Schizophrenia is a complex mental disorder explored in the AQA A-level Psychology syllabus. The specification covers its classification, including positive symptoms like hallucinations and delusions, and negative symptoms such as avolition and speech poverty. It examines biological explanations, including genetic and neural factors, psychological explanations like family dysfunction and cognitive deficits, and therapeutic approaches, such as drug therapy, CBT, and family therapy. The interactionist approach, including the diathesis-stress model, integrates genetic and environmental factors, providing a comprehensive framework for understanding schizophrenia.

Classification of schizophrenia. Schizophrenia is classified as a severe mental disorder characterised by a range of symptoms. Positive symptoms include hallucinations, such as hearing voices, and delusions, which are false, fixed beliefs. Negative symptoms include speech poverty, where communication becomes limited, and avolition, marked by a lack of motivation or goal-directed behaviour

Reliability and validity in diagnosing schizophrenia remain challenges due to issues like co-morbidity, where symptoms overlap with other conditions such as bipolar disorder or depression, complicating accurate diagnosis. Cultural and gender biases also affect validity, with cultural differences in symptom expression and clinician interpretation leading to over- or under-diagnosis in certain groups. Symptoms overlap with other disorders, like schizoaffective disorder, further reducing diagnostic precision, and highlighting the need for consistent and objective classification systems

Schizophrenia has a strong genetic component, supported by evidence from family, twin, and adoption studies. First-degree relatives face a 9–13% risk, and identical twins show a 48% concordance rate, highlighting heritability. Adoption studies further separate genetic and environmental influences, showing higher rates among biological relatives. Modern research reveals schizophrenia is polygenic, involving multiple genetic variations. Explore how genes and environment interact in this complex disorder.

Schizophrenia is linked to dopamine imbalances, with overactivity in the mesolimbic system contributing to positive symptoms and underactivity in the mesocortical pathway linked to negative symptoms. The reformulated dopamine hypothesis highlights broader neural dysfunction, including glutamate dysregulation, where reduced glutamate activity may explain cognitive and emotional symptoms. These insights point to a complex interplay of neurotransmitters in schizophrenia.

Psychodynamic theories of schizophrenia, such as those by Frieda Fromm-Reichmann and the double-bind theory, focus on the impact of dysfunctional family dynamics. Fromm-Reichmann introduced the concept of the 'schizophrenogenic mother,' suggesting that cold, overcontrolling parenting could contribute to the development of schizophrenia. Similarly, the double-bind theory posits that conflicting communication patterns within families create stress and confusion, leading to schizophrenic symptoms. While these theories highlight the role of the environment, they are often criticised for lacking scientific support and for unfairly blaming parents for the disorder

Cognitive explanations of schizophrenia focus on dysfunctional thought processes. Impaired information processing, such as difficulties in filtering irrelevant stimuli or forming coherent thoughts, can lead to symptoms like delusions and hallucinations. Cognitive theories also highlight how faulty interpretations of experiences and biological vulnerabilities exacerbate symptoms. These insights inform therapies targeting thought patterns to improve outcomes for patients.

Expressed emotion (EE) refers to the level of criticism, hostility, and emotional overinvolvement within a family. High EE environments are linked to higher relapse rates in individuals with schizophrenia, as the stress from negative family interactions exacerbates symptoms. Reducing EE through family therapy can improve outcomes, highlighting the significant role of social dynamics in managing the disorder.

An interactionist approach to schizophrenia combines biological, psychological, and social factors, recognising that no single factor can fully explain the disorder. The diathesis-stress model highlights this interplay, proposing that genetic or biological vulnerabilities (diathesis) interact with environmental stressors, such as trauma or family dysfunction, to trigger schizophrenia. This perspective informs holistic treatments, combining medication to address biological factors with psychological therapies to manage environmental and cognitive influences.

Drug therapy for schizophrenia includes typical and atypical antipsychotics. Typical antipsychotics, like chlorpromazine, primarily reduce positive symptoms by blocking dopamine receptors but can cause side effects like tardive dyskinesia. Atypical antipsychotics, such as clozapine, target both dopamine and serotonin pathways, addressing positive and some negative symptoms with fewer motor side effects, though they carry risks like weight gain or agranulocytosis