Psychological Explanations - Family Dsyfunction

Question 1

Schizophrenogenic Mother

Answer 1

• Fromm-Reichmann (1948) proposed a psychodynamic explanation for schizophrenia based on the accounts she heard from patients about their childhoods
• She noted that many of them spoke of a particular type of parents, called the schizophrenogenic (schizophrenia-causing) mother
• The schizophrenogenic mother is 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 then schizophrenia

Question 2

Double-Bind Theory

Answer 2

• Bateson et al (1972) agreed that family climate is important in the development of schizophrenia but emphasised the role of communication style within a family
• The developing child regularly finds themselves trapped in situations where they fear doing the wrong thing but get mixed messages about what this is, and they feel unable to comment on the unfairness of this situation/seek clarification – when they often ‘get it wrong’, the child is punished by love withdrawal
• This leaves them with an understanding of the world as confusing and dangerous, and 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 someone with schizophrenia/the only factor in developing it, merely a risk factor

Question 3

Expressed Emotion (EE)

Answer 3

• Level of emotion, particularly negative, expressed towards a person with schizophrenia by their carers who are often family members
• EE contains several elements – verbal criticism of the person (occasionally accompanied by violence), hostility towards the person (anger, rejection, etc), and emotional overinvolvement in the life of the person (needless self-sacrifice, etc)
• These high levels of emotion directed towards the individual are a serious source of stress for them
• This is primarily an explanation for relapse in those with schizophrenia, but it may be a source of stress that can trigger the onset of schizophrenia in an already vulnerable person

Question 4

Evaluation - Evidence linking family dysfunction to schizophrenia

Answer 4

• Indicators of family dysfunction include insecure attachment and exposure to childhood trauma, especially abuse
• According to Read et al (2005), adults with schizophrenia are disproportionately likely to have insecure attachment, particularly Type C or D + 69% of women and 59% of men with schizophrenia have a history of physical/sexual abuse
• In the Mørkved et al (2017) study, most adults with schizophrenia reported at least one childhood trauma, mostly abuse
• Family dysfunction makes people more vulnerable to schizophrenia

Question 5

Evaluation - Poor evidence base for explanations

Answer 5

• There is plenty of evidence supporting the idea that childhood family-based stress is associated with adult schizophrenia
• However, there is almost none to support the importance of traditional family-based theories like the schizophrenogenic mother and double-bind as they are based on clinical observation of people with schizophrenia and informal assessment of mothers’ personalities, not systematic evidence
• Family explanations have not been able to account for the link between childhood trauma and schizophrenia