1. Lesson 15: Schizophrenia Psychological & Socio-Cultural
Factors

2. Lesson 14: Schizophrenia Biological Factors
Exam Question
2011 exam

3. Exam Question Answer

4. Lesson 15: Schizophrenia Psychological & Socio-Cultural
Factors
Outcomes
: Explain the psychological contributing factors: impaired mechanisms
for reasoning and memory; the use of psychotherapies in
management including cognitive behavioural and remediation
therapies, stress management
: Explain the social-cultural contributing factors; social disadvantage,
trauma and psycho-social stress as risk factors; psychoeducation,
supportive social (including family) environments, removal of social
stigma

5. Though we’ve made advances in treatment and some strides in
minimising stigma, people with schizophrenia still face little
empathy or even sympathy from others — in addition to the
devastating symptoms they deal with on a daily basis.
“Your daughter has schizophrenia,” I told
the woman.
“Oh, my God, anything but that,” she “My greatest fear is this brain
replied. “Why couldn’t she have leukemia of mine….The worst thing
or some other disease instead?” imaginable is to be terrified of
“But if she had leukemia she might die,” I one’s own mind, the very
pointed out. “Schizophrenia is a much matter that controls all that
more treatable disease.” we are and all that we do and
The woman looked sadly at me, then down feel.” (p. 2)
at the floor. She spoke softly. “I would still
prefer that my daughter had leukemia.”
A Look Inside the Mind of Schizophrenia
By MARGARITA TARTAKOVSKY, M.S.
http://psychcentral.com/blog/archives/2011/06/04/a-look-inside-the-mind-of-schizophrenia/

6. Psychological Contributing Factors
Impaired Reasoning Impaired Memory

7. Impaired Reasoning
Reasoning involves goal-directed thinking
When we engage in reasoning we use what we already know
to understand and interact with the present situation
There are many types of reasoning, however the type that is
found to influence schizophrenia sufferers is probabilistic
reasoning
Probabilistic reasoning involves making judgements related to
the probability of its occurrence
Linked with the development and persistence of delusions

8. Impaired Memory
Extensive research has shown individuals suffering from
schizophrenia usually have some degree of mental
impairment
This is consistent with the idea of schizophrenia being a
brain disorder
Aleman et el (1999) findings revealed memory impairment
to be wide-ranging with significant impairments of short-
term (working) memory and long-term memory. Severity,
time since diagnosis or age did not alter degree of memory
impairment.

9. Psychological Management
CBT - Cognitive Behavioural Therapy
Aims to change the thinking of patients, in particular - question there judgements
related to their delusions. Linked with probabilistic reasoning. Can also assist with
negative symptoms such as anhedonia by shifting ones thinking about the
enjoyment of an activity.
CRT - Cognitive Remediation Therapy
Focuses on improving cognitive functions - in particular, improve working memory,
language, problem-solving and attention by completing cognitive training tasks.
Stress management
Involves the use of various techniques to alleviate or cope with the effects of stress,
usually for the purpose of everyday functioning. Such techniques explored in stress
(biofeedback, mediation, physical exercise etc.) are also helpful for those suffering
from schizophrenia

10. Social Contributing Factors
Risk Factors Protective Factors
*Social Disadvantages *Psycho-education
*Trauma *Supportive Social
*Psycho-social Stress Environments
*Removal of Social
Stigma

11. Social Disadvantages
Involves the range of difficulties that block life opportunities and prevent people from participating
within society
Socio-economic status is commonly used to measure ones social stance
Social Causation Hypothesis suggests members of a lower socio-economic class can trigger the
development or onset of schizophrenia, one reason being they are exposed to higher levels of stress in
their environment.
Low Socio-economic Status
schizophrenia
(social disadvantage)
Social Drift Hypothesis (aka downward drift hypothesis) suggests low socio-economic status and
therefore social disadvantage is a result or consequence of schizophrenia. A person’s onset of
schizophrenia occurs first, resulting in their ‘drifting downward’ to the lowest socio-economic group.
Low Socio-economic Status
schizophrenia
(social disadvantage)
(Research supports both hypotheses)

12. Trauma
Trauma refers to an event that a person experiences, witnesses or
confronts that is extremely distressing and to which the person’s
response involves intense fear, helplessness or horror.
Many research studies have found a relationship between the
experience of trauma and development or onset of schizophrenia
Shevlin et el. (2008) found that participants that reported more
than one experience of trauma significantly increased the
likelihood of psychosis
This does not mean trauma causes schizophrenia!

13. Psycho-social Stress
Schizophrenia is not a stress-related disorder nor can
stress cause schizophrenia however research findings
suggest the family environment can pose a risk for the
development of schizophrenia.
Research is inconclusive if families with high expressed
emotion causes schizophrenia or if it is a response to living
with a person with schizophrenia

14. Protective Factors: Social Management
Supportive environments
Includes friends and family whom offer support, advice and understanding
to assist in the presence of stressors
Psycho-education
Educate people about the illness. Helpful for both patients and carers with
an understanding of what is characteristic of symptoms and how to
manage the experience
Removal of Social Stigma
Due to a grave misunderstanding of schizophrenia, a negative attitude
toward the illness has developed. This can have a negative impact on an
individual suffering from schizophrenia, making them feel even more
excluded from society. By removing the negative stigma, it encourages
understanding and acceptance of schizophrenia.

15. NB: This topic is next lesson however because we are watching a film it is covered here :)
BioPsychoSocial Approach

16. Vulnerability theory
Describes how biological, psychological and social factors interact
Four points
1. Susceptibility to the illness is biological
2. Different people have different levels of vulnerability
3. Susceptibility dependent on genetics and abnormalities
4. Psychological and socio-cultural factors can influence a person’s
vulnerability
Someone’s vulnerability, mixed with stress, can lead to
schizophrenia

17. Essential Learning Activities
Activity 1:
Youtube clip and table (see wiki)
Activity 2:
1) Draw or download two cartoon brains.
2) Label the brains to have one as 'feeling' brain and one 'logical' brain
Feeling brain - delusions heavily influenced by emotion - jumps to conclusions about delusion -
feels delusion is true
Logical brain - considers alternatives to delusion - weighs up the evidence - may not decide on
whether delusion real
3) Choose a situation from the list below and annotate the brains on how each will interpret
the situation
Helicopter flying over house
People whispering behind you
The power going off
Activity 3:
Create a concept map of the biopsychosocial model of schizophrenia