Schizophrenia: topic 4 ‘psychological explanations of SZ including family dysfunction’

Question 1

what does the family dysfunction explanation of SZ focus on and claim?

Answer 1

• focused on the role of the family in SZ
• ‘family dysfunction’ explanations claim that the risk of SZ is increased when there are abnormal patterns of communication within the family

Question 2

what is the ‘double-bind’ theory of psychological explanations of SZ and who proposed it?

Answer 2

• bateson
• suggested that children who receive contradictory messages from their parents are more likely to develop SZ

Question 3

what is an example of double bind theory

Answer 3

• if mother tells her son she loves him yet at the same time turns her head away in disgust

Question 4

why do these contradictory messages make people more likely to develop SZ

Answer 4

• the child regularly finds themselves traps in situations where they fear doing the wrong thing but receive mixed messages about how to think or behave
• this leaves a child with an understanding of the world as confusing and dangerous, and this is later reflected in symptoms such as paranoid delusions

Question 5

what is the ‘schizophrenic mother’ theory of psychological explanations of SZ and who proposed it?

Answer 5

• freida fromm-reichman
• found that many patients who were asked about their childhood described a mother who is cold, rejecting, controlling
• when asked about their atmosphere in the home it was characterised by tension and secrecy

Question 6

how does the schizophrenic mother lead to SZ?

Answer 6

• the ‘schizophrenia-causing’ mother leads to distrust which can cause paranoid delusions

Question 7

what is the ‘expressed emotion’ theory of psychological explanations of SZ?

Answer 7

• refers to the level of emotion expressed towards a SZ sufferer by their family or carers

Question 8

what are the two ways in which expressed emotion may be shown

Answer 8

• verbal criticism
• emotional over-involvement

Question 9

what is the ‘verbal criticism’ explanation of expressed emotion

Answer 9

• verbal criticism of the patient and hostility towards them, including anger and rejection

Question 10

what is the ‘emotional over-involvement’ explanation of expressed emotion

Answer 10

• emotional over-involvement in the life of the patient, including needless self-sacrifice

Question 11

is expressed emotion linked to the course of SZ or seen as the cause? why?

Answer 11

• linked to the course of the disorder
• high levels of expressed emotion in carers have been found to lead to poorer outcomes and an increased likelihood of relapse and a return to psychotic experiences for the patient

Question 12

strengths of family dysfunction explanations

Answer 12

P - evidence to support double bind theory as a risk factor for SZ
E/E - berger found that schizophrenics reported higher recall of double-bind statements from their mothers than non-schizophrenics
L - seems to suggest contradictory messages during upbringing may increase the risk of SZ in later life
E - HOWEVER this is retrospective and memory can be distorted and biased, it suits the child to report this

P - support for the role of expressed emotion in the course of SZ
E - tienari assessed adopted children whose biological mother had schizophrenia compared to control group of adoptees without any genetic risk, found that when the parenting style of the adopted family was characterised as highly critical with low levels of empathy, this greatly increased the risk of schizophrenia, but those in a healthy adopted family had a protective effect on those at genetic risk
L - suggest the expressed emotion in families can increase the risk of schizophrenia but also being in a low expressed emotion family can help prevent schizophrenia

P - family dysfunction theories have practical applications
E - the focus on the role of the family in schizophrenia has led researchers to develop family therapy to increase the patient’s chance of recovery and decrease chances of relapse
E - evidence from NICE who found that the relapse rate in a family therapy condition was 26% compared to 50% relapse in a control group receiving standard care
L - this is positive as it suggests family dysfunction theories have led to psychological therapies that have benefited real peoples lives

P - evidence to support that dysfunctional offence within a family may be a risk factor for schizophrenia
E/E - Read found that 69% of female adult schizophrenic had a history of physical and/or sexual abuse and 59% of male schizophrenics
L - they suggest that family dysfunction in the form of abuse may be a risk factor for the development of schizophrenic symptoms in the future

Question 13

limitations of family dysfunction explanations

Answer 13

P - reductionist
E - only focuses on family communications as a cause of SZ and not biological factors
E - there are biological explanations of SZ such as neural correlates and the dopamine hypothesis which argue that SZ is associated with abnormalities to the structure or function of the brain
L - family explanations alone may not explain all aspects of SZ

P - determinist
E/E - SZ is caused by family communication patterns outside a sufferers control
L - if an individual feels they have no ctomrol over developing the disorder they may engage in risk behaviours (eg substance abuse) which could in turn trigger the onset of SZ
E - HOWEVER could be seen as positive as it removes blame from the patient for developing the disorder