Individual differences explanation - cognitive approach

• In the first half of the 20th century, the psychodynamic approach dominated psychiatry. However, by the start of the 21st century the cognitive approach had superseded the 'unscientific work of Freud and his followers. This approach proposed explanations of schizophrenia that did not condemn the individual with schizophrenia or their family members.
• Instead, the cognitive approach offered logical explanations based on malfunctions in cognitive systems such as perception, attention and working memory. Although as yet this approach has been unable to offer on explanation that can account for all of the behaviours seen in individuals with schizophrenia, it has tackled some of the key positive and negative key symptoms.
• EXPLAINING HALLUCINATIONS

  Even though hallucinations are experienced by many with schizophrenia, it is estimated that between 2.5% and 4% of the general population have experienced hallucinations, most of whom are not diagnosed with a psychiatric problem (Claiborn, 2009).
• EXPLAINING HALLUCINATIONS

  Anthony Morrison (1998) proposed that triggers, such as sleep deprivation, can cause some individuals to hear voices in maladaptive ways. The individuals appraise these voices inappropriately as belonging to the devil, for example. This elicits behaviours such as social withdrawal or self-harm. 
• EXPLAINING HALLUCINATIONS

  The emotions that these behaviours produce, normally sadness and/or shame, reinforce the messages being offered by the critical voices, causing them to be perpetuated in a vicious circle.
• EXPLAINING NEGATIVE SYMPTOMS

  The cognitive approach has traditionally had more difficulty explaining the negative symptoms of schizophrenia than, for example, hallucinations. However, Aaron Beck et al. (2008) have drawn heavily from the idea of the cognitive triad, usually used to explain depression, to also offer a reasonable model of the negative symptoms seen in some individuals with schizophrenia.
• Beck et al. propose that the individual endorses dysfunctional beliefs about their performance and their ability to experience pleasure, they also hold a cynical and gloomy view of the future. Their mental filters only allow in negative messages and deficits in information processing bolster their pessimistic view. 
• These leads to the negative symptoms of schizophrenia such as flatness of affect, avolition (indifference to surroundings) and anhedonia (not reacting appropriately to pleasurable experiences).
• LACK OF PRECONSCIOUS FILTERS

  The psychologist Christopher Frith (1979) proposed that the core positive symptoms of schizophrenia could be explained by difficulties in inhibiting preconscious content. Normally, our senses receive a tremendous amount of Information from our environment, this information reaches our awareness and we interpret it (this is in our preconscious). 
• LACK OF PRECONSCIOUS FILTERS

  The 'best fit' of the incoming information gets propelled into our consciousness, allowing us to make sense of the information. Frith proposed that in some people the attentional filters that inhibit most of the sensory information from making it out of the preconscious are defective.
• Frith claims that this leads individuals with schizophrenia to 'become aware of ambiguous and multiple interpretations of events and find it difficult to select and carry through an appropriate course of action!.
• COMPROMISED THEORY OF MIND

  More recently, Frith (1992) proposed that individuals with schizophrenia are working with a compromised theory of one's own and others' minds. He believes that many of the symptoms seen In those with schizophrenia are the result of disorders within three separate cognitive systems:

  • The disorders of willed actions
  • Disorders of self-monitoring
  • Disorders of monitoring other people's and intentions
• The disorders of willed action (i.e. voluntary behaviour) can explain negative and disorganised symptoms of schizophrenia.
• Disorders of self-monitoring can explain symptoms such as delusions of alien control and vocal hallucinations.
• Disorders of monitoring other person's' thoughts and intentions, can lead to symptoms such as delusions of persecution.
• THE COGNITIVE TRIAD

  Beck believed that depressed people have a negative cognitive triad. This is where they have unrealistic thoughts about:

  • The self (I am a bad person).
  • The world (my life is terrible).
  • The future (things will not improve).

  The cognitive triad can be used to explain the development of negative symptoms that may lead to a diagnosis of schizophrenia - but they must be accompanied by some positive symptoms as well.