psychological explanations for schizophrenia

Question 1

family dysfunction - the schizophrenogenic mother

Answer 1

• Frieda Fromm-Reichmann proposed psychodynamic explanation for schizophrenia based on accounts she heard from parents about their childhoods
• noted that many patients spoke of particular type of parent, which she called the schizophrenogenic mother (meaning schizophrenia-causing)
• Fromm-Reichmann said the schizophrenogenic mother is cold, rejecting, self-sacrificing and controlling, and creates a family climate characterised by tension and secrecy
• this leads to distrust that later develops into paranoid delusions, auditory hallucinations and ultimately schizophrenia

Question 2

family dysfunction - double-bind theory

Answer 2

• Gregory Bateson agreed that family climate is important in development of schizophrenia, but he emphasised role of communication style within a family
• developing child regularly finds themselves trapped in situations where they fear doing the wrong thing, but receive mixed messages about what this is and feel unable to comment on the unfairness
• child is often punished by withdrawal of love, leaving them with understanding of the world as confusing and dangerous, this is reflected in symptoms such as disorganised thinking or paranoid delusions
• eg. parents showing affection and saying nice words but not having the body language to match, for example stiffening during a hug
• Bateson was clear this was not the main type of communication in the family of someone with schizophrenia and not the only factor, but a risk factor

Question 3

family dysfunction - expressed emotion

Answer 3

• level of emotion, usually negative, expressed towards someone with schizophrenia by their carers (often family members)
• can also trigger schizophrenia, or could be a communication change in response to a diagnosis

contains several elements -
- verbal criticism of person, often accompanied by violence
- hostility towards person, including anger and rejection
- emotional over involvement in life of person, including needless self-sacrifice

• high levels of expressed emotion are serious source of stress for individual
• primarily an explanation for relapse in people with schizophrenia
• also suggested it may be a source of stress that can trigger the onset of schizophrenia in someone who is already vulnerable, for example due to genetic make-up
• any kind of trauma can also act as a trigger, eg. abuse

Question 4

cognitive explanations - dysfunctional thinking

Answer 4

• schizophrenia associated with several types of dysfunctional thought processing, these can provide possible explanations
• schizophrenia characterised by disruption to normal thought processing
• reduced thought processing in ventral striatum is associated with negative symptoms
• reduced processing in temporal and cingulate gyri is associated with hallucinations
• this lower level of information processing suggests that cognition is likely to be impaired

Question 5

cognitive explanations - metarepresentation dysfunction

Answer 5

• Christopher Frith identified two kinds of dysfunctional thought processes
• first is metarepresentation, cognitive ability to reflect on thoughts and behaviour
• ability to differentiate between our inner speech about ourselves and internal thoughts about others
• allows us insight into our own intentions and goals, and allows us to interpret actions of others
• dysfunction in metarepresentation would disrupt ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else
• this explains hallucinations of hearing voices and delusions like thought insertion (experience of having thoughts projected into mind by others)

Question 6

cognitive explanations - central control dysfunction

Answer 6

• Frith also identified issues with cognitive ability to suppress automatic responses while we perform deliberate actions
• speech disorganisation and thought disorder could result from inability to suppress automatic thoughts and speech triggered by other thoughts
• eg. people with schizophrenia tend to experience derailment of thoughts due to each word triggering associations, and the person cannot suppress automatic responses to these

Question 7

evaluation strength for family dysfunction - research support

Answer 7

• indicators of family dysfunction include insecure attachment and childhood trauma
• review by Read revealed that adults with schizophrenia are disproportionately likely to have insecure attachment
• also reported that 69% of women and 59% of men with schizophrenia have a history of physical or sexual abuse
• strongly suggests that family dysfunction makes people more vulnerable to schizophrenia

Question 8

evaluation limitation for family dysfunction - explanations lack support ⭐️

Answer 8

• almost no evidence to support importance of traditional family-based theories such as the schizophrenogenic mother and double blind
• both of these are based on clinical observation of people with schizophrenia and also information assessment of personalities, but not systematic evidence
• means that family explanations have not been able to account for link between childhood trauma and schizophrenia
• only a small percentage of women who might fit the criteria of a schizophrenogenic mother actually produce schizophrenic children

Question 9

evaluation strength for family dysfunction - support for expressed emotion ⭐️

Answer 9

• Brown’s study
• 58% of people with schizophrenia return to hospital for further treatment if released back to a high EE family
• compared to only 10% for low EE families
• suggests that high EE families cause stress which then triggers schizophrenia
• family therapy should be offered in order to decrease relapse rates

Question 10

evaluation strength for cognitive explanations - research support ⭐️

Answer 10

• Stirling compared performance on range of cognitive tasks in 30 people with schizophrenia and 30 without
• eg. Stroop task, participants had to name font-colours of colour-words, therefore suppressing tendency to read words aloud
• as predicted by Frith, people with schizophrenia took twice the amount of time to name font-colours
• suggesting that people with schizophrenia have problems with suppressing automatic control (reading the word), slower cognitive processing
• means that cognitive processes of those with schizophrenia are impaired

Question 11

evaluation limitation for cognitive explanations - cause and effect ⭐️

Answer 11

• only describes how information processing is affected in schizophrenia
• doesn’t explain what causes cognitive changes, not a complete understanding about initial cause
• cognitive changes may be symptoms of schizophrenia rather than an explanation
• not a full explanation, focuses on proximal origins, not distal