cognitive explanations

• The cognitive explanation of schizophrenia suggests the symptoms of schizophrenia are caused by dysfunctional mental processes such as dysfunctional attention and dysfunctional reasoning.
• Jumping to conclusions bias is when a person has a tendency to assume something about a particular situation, based on very little evidence. This is a type of dysfunctional reasoning.
• Persecution bias is when a person has a tendency to believe that they are being singled out and unfairly treated. This is a type of dysfunctional reasoning.
• Dysfunctional attention is when someone gets easily distracted and tends to over-focus their attention on irrelevant details.
• Dysfunctional attention causes patients to overfocus on irrelevant details and coincidences. This makes the coincidences feel more important than they really are. When the patient tries to explain why all these coincidences are happening, their explanation is irrational, because of their dysfunctional reasoning, causing a delusional belief.
• Due to dysfunctional attention, people overfocus on things that they imagine. Over focussing on imagined events causes the imagined events to begin to feel real. People with schizophrenia struggle to tell the difference between things that they imagine and things that have actually happened which causes hallucinations.
• Dysfunctional processes lead to negative symptoms of schizophrenia as patients start to become overwhelmed by their hallucinations or delusions and want to avoid their abnormal experiences so begin to isolate themselves from the outside world causing speech poverty and avolition
• Supporting evidence for cognitive explanation of schizophrenia. O'Carroll reviewed studies on people with schizophrenia and those who were at risk of developing schizophrenia and found dysfunctional mental processes may cause the symptoms of schizophrenia. This is positive as it suggests that the cognitive explanation of schizophrenia is credible.
• Cognitive explanation ignores biological factors. Gottesman and Shields found the concordance rate for MZ twins developing schizophrenia was 74% compared to 24% in DZ twins. Also, antipsychotics treat symptoms of schizophrenia by decreasing dopamine activity. This is problematic because the cognitive explanation is reductionist.
• CBT corrects the biases in reasoning that schizophrenics experience, such as jumping to conclusions bias and persecution bias. This helps to reduce the symptoms of schizophrenia, such as delusional beliefs.
• CBT aims to treat the dysfunctional thought processes that schizophrenics experience by challenging and correcting the biases in reasoning that cause symptoms of schizophrenia.
• In CBT, the patient will first describe their experiences and beliefs. Second, the doctor normalises the patient’s experiences. Next, the doctor challenges beliefs and experiences and then the patient is asked to develop alternative explanations for beliefs and experiences.
• Supporting evidence for effectiveness of CBT. NICE conducted a review of studies comparing the use of CBT combined with medical drugs, to medical drugs alone and found treatments with CBT were more effective at reducing symptoms of schizophrenia and reduced the likelihood of a patient relapsing. This is positive as it demonstrates that CBT is an effective treatment for schizophrenia. However, many studies failed to use random allocation or blinding and may have had confounding variables so the effectiveness of CBT may have been overexaggerated
• A limitation of CBT is availability and cost. CBT is an expensive and time-consuming treatment for schizophrenia as it requires multiple sessions. This is problematic as it is not the most efficient treatment for schizophrenia and antipsychotics may be a better alternative as they are less expensive to produce and easier to give to patients.