Describe what scientists have found out about schizophrenia

Schizophrenia is a mental illness that affects approximately 1% of the population. Literally

meaning split mind, the DSM-IV outlines schizophrenia as: hearing voices, hallucinations,
delusions, disorganised or catatonic behaviour, and flattening of emotions. The symptoms must
be serious enough to cause a decline in social and occupational functioning, and must not be
accounted for by other medical factors. The main two categories of schizophrenia are catatonic
schizophrenia, which involves erratic motor activity, which can have them sitting in a corner
curled up for hours on end. The other form of schizophrenia is paranoid, which involves feelings
of extreme paranoia and anxiety, often accompanied by voices and hallucinations. Notable
cases of people suffering from schizophrenia include the mathematician John Nash, and Ronnie
Kray of the Kray twins, gangsters in London. Both were paranoid schizophrenics; Nash believed
he was an agent for the CIA fighting against Russia, while Krays symptoms manifested in
extreme and irrational violent outbursts.
The biological explanations for schizophrenia talk about neurotransmitters, genetics, and the
brain. The neurotransmitter theory proposed by Seeman states that schizophrenia is due to an
excess of dopamine in the brain. Gottesman and Shields proposed the genetic theory that
suggested one had a higher chance to develop schizophrenia if one of their relatives had the
illness, and the closer related the two were, the higher that chance would be they conducted
their research using monozygotic twins. Other biological hypotheses include suggestions that
schizophrenics have larger brain ventricles, and that the illness may be related to a virus
targeting infants that circulates in winter time. Treatments using the biological approach involve
giving the patient drugs that suppresses dopamine release or block dopamine receptors.
Electroconvulsive therapy is also sometimes used; a technique that involves passing a current
through two electrodes attached on opposite sides of the patients head and shocking the brain.
Behavioural explanations for schizophrenia include positive reinforcement and social learning.
Positive reinforcement states that as a schizophrenic displays unusual behaviour, they receive
attention, and it is this attention that they are seeking; being rewarded for their unusual
behaviour, the probability of recurrent behaviour increases, and the cycle repeats. The social
learning theory proposed by Bandura states that schizophrenics learn their behaviour from
witnessing others perform similar behaviour. The token economy is a treatment that uses the
behavioural approach; it consists of giving the patient some kind of currency - positive
reinforcers - whenever they show normal behaviour, and allowing the currency to be exchanged
later for goods such as food or clothes.
Frith presents a cognitive explanation for schizophrenia, that schizophrenics lack a theory of
mind, and cannot interpret the emotions and actions of others; this would explain why they are
so removed from reality. Frith also suggested that inner monologue would not be registered as
coming from the self in schizophrenics, thus leading to the belief that they are hearing voices.
Maher suggests that schizophrenia is caused by an inability to process information in the brain,
and Pickering suggests that the illness is caused by too much information bombarding the brain
at once. Cognitive behavioural therapy draws upon this approach to try and treat schizophrenia;

the therapist will talk with the patient, using methods such as distraction or imagery, in order to
alleviate the symptoms and disorder of the illness. Therapists will talk with patients to try and get
them to understand that their thoughts are not real, and give strategies on how to separate and
block out their hallucinations and voices.
Freud suggests that schizophrenia results from an imbalance between the super-ego and the id;
the ego tries to balance out this incompatibility, but fails. As a result, the ego reverts to its initial
state of infancy, causing child-like behaviour we sometimes see in schizophrenics. The Laingian
or family model states that schizophrenia is a result of an inability to make decisions in
childhood; a term coined a double bind. As the child is unable to make any meaningful impact
on their world through their actions, they believe that they are separated from reality as their
actions have no effect. Szaz states that schizophrenia is simply a reaction to a threatening and
disturbing world. When a traumatic event arises, such as getting fired or undergoing a divorce,
schizophrenic behaviour manifests as a reaction to a problem in living

Evaluate what scientists have found out about schizophrenia and include a discussion
about nature vs nurture
The genetic explanation has been supported by Gottesman and Shields experiments with
relatives experiencing schizophrenia. They reported a 48% concordance rate in monozygotic
twins that is, if one twin had schizophrenia, there was a 48% chance the other would have the
illness. However, these results also show that genetics cannot be the only thing influencing
schizophrenia; since monozygotic twins have identical DNA, if genetics was solely responsible
we would expect a 100% concordance rate. Moreover, the actual results from the experiment
were around 20%, much lower than the 48% reported, casting further doubt on the impact of
genetics in schizophrenia. However, it cannot be denied that genetics does seem to play a part;
20% is much higher than the 1% expected if genetics was not involved. The dopamine
hypothesis is backed up by studies done by Linstroem et al, in which schizophrenics and
controls were tested with L-DOPA, a substrate that is used to synthesise dopamine. By using
PET scans, they discovered that schizophrenics used up L-DOPA much faster than the controls,
suggesting increased dopamine production in schizophrenics. Another piece of evidence that
supports the dopamine hypothesis is the use of amphetamines, which cause excess dopamine
release in the brain, and cause users to show symptoms similar to those of schizophrenia.
However, the symptoms shown by these drug users could simply be due to the lack of sleep the
drugs induce in the user sleep deprivation will also cause hallucinations and hearing voices
and may not be related to dopamine.
The brain ventricle hypothesis is supported by brain scans taken of schizophrenics that show
enlarged brain ventricles; however this correlation is not necessarily causation, as the damage
may not be great enough to cause schizophrenia, and many schizophrenics show no sign of
brain damage. The virus hypothesis is supported by data gathered by Torrey, but once again,
the virus only increases susceptibility to schizophrenia, and may not be the cause.

All the biological theories are reductionist as they do not consider the effect of the environment
on the individual. While factors like genetics definitely play a part in schizophrenia, there is
undoubtedly evidence that the environment has an effect; many schizophrenics begin to show
symptoms after a traumatic experience such as violent abuse.
The drug treatments that are used to treat schizophrenia can have side-effects associated with
a lack of dopamine; Parkinsons-like symptoms and dystonia (muscle rigidity). There have been
many contemporary studies done on the effectiveness of antipsychotic drugs, most of which
show some beneficial effect on reducing schizophrenic behaviour; however much more
development in this area is needed to eliminate side-effects as much as possible.
Electroconvulsive therapy is becoming much less common nowadays, as the treatment itself is
very painful for the patient, raising the question of ethics - oftentimes it is the patients relatives
who allow for the treatment to be conducted, not the patient themselves. Regular trips to the
hospital over a long period of time are required, which are inconvenient and disrupt the life of
the patient; may also lead to a high attrition rate. Moreover, there is no scientific evidence or
explanation of the treatment being effective, so the legitimacy of the treatment is questionable.
Behavioural theories are very good for accounting for why schizophrenics behave how they do.
However, the theory does not explain why schizophrenics hear voices and hallucinate. It seems
unlikely that all schizophrenics would be lying about their hallucinations and voices simply to
attract attention, so there must be some other reason as to why they hear and see things, that
the behavioural approach does not account for. Moreover, the approach is reductionist as it
does not consider the predisposed tendencies of some people to be more susceptible to
schizophrenia.
The treatment of using a token economy has been shown to be moderately successful in
research. Gholipour conducted studies to show that schizophrenic behaviours were most
suppressed in patients participating in a token economy, as opposed to the exercise and control
groups. However, in reality there is a very high attrition rate for these programs, and there are
ways to cheat the system to negate the necessity of showing good behaviour. The token
economy must be set up carefully so the rewards are enticing enough for patients to participate,
but it must be difficult enough to earn rewards so that patients are reinforced to show continued
good behaviour. The whole economy is very fake and has little ecological validity, so there is the
issue of if patients will behave in the same way once reintroduced to society.
The cognitive explanations for schizophrenia are very good for explaining the causes of
catatonic schizophrenia, accounting for why catatonic behaviour occurs. Frith also noted that
schizophrenics had difficulty performing tasks such as naming a wide range of fruits, or listing
many different designs for something. This supports the theory that schizophrenics lack a theory
of mind and have difficulty processing data.
Freuds hypothesis of the ego reverting to infancy is good at explaining some symptoms of
schizophrenia - the disorganised speech and catatonic behaviour - but other schizophrenic
behaviours, such as feelings and grandeur and paranoia, cannot be said to be infant-like.

Freuds research into this is also purely theoretical, and not backed up by any solid scientific
evidence.
Cognitive behavioural therapy is quite effective treatment for schizophrenics, only if the full
course of the treatment is administered. Studies conducted by Bechdolf, Davis, and Ng, Hui &
Pau show increased quality of life, in particular self-esteem, after treatment with CBT. However,
the treatment is extremely expensive and requires regular appointments over a long period with
a specialist, taking up time and meaning the attrition rate is quite high; the effectiveness of the
treatment decreases dramatically if the course is not finished.
The nature vs nurture debate is supported largely by the biological approach on the nature side,
and the behavioural approach on the nurture side. Nature points to evidence such as
concordance rate in monozygotic twins and neurotransmitters to being the cause of
schizophrenia, while nurture uses ideas such as positive reinforcement, social learning, and
Szazs hypothesis of schizophrenia being a reaction to problems in living as evidence towards
the cause of schizophrenia. Both fail to fully explain the causes of the illness; the less-than100% concordance rate means genetics cannot be fully responsible, and the behavioural
approach fails to explain why people hallucinate and hear voices. However, the biological
approach seems to dominate when treating schizophrenia, as antipsychotic drugs are easy to
use and have been shown, at least in some studies, to be effective at treating symptoms. Thus,
although schizophrenia is undoubtedly caused by a combination of nature and nurture, the
current treatments predominantly focus on curing the nature side of the illness.