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Summary Schizophrenia - AQA Psychology
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An in-depth description of schizophrenia written by an A star student who now tutors 14 students.
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SchizophreniaClassifying and Diagnosing Schizophrenia
VALIDITY AND RELIABILITY
Validity - Refers to how accurately something is measured.
Reliability - Refers to how consistent something is.
DIAGNOSING AND CLASSIFICATION
Diagnosing - completed by a trained professional. To diagnose a disorder is to identify an illness
through the presentation of symptoms.
Classification - in this context, classification refers to how schizophrenia is clarified in diagnostic
manuals (DSM, ICD etc). A classification outlines what symptoms should be expected with each
disorder.
COMORBIDITY
This term refers to the concept that two or more conditions occur together in the same person at the
same time.
Buckley (2009) found comorbidity rates of schizophrenia and depression (50%), post-traumatic stress
disorder (29%) and OCD (23%).
Additionally, substance abuse was also found to be high (47%)
CULTURAL BIAS IN THE DIAGNOSIS OF SCHIZOPHRENIA
Cochrane (1977) reported that the incidence of schizophrenia in the West Indies and Britain to be
similar at around 1 percent. However, Afro-Caribbean men are several times more likely to be
diagnosed with schizophrenia when living in Britain.
GENDER BIAS IN THE DIAGNOSIS OF SCHIZOPHRENIA
Longnecker et al (2010) reviewed studies of the incidences of schizophrenia and concluded that since
the 1980s males have been diagnosed with schizophrenia more often than women. Prior to the 1980s
this was not the case.
SYMPTOM OVERLAP
Given that schizophrenia could be argued as an amalgamation of other disorders, the reliability and
validity of clinicians diagnosing schizophrenia should also be questioned. Symptom overlap reduces
the validity of diagnoses.
SYMPTOM OVERLAP FOR SCHIZOPHRENIA AND BIPOLAR
The positive symptoms of schizophrenia can look like the symptoms in about 50% of manic episodes,
especially those with psychotic features. These can include delusions of grandeur, hallucinations,
disorganised speech, paranoia, etc. The negative symptoms of schizophrenia can closely resemble
the symptoms of a depressive episode. These include apathy, extreme emotional withdrawal, lack of
affect, low energy, social isolation, etc.
Genetic Evidence - Wray et al (2013) report that both illnesses are linked to a variation at four
chromosomal sites. They found that the overlap in heritability attributable to common genetic variation
was about 15 percent between schizophrenia and bipolar disorder, about 9 percent between
schizophrenia and depression, and about 3 percent between schizophrenia and autism
Neurochemical Evidence - the two disorders share abnormalities in some of the same
neurotransmitter systems. For example, both depressive episode symptoms and the negative
symptoms of schizophrenia are at least partially mediated by serotonin. Likewise, the positive
symptoms of schizophrenia and the symptoms of mania are mediated in some way by excesses of
, dopamine signalling. The atypical antipsychotics approved for both these disorders work on both the
serotonin and the dopamine systems
VALIDITY OF DIAGNOSIS - RESEARCH EVIDENCE
Rosenhan (1973) - The pseudopatients were not ill, yet they were incorrectly diagnosed as mostly
having schizophrenia.
Cochrane (1977) - Showed that culture can impact how accurately clinicians diagnose schizophrenia -
in this case, Afro-caribbean men were 7 times more likely to be diagnosed. This research can also be
used to evaluate the reliability of diagnosis.
DELUSIONS
A delusion is a belief that is clearly false and that indicates an abnormality in the affected person's
content of thought. They are difficult to hide as people truly believe them.
Erotomania - when someone is fixated on the idea that another person is intensely in love with them.
Grandiose - when someone sees themselves as great, highly accomplished, more important than
others or even magical.
Persecutory - they believe a person or group wants to hurt them. They believe either their thoughts
are being withdrawn by the government or their thoughts are being put inside their head by the
government.
EVALUATION
Reliability and validity of major classification manuals (DSM and ICD)
Reliability of different clinicians across different cultures and whilst examining different genders
Range of different symptoms (positive and negative) in patients suggests schizophrenia may not even
be a disorder in itself
This is further compounded by symptom overlap with other, more fully-understood disorders.
Psychological Explanations
FAMILY DYSFUNCTION
Factors within the family involved with the development of schizophrenia in adulthood:
1. High levels of interpersonal conflict
2. Poor communication, or difficulty in communication
3. Being overly critical and controlling of children
DOUBLE BIND THEORY - BATESON ET AL
Children who frequently receive contradictory messages from their parents are more likely to develop
schizophrenia. For example parents who say they care whilst appearing critical.
They did not believe that schizophrenia was a disease but that it was a result of social pressures from
life.
Prolonged exposure to these interactions led to symptoms like ‘flattened affect’ due to blocking off all
emotions so that they do not feel hurt by what happened to them
SCHIZOPHRENOGENIC MOTHER
A mother who is domineering, insensitive, controlling, overprotective as well as rejective and lacking
emotional warmth
This type of mother may micromanage their children and refuses to acknowledge their independence
which then leads to lines of faulty communication between her and her child.
EXPRESSED EMOTION THEORY
Expressed emotion is a family communication style that involves criticism, hostility and emotional
over-involvement. The researchers concluded that this is more important in maintaining schizophrenia
rather than causing it.
Patients that returned to a household with high expressed emotion were more likely to relapse than
patients returned to a low expressed emotion household.
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