Summary AQA A Level Psychology Schizophrenia Example Essay Plans
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Course
Schizophrenia
Institution
AQA
Book
AQA Psychology for A Level Year 2
Essay plans for AQA A Level Psychology, Schizophrenia. Will help students achieve high levels following the plan, particularly with the PEE(L) structure for AO3.
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1. Introduction into schizophrenia
AO1, Diagnosis and classification:
- Schizophrenia: severe mental disorder where contact with reality and insight are
impaired, examples of psychosis.
- Classification of mental disorder: process of organising symptoms into symptoms that
are clustered together. Two main forms; WHO’s ICD-10, American ICD-10;
classifications of schiz may be different.
- Positive symptoms: atypical symptoms in addition to normal experiences;
hallucinations/delusions.
- Hallucinations: sensory experiences that have no basis of reality, things that aren’t
there. (positive symptom)
- Delusions: involve beliefs that hold no basis in reality; believing that they are
something they are not. (positive symptom)
- Negative symptoms: usual experiences that are lost e.g. clear thinking or normal
levels of motivation. (positive symptom)
- Speech poverty: reduced frequency/quality of speech. (negative symptom).
- Avolition: loss of motivation for tasks, lower activity levels. (negative symptom)
- Comorbidity: presence of two or more disorders in one individual. May cause
questioning in the validity of classifying two disorders separately.
- Symptom overlap: when two or more conditions share symptoms, questioning the
validity of classifying the disorders separately.
AO1, issues in diagnosis and classification:
- Reliability: P: strength, consistency. E: Inter-rater reliability; reliable psychiatric
diagnosis when multiple clinicians reach the same conclusion. When the same
clinician reaches the same diagnosis for the same individual twice - test-retest
reliability. Reliability has increased since the DSM-5. E: diagnosis of schizophrenia
can consistently be applied.
- Low validity: P: limitation, diagnosis. E: assessing validity of psychiatric diagnosis can
be through criterion validity. Cheniaux et al found that 2 psychiatrists assessing the
same 100 clients under ICD-10 and DSM-4; 68 diagnosed with ICD, 39 under DSM.
E: shows that schizophrenia is either under or over diagnosed. Criterion validity is
low.
- CP: in the same study, there was agreement when using two measures to diagnose
from DSM; criterion validity could be good when using single diagnostic system
- Culture bias: P: limitation, diagnosis. E: different cultures may take symptoms
different e.g. afro-caribbean cultures see it as communication from ancestors. These
communities living in Britain are 10x more likely to receive diagnosis compared to
white British people. Likely due to different cultural backgrounds of psychiatrists.
Overinterpretation of symptoms of Black British people. E: Afro-Caribbean people
may be discriminated against by a culturally-biased system.
- Symptom overlap: P: limitation, diagnosis. E: severe overlap in symptoms of
schizophrenia and other conditions. E.g. schiz and BPD have similar pos/neg
symptoms, which may lead classification as variations of a single condition. May be
hard to distinguish. E: classification and diagnosis are flawed with the existence of
comorbidity.
2. Biological explanation for schizophrenia
AO1:
, - Genetic basis: risk of schizophrenia increases with genetic similarity e.g. Gotteman
(1991) 2% aunt, 48% MZ twin. Environment tends to be shared by family.
- Candidate genes: different combo of genes (polygenic). Ripke et al (2014) found 108
separate genetic variants in those with schizophrenia with 37000 people with 113000
controls. Findings; schizophrenia is aetiologically heterogeneous - different combos
of factors/genetic variations can cause it.
- Genetic mutation: no previous family history can be due to mutation of parental DNA
e.g. risk from 0.7% to 2% in fathers 50+ (Brown et al).
- Neural correlates: patterns of structure in the brain that occur in conjunction with
experience are implicated in origins of the experience.
AO3:
- STRENGTH: P: research support. E: Gottesman et al, genetic similarity increases
risk. Tiernari et al (2004) shows that biological children of those with disorder still
have heightened risk of it even in adoptive families. E: some are more vulnerable to it
due to genetic makeup.
- LIMITATION: environmental factors. E: biological factors as a result of environment
e.g. smoking THC cannabis in teenage years (Di Forti et al) and psychological
factors such as childhood trauma. Mørkved et al linked 67% people with disorders to
at least one childhood trauma compared to a matched group of 38% with non
psychotic mental disorders.
- Dopamine: neurotransmitter with excitatory effect, linked to sensation of pleasure.
The original DA hypothesis: High levels associated with schizophrenia in the
subcortex. (hyperdopaminergia). Found when antipsychotic drugs caused symptoms
similar to Parkinson’s disease. Excess DA in the subcortex can explain speech
poverty/hallucinations.
- Updated versions: high DA in subcortex and low DA in cortex explain negative
symptoms. DA levels are affected by genetic vulnerability and stress factors in
child/teen life (Howes et al).
AO3:
- STRENGTH: P: evidence for dopamine. E: amphetamines increase DA and worsen
symptoms of disorder, induce symptoms in those without (Curran et al). Antipsychotic
drugs that reduce DA levels reduce symptoms (Taucher et al). E: suggests
involvement of DA in schizophrenia.
- LIMITATION: P: central role of glutamate. E: post-mortem/live scanning. Raised
levels of glutamate (which should be controlled tightly) in brains of those with
schizophrenia (McCutcheon et al). Candidate genes of schiz are also linked to
glutamate production. E: An equally strong case can be made for other NTs.
3. Psychological explanations of schizophrenia
AO1:
- Family dysfunction: abnormal processes within a family that can lead to development
and maintenance of schizophrenia.
- Schizophrenogenic mother: Fromm-Reichmann (1948) - psychodynamic approach
where cold, rejecting and controlling mother leads to distrust/paranoid delusions.
1950/70s, idea that the mother has induced it.
- Double bind theory: Bateson et al - contradictory family communication. Not a cause,
just a risk factor.
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