Lesson 3: Psychological Explanations Of SZ

Question 1

Family dysfunction

Answer 1

Psychologists have attempted to link SZ to childhood and adult experiences of living in a dysfunctional family where they may be abuse, complicated divorced, high poverty etc.

Question 2

Schizophrenogenic mother

Answer 2

Fromm-Reichmann (1948) proposed a psychodynamic explanation for SZ based on the accounts she heard from her patients about their childhood. She noted that many of her patients spoke about a particular type of parent which she called ‘the Schizophrenogenic mother’ whose characteristics were being cold, rejecting, 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 lead to paranoid delusions, ultimately developing into SZ. Father is often passive in these situations.

Question 3

Double bind theory

Answer 3

Bateson et al (1972) agreed that family climate in important in the development of SZ but focused more on actual family communication style. He suggested that children who frequently receive contradictory messages from their parents are likely to develop SZ in adulthood. This is because children find themselves confused about the world and sees it à as a dangerous place - reflected in SZ symptoms such as paranoid delusions. However Bateson clarified this was a risk factor not the only cause.

Question 4

Expressed emotion

Answer 4

Level of emotion (particularly negative) expressed towards a patient by their carers.
- Verbal criticism of the patient
- hostility towards the patient
- emotional over-involvement in the life of the patient

High levels of EE by the carers creates a serious source of stress which might cause the SZ patient to relapse. EE can also be a trigger for the onset of SZ as well especially if the person has a genetic vulnerability to the disorder.

Question 5

Strengths of family dysfunction as a risk factor

Answer 5

• Research support. In an adoption study by Tienari, adopted children who had SZ biological parents were more likely to have SZ themselves than those children with non-SZ 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
• Read et al (2005) reviewed 46 studies of child abuse and SZ and 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 the figure was 59%.
• Adults with insecure attachments to their primary carer are also more likely to develop SZ thus strengthening the family dysfunction explanation.
• Evidence to support double-bind theory and SZ. Berger (1956) found that schizophrenics reported a higher recall of double-bind statements by their mothers than non-SZs. However, this evidence may not be reliable as patient’s recall might be affected by their SZ.

Question 6

Weaknesses of family dysfunction as a risk factor

Answer 6

• Evidence for family dysfunction as a contributing factor to developing SZ is not very strong. Lies (1974) measured patterns of parental communication in families with a schizophrenic child and found no different compared to normal families.
• Also not all patients who live in high EE families relapse but 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.
• One problem with dysfunctional family explanations for SZ is that they have led historically to parent blaming - parents who have already suffered seeing their child developing SZ have had to bear life-long responsibility for their care will also suffer further trauma by being blamed for their condition. Not ethical.
• explanation 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 is suggested that individuals who possess the PCM1 gene are more likely to become schizophrenic. Therefore we should be cautious in saying family dysfunction is a cause of SZ as other factors may be important
  Need to take holistic approach

Question 7

Cognitive explanations

Answer 7

• focus on the role of mental processes
• associated with several types of dysfunctional thought processing and thus provide explanations for SZ as a whole

Question 8

Meta representation

Answer 8

• Frith et al (1992) identifies two kinds of dysfunctional thought processing that could underlie some symptoms:
• Metarepresentation is the 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 the actions of others
• A dysfunction in meta representation would disrupt this ability to recognise our own actions and thoughts as being our own rather than someone else. This could explain auditory hallucinations and delusions where you believe that someone is putting thoughts into your head.

Question 9

Central control

Answer 9

• Cognitive ability to suppress automatic responses while we perform other actions instead
• speech poverty and thought disorder could result from the inability to ignore your own automatic thoughts as well as what others could be saying to you in your head
• sufferers with SZ tend to experience derailment of their thoughts and what they say because there is too much going on in their thoughts processes thus they lose control of their own thoughts

Question 10

Strengths of cognitive explanations of SZ

Answer 10

• Strong evidence for dysfunctional thought processing in SZ.
• Stirling et al (2006) compared 30 patients with a diagnosis of SZ with 18 non-patient controls on a range of cognitive tasks such as the strop effect. (Colour of word is different to the colour name). Found that patients with SZ took twice as long to say the colour of the word than controls - this study shows dysfunctional thought processing in schizophrenics since they were struggling with separating the actual colour word from the actual colour that it was.
• Success of cognitive behaviour therapy used alongside drugs to treat schizophrenia. As schizophrenia is a thought disorder, clearly drugs cannot completely treat the disorder thus CBT will aim to question and challenge the hallucinations and delusions as well as using behavioural techniques (such as positive reinforcement). CBT has been proven to be effective thus further supporting the cognitive explanations of SZ.

Question 11

Weaknesses of cognitive explanations of SZ

Answer 11

• although there is a wealth of evidence to support the idea of SZs having dysfunctional thought processing, it is difficult to establish whether this is a cause or consequence of SZ for example did the dysfunctional thought processing begun and then the person had symptoms of SZ or is the dysfunctional thought processing a consequence of SZ.
• problematic in that it fails to take into account biological factors and does not acknowledge the fact that dysfunctional thought processing could also be due to abnormal dopamine levels in the brain. This explanation is therefore reductionist because it is simplifying SZ to very basic levels e.g. dysfunctional thoughts rather than considering other factors such as genes, neurotransmitters and stress which all have been shown to contribute to schizophrenia.