psych explanations of schizophrenia (family dysfunction and cognitive exp) Flashcards
all notes from booklet completed, notes from ppqs ppt done
what are the two psychological explanations
family dysfunction (focus on psych envr, fam as a risk factor) and cognitive explanations
what problems could there be in family dysfunction
lack of warmth between parents and child, dysfunctional communication patterns and parental overprotection
what are the explanations for family dysfunction
schizophrenogenic mother, double blind theory, expressed emotion
as well as childhood experiences in terms of experience of abuse/development of insecure attachment
what is the explanation of schizophrenogenic mother
what did fromm reichmann find
it is a psychodynamic explanation
argued that many of her patients described having a mother who was cold, rejecting and controlling and created a family environment that was tense and secret.
> to distrust > to paranoid delusions > SZ
what does the double blind theory (bateson) say, inc explained eg in leading to sz
emphasises role of comms style within fam.
kids of frequently get contradictory messages from parents more likely to develop sz.
eg mum tells son she loves him but at same time turns head away in disgust > child gets 2 conflicting messages on diff levels one affection verbally, other rejection nonverbally
the child cant respond as messages invalidate each other.
> prevents development of conception of reality and leads to a view of the world as confusing and dangerous
> manifests as sz (disorganised thinking, paranoid delusions)
this is a RISK FACTOR
support for dbtheory: berger found..
plus counterpoint/limitation: liem found
that individuals with sz reported a higher recall of db statements by their mothers than people without sz
liem measured patterns of parental comms in fams with/out a sz member and found no difference
limitation of research into schizophrenogenic mother and dbtheory
there is a lack of research support
what there is is based on clinical observation of patients and informal assessments of personality of mothers.
NO systematic evidence so the evidence base of these exps is POOR
what is expressed emotion inc the elements
EE is the level of emotion, particularly negative emotion expressed towards the sz individual by their family members/carers
elements are:
verbal criticism
hostility towards individual (anger and rejection)
emotional over involvement in their life (inc needless self sacrifice)
mostly a negative emotional climate
link EE to sz
high levels of EE from fam to szi are a serious source of stress > trigger onset of sz in a vulnerable person (eg genetically) OR relapse
szi have a lower tolerance for intense environmental stimuli (emotional comments and interactions)
a negative emotional climate > too much stress > sz episode
vs a supportive fam and emotionally undemanding may help the szi to reduce their dependence on APs and help reduce likelihood of relapse
support for role of ee in sz (linszen) found that a patient returning to a family with ….
pls cp: however not all … (general statement)
altorfer found that ….. of patients showed no …..
high ee is 4 times more likely to relapse than a patient whose family is low in ee
however not all patients who live in high ee families relapse and not all who live in low ee homes avoid relapse.
1/4 showed no phsiological responses to stressful comments from relatives indicated no relapse of sz symptoms when high ee is present
support for the role of childhood trauma: read, ….. studies of child abuse and sz and found ……
and insecure attachment: read szi adults were found to be …….. likely to have had ….
46 studies
found 69% of female in patients with sz has a history of childhood abuse and 59% of out patients.
disproportionately likely to have insecure attachment
limitation of family dysfunction: ethical problems with parent blaming
parents feel responsible for childs condition > greater stress and anxiety
outdated views are no longer tolerated by families and so seen as destructive rather than productive, is fam is part of the problem then it is difficult to change
it is highly socially sensitive.
is it useful to blame the family?
limitation of family dysfunction: the data is reported retrospectively …
parents report childhood experiences retrospectively so the recall may be inaccurate and so the recall of data may be unreliable and so the data may like validity.
prospective evidence is rare
a strength of fd: tienari prospective study of adopted children saw a child rearing style characterised by …….. was associated with ….
but only when …..
characterised by lots of criticism, conflict and lack of empathy was associated with increased risk of sz
but only when child had genetic risk (bio mother has sz)
genetically vulnerable children may be more sensitive to family dysfunction.
evaluation of family dysfunction: fd might be a trigger but the cause …
link to tienari
may be biological eg dopamine hypothesis
link to tienari: there was only increased risk when the child had a genetic risk of condition (mother with sz) so genetically vulnerable children may be more sensitive to family dysfunction.
