Let's Discuss - Frith's Cognitive Explanation of Schizophrenia
(*Please
Note - I have diversified my work on Excelling Psychology into
different blogs for better organization of content. I am continually
working on the same, so these sites will be updated with more content
soon.
CIE IGCSE Psychology learners may be interested in the following:
Model Answers on the following blog:
https://psychologymodelanswers.blogspot.com
References of studies for answer writing in a highly organized, detailed format:
https://psychologyreferencesummaries.blogspot.com)
References of studies for answer writing in a highly organized, detailed format:
https://psychologyreferencesummaries.blogspot.com)
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No amount of exam-related discussion can help you unless you have a complete understanding of the topic to begin with. If you need an easy and thorough explanation of Frith's Cognitive Explanation of Schizophrenia, do visit my site.Section I - FAQs
In this section, I'll look at some of the most expressed doubts from students when I teach them the topic in question, in order of the frequency these questions are asked. Let's begin-
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Q.1. There are too many subtopics to remember in this study - nature, types, phases, etc. How do I avoid being confused between these?
Ans.If you read the study carefully and thoroughly, you will realize that there is absolutely no overlap between these different topics.
The phases
The phases
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Q.2. The synopsis on the site is too long to write in a single answer. I am very confused what to include, and what not. Isn't it better to learn from one-paragraph synopses?
There are two parts to this question, so let me answer accordingly.
(1) The synopsis I have provided on my site are for the learner to understand the study, not as a final answer that can be copy-pasted into the paper. The CIE examination is certainly not about rote learning. There are two reasons for a huge number of candidates failing the exam as I mention time and again - the first is a lack of understanding of the material, the other is failing to show one's own knowledge in the paper, and this is connected to the first.
Simply put, you are expected to put into simple words, the explanation of the topic asked into the paper. This is not possible unless you have understood the material thoroughly, and I have already posted as a proof, the coverage expected from the actual mark scheme of the paper.
A related concern is that students believe that the lesser they have to read, the better they will remember. Do read my previous post, to understand why this is a very poor belief system.
(2) Let's consider with evidence what one-paragraph synopsis can do for the student.
First, take a look at what is considered a 'good' 6-mark answer as per the Cambridge Psychology Example Candidate's Booklet.
The answer credited 'good,' and given its due full marks, certainly does not have a coverage of one paragraph. On the contrary, it covers a diverse range of points that matches the expected answer as outlined in the mark scheme.
Students unfortunately believe that length matters. Actually, length and coverage go hand-in-hand, and coverage does matter - the most. It's up to you to decide now, if one-paragraph synopses provide adequate coverage.
There is one more very important point to discuss here - that of the so-called 'textbook.' A CIE recommended guide book used across schools covers the Frith study in a mere two sentences. It's a no-brainer that so much information is not sufficient to even answer 2 and 4 marks section in the paper. The book is certainly not at fault here, for it claims to be a guide that provides support to the student, and that is exactly what it does.
The bottomline is that the student needs to distinguish between answer-writing material, and material for review.
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There are two parts to this question, so let me answer accordingly.
(1) The synopsis I have provided on my site are for the learner to understand the study, not as a final answer that can be copy-pasted into the paper. The CIE examination is certainly not about rote learning. There are two reasons for a huge number of candidates failing the exam as I mention time and again - the first is a lack of understanding of the material, the other is failing to show one's own knowledge in the paper, and this is connected to the first.
Simply put, you are expected to put into simple words, the explanation of the topic asked into the paper. This is not possible unless you have understood the material thoroughly, and I have already posted as a proof, the coverage expected from the actual mark scheme of the paper.
A related concern is that students believe that the lesser they have to read, the better they will remember. Do read my previous post, to understand why this is a very poor belief system.
(2) Let's consider with evidence what one-paragraph synopsis can do for the student.
First, take a look at what is considered a 'good' 6-mark answer as per the Cambridge Psychology Example Candidate's Booklet.
The answer credited 'good,' and given its due full marks, certainly does not have a coverage of one paragraph. On the contrary, it covers a diverse range of points that matches the expected answer as outlined in the mark scheme.
Students unfortunately believe that length matters. Actually, length and coverage go hand-in-hand, and coverage does matter - the most. It's up to you to decide now, if one-paragraph synopses provide adequate coverage.
There is one more very important point to discuss here - that of the so-called 'textbook.' A CIE recommended guide book used across schools covers the Frith study in a mere two sentences. It's a no-brainer that so much information is not sufficient to even answer 2 and 4 marks section in the paper. The book is certainly not at fault here, for it claims to be a guide that provides support to the student, and that is exactly what it does.
The bottomline is that the student needs to distinguish between answer-writing material, and material for review.
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Q.3. Do I need to remember which cognitive explanations are correlated to which specific symptoms as stated by Frith?
This question is a proof of the need for practice of answer-writing over mere reading of study material. To answer the question directly - no, you need not remember the specific explanation behind every symptom. However, for a good answer, you need to be able to provide examples of symptoms relevant to Frith's explanations. You will see this more clearly in the next section, where I provide specimen answers. For now, keep in mind that when you practice answer-writing, you are able to do the following:
Do look at the next section do get an idea of how you can prepare your answers.
This question is a proof of the need for practice of answer-writing over mere reading of study material. To answer the question directly - no, you need not remember the specific explanation behind every symptom. However, for a good answer, you need to be able to provide examples of symptoms relevant to Frith's explanations. You will see this more clearly in the next section, where I provide specimen answers. For now, keep in mind that when you practice answer-writing, you are able to do the following:
- Prepare answers from research papers that include only those sections that are relevant to the syllabus
- Use previous mark schemes to know whether your coverage is adequate
- Prepare material for review that is actually useful to answer-writing
- Build confidence in your ability to answer the paper
Do look at the next section do get an idea of how you can prepare your answers.
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Section II - Specimen Answers
Let's look at how some questions from this study can be dealt with. I'll be following the CIE 9990 pattern here.
PAPER 3
Q 1 (a). What did Frith mean by the 'cognitive explanation of schizophrenia? [2]
This is a direct, 2-mark question that must be answered absolutely to-the-point. You can refer to the introduction of section 2 on my site for the relevant study material.
Specimen Answer. Frith attempted to explain the signs and symptoms of schizophrenia in terms of the underlying cognitive processes that are affected due to the disorder. Frith believed that cognitive processes do not cause schizophrenia, but are the basis of the different positive and negative symptoms seen in the disorder.
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Q 1(b). Describe the cognitive explanation of schizophrenia, as outlined by Frith (1992). [4] (*included in the specimen paper of the 9990 syllabus)
Though this question seems be identical to the previous, it has two major distinctions. First, it demands more coverage, because it has been given more weightage in terms of marks. Second, if we look at the glossary of command words provided by the CIE, a 'what' questions demands precise meaning while a 'describe' question demands the main features of the concept to be stated.
Keeping this in mind, let us look at a specimen answer. (You can refer to section 2 and diagram 5.4 on my site for the relevant study material) :
Specimen Answer. Frith attempted to explain the signs and symptoms of schizophrenia in terms of the underlying cognitive processes that are affected due to the disorder.
He found that the following faulty cognitive processes play a role in the development of schizophrenia:
(1) Failure of metarepresentation of one's own intentions - People with schizophrenia can fail to understand why they are performing tasks, which leads to a difficulty of monitoring themselves. Consequently, they show hallucinatory symptoms like auditory and verbal hallucinations.
(2) Failure of metarepresentation of others' intentions - People with schizophrenia can also fail to understand why others are performing certain actions, especially towards them which leads to a problem in other-monitoring. This results in delusions related to persecution, reference, etc.
(3) Failure of metarepresentation of goals - People with schizophrenia can fail to see the purpose of an activity, which results in a poverty of will.This causes them to show symptoms such as poverty of action and inappropriate action.
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Q1. (c) Discuss one strength and one weakness of the cognitive explanation of schizophrenia. [6]
This answer requires an evaluation of the study, which comes from the application of issues and debates to what the learner has learnt from the study. Also, since this is a 6-marks answer, the issues and debates chosen should be noted in detail. 'Discuss' in the syllabus corresponds to giving arguments for and against a topic, converging into a conclusion.
Let's take a look:
Specimen Answer. Cognitive explanations provide useful insight into how thoughts and beliefs of individuals contribute to abnormality.
A strength of the cognitive explanation of schizophrenia is as follows:
Accounts for the role of the individual - A cognitive explanation of schizophrenia tells us why some people develop schizophrenia and not others, even if both have a biological disposition for the same. For example, if two people have a moderate genetic probability of developing schizophrenia, one might develop the disorder while the other might not. This is because one might have developed a problem with metarepresentation - the representation of the intentions of oneself, others and one's goals - as described by Frith (1992), while the other might have not. Such individual differences can help us better predict who will develop schizophrenia, and take early preventive measures.
Cognitive explanations also have weaknesses, such as the following:
May not be causes but effects in reality - It is difficult to establish whether cognitive issues in schizophrenia cause the disorder, or are a result of the disorder. For example, we know from various studies that people with schizophrenia show problems related to willed action, self-monitoring and other-monitoring. However, what we cannot establish is whether these factors have preceded or succeeded the disorder. Since people with schizophrenia have genes that predispose them for the abnormality right from birth, it is difficult to ascertain how much of the disorder is stemming from biological factors, and how much from cognitive factors.
We can thus conclude from the above consideration of strengths and weaknesses of cognitive explanations that though these explanations have tremendous value in understanding how symptoms of abnormality develop, which thereby aids their treatment; they cannot be looked upon as standalone factors that can explain the entire course of an abnormality. They can rather, be used along with other explanations to give us a complete picture of abnormality.
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Q 1(b). Identify two advantages of the cognitive explanation of schizophrenia. [4]
Let us look at the command word, 'identify.'
The learner is expected to characterize i.e. give only succinct explanations when it comes to these type of questions. Though the learner need not refer to specific issues and debates since it is not an 'Evaluate' question, we can for our own purposes refer to issues and debates during preparation of such answers.
Specimen Answer. The cognitive explanation of schizophrenia has contributed to our understanding of the disorder, its major merits being the following:
1) It contributes to our understanding of different symptoms of schizophrenia - The genetic and biological explanations indicates why the disorder develops. However, the cognitive explanation tells us how a variety of negative and positive symptoms develop in the disorder. For example, according to Frith (1992), hallucinations are a product of the patient's inability to monitor his own intentions while delusions are the result of the patient's inability to monitor the intentions of others.
2) It contributes to the development of cognitive therapy of schizophrenia which can alleviate the symptoms of schizophrenia - Every patient of schizophrenia cannot and need not be subject to intrusive surgical procedures for the treatment of the disorder. The cognitive explanation can help develop techniques that can improve the condition of the patient. For example, in Frith's (1992) scheme, disorganized speech is the result of the patient's inability to monitor himself. Therefore, an intervention which can help patient's be reminded of their intentions, like simply asking them frequently of their aim of speech, can help alleviate this symptom.
Thus, the cognitive explanation of schizophrenia has greatly contributed to research and application of the disorder.
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Q1. (c) Describe two problems with trying to find a single explanation for an abnormality.
Specimen Answer. Here, the student has a variety of answers at his disposal. It is important, however, that though the question is stated in generic terms, the answer must be associated with the ongoing topic. Keeping this in mind, a sample answer is:
Psychological abnormalities involve a diverse set of symptoms and emerge from a dynamic combination of underlying causes. Therefore, it is unlikely that a single factor can explain a complete disorder. Two problems that can arise if such a factor is identified are:
1] Partial Explanation (Reductionism) - The single explanation may not explain everything about the disorder, but only some aspects of it. For example, Frith (1992) recognized that a single cognitive explanation like metarepresentation can only explain why the symptoms of schizophrenia occur, but not why the disoder develops in the first place. That is better explained by studying biological factors.
2] Difficulty in Treatment - If only a single factor is accepted as the explanation of a disorder, then useful benefits that can be derived from other explanations in the treatment of the disorder may be overlooked. For example, when only the biological explanations of schizophrenia were investigated, cognitive explanations were completely overlooked. Biological treatments could be harmful to patients. Therefore in cases that are not very severe, cognitive treatment like CBT could be used to at least alleviate the symptoms of schizophrenia, than not giving any treatment at all.
Thus, it is best to look for a variety of explanations for an abnormality rather than concentrating on a single explanation.
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Q1. (d) Discuss the evidence suggesting that schizophrenia is caused due to excessive dopamine. You should consider both sides of the argument and include a conclusion. [5]
I have intentionally selected this question to avoid a repetition of questions, and to present how one topic is used to act as evidence in another. Keeping with the present topic, I include only the section that makes use of the cognitive explanation of schizophrenia.
Specimen Answer. ..............................................
The following explanations suggest that schizophrenia is not caused by excessive dopamine alone:
Frith's Cognitive Explanation of Schizophrenia - Frith (1992) suggested that different problems with metarepresentation, including problems with representation of one's own intentions, problems with representation of others' intentions and problems with representation of the goals of activities leads to different symptoms of schizophrenia. According to this view, the biological explanation of excess dopamine is not sufficient to explain why particular symptoms of schizophrenia develop.
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Q. 5 (a) Design a longitudinal study to investigate the cognitive explanation of schizophrenia. [10]
Specimen Answer. I would conduct a longitudinal study right from childhood into the adulthood of children diagnosed with schizophrenia as detailed below:
Aim - To investigate the cognitive explanation of schizophrenia i.e. to investigate whether the cognitive abilities of people with schizophrenia visibly deteriorate as the symptoms their disorder progress.
Sample - 30 or more children diagnosed with any type schizophrenia of either gender. I would contact a mental instituition and request for my study to be conducted with children in the schizophrenia ward there. The sample for my study would be children of five years or more.
Procedure and Data Analyses - I would test the children for willed actions, self-monitoring and other-monitoring by testing them after every academic year that they complete up till they are of age 18. Thus, I would test them after age 5, age 6... upto age 18 i.e. a total of 14 tests to see the growth or decline in their cognitive performance with age. I would use the following tests to measure the aforementioned cognitive factors:
'Willed' Action - I would give participants a verbal fluency task to investigate their potential in generating 'willed' actions. An example of this task is:
"In the next five minutes, I want you to generate as many words as you can from the category 'food.'"
I would assess the words they generate based on their meaningfulness, relevance and repetition.
Self-Monitoring - I would give participants puzzles like the jigsaw, simple crossword, Tower of Hanoi or some other which requires long-span of attention.
I would assess their performance by checking how appropriately and for how much duration they were able to perform the task without engaging in irrelevant behaviours.
Other-Monitoring - I would give the participant a task to perform that would require him to co-ordinate with another person. For example, I would ask him to do some simple task like arranging furniture in a room with the other.
I would assess the participant's performance by asking him to evaluate the other's performance at the end of the task.
Since this is a longitudinal study, I would use similar tasks on every year of the performance, but upgrade the difficulty of the task as per the development the participant has shown till that year.
Results and Conclusion - I would compare the performance of the participants year after year, graphing out their mean performance on the different tasks across several years, and noting the trend in performance - whether upward or downward, and the intensity of fluctuation. I would then conclude whether or not cognitive performance of the participants actually deteriorates as their disorder progresses, which would serve as evidence for or against the cognitive explanation of schizophrenia.
I would use my knowledge that symptoms of schizophrenia intensify as the affected people age, and use this to correlate it with their performance on tasks measuring cognitive abilities.
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Q 5. (b) Explain the psychological and methodological evidence on which your study is based. [8]
Therefore, in an 'Explain' question, the student is expected to clarify his use of design, while linking relevant sections of the study as examples to justify his/her answer.
Looking at the question, the psychological evidence the student is expected to present is from the research study of the relevant topic. The methodological evidence is the justification of the design used.
In the specific question asked above, the psychological evidence pertains to the cognitive explanation of schizophrenia as outlined by Frith. The methodological evidence is the use of a longitudinal study - the sample, the procedure, etc. that the student has chosen for the same.
A specimen answer for this part is:
Specimen Answer.
Frith proposed that the single underlying cause of the symptoms of schizophrenia is a problem with the cognitive component of metarepresentation -- which is the complete and accurate mental representation of reality. Accordingly, he proposed that there are three main failures of metarepresentation that compound the problem of schizophrenia. In the design of my study in the previous part of the answer, I have attempted to investigate these three different failures through different activities as follows:
Failure of Metarepresentation of Goals - A failure to understand one's own purpose of carrying out activities leads to a deficiency of the will to perform activities. I have attempted to investigate this issue with the help of a word-generation task which gives the participant minimum instructions of performance, thereby requiring him to complete the task using his independent will power which comes from keeping the goal of the task in mind.
Failure of Metarepresentation of One's Own Intentions - A failure to understand one's own motives in performing an activity leads to a failure of the ability to monitor one's own performance. Therefore, a task like a time-demanding puzzle can need the participant's attention over a long period of time, and require him to monitor his own behaviour over this time.
Failure of Metarepresentation of Others' Intentions - A failure to understand others' motives leads to a failure to monitor others, and thereby perform activities in co-ordination with them. Thus, I have presented a task requiring co-operation, and a small interview at the end to check if the participant had any doubts on the other's intentions, or difficulty in performing with them.
Further, since the study is longitudinal in nature, I have taken the following measures to maintain methodological precision:
1) Sample - I have chosen a sample of children, since schizophrenia develops in intensity from childhood to adulthood. I have chosen children from a psychiatric ward for easy availability. To assure that the children can perform the tasks like puzzles, they are required to be 5 years or more in age.
2) Procedure - I have chosen simple tasks to be performed which are not very challenging for the participants with schizophrenia who may have language and comprehension issues. I have also chosen the difficulty to be increased every year so that the performance of the participant is not made easy by being beneath the level of his development. Also, since the participant is already being treated by psychiatrists, it is expected that this can slow down the decline otherwise expected as the disorder progresses.
3) Results - I have chosen a comparison of performance of participants across years since the expected trend is that the performance of participants will deteriorate steadily as the disorder intensifies. Similarly if there is improvement due to treatment that the participants are receiving, performance should improve. These trends can be observed from long-term comparison.
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I ask students to keep this diagram in front of them and orally elaborate on each point to make sure they are ready for the paper. Do try this exercise for yourself.
I'll cover the evaluation for the cognitive explanation and possible study designs and their evaluations in a post to come.
Specimen Answer. Frith attempted to explain the signs and symptoms of schizophrenia in terms of the underlying cognitive processes that are affected due to the disorder. Frith believed that cognitive processes do not cause schizophrenia, but are the basis of the different positive and negative symptoms seen in the disorder.
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Q 1(b). Describe the cognitive explanation of schizophrenia, as outlined by Frith (1992). [4] (*included in the specimen paper of the 9990 syllabus)
Though this question seems be identical to the previous, it has two major distinctions. First, it demands more coverage, because it has been given more weightage in terms of marks. Second, if we look at the glossary of command words provided by the CIE, a 'what' questions demands precise meaning while a 'describe' question demands the main features of the concept to be stated.
Keeping this in mind, let us look at a specimen answer. (You can refer to section 2 and diagram 5.4 on my site for the relevant study material) :
Specimen Answer. Frith attempted to explain the signs and symptoms of schizophrenia in terms of the underlying cognitive processes that are affected due to the disorder.
He found that the following faulty cognitive processes play a role in the development of schizophrenia:
(1) Failure of metarepresentation of one's own intentions - People with schizophrenia can fail to understand why they are performing tasks, which leads to a difficulty of monitoring themselves. Consequently, they show hallucinatory symptoms like auditory and verbal hallucinations.
(2) Failure of metarepresentation of others' intentions - People with schizophrenia can also fail to understand why others are performing certain actions, especially towards them which leads to a problem in other-monitoring. This results in delusions related to persecution, reference, etc.
(3) Failure of metarepresentation of goals - People with schizophrenia can fail to see the purpose of an activity, which results in a poverty of will.This causes them to show symptoms such as poverty of action and inappropriate action.
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Q1. (c) Discuss one strength and one weakness of the cognitive explanation of schizophrenia. [6]
This answer requires an evaluation of the study, which comes from the application of issues and debates to what the learner has learnt from the study. Also, since this is a 6-marks answer, the issues and debates chosen should be noted in detail. 'Discuss' in the syllabus corresponds to giving arguments for and against a topic, converging into a conclusion.
Let's take a look:
Specimen Answer. Cognitive explanations provide useful insight into how thoughts and beliefs of individuals contribute to abnormality.
A strength of the cognitive explanation of schizophrenia is as follows:
Accounts for the role of the individual - A cognitive explanation of schizophrenia tells us why some people develop schizophrenia and not others, even if both have a biological disposition for the same. For example, if two people have a moderate genetic probability of developing schizophrenia, one might develop the disorder while the other might not. This is because one might have developed a problem with metarepresentation - the representation of the intentions of oneself, others and one's goals - as described by Frith (1992), while the other might have not. Such individual differences can help us better predict who will develop schizophrenia, and take early preventive measures.
Cognitive explanations also have weaknesses, such as the following:
May not be causes but effects in reality - It is difficult to establish whether cognitive issues in schizophrenia cause the disorder, or are a result of the disorder. For example, we know from various studies that people with schizophrenia show problems related to willed action, self-monitoring and other-monitoring. However, what we cannot establish is whether these factors have preceded or succeeded the disorder. Since people with schizophrenia have genes that predispose them for the abnormality right from birth, it is difficult to ascertain how much of the disorder is stemming from biological factors, and how much from cognitive factors.
We can thus conclude from the above consideration of strengths and weaknesses of cognitive explanations that though these explanations have tremendous value in understanding how symptoms of abnormality develop, which thereby aids their treatment; they cannot be looked upon as standalone factors that can explain the entire course of an abnormality. They can rather, be used along with other explanations to give us a complete picture of abnormality.
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Q 2 (a). Describe explanations of schizophrenia and delusional disorder. [8]
This is perhaps the most challenging question in paper 3 since it requires that the student discuss 3-4 subtopics in the syllabus for a total of only eight marks. It requires that every topic be given due yet extremely precise coverage, which requires good practice. It also has the advantage, though, that such a question is highly predictable and the student can be confident while practicing it.
First, let us look at the expansion of the command term 'describe':
We should focus on providing main features here, which should suffice for the 2-3 marks this study holds in the overall answer. In the following specimen answer, I cover only the part relevant to the present study.
Specimen Answer.
...........................................................
Cognitive Explanation of Schizophrenia -
Frith attempted to explain the signs and symptoms of schizophrenia in terms of the underlying cognitive processes that are affected due to the disorder. He proposed that a failure of metarepresentation i.e. with the mental representation of reality was the single cognitive explanation for the disorder. This failure is of three types - pertaining to one's own intentions, the intentions of others, and goals of activities. These three different failures contribute to different positive and negative symptoms of the disorder respectively.
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Q 2 (b). Evaluate the cognitive explanation of schizophrenia, including a discussion of usefulness of different psychological explanations. [10]
Let us first look at what kind of an answer is expected in response to 'evaluate.'
In this question, we are expected to outline issues and debates relevant to the cognitive explanation, and use them to judge whether the cognitive evaluation is important to the study of schizophrenia. This should be done systematically.
Also, it is good to consider both strengths and weaknesses of a given topic to present a balanced view on the topic, rather than a biased one. This question is like an extension of the previous, and since it has more weightage, we can aim to give two points of strength and two points of weakness.
A common mistake that students commit here is that they just list out a number of issues and debates without elaborating upon any. Remember. your understanding must be reflected in your answers which can only be done through explanations.
Lastly, the mentioned issue or debate - in this case, usefulness of different explanations - must be given most attention in the answer.
Specimen Answer. Cognitive explanations provide useful insight into how thoughts and beliefs of individuals contribute to abnormality.
Some strengths of the cognitive explanation of schizophrenia are as follows:
1. Accounts for the role of the individual - A cognitive explanation of schizophrenia tells us why some people develop schizophrenia and not others, even if both have a biological disposition for the same. For example, if two people have a moderate genetic probability of developing schizophrenia, one might develop the disorder while the other might not. This is because one might have developed a problem with metarepresentation - the representation of the intentions of oneself, others and one's goals - as described by Frith (1992), while the other might have not. Such individual differences can help us better predict who will develop schizophrenia, and take early preventive measures.
(This point uses the issue of individual differences)
2. Accounts for delayed development of abnormality - Though some individuals might possess genes for a disorder like schizophrenia, not all of them develop the disorder right from their childhood. Also, many explanations like psychoanalytic explanations look at traumatic events in early life that may have caused abnormality. These explanations do not account for people who develop abnormality in adolescence or adulthood. Cognitive explanations can suggest why such late development might occur. For example, a person with genetic predisposition for schizophrenia might have had a smooth childhood, but faced severe stress like a financial crisis in adulthood. His cognitive response to this situation may have affected the performance his higher cognitive abilities, like the functioning of his supervisory attentional system as proposed by Frith. Thus, he may have developed the symptoms of the disorder in later years.
(This point uses the issue of nature v/s nurture)
Some weaknesses of cognitive explations are as follows:
1. Overlook the role of genetics, social environment, culture, etc. - Cognitive explanations are not comprehensive. They fail to account for other factors that come together to present a complete picture of a disorder. For example, in the case of schizophrenia Frith mentions that cognitive explanations can only explain the symptoms of schizophrenia, not why the disorder develops. Two people might both have problems with metarepresentation, but only the person with a genetic predisposition for schizophrenia may develop the abnormality.
(This point uses the issue of reductionism)
2. May not be causes but effects in reality - It is difficult to establish whether cognitive issues in abnormality cause the disorder, or are a result of the disorder. For example, we know from various studies that people with schizophrenia show problems related to willed action, self-monitoring and other-monitoring. However, what we cannot establish is whether these factors have preceded or succeeded the disorder. Since people with schizophrenia have genes that predispose them for the abnormality right from birth, it is difficult to ascertain how much of the disorder is stemming from biological factors, and how much from cognitive factors.
(This point uses the issue of determinism)
There are several other explanations of schizophrenia besides the cognitive explanation. Their usefulness can be evaluated briefly as follows:
- The genetic explanation (Gottesman and Shields, 1972) is useful to identify as early as possible, the people at risk for schizophrenia which aids prevention of the disorder. However, it is limited in that it cannot explain cases that are purely a product of the environment, or why certain predisposed cases do not fully develop into schizophrenia.
- The biochemical explanation which includes the dopamine hypothesis gives specific causes for the development of schizophrenia in some people of our population. This very specific explanation helps in the development of medication against dopamine that can reduce the severity of the disorder, and aid prevention of the disorder in those genetically predisposed to it. However, this explanation does not explain why different symptoms are seen in different cases of schizophrenia, or why the disorder develops with more or less intensity in different people, which lends to its reductionist nature.
- The cognitive explanation by Frith (1992) explains why different symptoms of schizophrenia occur, which can help target specific symptoms and intervene for their improvement in a non-intrusive manner. This can help people with schizophrenia live with greater independence. However, this explanation is limited that it does not explain why schizophrenia develops in the first place, and thus, cannot be used to treat the disorder completely.
We can thus conclude from the above consideration of strengths and weaknesses of cognitive explanations that though these explanations have tremendous value in understanding how symptoms of abnormality develop, which thereby aids their treatment; they cannot be looked upon as standalone factors that can explain the entire course of an abnormality. They can rather be used along with other explanations to give us a complete picture of abnormality.
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PAPER 4
Q 1(a). Frith proposed that metarepresentation is the single underlying cognitive factor that can explain the varied features of schizophrenia. In order to explain the concept of metarepresentation, he wrote:
(The relevant section for this answer is section 5.1 on my site.)
"While thinking what to write at this point, I have been staring straight out of the window. In front of me are many trees. When I become conscious of this activity, what I become conscious of is "me looking at trees". This is the critical feature of conscious awareness."
Explain how metarepresentation is illustrated in this example. [2]
Ans. An answer to this question requires two steps:
-Explaining what metarepresentation is
-Connecting the explanation to the example given
Let's take a look at the command word 'give':
This type of a question clearly does not demand an explanation, but a factual and precise answer.
On these lines, a sample answer would be:
"Metarepresentation is the conscious awareness of one's own activities. In the given illustration, the author gives an example of 'me looking at trees.' In this case, if a person represents the trees in his mind, that is only representation. If, however, he represents himself looking at trees, then it is metarepresentation."
This is perhaps the most challenging question in paper 3 since it requires that the student discuss 3-4 subtopics in the syllabus for a total of only eight marks. It requires that every topic be given due yet extremely precise coverage, which requires good practice. It also has the advantage, though, that such a question is highly predictable and the student can be confident while practicing it.
First, let us look at the expansion of the command term 'describe':
We should focus on providing main features here, which should suffice for the 2-3 marks this study holds in the overall answer. In the following specimen answer, I cover only the part relevant to the present study.
Specimen Answer.
...........................................................
Cognitive Explanation of Schizophrenia -
Frith attempted to explain the signs and symptoms of schizophrenia in terms of the underlying cognitive processes that are affected due to the disorder. He proposed that a failure of metarepresentation i.e. with the mental representation of reality was the single cognitive explanation for the disorder. This failure is of three types - pertaining to one's own intentions, the intentions of others, and goals of activities. These three different failures contribute to different positive and negative symptoms of the disorder respectively.
....................................................................................
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Q 2 (b). Evaluate the cognitive explanation of schizophrenia, including a discussion of usefulness of different psychological explanations. [10]
Let us first look at what kind of an answer is expected in response to 'evaluate.'
In this question, we are expected to outline issues and debates relevant to the cognitive explanation, and use them to judge whether the cognitive evaluation is important to the study of schizophrenia. This should be done systematically.
Also, it is good to consider both strengths and weaknesses of a given topic to present a balanced view on the topic, rather than a biased one. This question is like an extension of the previous, and since it has more weightage, we can aim to give two points of strength and two points of weakness.
A common mistake that students commit here is that they just list out a number of issues and debates without elaborating upon any. Remember. your understanding must be reflected in your answers which can only be done through explanations.
Lastly, the mentioned issue or debate - in this case, usefulness of different explanations - must be given most attention in the answer.
Specimen Answer. Cognitive explanations provide useful insight into how thoughts and beliefs of individuals contribute to abnormality.
Some strengths of the cognitive explanation of schizophrenia are as follows:
1. Accounts for the role of the individual - A cognitive explanation of schizophrenia tells us why some people develop schizophrenia and not others, even if both have a biological disposition for the same. For example, if two people have a moderate genetic probability of developing schizophrenia, one might develop the disorder while the other might not. This is because one might have developed a problem with metarepresentation - the representation of the intentions of oneself, others and one's goals - as described by Frith (1992), while the other might have not. Such individual differences can help us better predict who will develop schizophrenia, and take early preventive measures.
(This point uses the issue of individual differences)
2. Accounts for delayed development of abnormality - Though some individuals might possess genes for a disorder like schizophrenia, not all of them develop the disorder right from their childhood. Also, many explanations like psychoanalytic explanations look at traumatic events in early life that may have caused abnormality. These explanations do not account for people who develop abnormality in adolescence or adulthood. Cognitive explanations can suggest why such late development might occur. For example, a person with genetic predisposition for schizophrenia might have had a smooth childhood, but faced severe stress like a financial crisis in adulthood. His cognitive response to this situation may have affected the performance his higher cognitive abilities, like the functioning of his supervisory attentional system as proposed by Frith. Thus, he may have developed the symptoms of the disorder in later years.
(This point uses the issue of nature v/s nurture)
Some weaknesses of cognitive explations are as follows:
1. Overlook the role of genetics, social environment, culture, etc. - Cognitive explanations are not comprehensive. They fail to account for other factors that come together to present a complete picture of a disorder. For example, in the case of schizophrenia Frith mentions that cognitive explanations can only explain the symptoms of schizophrenia, not why the disorder develops. Two people might both have problems with metarepresentation, but only the person with a genetic predisposition for schizophrenia may develop the abnormality.
(This point uses the issue of reductionism)
2. May not be causes but effects in reality - It is difficult to establish whether cognitive issues in abnormality cause the disorder, or are a result of the disorder. For example, we know from various studies that people with schizophrenia show problems related to willed action, self-monitoring and other-monitoring. However, what we cannot establish is whether these factors have preceded or succeeded the disorder. Since people with schizophrenia have genes that predispose them for the abnormality right from birth, it is difficult to ascertain how much of the disorder is stemming from biological factors, and how much from cognitive factors.
(This point uses the issue of determinism)
There are several other explanations of schizophrenia besides the cognitive explanation. Their usefulness can be evaluated briefly as follows:
- The genetic explanation (Gottesman and Shields, 1972) is useful to identify as early as possible, the people at risk for schizophrenia which aids prevention of the disorder. However, it is limited in that it cannot explain cases that are purely a product of the environment, or why certain predisposed cases do not fully develop into schizophrenia.
- The biochemical explanation which includes the dopamine hypothesis gives specific causes for the development of schizophrenia in some people of our population. This very specific explanation helps in the development of medication against dopamine that can reduce the severity of the disorder, and aid prevention of the disorder in those genetically predisposed to it. However, this explanation does not explain why different symptoms are seen in different cases of schizophrenia, or why the disorder develops with more or less intensity in different people, which lends to its reductionist nature.
- The cognitive explanation by Frith (1992) explains why different symptoms of schizophrenia occur, which can help target specific symptoms and intervene for their improvement in a non-intrusive manner. This can help people with schizophrenia live with greater independence. However, this explanation is limited that it does not explain why schizophrenia develops in the first place, and thus, cannot be used to treat the disorder completely.
We can thus conclude from the above consideration of strengths and weaknesses of cognitive explanations that though these explanations have tremendous value in understanding how symptoms of abnormality develop, which thereby aids their treatment; they cannot be looked upon as standalone factors that can explain the entire course of an abnormality. They can rather be used along with other explanations to give us a complete picture of abnormality.
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PAPER 4
Q 1(a). Frith proposed that metarepresentation is the single underlying cognitive factor that can explain the varied features of schizophrenia. In order to explain the concept of metarepresentation, he wrote:
(The relevant section for this answer is section 5.1 on my site.)
"While thinking what to write at this point, I have been staring straight out of the window. In front of me are many trees. When I become conscious of this activity, what I become conscious of is "me looking at trees". This is the critical feature of conscious awareness."
Explain how metarepresentation is illustrated in this example. [2]
Ans. An answer to this question requires two steps:
-Explaining what metarepresentation is
-Connecting the explanation to the example given
Let's take a look at the command word 'give':
This type of a question clearly does not demand an explanation, but a factual and precise answer.
On these lines, a sample answer would be:
"Metarepresentation is the conscious awareness of one's own activities. In the given illustration, the author gives an example of 'me looking at trees.' In this case, if a person represents the trees in his mind, that is only representation. If, however, he represents himself looking at trees, then it is metarepresentation."
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Q 1(b). Identify two advantages of the cognitive explanation of schizophrenia. [4]
Let us look at the command word, 'identify.'
The learner is expected to characterize i.e. give only succinct explanations when it comes to these type of questions. Though the learner need not refer to specific issues and debates since it is not an 'Evaluate' question, we can for our own purposes refer to issues and debates during preparation of such answers.
Specimen Answer. The cognitive explanation of schizophrenia has contributed to our understanding of the disorder, its major merits being the following:
1) It contributes to our understanding of different symptoms of schizophrenia - The genetic and biological explanations indicates why the disorder develops. However, the cognitive explanation tells us how a variety of negative and positive symptoms develop in the disorder. For example, according to Frith (1992), hallucinations are a product of the patient's inability to monitor his own intentions while delusions are the result of the patient's inability to monitor the intentions of others.
2) It contributes to the development of cognitive therapy of schizophrenia which can alleviate the symptoms of schizophrenia - Every patient of schizophrenia cannot and need not be subject to intrusive surgical procedures for the treatment of the disorder. The cognitive explanation can help develop techniques that can improve the condition of the patient. For example, in Frith's (1992) scheme, disorganized speech is the result of the patient's inability to monitor himself. Therefore, an intervention which can help patient's be reminded of their intentions, like simply asking them frequently of their aim of speech, can help alleviate this symptom.
Thus, the cognitive explanation of schizophrenia has greatly contributed to research and application of the disorder.
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Q1. (c) Describe two problems with trying to find a single explanation for an abnormality.
Specimen Answer. Here, the student has a variety of answers at his disposal. It is important, however, that though the question is stated in generic terms, the answer must be associated with the ongoing topic. Keeping this in mind, a sample answer is:
Psychological abnormalities involve a diverse set of symptoms and emerge from a dynamic combination of underlying causes. Therefore, it is unlikely that a single factor can explain a complete disorder. Two problems that can arise if such a factor is identified are:
1] Partial Explanation (Reductionism) - The single explanation may not explain everything about the disorder, but only some aspects of it. For example, Frith (1992) recognized that a single cognitive explanation like metarepresentation can only explain why the symptoms of schizophrenia occur, but not why the disoder develops in the first place. That is better explained by studying biological factors.
2] Difficulty in Treatment - If only a single factor is accepted as the explanation of a disorder, then useful benefits that can be derived from other explanations in the treatment of the disorder may be overlooked. For example, when only the biological explanations of schizophrenia were investigated, cognitive explanations were completely overlooked. Biological treatments could be harmful to patients. Therefore in cases that are not very severe, cognitive treatment like CBT could be used to at least alleviate the symptoms of schizophrenia, than not giving any treatment at all.
Thus, it is best to look for a variety of explanations for an abnormality rather than concentrating on a single explanation.
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Q1. (d) Discuss the evidence suggesting that schizophrenia is caused due to excessive dopamine. You should consider both sides of the argument and include a conclusion. [5]
I have intentionally selected this question to avoid a repetition of questions, and to present how one topic is used to act as evidence in another. Keeping with the present topic, I include only the section that makes use of the cognitive explanation of schizophrenia.
Specimen Answer. ..............................................
The following explanations suggest that schizophrenia is not caused by excessive dopamine alone:
Frith's Cognitive Explanation of Schizophrenia - Frith (1992) suggested that different problems with metarepresentation, including problems with representation of one's own intentions, problems with representation of others' intentions and problems with representation of the goals of activities leads to different symptoms of schizophrenia. According to this view, the biological explanation of excess dopamine is not sufficient to explain why particular symptoms of schizophrenia develop.
.....................................................................................
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Q. 5 (a) Design a longitudinal study to investigate the cognitive explanation of schizophrenia. [10]
Ans. The
student must demonstrate his understanding of what a longitudinal study
is, why it would be helpful, and present his specific knowledge of
Frith's study in the answer to this question.
Let's take a look at the command word, 'design' used in this question:
Let's take a look at the command word, 'design' used in this question:
Specimen Answer. I would conduct a longitudinal study right from childhood into the adulthood of children diagnosed with schizophrenia as detailed below:
Aim - To investigate the cognitive explanation of schizophrenia i.e. to investigate whether the cognitive abilities of people with schizophrenia visibly deteriorate as the symptoms their disorder progress.
Sample - 30 or more children diagnosed with any type schizophrenia of either gender. I would contact a mental instituition and request for my study to be conducted with children in the schizophrenia ward there. The sample for my study would be children of five years or more.
Procedure and Data Analyses - I would test the children for willed actions, self-monitoring and other-monitoring by testing them after every academic year that they complete up till they are of age 18. Thus, I would test them after age 5, age 6... upto age 18 i.e. a total of 14 tests to see the growth or decline in their cognitive performance with age. I would use the following tests to measure the aforementioned cognitive factors:
'Willed' Action - I would give participants a verbal fluency task to investigate their potential in generating 'willed' actions. An example of this task is:
"In the next five minutes, I want you to generate as many words as you can from the category 'food.'"
I would assess the words they generate based on their meaningfulness, relevance and repetition.
Self-Monitoring - I would give participants puzzles like the jigsaw, simple crossword, Tower of Hanoi or some other which requires long-span of attention.
I would assess their performance by checking how appropriately and for how much duration they were able to perform the task without engaging in irrelevant behaviours.
Other-Monitoring - I would give the participant a task to perform that would require him to co-ordinate with another person. For example, I would ask him to do some simple task like arranging furniture in a room with the other.
I would assess the participant's performance by asking him to evaluate the other's performance at the end of the task.
Since this is a longitudinal study, I would use similar tasks on every year of the performance, but upgrade the difficulty of the task as per the development the participant has shown till that year.
Results and Conclusion - I would compare the performance of the participants year after year, graphing out their mean performance on the different tasks across several years, and noting the trend in performance - whether upward or downward, and the intensity of fluctuation. I would then conclude whether or not cognitive performance of the participants actually deteriorates as their disorder progresses, which would serve as evidence for or against the cognitive explanation of schizophrenia.
I would use my knowledge that symptoms of schizophrenia intensify as the affected people age, and use this to correlate it with their performance on tasks measuring cognitive abilities.
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Q 5. (b) Explain the psychological and methodological evidence on which your study is based. [8]
Therefore, in an 'Explain' question, the student is expected to clarify his use of design, while linking relevant sections of the study as examples to justify his/her answer.
Looking at the question, the psychological evidence the student is expected to present is from the research study of the relevant topic. The methodological evidence is the justification of the design used.
In the specific question asked above, the psychological evidence pertains to the cognitive explanation of schizophrenia as outlined by Frith. The methodological evidence is the use of a longitudinal study - the sample, the procedure, etc. that the student has chosen for the same.
A specimen answer for this part is:
Specimen Answer.
Frith proposed that the single underlying cause of the symptoms of schizophrenia is a problem with the cognitive component of metarepresentation -- which is the complete and accurate mental representation of reality. Accordingly, he proposed that there are three main failures of metarepresentation that compound the problem of schizophrenia. In the design of my study in the previous part of the answer, I have attempted to investigate these three different failures through different activities as follows:
Failure of Metarepresentation of Goals - A failure to understand one's own purpose of carrying out activities leads to a deficiency of the will to perform activities. I have attempted to investigate this issue with the help of a word-generation task which gives the participant minimum instructions of performance, thereby requiring him to complete the task using his independent will power which comes from keeping the goal of the task in mind.
Failure of Metarepresentation of One's Own Intentions - A failure to understand one's own motives in performing an activity leads to a failure of the ability to monitor one's own performance. Therefore, a task like a time-demanding puzzle can need the participant's attention over a long period of time, and require him to monitor his own behaviour over this time.
Failure of Metarepresentation of Others' Intentions - A failure to understand others' motives leads to a failure to monitor others, and thereby perform activities in co-ordination with them. Thus, I have presented a task requiring co-operation, and a small interview at the end to check if the participant had any doubts on the other's intentions, or difficulty in performing with them.
Further, since the study is longitudinal in nature, I have taken the following measures to maintain methodological precision:
1) Sample - I have chosen a sample of children, since schizophrenia develops in intensity from childhood to adulthood. I have chosen children from a psychiatric ward for easy availability. To assure that the children can perform the tasks like puzzles, they are required to be 5 years or more in age.
2) Procedure - I have chosen simple tasks to be performed which are not very challenging for the participants with schizophrenia who may have language and comprehension issues. I have also chosen the difficulty to be increased every year so that the performance of the participant is not made easy by being beneath the level of his development. Also, since the participant is already being treated by psychiatrists, it is expected that this can slow down the decline otherwise expected as the disorder progresses.
3) Results - I have chosen a comparison of performance of participants across years since the expected trend is that the performance of participants will deteriorate steadily as the disorder intensifies. Similarly if there is improvement due to treatment that the participants are receiving, performance should improve. These trends can be observed from long-term comparison.
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Section III - Some Important Notes
Perpetually associated with the Frith (1992) study are questions on its length, and students are desperate to avoid the effort involved in reading through it. Remember that for the present syllabus, paper 4 focuses on application of studies, of which, designing studies is a major component. Reading through methods used in papers will equip you to answer these types of questions. Enough discussed on this, I will now share a small memory scheme on the lines of what I ask students to prepare for themselves to review what they've learnt before the examination:I ask students to keep this diagram in front of them and orally elaborate on each point to make sure they are ready for the paper. Do try this exercise for yourself.
I'll cover the evaluation for the cognitive explanation and possible study designs and their evaluations in a post to come.
Your blog is amazing, thank you so much! I wasn't even aware of the gaps in my knowledge of A level Psychology, but by reading your blog I filled them.
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