Lesson 3 Flashcards
family dysfunction
-psychologists have attempted to link sz to childhood and adult experiences of living in a dysfunctional family
-schizophrenogenic mother, double bind theory, expressed emotion
schizophrogenic mother
-Fromm-Reichmann 1948 proposed explanation based on accounts she heard from patients about childhood, many spoke about type of mother: cold, rejecting, controlling, creates a family climate full of secrecy and tension, leads to later lack of trust in relationshipsthat develops to paranoid delusions, sz, father is often passive and does not involve in child upbringing
double bind theory
-Bateson et al 1972 agreed family climate is important in development of sz but focused more of actual family communication style, suggested children whp frequently receive contradictory messages from parents, child is trapped worried about doing wrong thing but receive mixed messages about what this is, child is unable to comment about unfairness of situation or seek clarification, child may get it wrong and be punished by withdrawal of love, child is then confused about thw world and sees it as dangerous, paranoid delusions, clarified this was a risk factor but not only cause
expressed emotion
-level of emotion, particularly negative, expressed towards a patient by carers
-verbal criticism of patient, occassionally shown with violence
-hostility towards patient, including anger and rejection
-emotional over-involvement in the life of the patient including self sacrifice
-high levels creates serious source of stress, may be reason of relapse, can also trigger onset of sz especially if genetically vulnerable
family dysfunction evaluation
-research support, Tienari et al 1994, adopted children who had sz biological parents were more likely to have sz, however only emerged in adopted families that were disturbed/dysfunctional, illness only manifested itself under appropriate environmental conditions
-Read et al 2005 reveiwed 46 studies of child abuse and sz, concluded 69% of adult women in patients with diagnosis had history of physical/sexual abuse in childhood, for men 59%
-adults with insecure attachment to primary carer are more likely to develop sz
-Berger 1965 found sz reported higher recall of double-bind statements by their mothers than non, however may not be reliable as recall may be affected by sz
-Liem 1974 measured patterns of parental communication in families with sz child and found no difference when compared to normal families
-not all patients with high EE relapse not all with low EE avoid it, Altorfer et al 1998 found 1/4 of patients they studied showed no psychological responses to stressful comments from their relatives, shows EE contribution is mixed
-led to parent blaming, parents already see child develop sz then have to bear life-long responsibility for care will also suffer trauma by being blamed for condition, may not be entirely ethical
cognitive explanation
-focus on the role of mental processes, sz associated with several types of dysfunctional thought processing
-Frith et al 1992 identified two types of dysfunctional thought processing that could underlie symptoms- metarepresentation and central control
metarepresentation
-cognitive ability to reflect on thoughts and behaviour which enables us an insight into our own intentions and goals as well as allowing us to interpret actions of others
-dysfunction would disrupt ability to recognise own actions and thoughts as being our own rather than somsone elses, could explain hallucinations/delusions
central control
-cognitive ability to suppress automatic responses while we perform other actions instead
-speech povery and thought disorder could result from the inability to ignore own automatic thoughts as well as what others could be saying
-sz sufferers tend to experience derailment of thoughts and what they say as too much is going on in thought processes
cognitive explanations evaluation
-Stirling et al 2006 compared 30 patients with sz diagnosis to 18 non-patients on a range of cognitive tasks eg stroop effect, found patients with sz took twice as long to say colour of word than controls, shows dysfunctional thought processing, difficulty separating word and colour
-success of CBT alongside drugs as treatment, thought disorder so drugs alone cannot completely treat, cbt aims to question/challenge hallucinations and delusions, as well as behavioural techniques, proven to be effective
-cause and effect not clear
-fails to take into account biological factors, could be due to dopamine levels in brain, also reductionist as simplifies sz to very basic elements eg just dysfunction thoughts rather than other factors
