Lesson 3 – Psychological Explanations of Schizophrenia Flashcards
What are the two main psychological explanations for schizophrenia
The two main psychological explanations for SZ are Family dysfunction and Cognitive Explanations
What is family dysfunction
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)
How is family dysfunction explained
The family dysfunction explanation can be explained in three ways:
1.The schizophrenogenic mother
2.Double-bind Theory
3.Expressed Emotion
The schizophrenogenic mother
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. A point to be noted about the schizophrenogenic mother is that in those type of families, the father is often passive and doesn’t really get involved in child upbringing.
Double-bind Theory
Bateson et al. (1972) agreed that family climate is important in the development of SZ but focused more on the actual family communication style. He suggested that children who frequently receive contradictory messages from their parents. In this case, the child finds themselves trapped in situations which they fear doing the wrong thing but receive mixed messages about what this is. (An example of 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. Thus 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.
Expressed Emotion
Expressed Emotion (EE) is the level of emotion, in particular negative emotion, expressed towards a patient by their carers.
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)
Strengths of family dysfunction as a risk factor of schizophrenia
There is research support for family dysfunction as a risk factor. For example in an adoption study by Tienari et al (1994). In this study, 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.
Also there is some evidence to support the Double-bind theory and SZ. Berger (1965) found that schizophrenics reported a higher recall of double-bind statements by their mothers than non-schizophrenics. However, this evidence may not be reliable as patient’s recall may be affected by their SZ in other words because they have suffered from hallucinations and delusions – they may just be assuming that their mothers used more double bind statements and we don’t know if their memory may have been affected by their symptoms.
Weaknesses of family dysfunction as a risk factor of schizophrenia
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.
Finally 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 for example, 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.
What are the cognitive explanations for schizophrenia
Cognitive explanations for schizophrenia focus on the role of mental processes. SZ is associated with several types of dysfunctional thought processing and thus provide explanations for SZ as a whole.
What two cognitive abilities that can be affected dysfunctional thought processing
Metarepresentation and Central control
Metarepresentation
This 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.
Metarepresentation - dysfunction
A dysfunction in metarepresentation 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 (like thought insertions – where you believe that someone is putting thoughts into your head)
Central control
This is the cognitive ability to suppress automatic responses while we perform other actions instead (e.g. a voice in you might say: ‘don’t do this’ – then you choose whether you do it or not)
Central control - dysfunction
Speech poverty and thought disorder could result from the inability to ignore your own automatic thoughts as well as what other could be saying to you (in your head) (e.g. so and so would tell me not to do this)
Sufferers with SZ tend to experience derailment (a confusion and breakdown) of their thoughts and what they say because there is too much going on in their thought processes thus they lose control of their own thoughts.
Strengths of cognitive explanations of schizophrenia
There is strong evidence for dysfunctional thought processing in SZ. In one study 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 stroop effect (this is when the colour word is written in a different colour and you have to actually say the colour of the word rather than just reading the word). In his study Stirling 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 colour word from the actual colour that it was (e.g. saying the colour blue but the actual colour word written is red) because the Schizophrenics were not able to separate the actual colour from the written word.
Another strength of cognitive explanations of schizophrenia is the success of cognitive behaviour therapy (CBT) used alongside drugs to treat schizophrenia. As schizophrenia is a thought disorder, clearly drugs cannot completely treat the disorder thus cognitive behavioural therapy 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.
