Cognitive Explanation of Schizophrenia

• The Cognitive Explanation of Schizophrenia: Dysfunctional Attention

  According to the cognitive explanation of schizophrenia, the symptoms of schizophrenia are caused by

  • dysfunction mental processes
  • dysfunctional reasoning
  • dysfunctional attention
• Jumping to Conclusion Bias

  tendency to assume something about a particular situation, based on very little evidence

  type of dysfunctional reasoning
• Persecution bias

  A tendency to believe that you are being singled out and unfairly treated

  type of dysfunctional bias
• how dysfunctional thought processes cause delusions

  1.  Dysfunctional attention causes patients to overfocus on small irrelevant details of real events and coincidences.
  2. the patient tries to explain why coincidences keep happening
  3. their dysfunctional reasoning makes their explanation irrational, causing a delusional belief.
• how dysfunctional processes cause hallucinations

  1. Due to dysfunctional attention, people overfocus on things that they imagine
  2. over focussing on imagined events causes the imagined events to begin to feel real.
  3.  People with schizophrenia struggle to tell the difference between things that they imagine and things that have actually happened.
• Dysfunctional Thought Processes Lead to Negative Symptoms

  1. patients become overwhelmed by abnormal experiences e.g hallucinations and delusions
  2. patients want to avoid their abnormal experiences, hallucinations or delusions.
  3. Patients isolate themselves from the outside world.
• Study Support for the Cognitive Explanation

  O'Carrell

  He reviewed studies on people with schizophrenia.

  He reviewed studies on people who were at risk of developing schizophrenia.

  FINDINGS-

  people who at risk of developing schizophrenia already showed dysfunctional mental processes

  showing dysfunctional mental process may have caused the symptoms
• Limitations of the Cognitive Explanation: Ignores Biological Factors

  • doesn't not account for the biological explanations of schizophrenia e.g. genetics + antipsychotics as a treatment
• Cognitive Treatments: Cognitive Behavioural Therapy

  • CBT aims to treat the dysfunctional thought processes that the patient is having.
  • CBT challenges and corrects the biases in reasoning that cause the symptoms of schizophrenia.

  step of CBT

  1. normalisation: doctor normalises the patient’s experiences.
  2. explanation: the patient describes their experiences and beliefs.
  3. challenges: the doctor challenges beliefs and experiences.
  4. alternative explanations: the patient is asked to develop alternative explanations for beliefs and experiences.
• Study Support for CBT

   NICE conducted a review of studies.

  NICE compared the use of CBT combined with medical drugs, to medical drugs alone

  FINDINGS-

  Treatments with CBT were found to reduce the likelihood of a patient relapsing and having to go back into hospital.

  Treatments with CBT were found to be more effective at reducing symptoms of schizophrenia.
• Limitations of CBT: Study Limitations

  found that CBT studies not well designed

  • Many studies failed to use random allocation or blinding.
  •  Studies may have suffered from confounding variables.
  • Researchers may have lacked objectivity

  Effectiveness on CBT might be overexaggerated

  Wykes at al

  did a better research design:

  • blind
  • random allocation
  • control groups

  found CBT to be less successful
• Limitations of CBT: Availability and Cost


  It requires lots of expensive sessions, which are usually one-to-one with a therapist.which limits the availability of the treatment.