L3 - Psychological Explanations Of SZ Flashcards
1
Q
What are the 2 main psychological explanations for SZ
A
- family dysfunction
- cognitive explanations
2
Q
Family dysfunction
A
- Psychologists have attempted to link SZ to childhood and adult experiences of living in a dysfunctional family (i.e. a family that is not functioning properly e.g. where there may be abuse, messy divorces, criminal activities, high poverty etc)
The family dysfunction explanation can be explained in three ways:
1.The schizophrenogenic mother
2.Double-bind Theory
3.Expressed Emotion
3
Q
The schizophrenogenic mother
A
- Fromm-Reichmann (1948) proposed a psychodynamic explanation for SZ based on the accounts she heard from her patients about their childhoods. She noted that many of her patients spoke about a particular type of parent which she called the schizophrenogenic mother
- The term ‘schizophrenogenic’ means ‘schizophrenia’ causing
- Characteristics of this type of mother are: cold, rejecting and controlling as well as creating a family climate full of secrecy and tension
- This leads the child to having a lack of trust in relationships that later develop into paranoid delusions (the belief that one is being persecuted by another person) thus ultimately developing SZ
- in these type of families, the father is often passive and doesn’t really get involved in child upbringing.
4
Q
Double bind theory
A
- Bateson et al. (1972) agreed that family climate is important in the development of SZ but focused more on the actual family communication style
- suggested that children who frequently receive contradictory messages from their parents
- the child finds themselves trapped in situations which they fear doing the wrong thing but receive mixed messages about what this is. (E.g. a mixed message could be when a mother tells her child she loves him but is actually showing disgust when she tells him.)
- As a result the child is unable to comment about the unfairness of the situation or seek clarification
- so when the child may get it wrong (which they often do), the child is punished by withdrawal of love
- The child then feels confused about the world and sees it thus as a dangerous place – this may be reflected in SZ symptoms such as paranoid delusions
- Bateson did clarify that this family communication style was a risk factor in the development of SZ but not the only cause
5
Q
Expressed emotion
A
- Expressed Emotion (EE) is the level of emotion, in particular negative emotion, expressed towards a patient by their carers who are often family members e.g. when they have come out of hospital
EE has several parts: - Verbal criticism of the patient, occasionally shown with violence
- Hostility towards the patient, including anger and rejection
- Emotional over-involvement in the life of the patient, including needless self-sacrifice
- High levels of EE by the carers of the patients creates a serious source of stress – this may be a reason for the SZ patient to relapse – although EE can also be a trigger for the onset of SZ as well especially if the person has a genetic vulnerability to the disorder (diathesis-stress model)
6
Q
Evaluation
A
strengths
- research support
- child abuse support
- double-bind theory support
- expressed emotion support
weaknesses
- evidence isn’t very strong
- mixed expressed emotion research
- parent blaming
- environmentally reductionist
7
Q
Research support
A
- There is research support for family dysfunction as a risk factor.
- adoption study by Tienari et al (1994) found those adopted children who had schizophrenic biological parents were more likely to have SZ themselves than those children with non-schizophrenic biological parents
- However, this difference only emerged in situations where the adopted family was rated as disturbed or ‘dysfunctional’.
- In other words, the illness only manifested itself under appropriate environmental conditions.
- Genetic vulnerability alone was not sufficient.
-This shows that family dysfunction is a contributing factor to SZ.
8
Q
Child abuse support
A
- Read et al. (2005) reviewed 46 studies of child abuse and SZ & concluded that 69% of adult women in-patients with a diagnosis of SZ had a history of physical abuse, sexual abuse or both in childhood.
- For men it was 59%.
- This study shows that family dysfunction contributes to an individual developing SZ.
- He also that that adults who had insecure attachments to their primary carer in childhood, are
also more likely to develop SZ thus strengthening the family dysfunction explanation.
9
Q
Child abuse support
A
- Read et al. (2005) reviewed 46 studies of child abuse and SZ & concluded that 69% of adult women in-patients with a diagnosis of SZ had a history of physical abuse, sexual abuse or both in childhood.
- For men it was 59%.
- This study shows that family dysfunction contributes to an individual developing SZ.
- He also that that adults who had insecure attachments to their primary carer in childhood, are
also more likely to develop SZ thus strengthening the family dysfunction explanation.
10
Q
Double-bind theory support
A
- Bateson (1956) reported on a case study when a recovering schizophrenic was visited in hospital by his mother.
- He embraced her warmly, but she stiffened, and when he withdrew his arms she said, ‘Don’t you love me any more?’ To which he blushed and she commented, ‘Dear, you must not be so easily embarrassed and afraid of your feelings.’
- She then left and he assaulted an aide and had to be restrained.
- This gives support to the idea of double bind as the mother had obviously given mixed messages to her son in childhood hence his behaviour towards the aide.
11
Q
Expressed emotion support
A
- There is also evidence for expressed emotion as a contributing factor to the relapse of SZ
- Kavanagh (1992) reviewed 26 studies of expressed emotion, finding that the mean relapse rate for schizophrenics who returned to live with high expressed emotion families was 48% compared to 21% to those who went to live with low expressed emotion families.
- This supports the idea that expressed emotion increases the risk of relapse for recovering schizophrenics.
12
Q
Evidence isn’t very strong
A
- The evidence for family dysfunction as a contributing factor to developing SZ is not very strong.
- For example, with regards to Double-bind theory, Liem (1974) measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families.
- This shows that this theory may not be specifically related to SZ.
13
Q
Mixed expressed emotion support
A
- Also not all patients who live in high EE families relapse, and not all patients who live in low EE homes avoid relapse.
- Altorfer et al (1998) found that one-quarter of patients that they studied showed no physiological responses to stressful comments from their relatives.
- This shows that the evidence for EE as a contributing factor towards relapse and SZ is very mixed.
14
Q
Parent blaming
A
- One problem with dysfunctional family explanations for SZ is that they have led historically to parent blaming
- parents who have already suffered seeing their son/daughter developing SZ and having to bear life-long responsibility for their care will also suffer further trauma by being blamed for their son/daughter’s condition.
- This means that family dysfunction explanations may not be entirely ethical and may cause more harm than help to both the sufferer and their parents.
15
Q
Environmentally reductionist
A
- the family dysfunction explanation of SZ can be criticised as being environmentally reductionist as it is simplifying the cause of SZ to family upbringing and ignoring other factors which could be more important
E.g. it has been suggested that individuals who possess the PCM1 gene are more likely to become
schizophrenic. - Therefore we should be cautious when stating that family dysfunction could be a cause of SZ as other factors may be important.
- It is therefore important to look at a more holistic explanation of SZ rather than just focusing on family upbringing.
