SZ EXPLANATIONS
- Created by: elliegmullins
- Created on: 12-05-14 17:55
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- EXPLANATIONS FOR SZ
- PSYCHOLOGICAL
- PSYCHODYNAMIC EXPLANATION - FREUD
- PARENTS COLD & UNCARING, person REGRESSES to earlier stage of development BEFORE EGO - may be DUE TO WORLD of SZ being PARTICULARLY HARSH
- LITTLE EVIDENCE - H/E PARENTS SHOWN TO BEHAVE DIFF - CONSEQUENCE OR CAUSE?
- REDUCTIONIST - CAN'T empirically TEST EGO - internal valid - genetic factors
- SZ seen as infantile state - result of attempts to ESTABLISH EGO CONTROL. Some symptoms .e.g dellusions of grandeur reflect PRIMITIVE CONDITION. ALL SYMPTOMS suggest PRODUCT of WEAK & CONFUSED EGO
- LACK OF RESEARCH SUPPORT - H/E claims of distorted family patterns as cause of sz - FROMM - REICHMANN - 'sz mothers' rejecting, overprotective as development factors - support
- SUPPORT from SUCCESS OF PSYC THERAPY - meta-analysis GOTTDIENER 37 studies, effective treat. support claim psy origins
- PARENTS COLD & UNCARING, person REGRESSES to earlier stage of development BEFORE EGO - may be DUE TO WORLD of SZ being PARTICULARLY HARSH
- SOCIO-CULTURAL FACTORS
- LIFE EVENTS - STRESSORS associated with higher RISK of sz EPISODES - BROWN & BIRLEY found prior to sz episode, patients reported TWICE as many STRESSFUL LIFE EVENTS compared to healthy control grp.
- LACK OF RESEARCH SUPPORT - VAS OS ET AL - NO LINK between sz & life events - retrospective part of study - patients not more likely to have had experience makor life event 3 months prior to sz episode. Prospective - major life event - lower relapse rates!
- CORRELATIONAL RESEARCH - NO CAUSE - May be that EARLY SYMPTOMS CAUSE OF MAJOR LIFE EVENTS - major life events in sz lifes - consequence
- FAMILY RELATIONSHIPS - DOUBLE-BLIND THEORY - BATESON ET AL - CHILDREN who RECIEVE CONTRADICTORY MESSAGES from parents more likely to develop sz. PREVENTS DEVELOPMENT OF INTERNALLY CONSISTENT CONSTRUCTION OF REALITY - can manifest itself as sz symptoms
- SUPPORT - TINARI et al adopted children who had sz bio parents more likely to develop sz but ONLY WHEN ADOPTED FAMILY RATED AS DISTURBED - ILLNESS MANIFESTED UNDER APPROPRIATE ENVIROMENTAL CONDITIONS
- double blind theory has MIXED SUPPORT - lack reliability - BERGER found sz reported higher double blind statements than non-sz h/w LIEM - no difference in patterns of parental communcation in families of sz's and nonsz's
- LIFE EVENTS - STRESSORS associated with higher RISK of sz EPISODES - BROWN & BIRLEY found prior to sz episode, patients reported TWICE as many STRESSFUL LIFE EVENTS compared to healthy control grp.
- PSYCHODYNAMIC EXPLANATION - FREUD
- BIOLOGICAL
- GENETIC FACTORS - TWIN & ADOPTION STUDIES
- TWIN STUDIES - JOSEPH, meta-analysis, CONCORDANCE RATE of 40% for mz, over 7% for dz. SUPPORTs bio exp.
- CONC rates may oncly REFLECT ENVIROMENTAL DIFFERENCES - JOSEPH - SZ treated similarly - experience more 'IDENTITY CONFUSION'
- Methodologically sound, recent studies - blind tech - reported lower conc rates for mz. h/w still higher than dz.
- ADOPTION STUDIES - TIENARI ET AL - bio mothers with sz, 6.7% adoptees developed sz, only 2% developed sz born to non-sz mothers. SUPPORTS BIO EXP.
- SELECTIVE PLACEMENT - adoptees know child born to sz - TREATED DIFFERENTLY - who would adopt them?
- METHODOLOGICAL PRBLMS - research only finding differences when children born to sz parents 'sz spectrum disorder' validity
- TWIN STUDIES - JOSEPH, meta-analysis, CONCORDANCE RATE of 40% for mz, over 7% for dz. SUPPORTs bio exp.
- DOPAMINE HYPOTHESIS
- MESSAGES from NEURONS that TRANSMIT DOPAMINE FIRE TOO EASILY/OFTEN leading to sz symptoms. SZ'S have ABNORMALLY HIGH numbers of D2 RECEPTORS, resulting in more dopamine neurons firing
- REDUCTIONIST - DOP ALONE DOES NOT CAUSE SZ - psyc factors (expressed emotion) influence development/ recovery. BIOLOGICAL VULNERABILITY. only develops in presence of sig stressors
- HIGH DOP LEVELS - CONSEQUENCE rather than cause. review POST-MORTEM studies (HARACZ) found elevated dop levels in those who received antipsychotics shortly before death - consequence of treatment
- EVIDENCE for DOP HYP - use of AMPHETAMINES - dopamine agonists, causing SYNAPSES to be FLOODED WITH DOPAMINE. LARGE DOES CAUSE HALLUCINATIONS - support - symptom of sz
- IF caused by solely dop - ANTIPSYCHOTICS should work for every1 - NOT CASE - cannot explain development of sz
- INCONCLUSIVE EVIDENCE from NEUROIMAGING. CHALLANGES DOP HYP - DEVELOPMENT OF PET SCANS - SHOWN NOW ALTERED DOP LEVELS IN SZ - COPOLOV & CROOK
- MESSAGES from NEURONS that TRANSMIT DOPAMINE FIRE TOO EASILY/OFTEN leading to sz symptoms. SZ'S have ABNORMALLY HIGH numbers of D2 RECEPTORS, resulting in more dopamine neurons firing
- GENETIC FACTORS - TWIN & ADOPTION STUDIES
- PSYCHOLOGICAL
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