Psychological explanations. Flashcards
Family dysfunction.
- Psychologists have attempted to link SZ to childhood and adult experiences of living in a dysfunctional family (family dysfunction).
- The family dysfunction explanation sees maladaptive relationships and patterns of communication with families as sources of stress, which can cause/influence the development of SZ.
Family dysfunction - 1. The Schizophrenogenic Mother.
Frieda Fromm-Reichmann (1948) proposed a psychodynamic explanation for SZ based on the accounts she heard from her clients about their childhoods. She noted the following:
- Her clients spoke of a particular parent, which she called the schizophrenogenic mother (meaning schizophrenia-causing).
- The mother is described as cold, rejecting, controlling and tends to create a family climate characterised by tension and secrecy.
- This leads to distrust that later develops into paranoid delusions and ultimately SZ.
Family dysfunction - 2. Double-bind theory.
- Gregory Bateson et al (1972) agreed that family climate is important in the development of SZ but emphasised the role of communication style within a family.
- Symptoms of SZ are an expression of contradictory patterns of interaction in the family.
- The developing child finds themself where they fear doing the wrong thing, but receive mixed messages about what this is, and feel unable to comment on the unfairness of the situation. When they get it wrong, the child is punished by withdrawal of love.
- This leaves them with the understanding of the world as confusing and dangerous, this is reflected in symptoms like disorganised thinking and paranoid delusions.
- Bateson was clear that this was not the main type of communication in the family of a person with SZ nor the only factor in developing SZ, just a risk factor.
Family dysfunction - 3. Expressed Emotion (EE)
Expressed emotion is the level of emotion, in particular negative emotion, expressed towards a person with SZ by their carers/family.
- Verbal criticism of the person, occassionally accompanied by violence.
- Hostility towards the person, including anger and rejection.
- Emotional over-involvement in the life of the person, including needless self-sacrifice.
- These high levels of expressed emotion in carers directed to the person are a serious score of stress for the patient.
- This is primarily an explanation for relapse in people with SZ.
- It has also been suggested that it may be a source of stress that can trigger the onset of SZ in a person who is already vulnerable due to their genetic make-up (diathesis-stress model).
Can we ignore genetics? (1)
- Certain children, due to their biological/genetic makeup, are much more sensitive to environmental stressors. The root cause of SZ is likely to be genetic/biological, but the contributing factors and triggers of SZ are likely to be environmental and stress related.
- Families with a child who develops SZ are not necessarily less healthy (or more dysfunctional) than other families. Instead, research suggests that the genetically-at-risk individual is much more sensitive to any ongoing stress and dysfunction that exists in their given family.
Can we ignore genetics? (2)
- Research shows that having a healthy family environment was shown to reduce the risk of SZ by about 86%. However, a significant percentage of children (5.8%) developed SZ even though the family environment was healthy.
- Even in a healthy family environment, there are still other environmental factors (e.g. prenatal stress or toxin exposure, nutritional deficiencies, social stress in peer groups and schools, substance abuse etc.) that may contribute to the risk/trigger SZ in those who are genetically-at-risk.
Cognitive explanations.
- A cognitive explanation for any behaviour is one that focuses on the role of mental processes. SZ is associated with several types of abnormal info processing; these can provide possible explanations for SZ as a whole.
- Reduced processing in the ventral striatum is associated with negative symptoms.
- Reduced processing of info in the temporal and cingulate gyri associated with hallucinations.
- Lower than usual level of info processing suggests impaired cognitions.
Cognitive explanations - Christopher Firth et al (1992) identified 2 kinds of dysfunctional thought processing that could underpin some symptoms. 1) Meta-representation.
Disrupted ability to recognise and reflect on own actions. Cannot interpret actions of others.
SZ symptoms:
- Positive symptoms (delusions) - cognitive biases from thinking in irrational ways - believing that they are being persecuted (victimised).
- Hallucinations - biased info processing, sufferers believe that external people/forces are exerting influence over their thoughts and behaviour.
Cognitive explanations - Christopher Firth et al (1992) identified 2 kinds of dysfunctional thought processing that could underpin some symptoms. 2) Central control.
Unable to suppress automatic thoughts/speech triggered by other speech/thoughts.
SZ symptoms:
- Negative symptoms - due to the use of cognitive strategies to control the high levels of mental stimulation being experienced (can result in lack of speech/diagnosed speech).
- Experience greater level of emotion more than they display (flat effect).
The Stroop Test
- Is a classic test of cognitive inhibition, in which the processing of an irrelevant dimension of stimuli (words) conflicts with a competing stimulus dimension (colours).
- Cognitive inhibition is the blocking out/tuning out of info that is irrelevant to the task or focus at hand.
- SZ patients exhibit increased interference, consistent with the distractibility they exhibit in everyday life.
P: A strength is that there is research support suggesting that difficult family
relationships are associated with increased risk of SZ in adulthood.
E: Read at el (2005) reviewed 46 studies of child abuse and SZ and concluded that 69% of adult in-patient women with a diagnosis of SZ had a history of either physical or sexual abuse (even both) during their childhood. For men, 59% had insecure attachments to primary caregiver were more likely to develop SZ.
L: Therefore, there is a large body of evidence linking family dysfunction to SZ. However, this information about childhood experiences was gathered after developing symptoms of SZ. This means that their recollections may have been distorted, creating a serious problem for validity.
I&D: The family dysfunction explanation is environmentally reductionist. It is simplifying a complex mental health illness to the simplistic notion of strained family relationships and patterns of communication as factors increasing the risk of developing SZ.
Limitation of psychological explanations: limited evidence.
P: A limitation is that there is very limited evidence to support the importance of the schizophrenogenic mother or double bind.
E: Both theories are based on clinical observation and early evidence involved assessing the personality of mothers of patients for ‘crazy-making
characteristics’ – an approach that is disapproved by modern psychologists.
L: This has led to parent blaming, it is already hard enough to see their child suffer through SZ and needing long term care – they additionally now have the trauma of receiving blame for their child’s condition.
I&D: Such theories may have ethical implications due to the consequences this research has on the rights of other people. In this case, the parents of any child that has a severe mental health illness.
Strength of psychological explanations: info processed differently in mind of SZ patient.
P: A strength is that there is strong support for the idea that information is
processed differently in the mind of an SZ patient.
E: Stirling et al (2006) compared 30 patients with a diagnosis of SZ with 18
non –patient controls on a range of cognitive tests (including stoop test). In
line with Firth’s theory of central control dysfunction, patients took over twice as long to name the ink colours than the control group.
L: This suggests that links between symptoms and faulty cognitions are clear. However this does not tell us anything about the origins of these cognitions or of schizophrenia.
