S or contribute to a relapse.  This type of therapy programme involves other family members and aims at reducing level of negative expressed emotion within the family.  Key family members are trained to develop more effective and positive communication styles.  In the case of a patient being discharged form hospital, the family is trained prior to the patient’s returned at lowering expressed emotion levels and adjusting expectations.

EVALUATION. 
Pharoah’s meta-analysis study (2003) found that f.i. reduces the rates of both admissions to hospital and of relapse.  It also improves levels of compliance with drug therapy.  The outcomes of the therapy are however quite varied.  Also, it can really only be used with people who live with their family.
PSYCHODYNAMIC THERAPY
As the conflicts that have pushed the ego to regress to a pre-ego stage are largely unconscious, the AIM of the therapy is to bring them to the conscious mind where they can be dealt with.  The therapist tries to connect with the patients by offering help with the perceived problem. 
Freud was pessimistic about the appropriateness of psychoanalysis to treat psychoses in general.
However other forms of psychotherapy have been tried with some success.

EVALUATION.


 The findings of research into the effectiveness of psychodynamic treatments are contradictory.  Gottdiener carried out a meta-analysis which shows that 66% of patients receiving psychotherapy improved compared with 35% of the group that didn’t receive psychotherapy.  Within the psychotherapy group, psychoanalysis was as successful as CBT.  However there are some methodological issues with this study, as it spanned many years, so different diagnostic and methodological tools were used.