1 2 3 4 5
Diagnosis Strength Limitation Limitation Limitation Limitation
and Good reliability Low criterion validity Co-morbidity Gender bias Culture bias
classification DSM low but improved Cheniaux et al. – 2 Single condition? 1980s – men more (1.4:1) Hearing voices – Afro-
Osario et al: 180 ppl, DSM-5, psychiatrists, 100 clients, Buckley et al. – 50% Cotton et al.: women closer Caribbean communication
pairs of interviewers, IRR ISM-10, DSM-4, 68 w ICD, 39 depression, 47% substance relationships, get support from ancestors
+0.97, TRR +0.92 w DSM abuse, 23% OCD, 29% PTSD ‘Function and cope’ better Pinto and Jones: A-Cs in UK
Appropriate treatment Over or under Women under-diagnosed 9x more likely but people in
BUT No treatment A-C countries not
Osario – good agreement w Overinterpretation of
2 DSM measures to symptoms
diagnose
Biological Strength Limitation Strength
explanations Research support Ignores environmental Genetic Counselling
for SZ: Gottesman: risk = genetic factors 1+ SZ parents = higher risk
genetic similarity w SZ family Morgan et al: birth Managing personal risk
explanations member complications factors, if they want
Tienari et al.: 164 bio. DiForti et al: smoking THC- Average figure of risk –
Children of SZ parents, 6.7% rich cannabis in asolescence vague, also environment
SZ vs 2% from 197 controls Psychological e.g. childhood Unethical – not necessarily
‘selectively placed’ trauma SZ
Hilker et al. – 33% MZ and Morkved et al. – 67% SZs
7% DZ had childhood trauma, 38%
of matched group w non-
psychotic mental health
problems
Biological Strength Limitation Limitation Limitation Strength
explanations Research support Glutamate Social sensitivity Biological reductionism Amphetamine psychosis
for SZ: neural Amphetamines increase DA, McCutcheon et al.: Post- Less accountable Ignores environmental Tenn et al.: reduced SZ-like
correlates worsen symptoms, cause SZ- mortem and live scanning: Lebowitz & Ahn: biological factors symptoms in rate w
like symptoms in those more glutamate in brain for explanations = less empathy Double bind and expressed amphetamines, less
without SZs from clinicians emotion – causes symptoms w drugs reducing
Tauscher et al.: Some candidate genes - Different, less than Yousef et al.: adverse DA
antipsychotics reduce DA involved in glutamate human, merits social childhood experiences = risk Depatie and Lal: drugs that
activity + symptom intensity production/processing exclusion Diathesis-stress increase DA e.g.
Some candidate genes act Dopamine incomplete Improper care and respect apomorphine doesn’t cause
on production of DA/DA symptoms
receptors Garson: amphetamine
, psychosis may not closely
mimic SZ
Psychological Strength Limitation Limitation Limitation
explanations Research support Poor research Social sensitivity Ignores biological factors
for SZ: family Indicators of family Childhood-based stress and Unethical parent-blaming Gottesman – 48% MZ, 17%
dysfunction dysfunction: insecure adult SZ linked Child’s struggle – lifelong DZ – genetic vulnerability
attachment, childhood But no support of traditional responsibility w caring for Antipsychotic drugs based
trauma esp. abuse family-based theories e.g. SZ them – held responsible on DA effective
Read et al.: 46 studies child mother, double bind 1980s hospital-centred care D-S
abuse and SZ, SZ adults Clinical observation of --> community-based care
more likely to be insecure patients and informal inc. parental support
esp. C/D assessment of personality of
69% SZ women, 59% men patients/mothers
history of physical and/or No systematic evidence
sexual abuse
Morkved et al.: most SZ
adults reported at least one
childhood trauma esp.
abuse
Vaughn and Leff: 48% high
EE family patients have
relapse than w low EE (6%)
Psychodynamic
Psychological Strength Strength Limitation Strength Limitation
explanations Research support Research support Proximal explanation Effectiveness of CBTp Psychological or biological?
for SZ: Stirling et al. – 30 people w Sarin and Wallin: reviewed What is happening now to To assess content of Cognitive: SZ is psychological
cognitive SZ, 30 control, cognitive research on cognitive biases, produce symptoms – not delusions/voices Toulopoulou et al.:
explanations tasks, Stroop (font colours of positive symptoms from distal/initial causes Validity of beliefs – thoughts Abnormal cognition genetic,
colour words) read words flawed cognitions Poss. Distal ex.s – genetic in manifestation of due to abnormal brain
aloud, SZs took over 2x avg SZs with delusions had and family dysfunction symptoms development
to name them biases in information Unclear, not well-addressed NICE 2014 – more effective
processes inc. jumping to how genetic than antipsychotics w
conclusions, lack of reality variation/childhood trauma lowering symptoms severity
testing might cause problems w + improving social
Hallucinations – less self- metarepresentation/central functioning – cognitions
monitoring, saw own control over bio. factors
thoughts as external voices Partial ex.
Biological Strength Limitation Limitation Limitation Strength
