Psychological: Cognitive Explanation of Schizophrenia (AQA A Level Psychology): Revision Note

Dysfunctional thought processing

• Dysfunctional thought processing (DTP) refers to how a person with schizophrenia understands, perceives and interprets the world (and other people) around them

  • An individual with schizophrenia may struggle to differentiate between the typical internal dialogue that most people experience (such as mentally reading words, rehearsing a to-do list, or daydreaming) and what they interpret as external voices directed at them, which they perceive as originating outside of themselves

• Dysfunctional thought processing, as suggested by Frith (1992), involves two mechanisms: metarepresentation and central control

• Metarepresentation involves

  • the ability to reflect on one’s thoughts and behaviours and to know what one’s intentions, goals and motivations are

  • the ability to interpret the behaviour of others and to understand that another person’s actions/thoughts are particular to that person and not to oneself, i.e., I am not that person; I am a separate and distinct individual

    • This representation is a type of Theory of Mind (TOM), and so to lack metarepresentation means to lack TOM

    • Frith (1992) claims that the lack of both TOM and metarepresentation can produce can produce the extreme paranoid delusions seen in schizophrenia

      • E.g., The FBI are out to get me; they’re watching me all the time

• Central control is the cognitive ability to suppress automatic responses while carrying out deliberate actions

  • People with schizophrenia may experience derailment of thoughts and speech because each word they produce triggers automatic associations which they cannot suppress

  • This explains disorganised speech and thought disorder - symptoms that metarepresentation alone cannot account for

Attentional biases

• Attentional bias refers to the tendency to pay attention to specific stimuli and to ignore other types of stimuli

• Someone who is suffering from a mental illness, for example, schizophrenia, may prioritise what they perceive to be threat- or danger-related stimuli over benign, harmless stimuli

  • E.g. my neighbour mows his lawn every Sunday, which means that he intends to kill me soon

• The perceived threat may not present any real danger or threat at all, but to a person with schizophrenia (particularly for individuals whose schizophrenia involves prominent paranoid delusions), the harmless actions of others may be viewed from a biased perspective involving misinterpretation of others’ actions and intentions

• The person with schizophrenia may be unable to exercise self-monitoring/management, i.e., they cannot use rational thought to reassure themselves that the threat is not real

• The person with may lack the ability to recognise benign stimuli and signs that the world is not an entirely dangerous place, which contributes to the positive symptom of delusion

Research which investigates cognitive explanations

• Scherzer et al. (2012) found that people with schizophrenia who experienced paranoid delusions and did not pass a ToM test were unable to distinguish between their mental state and that of others when compared to a normal control group

• Navalón et al. (2021) found that patients with schizophrenia displayed an attentional bias towards threatening scenes on video, showing a ‘late avoidance’ of sad scenes and increased attention to scenes containing threats

Evaluation of cognitive explanations of schizophrenia

Strengths 

• Schizophrenia is a condition that is marked by a misperception of reality, which means that cognitive explanations have good validity in their assumptions, i.e., hallucinations are the product of a distorted sense of what is real and what is fantasy

• The link between dysfunctional thought processing and TOM can be tested using standardised TOM false-belief tasks, which can be replicated to test for reliability

Limitations

• Cognitive explanations lack cause-and-effect conclusions:

  • Does schizophrenia cause dysfunctional thought processing, or does that dysfunctional thought processing lead to schizophrenia symptoms?  

• There may be issues with the validity of cognitive explanations, e.g., a person’s thought processing is likely to be highly subjective, regardless of whether they have schizophrenia or not

  • It is difficult to know how to judge and assess what is ‘dysfunctional’ or ‘biased’ when it comes to idiosyncratic cognitions

Issues & Debates

• The theory implies that schizophrenia symptoms are caused by automatic cognitive dysfunctions, which supports a deterministic view — individuals cannot easily control their thoughts or perceptions

  • This has implications for treatment and responsibility, as it suggests symptoms arise from underlying cognitive deficits, not from conscious choice