Example Answers for Schizophrenia: A Level Psychology, Paper 3, June 2019 (AQA)

Here are some example answers to the two Paper 3 questions on Schizophrenia in the 2019 AQA exams.

Question 13

One reason is that a volunteer sample has been used and it is possible that the members of the self-help group with schizophrenia who volunteered had better language ability then most people with schizophrenia. This means it would not be appropriate to generalise the findings to all people with schizophrenia. This study could be modified by using a random sample of people diagnosed with schizophrenia, as this should produce a less biased and more representative sample, meaning that the findings could be generalised more widely.

Question 14

The interactionist approach considers the combined effects of biological, psychological and social factors on the development of schizophrenia. The most well-known is the diathesis-stress model which was first proposed by Meehl (1962) who suggested that the diathesis (vulnerability) was entirely genetic and the result of a single ‘schizogene’. He said that if a person did not have the gene, they would not be able to develop schizophrenia, regardless of much stress they were exposed to. However, if someone did have the gene, then chronic stress through childhood and adolescence, maybe as a result of having a ‘schizophrenogenic mother’, would trigger the gene and result in schizophrenia.

However, Meehl’s original model has been criticised for being too simplistic and has now been revised to account for the discovery that schizophrenia is a polygenetic condition and there is no single ‘schizogene’. It is also accepted that a range of factors can cause the predisposition or diathesis, and these include physical and psychological trauma that effect the developing brain. In addition, the range of stressors that can trigger schizophrenia has been widened to include cannabis use, as it appears to increase the risk of developing schizophrenia by up to 7 times. Evidence to support this comes from research by Brzustowicz et al. which found early trauma, defined as a threat to physical, emotional or sexual integrity at or younger than 19 years, was significantly associated with the expression of schizophrenia in families demonstrating genetic predisposition to schizophrenia.

Further evidence to support the interactionist approach to explaining schizophrenia comes from Tienari et al. who investigated the combination of genetic vulnerability and parenting style in children adopted from Finnish mothers with schizophrenia. The adoptive parents were assessed for child-rearing style and the rates of schizophrenia were compared to those in a control group of adoptees without any genetic risk. They found that a child rearing style with high levels of criticism and conflict and low levels of empathy appeared to be associated with developing schizophrenia but only for the children with high genetic risk. This supports the interactionist explanation that both genetic vulnerability and family-related stress are important in the development of schizophrenia.

The interactionist approach to treatment involves combining anti-psychotic medication (either typical or atypical) with a psychological therapy, most commonly CBT. The antipsychotic medication will reduce the activity of dopamine, while the CBT will help those with schizophrenia to identify negative thoughts and try to change them. This is standard practice in the UK, however in the USA it has been slower to be accepted. This is despite there being evidence to show that combining treatments is more effective than using them alone. For example, Tarrier et al. randomly allocated patients to either a medication plus CBT group, a medication plus supportive counselling group and a control group who just took medication. They found that patients in the two combination groups showed lower levels of symptoms than those in the control group, although there was no difference in hospital readmissions. This could be due to patients stopping their medication because of the side effects. This evidence suggests that taking an interactionist approach to treatment is beneficial and reduces suffering. However, the fact that combining treatment works does not necessarily mean that the interactionist approach is correct. Suggesting that it does could actually be an error known as the treatment causation fallacy.