Cognitive explanation

• Cognitive Explanation


  Frith: the dopamine do not really explain the subjective experience of voice-hearing
• Frith's cognitive explanation


  • 1990: both positive and negative symptoms result from faulty information processing
  • Errors in self-monitoring
  • Difficulties with mentalising
  • Thinking errors and biases
• Patients fail to recognise that their perceived hallucinations are in fact just inner speech
• Patients attribute what they are hearing to someone else (a voice speaking to them from an external source)
• Errors in self-monitoring
• Experiment


  1. Participants listened to pre-recorded words

  2. Underwent fMRI brain scan
• Words


  • Spoken by the participant themselves
  • Spoken by someone else
  • Distorted
  • Undistorted
• Participants with schizophrenia who hear voices


  More likely to say their own words were spoken by someone else than people with or without schizophrenia who do not hear voices
• Brain activity was the same regardless of whether the voice of the speaker belonged to them or someone else, and whether the words were distorted or not
• Control participants


  Showed different brain activity across the 4 conditions, showing that they were aware of the differences between the voices
• Mentalising


  Understanding mental states and intentions of others
• Difficulties in mentalising


  In persecutory delusions/paranoia
• If people with schizophrenia have difficulties understanding mental states/intentions

  Neutral behavior may be misinterpreted as hostility
• Under-developed theory of mind


  People with schizophrenia believe that others have the same opinion of them as they have of themselves
• If a person with schizophrenia believes they are a bad person, they may believe that others also think the same
• Negative symptoms (e.g. social withdrawal)

  Result from the difficulties that people with schizophrenia have in the social world, which may be perceived as a dangerous and threatening place
• Beliefs, values and attitudes


  Shape how we think about our own thinking
• People from certain cultural backgrounds may find 'experience of influence' more distressing than others
• The stress that this generates may make their symptoms more difficult to bear
• In some cultures, the experience of voice hearing is not seen as a sign of illness; voice-hearers may be respected as healers and visionaries in the community
• Attitudes of other people in society

  Central to our wellbeing
• We modify our views about the world in the light of new evidence
• Abnormal beliefs may be formed and maintained if people fail to update their understanding based on new evidence
• People with schizophrenia


  • Draw conclusions based on insufficient evidence
  • Show a bias against counter-evidence - info that disconfirms their delusions
• Errors of judgment and biases explain why people with schizophrenia hold bizarre beliefs, even in the face of conflicting evidence
• Participants had to judge whether a jar mostly contained pink or mostly green beads


  Based on the color of beads taken one by one from the jar
• The beads were in two jars

  • One contained 85 pink and 15 green, the other 85 green and 15 pink
• People with schizophrenia


  Requested fewer beads to be removed before making their judgment than people without schizophrenia
• People with schizophrenia


  Were more likely to change their mind based on a single piece of evidence (e.g. following 4 green beads, they were more likely than controls to decide the jar contained 'more pink beads' as soon as one pink bead was drawn)
• Reductionism


  Overly reductionist approach
• Holism


  Taking a more holistic approach and examining interactions between biological, cognitive and social factors may provide a more comprehensive account
• Cognitive theories suggest that symptoms develop due to faulty thinking strategies, but do not explain why some people think in ways that are different to others
• Cognitive theories only provide a partial account of schizophrenia
• Cognitive theory


  Helps to explain individual differences in mental health by highlighting the differences in the ways people process info
• Cognitive theory cannot explain the episodic nature of schizophrenia - that people do not suffer from symptoms all the time, despite presumably processing information in the same way
• Situational factors


  • High levels of stress
  • Increase cognitive load to a point where they cannot cope
  • Triggers a psychotic breakdown
• Cognitive deficits


  Predispose people to psychotic breaks
• Precipitating factors


  Required for the symptoms of schizophrenia to actually manifest themselves
• Schizophrenia may be influenced by both individual and situational explanations
• Schizophrenia


  Best understood as the result of an interaction between genetic and environmental factors