Schizophrenia & the Biological Perspective

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Q. Does the Biological perspective in abnormal psychology make other perspectives obsolete? Answer with reference to one mental disorder of your choice. (35% of total module marks). Psychologists have been trying to understand mental illnesses, and many years ago, the biological perspective was the most popular due to its scientific nature. Schizophrenia – a chronic condition whereby patients lose touch with reality – was best explained by the Dopamine Hypothesis for example.

However, recent progression in Schizophrenia research emphasizes the importance of non-biological factors as well, such as environmental stressors. Thus a Diathesis-Stress model is generally accepted by many today. Schizophrenia is seen as a disease caused by the over-activity of dopamine receptors in the mesolimbic pathway i. e. the Dopamine Hypothesis (Richard Hall, 1998). This consequently increases the levels of dopamine in our brains, said to cause hallucinations and delusions in patients.

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To prove this, amphetamines (drugs that increase dopamine levels in the brain) were administered to rats in small dosages Randrup et al. (1966), which produced rotational behaviour – said to be associated with hallucinations. PET brain scans further showed that dopamine levels had infact increased. The main critism facing the conclusions of such studies is that humans and animals have different physiology. This thus limits generalisability. However, similar investigations have been carried out on humans, despite ethical concerns, but yielding consistent results.

Anti-psychotic drugs – most effective being Clozapine – were created, so as to reduce dopamine levels. These have shown to be highly effective in calming patients down and helping them cope with the illness, especially concerning hallucinations and delusions. However, there is a lot more to the disorder i. e. social withdrawal, apathy, alogia and inability to communicate emotion through voice and facial expressions – all of which are symptoms that are not affected by the drug in any way. This suggests that there is more to the disease than just increased levels of dopamine.

Before disregarding the Biological perspective however, it is essential to consider that glutamate, serotonin and GABA (Gamma – Amino Butyric Acid) , other neurotransmitters found in the brain, have been suggested to also have an affect in the development of mental illnesses, but evidence is limited. The Biological perspective also takes into consideration the view that there could be a predisposition to schizophrenia. In fact, Alastair (2000) provides evidence for this idea via his meta-analysis of twin studies conducted in the UK and Japan since 1995.

He found that the concordance rate (CR) for schizophrenia between Monozygotic (MZ) twins is 41-65%, whereas, that for Dizygotic (DZ) twins is 0-28%. Similar research has been conducted globally, ensuring that these conclusions are generalisable. However, some Psychologists argue against this saying that because twins share the same pre-natal and (sometimes) post-natal environments; this is what is really causing schizophrenia, not genes. Furthermore, it is often questioned that if MZ twins share 100% of the same genes, then they should have a much higher CR than 65%.

Despite, these arguments, a predisposition to schizophrenia is still evident. Most Psychologists do believe that there is a predisposition to schizophrenia and that environmental stressors trigger its development. This is known as the Diathesis Stress Model, whereby both perspectives are seen to equally contribute in understanding schizophrenia and other mental health issues. Environmental stressors come in many forms, for example poverty, racial discrimination, communication with families, stereotyping by individuals in society and the use of drugs – all of which are expanded on in the following few paragraphs.

Firstly, the Sociogenic Hypothesis explains how poor socio-economic conditions create stress that may trigger schizophrenia in people. Usually such individuals have to deal with poverty at a daily basis and they live in urban areas – known for the high levels of pollution and noise. Alternatively, the “downward drift” theory contradicts this, stating that individuals with schizophrenia move lower down in the socio-economic scale. Dohrenwend et al. (1994) investigated both opposing theories. The rates of schizophrenia were examined in 3 ethnic minorities in Israel – European, North African and Middle Eastern.

They experienced a considerable amount of discrimination and social prejudice – a form of stress – that should lead to the movement of these individuals down the social ladder. However, this was not the case. More accepted today is the “social drift” theory, but the influence of the social environment should not be ignored. For example, the prevalence of Schizophrenia in Africans from the Caribbean, which is their native country, was much lower compared to those who had immigrated to London (Hutchinson et al. 1996). This may well have been caused by the difficulties of assimilating into a new culture.

Furthermore, family related factors can also be significant in the development of Schizophrenia. Bateson et al. (1956) claimed that children who receive contradictory messages from their parents may develop schizophrenia in the future, due to the stress it causes – known as the Double Bind Theory. If for example, a mother tells her son that she loves him, yet at the same time turns her head away in disgust, a child may become confused i. e. verbal and non-verbal communication doesn’t match. To support this theory, Bateson carried out a study in 1965, which involved asking questions to schizophrenic patients.

This was so as to encourage recall of double-bind statements by their mothers. Schizophrenics scored higher in this recall test compared to participants in the control group, showing that indeed this may be a contributing factor in the development of the disease. It however, lacked validity because patient’s memory could have been affected by their schizophrenia. Therefore, the Double Bind theory is not exactly seen as plausible in psychological literature. Despite this, it should not be entirely neglected, as Bowlby’s research shows its significance.

Popular research such as Bowlby’s maternal deprivation hypothesis emphasizes on the importance of a loving, sustainable attachment between mother and child during the critical stage (i. e. the first 2 years of a child’s life). This is so as to avoid a lower intelligence, increased aggressive behaviour, affectionless psychopathology, delinquency and depression in adulthood. His theories are not only well known today, but also have gained a vast amount of support by research conducted on this issue – Bowlby’s (1994) study on 44 juvenile thieves is an example of this.

Hence, in general, parent-child relationship must be maintained in a positive manner, so as to avoid any chance of mental illnesses developing especially depression and schizophrenia. In addition, the “Expressed Emotion” (EE) theory illustrates how relapse of schizophrenia may occur once patients are dismissed from hospitals and integrated into family. The use of critical comments, hostility and overemotional involvement when interacting with the schizophrenic patient in the family may cause stress. Brown et al. (1966) conducted a 9-month follow-up longitudinal study of schizophrenic patients.

He found that 10% of patients returning to low-EE homes relapsed compared to 58% of those returning to high- EE homes. This once again emphasizes the importance of positive family relationships. The use of drugs such as Cannabis allows individuals to experience short-term hallucinations and paranoia i. e. psychosis. A widely publicized review in 2007 stated that there is a 40% risk of developing schizophrenia with prolonged use. Although this may be quite low, to avoid any chances of getting mentally ill, such drugs should be avoided at all costs.

Perspectives of Behaviourists such as Scheff (1966) have argued that Schizophrenia is as a result of the self-fulfilling prophecy. Basically, when a child shows some form of deviant behaviour i. e. not considered “normal”, society may label them as Schizophrenic, including Psychiatrists if taken to them for analysis. According to Corrigan (2007), they eventually begin to self-stigmatize, as soon as they believe that they are sick. They categorise themselves negatively as “us” the mentally ill and “them” normal people.

Over time, these individuals may in fact develop the illness. It has been an on-going debate whether psychologists should tell potential patients that they have Schizophrenia or keep it a secret, just so as to increase their chances for recovery. However, this encourages unethical practise and is avoided. Instead, elimination of self-stigmatisation is included in psychotherapy (Kroska and Harkness, 2006), which proves its significance in schizophrenia development – despite the limited available support for these theories.

Although, Rosenhan’s (1973) study does show how easily individuals in society can be labelled despite portraying only limited deviant behaviours. Plus, the distress caused to the pseudo-patients proved that if they stayed any longer perhaps mental health issues could have arose. Moving on to the views of Cognitive psychologists; Firth’s (1979) attention deficit theory evolves around the idea that Schizophrenia is as a result of the inability to filter out irrelevant information – individuals basically focus on everything that is going on around them.

This may cause confusion and as result lead to disordered speech, delusions and auditory hallucinations – all symptoms of Schizophrenia. Bentall (1994) goes on to say that such individuals are biased towards paying attention to and processing threatening stimuli, which leads to paranoid delusions – most common form of delusions amongst Schizophrenics. Goldberg’s (1993) study involved twins, whereby one of them was affected by schizophrenia and the other was not. Those who weren’t schizophrenic scored 80-95% higher on cognitive tests than their twin.

This means that schizophrenics possess weak cognitive abilities, hence indirectly supporting Firth’s theory. Many however have argued that it is unclear whether schizophrenia could have caused this lack of attention rather than the other way around. In addition, he did not explain how these defects occur, hence bringing out strength in the Biological causes, as it offers a more clear explanation to the reasons why positive symptoms emerge i. e. due to increase in dopamine levels.

To conclude, it is evident that there are several perspectives of mental health issues, all of which are equally important as discussed in this essay. This means that the Biological perspective does not make other ones obsolete. Schizophrenia research is on-going and many more views of the illness may come about in the future. Society has to be open-minded and be able to be accepting of them all, so as to give all suffering patients today, the best shot at recovery from any mental illness.

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