Family dysfunction Flashcards
Family dysfunction.
Refers to processes within a family such as poor family communication, cold parenting, and high levels of expressed emotion.
These may be risk factors for both the development and maintenance of schizophrenia.
Frieda Fromm-Reichmann (1948) proposed a…
Psychodynamic explanation for schizophrenia, based on the accounts she heard from her patients about their childhood.
Fromm-Reichmann spoke to many of her patients and identified the schizophrenogenic mother.
The Schizophrenogenic Mother.
Schizophrenia comes from being reared by a cold and dominant mother who is both overprotective and rejecting. Although such a mother appears self-sacrificing, she actually uses the child to satisfy her own emotional needs. Therefore, individuals brought up with this mothering style develop schizophrenia as they are confused by their mother’s overprotective but rejecting nature.
Schizophrenogenic mothers are cold, rejecting and controlling and tend to create a family climate of tension and secrecy. This leads to…
Distrust that later develops into paranoid delusions.
Gregory Bateson et al (1972) - Double-bind theory.
Emphasised the 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 of this situation or seek clarification.
When child gets it wrong, they are often punished by withdrawal of love leaving them with an understanding of the world as confusing and dangerous and hence reflected in symptoms.
Bateson was clear that this was neither the main type of communication in family of someone with schizophrenia nor the only factor in developing schiz, just a risk factor.
Expressed Emotion.
The level of emotion expressed towards a person with schiz by carers or family members.
Contains several elements:
Verbal criticism of person, occasionally accompanied by violence.
Hostility towards person, inclu. anger and rejection.
Emotional overinvolvement in life of person.
High levels of EE towards individual - serious source of stress - primary explanation for relapse.
Strength: There is evidence linking family dysfunction to schizophrenia.
Indicators of family dysfunction inlcude insecure attachment and exposure to childhood trauma, especially abuse.
According to a review by Read et al (2005) adults with schiz are disproportionately likely to have insecure attachment, especially Type C/D.
Read et al also reported that 69% of women and 59% of men with schiz have a history of physical and/or sexual abuse.
In Morkved et al (2017) study, most adults with schiz reported at least one childhood trauma.
This strongly suggests that family dysfunction makes people more vulnerable to schiz.
Limitation: There is poor evidence base for any of the explanations.
Although there is plenty of evidence supporting the idea that childhood family-based stress is linked with adult schiz, there is almost non to support the importance of traditional family-based theories.
Both these theories are based on clinical observation of people with schiz and also informal assessment of their mothers’ personalities, but not systematic evidence.
This means that family explanations have not been able to account for the link between childhood trauma and schiz.
