Psychological explanation for schizophrenia Flashcards
what are the 2 psychological explanations for schizophrenia?
- family dysfunction
- cognitive explanations
what are the main points for family dysfunction?
- schizophrogenic mothers are cold, rejecting and controlling
- double-bind theory: conflicting messages in family communication leads to disorganised thinking
- expressed emotions: criticism, hostility and over-involvement leads to relapse in patients
Fromm-Reichmann proposed a psychodynamic explanation based on her patient’s childhood experiences of what she termed
schizophrogenic mothers
according to the schizophrogenic mothers explanation , these mothers are
cold, rejecting and controlling and tend to create a family climate characterised by tension and secrecy- this leads to distrust that later develops into paranoid delusions, and ultimately schizophrenia
summarise double-bind theory
- Bateson et al emphasised the role of communication in the family as a risk factor in the development of schizophrenia
- the developing child regularly finds themselves trapped in situations where they fear doing the wrong thing, but receive conflicting messages about what counts as wrong, and feel unable to express their feelings about the unfairness of the situation
- when they get it ‘wrong’ (which is often) the child is punished by withdrawal of love; this leaves them with the understanding that the world is confusing and dangerous which leads to disorganised thinking and delusions
explain how expressed emotion leads to relapse in patients
- expressed emotion (EE) is the level of emotion (mainly negative) expressed towards a person with schizophrenia. This includes:
- verbal criticism of the patient
- hostility towards the patient
- emotional over-involvement in the life of the patient
- high levels of EE cause stress in the patient and is a primary explanation for relapse in patients with schizophrenia
what are the main points for cognitive explanations?
- cognitive explanations focus on dysfunctional thought processing
- dysfunctional thought processing in metarepresentation leads to hallucinations
- dysfunctional thought processing in central control leads to speech poverty
explain how cognitive explanations focus on dysfunctional thought processing
- cognitive explanations of schizophrenia focus on abnormal information processing as the root cause of schizophrenia
- lower levels of informational processing in some areas of the brain suggest that cognition is impaired
- for example, reduced processing in the ventral striatum is associated with negative symptoms
who identified dysfunctional thought processing in metarepresentation as a possible explanation of hallucinations and delusions?
Frith et al
what does metarepresentation refer to?
the cognitive ability to reflect on thoughts and behaviours; dysfunction in this ability would disrupt our ability to recognise our own thoughts as our own, which could lead to the sensation of hearing voices (hallucinations) and having thoughts placed in the mind by others (delusions)
Frith et al also identified dysfunctional thought processing in central control as an explanation of speech poverty. People with schizophrenia, tend to experience
derailment of thoughts and spoken sentences because each word triggers automatic associations that they cannot suppress
what are the evaluation points for psychological explanations?
- evidence for family-based explanations is weak
- one strength is support for different information processing in people with schizophrenia (Stirling et al)
- biological factors are not always adequately considered
- a limitation of the cognitive explanation is the direction of causality
explain how evidence for family-based explanations is weak
- although there is plenty of evidence supporting the principle that poor childhood experiences are associated with schizophrenia, there is little evidence to support the importance of schizophrogenic mothers, expressed emotion or double-bind. These theories are mainly based on clinical observations of patients, which are open to interpretation and subjectivity
- the dysfunctional family explanations have historically led to parent-blaming- parents already suffering through their child’s symptoms, underwent trauma by being blamed for their condition
- these issues undermine the appropriateness and credibility of family-based explanations
explain how one strength is support for different information processing in people with schizophrenia (Stirling et al)
- Stirling et al compared 30 patients with schizophrenia with 18 non-patient controls on cognitive tasks
- for example, in the Stroop test, participants had to name the ink colour of coloured words
- in line with Frith’s theory of central control of dysfunction, patients took over twice as long to suppress the impulse to read the word and to name the ink colour instead
- this, and a mass of other evidence, shows that processing is different in those who have schizophrenia
- HOWEVER, it is not clear whether these faulty cognitions are merely the proximal cause i.e. the cause of the symptoms or the underlying distal cause i.e the origins of the disorder
explain how biological factors are not always adequately considered
- in their pure forms, psychological explanations for schizophrenia (particularly family dysfunction) can be hard to reconcile with biological explanations such as genetic explanations and the dopamine hypothesis
- it could be that both biological and psychological factors can separately produce the same symptoms, which raises the question of whether both outcomes are really schizophrenia
- alternatively, we can view this in terms of the diathesis-stress model where the diathesis may be biological or psychological
