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Social Explanation for Schizophrenia: Social Causation Hypothesis, Social…
Social Explanation for Schizophrenia: Social Causation Hypothesis
Evaluation
X Alternative Theory: Social drift hypothesis
Schizophrenia leads to urbanicity
Suggests people with sz find it hard to keep a job and so they drift into a lower social class and migrate to inner-cities
✓ Fearon et al (2004)
Found that there are 4x more incidences of sz in black immigrants than in the white population
Demonstrates that the immigrant population are more at risk of developing sz
✓ Vassos et al (2012)
Meta analysis to correlate location with risk of sz
The risk was 2.37 times higher for people living in urban environments compared to rural
Shows relative risk of schizophrenia increases in line with population density
X The data is correlational
X Diathesis Stress Model
X Nurture
Ignores all Biological factors (eg. role of genetics and NT)
✓ Holistic
Urbanicity
City life is more stressful than rural life (noise and light pollution, criminality, fast paced living, anonymity)
High population density = competitive life which may increase experience of social defeat (a stressor that occurs when exposed to hostility and confrontations)
Long term exposure may make an individual more vulnerable to having an episode of sz
Definition: The world and people around you play a major cause of schizophrenia
Immigration and Minority Status
Research shows greater risk for first and second generation immigrants
Schizophrenia may be the reaction to chronic experience of prejudice and discrimination (Veling, 2008)
Greater risk for second generation immigrants because: • Weaker cultural identity
• Learned to fit in with the norms of society they live in
• Beliefs and expectations differ with family
Marginalisation of outgroups may leave people more vulnerable
This creates stress which worsens vulnerability
Social Isolation
People with schizophrenia withdraw because they find contact with other people stressful (Faris, 1934)
Self imposed isolation cuts them off feedback about behaviours = they begin to act 'strangely'
Social Adversity
People from lower socioeconomic groups may not be able to access treatment, making problems worse
Growing up in unfavourable environments = vulnerable to mental health disorders in the future
Eg. poverty, unemployment (poor standard of living) can be stressful
Also known as Environmental Breeder
Social Treatment for Schizophrenia: Assertive Community Therapy
Community Mental Health Teams (overall term)
Evaluation
✓ Idiographic
A plan made unique to the individual which can best support their needs
✓ Bond et al
Summarised 25 controlled studies to look at the effectiveness of ACT
Found that compared to standard community care, it was highly effective (improved quality of life)
✓ Helpful in all cultures
Can work on all ages. genders and cultures (Vugt et al 2011, Netherlands, Nisho et al 2012, Japan)
X Does not cure sz
Only provides support and how to manage symptoms, does not reduce positive and negative symptoms
X Only works in heavily populated areas
Lots of people available to help so would not be as effective in rural areas
X Social Control,
Gomory (2001)
Client is offered little choice and surrenders all responsibility for making decisions and taking care of themselves
Characteristics
Focus on those who need the most help
Help with independence, rehabilitation, recovery and to avoid re-hopsitalisation or homelessness
ACT is made up of
Social workers
Nurses
Occupational therapists
Pharmacists
Counsellors
Psychologists
Treatment of patients in real life settings (visiting)
Working with other professionals
Looks at the individuals needs
Used to help patients with sz who have relapses and bouts of hospitalisation
4 stages of Care Programme Approach (General Care)
2.) Care plan = plan is created to meet needs (with healthcare team)
3.) Key Worker Appointed = (usually social worker or nurse) your first point of contact
1.) Assessment = health and social needs are assessed
4.) Reviews = treatment will be reviewed and changed if needed
The goal is to reduce the reliance of hospitals