psychological explanations + therapies SZ Flashcards
(23 cards)
the schizophrenogenic mother
a psychodynamic explanation; if a mother is cold, rejecting and controlling she creates a family environment controlled by tension + secrecy
leads to distrust that later develops into paranoia in child and ultimately SZ.
characteristics of schizophrenogenic mother
Fromm - Reichmann described characteristics as:
cold + domineering, overprotective, insensitive, rejecting, fear of intimacy
this is suggested to cause SZ in child as there is faulty parental communication and contradictory behaviour. Mother can be overprotective yet rejecting and it may cause confusion in child.
double blind theory
mother and/or father would have a pattern of giving child conflicting messages
messages placed child in no win situation and caused confusion + anxiety
Prolonged exposure to a family that communicates in a destructively ambiguous fashion. They fear doing wrong thing but get mixed messaged about what this is.
child feels unable to comment on the unfairness. Leads to incoherent construction of reality which may become paranoid delusions (SZ)
expressed emotion
Level of negative emotion eg verbal criticism, anger, rejection and abuse
Causes stress for individuals which can trigger SZ in those already genetically vulnerable (diathesis stress model)
Can explain relapse in schizophrenic patients – negative emotion via carers.
E.g.
• Critical comments occasionally accompanied by violence
• Hostility towards the person, including anger and rejection
• Emotional over-involvement in the life of patient
Strength of psychological explanations
Supportive research
E: Read et al meta analysis: 69% of female and 59% of male schizophrenics had history of physical + sexual abuse in childhood
C: suggests a possible cause of SZ is linked to previous abuse which relates to expressed emotion. Also, meta analysis established high reliability
HOWEVER accounts of schizophrenics self report data may be invalid as it’s derived from delusion schizophrenics may have experienced as they aren’t in fit state of mind
Limitation of psychological explanations reductionist
E: reductionist as they are stating that SZ develops in people as a result of family dysfunction. Fails to consider bio explanations eg inherited genes where identical twins have 48% chance of developing it and lowers as you increase distance between relatives
C: limits understanding of what causes SZ which limits treatment that can be made available for schizophrenics
Limitation of psychological explanations
Family dysfunction is socially sensitive
E: schizophrenogenic mother is socially sensitive as it places entire cause of SZ on mothers role throughout childhood
C: strong negative impact on mothers/families if they are solely blamed for their child’s mental health issues (extreme guilt can affect own well being)
Cognitive explanations states that
SZ can be caused by faulty + abnormal mental processing, hence the disorganised thoughts
2 types of dysfunctional thought processing that impair our cognitions
- Meta representation
- Central control
Meta representation
Ability to recognise and reflect on your thoughts and behaviours and interpret the actions of others
Problems with MR affect our ability to be able to recognise our own thoughts + whether our actions are being carried out by ourselves and not someone else
- Many show auditory hallucinations and delusions
Central control
They have the ability to suppress automatic thoughts, and their speech is triggered by other thoughts which can lead to derailment of thoughts and speech
This is due to certain words that triggers an association and the patient cannot express ability to automatically respond to these
Could cause speech poverty
Strength of cognitive explanations
Supportive research
E: Stirling et al found schizophrenic patients took over twice as long to complete the stroop test compared to a control group (mean 123.2 for SZ and 58.12 for control group)
C: suggests that schizophrenic patients have low central control compared to a control group so it supports theory that abnormal mental processing cause SZ
Limitation of cognitive explanations of SZ
reductionist
E: breaks behaviour down into abnormal mental processing eg meta representation and central control. It fails to consider causes eg genetics where Gottesman found MZ twins had a 48% chance of getting SZ but general pop had only 1%
C: limits understanding of SZ so it limits treatment options. Cognitive explanations would only consider use of CBT rather than anti psychotics
CBT to treating SZ
According to cog approach, SZ is caused by faulty thinking
Aim of CBT is to change faulty belief systems
Use of CBT
Aims to identify and challenge irrational thoughts about themselves, the world and the future so they can cope better with symptoms
Helps to make sense of their delusions + hallucinations - what triggers the problem, how these impact behaviour. This can help reduce anxiety
How therapist disputes thoughts in CBT
Therapist will challenge delusions - is it logical or pragmatic and do you have empirical evidence to support this delusion
Eg delusion of persecution - ‘government trying to poison me’. Therapist may use logical disputing eg ‘does that make sense?’
Pragmatic disputing ‘is this helpful?’
Empirical evidence ‘where is the evidence to support this view?’
Process of CBT
Therapist aims to develop trusting relationship with patient
Let patient explain their distressing experiences eg abusive voices
Uncover patterns in clients distressing experiences
Challenge gently clients beliefs
Develop strategies to deal with distressing experiences … could include homework to test out beliefs
Family therapy
-stems from belief that poor family communication causes SZ
Aims to improve quality of communication and interaction between family members by reducing levels of expressed emotion in patient and family that might contribute to relapse
Aims of family therapy
Form therapeutic alliance with family members
Reduce stress of caring for SZ patient
Reduce guilt in family members
Improve beliefs of SZ
Token economy
Based on operant conditioning so it’s called a behaviour modification technique
Aims to modify directly observable behaviours - used to prevent institutionalisation
3 main steps of token economy
Identifying undesirable behaviour
Identify reinforcers that maintain such behaviour
Restructuring environment so that the undesirable behaviour is no longer reinforced and desirable behaviours are reinforced
Process of token economy
Aims to improve patients ability to function outside of hospital by reinforcing desirable beh with a token that can be exchanged with reward
Tokens are secondary reinforcers as they drive their value from association with reward
Modifying beh with TE doesn’t cure SZ but aims to address maladaptive beh that may have been formed from institutionalisation
How TE works
Undesirable behaviours repeated as it’s being reinforced, so you remove reinforcers. Punishment decreases
Desirable behaviour is displayed - pos reinforcement given
Tokens can be exchanged for things like watching TV, listening to music
