Cognitive Explanations

• Dysfunctional thought processing (DTP) refers to the ways in which a person with schizophrenia understands, perceives and interprets the world (and other people) around them
• A schizophrenic person may be unable to distinguish between the natural ‘inner voice’ that everyone is aware of on a minute-by-minute basis e.g. ‘hearing’ the words you are reading; going over a ‘to-do’ list in your head; daydreaming etc. and what they perceive to be a voice or voices speaking to them, personally and which exists outside of themselves
• Dysfunctional thought processing as suggested by Frith (1992) involves the mechanism of metarepresentation (‘meta’ meaning ‘of itself’) 
• Metarepresentation involves:
  • The ability to reflect on one’s own 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
  • Leading on from the above point, 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 paranoid schizophrenia which involves extreme delusions e.g. The FBI are out to get me, they’re watching me all the time

Even the most talented people may succumb to dysfunctional, paranoid thoughts…

• 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 actually present any real danger or threat at all, but to a person with schizophrenia (particularly the more extreme form of paranoid schizophrenia) the harmless actions of others may be viewed from a biased perspective involving misinterpretation of others’ actions and intentions
• The schizophrenic person 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 schizophrenic person 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 paranoid schizophrenics who did not pass a TOM test were unable to distinguish between their own mental state and that of others when compared to a normal control group
• Navalón et al. (2021) found that schizophrenic patients 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

Strengths 

• Schizophrenia is a condition which 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

Weaknesses

• Cognitive explanations lack cause-effect conclusions: does schizophrenia cause dysfunctional thought processing or is that dysfunctional thought processing leads to schizophrenia symptoms?  
• There may be issues with the validity of cognitive explanations, for example a person’s thought processing is likely to be highly subjective, regardless of whether they have schizophrenia or not, so it is difficult to know how to judge and asses what is ‘dysfunctional’ or ‘biased’ when it comes to idiosyncratic cognitions

Link to Issues & Debates:

This topic takes the determinism side of the determinism/free will debate as it assumes that anyone with schizophrenia will think in a disordered way using attentional biases to interpret the world. In short, it does not account for individual differences within the array of experience of people with schizophrenia.