DOES THE BIOLOGY GO AROUND THE SYMPTOMS - A COPERNICAN SHIFT IN SCHIZOPHRENIA PARADIGMS

It is often assumed that if physical differences exist between the bra ins of people with schizophrenia and normal people then. those biologi cal differences will have caused the psychological abnormalities to oc cur In this article, we challenge this view First, we argue that the r everse case is also plausible, namely, that it is possible for the phy siological differences associated with the condition to be the result of the condition and not the cause. Less contentiously, we propose tha t the relationship between the psychological problems and the physiolo gy should be viewed not as a simple billiard-ball style cause-and-effe ct relationship but more as a reciprocal and iterative relationship wh ere psychological effects can affect the physiology that can in turn a ffect the psychology. The evidence for the various physiological diffe rences between people with schizophrenia and normals is assessed and i t is concluded that these differences exist but that there is little e vidence to demonstrate that all (or indeed even any), of them precede the onset of schizo phrenic symptoms. Similarly, current information-p rocessing theories can also be considered as descriptive of a psychoti c state rather than causal to it. Similarities between traumatic shock and schizophrenia are discussed and it is argued that phenomena assoc iated with trauma might need to be considered as an integral part of t he psychotic's experience. It is also concluded that no psychological theory can deny the importance of the physiological level in schizophr enia. Copyright (C) 1996 Elsevier Science Ltd