Schizophrenia (Section A): biological, individual and social explanations of schizophrenia, and one therapy or intervention used to treat it.

What this dot point is asking

For schizophrenia you must give a biological, an individual, and a social explanation, and describe one therapy or intervention. Schizophrenia is a severe disorder with positive symptoms (hallucinations, delusions) and negative symptoms (flat affect, avolition), and the biological explanation is the strongest, so develop it carefully.

Biological explanation

This explanation has strong twin and drug-action evidence and underpins effective medication, but it is reductionist and deterministic, the genetic and dopamine evidence is correlational, and not everyone responds to dopamine-based drugs.

Individual explanation

The individual explanation focuses on the person's cognition and inner experience. Cognitive accounts argue schizophrenia involves faulty information processing and impaired attention and reality-monitoring, so the person misattributes inner speech as external voices (hallucinations) or forms delusions from biased reasoning. Psychodynamic ideas frame symptoms as regression to an early state. This explanation links to CBT for psychosis, but cognitive differences may be a consequence of the disorder as much as a cause.

Social explanation

The social explanation argues the social environment contributes to onset and relapse. Family dysfunction theories include high expressed emotion (a home environment high in criticism, hostility and over-involvement), which is associated with relapse. Social stress, urban living, social isolation and life events can act as triggers, often within a diathesis-stress framework where a biological vulnerability is set off by environmental stress. This explanation fits relapse and life-event evidence, but cause and effect are hard to separate, since the disorder can also disrupt family life.

Therapy or intervention

The main treatment is antipsychotic drugs: typical antipsychotics block D2 dopamine receptors and reduce positive symptoms, while atypical antipsychotics act more selectively with fewer movement side effects. CBT for psychosis helps the person challenge and cope with delusions and hallucinations and reduce distress, and family therapy lowers expressed emotion.

Examples in context

Example 1. Diathesis-stress in practice. A person with a genetic vulnerability who experiences a major stressor (such as leaving home for a high-pressure environment) develops symptoms, whereas a less vulnerable person does not. This shows biology and environment interacting.

Example 2. The dopamine evidence loop. Drugs that raise dopamine (such as amphetamines) can produce schizophrenia-like symptoms, while antipsychotics that lower dopamine reduce them, which is the core evidence for the dopamine hypothesis.

Try this

Q1. What does the dopamine hypothesis propose about schizophrenia? [1 mark]

• Cue. Excess dopamine activity (or too many or oversensitive receptors) is linked to the positive symptoms.

Q2. Outline the social explanation of schizophrenia. [3 marks]

• Cue. Family dysfunction such as high expressed emotion and social stress act as triggers, often within a diathesis-stress framework, and are linked to relapse.

Q3. Explain one strength and one weakness of antipsychotic drug therapy. [4 marks]

• Cue. Strength: effective at reducing positive symptoms and enables community living. Weakness: serious side effects, treats symptoms not causes, and high relapse on stopping.