Psychological Explanations Flashcards
Psychological Explanations
There are a range of psychological explanations of schizophrenia, some have focused on the psychological environment, in particular the family.
Others have focused more on the mind of the sufferer, emphasising the role of abnormal cognition in the experience of schizophrenia. Such cognitive impairments in sufferers of schizophrenia, e.g., poor attentional control, memory deficits, disorganised thinking, play an important role in the development and maintenance of schizophrenia.
Family Dysfunction
- The Schizophrenogenic Mother Hypothesis
- Double-Bind Theory
- Expressed Emotion
- The Schizophrenogenic Mother Hypothesis
- This hypothesis was first introduced by Fromm-Reichmann in 1948.
- It puts the blame for schizophrenia firmly on the mother’s shoulders.
- Fromm-Reichmann noted that many of her patients spoke of a particular type of parent, which she called ‘schizophrenogenic’, literally meaning ‘schizophrenia causing’, and argued that even though there had to be some genetic potential for a person to develop schizophrenia, the trigger was a domineering mother.
- According to Fromm-Reichmann, a ‘schizophrenogenic’ mother is cold, rejecting and controlling, for example; she may micromanage her child and refuses to acknowledge their independence.
- This creates a family climate characterised by tension and secrecy, leading to distrust that later develops into paranoid delusions.
- However, the family dynamics of the time would make the father much less involved and by the 1970s, the focus of research was moving away from the mother and out towards the wider family.
- It became evident, that a common theme that emerged was difficulty in communication.
- Double-Bind Theory
- A double bind is an emotionally distressing dilemma in communication in which an individual receives two or more conflicting messages, and one message negates the other.
- Bateson et al. suggested the double bind theory as a contributing factor to schizophrenia in which the members of families of schizophrenics communicate in a destructively ambiguous fashion.
- This theory suggests that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia.
- For example, parents who say they care whilst appearing critical or who express love whilst appearing angry.
- This leaves them with a world which is confusing and dangerous.
- Prolonged exposure to such interactions prevents the development of an internally coherent construction of reality; in the long run, this manifests itself as schizophrenic symptoms, such as affective flattening, paranoid delusions and hallucinations, and incoherent thinking and speaking.
- Expressed Emotion
- One aspect of communication that has been extensively researched is that of Expressed Emotion (EE).
- This refers to the hostile attitude that is often shown by relatives of the person with schizophrenia.
- It is concerned with the level of emotion, in particular negative emotion, expressed towards the patient by their carers.
- It contains several elements:
- Verbal criticism of the patient, occasionally accompanied by violence.
- Hostility towards the patient, including anger and rejection.
- Emotional over-involvement in the life of the patient, including needless-sacrifice.
- These high levels of expressed emotion in carers directed towards the patient are a serious source of stress for the patient.
- A number of studies have indicated that expressed emotion is a major cause of relapse when patients return home after a period in hospital following a psychotic episode.
- It has also been suggested that it may be the source of stress that can trigger the onset of schizophrenia in a person who is already vulnerable (diathesis-stress model).
Cognitive Explanations
- Perception Deficit
- Memory Deficit
- Dysfunctional Thought Processing
- Perception Deficit
- Research has been conducted in the field of perception, specifically facial perception.
- To properly perceive a face, we must process feature information; specific features (e.g., eyes, nose, mouth, etc) and configuration (e.g., distance between features).
- Shin et al. showed that schizophrenics were poor with configuration information.
- As this is what tells us about face expressions, a number of studies have found that schizophrenics do poorly on appreciation of facial emotional expressions and struggle to accurately describe the emotion being displayed.
- This misperception may lead to a misinterpretation of the person’s intent and might explain how persecutory delusions emerge.
- Memory Deficit
- Memory deficits in schizophrenia are well-evidenced and it has been suggested that poor perceptual processing could lead to poor encoding of material into working memory and, hence, a poor working memory.
- However, it is not just the working memory system that is affected; evidence shows that they also underperform on a variety of long-term memory tasks.
- Hemsley suggests that there is a substantial breakdown in the relationship between perception and memory in schizophrenics and that their poor integration of perception and memory leads to disorganised thinking and behaviour.
- Dysfunctional Thought Processing
- Frith et al identified two kinds of dysfunctional thought processing that could underlie some symptoms:
- Meta-representation - the cognitive ability to reflect on thoughts and behaviour. This allows us insight into our own intentions and goals. It also allows us to interpret the actions of others. Dysfunction in meta-representation would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else. This would explain hallucinations of voices and delusions like thought insertion (the experience of having thoughts projected into the mind of others).
- Central Control - the cognitive ability to supress automatic responses while we perform deliberate actions instead. Disorganised speech and thought disorder could result from the inability to supress automatic thoughts and speech triggered by other thoughts. For example, sufferers with schizophrenia tend to experience derailment of thoughts and spoken sentences because each word triggers associations and the patient cannot supress automatic responses to these.
Strength
Point: There is research evidence to suggest that difficult family relationships are linked to an increased risk of developing schizophrenia in adulthood.
Evidence: Read et al. reviewed 46 studies of child abuse and schizophrenia, finding that 69% of adult women with schizophrenia had experienced physical or sexual abuse in childhood. Additionally, 59% of men showed similar patterns.
Justification: This supports the idea that early trauma and negative family environments can act as a trigger for schizophrenia, which aligns with the diathesis-stress model where genetic vulnerability interacts with environmental stress.
Implication: This is therefore a strength of the family dysfunction explanation, as it suggests that improving family relationships and providing early support for children in high-stress or abusive environments could help reduce the risk of developing schizophrenia, highlighting the importance of family-based interventions and therapy.
Counterargument: However, a limitation of research into family dysfunction and schizophrenia is that much of the evidence relies on retrospective data.
Evidence: For example, information about childhood experiences is often gathered after the onset of symptoms, meaning that schizophrenia itself may have distorted the patients’ memories. While some prospective studies, which track individuals over time, have linked family dysfunction to schizophrenia, the evidence remains limited and inconclusive.
Justification: This demonstrates that the findings may not be entirely reliable, as distorted memories could lead to inaccurate conclusions about the role of family dysfunction in schizophrenia. Furthermore, prospective studies are considered more reliable since they avoid recall bias, but the inconsistent results as well as the lack of such studies conducted on schizophrenic patients prevents the likelihood of attaining generalisable and definitive data.
Implication: This raises questions about the validity of family dysfunction as a psychological explanation for schizophrenia as distorted recall could lead to overestimation of the impact of family dysfunction on schizophrenia. This emphasises the need for a greater focus on prospective, longitudinal studies to strengthen the evidence base and to ensure clarity on the relationship of the two factors.
Weakness
Point: The theories of the ‘schizophrenogenic mother’ and ‘double bind theory’ have been criticized for being socially sensitive research.
Evidence: The schizophrenogenic mother theory, proposed by Fromm-Reichmann, suggested that mothers with cold and controlling behaviour could cause schizophrenia in their children. Similarly, the double bind theory, which was introduced by Bateson et al. posited that conflicting messages from parents, such as receiving contrasting verbal and non-verbal cues, could contribute to the development of schizophrenia. The theory was pivotal at the time, as it linked communication patterns with the family to the onset of mental illness. However, such associations create a leverage for stigmatisation to occur towards the schizophrenic’s family, specifically their parents as they are regarded as the cause of their child’s schizophrenia.
Justification: Therefore these theories were socially sensitive as they place the blame for the onset of schizophrenia squarely on the shoulders of parents, particularly mothers. Such claims were damaging, as they implied that a parent’s actions could directly cause a serious mental health condition. This essentially leads to harmful discrimination towards the parents, who are already grappling with the challenges of caring for a child with a severe psychiatric disorder. This parent-blaming not only perpetuated societal stigma but also overlooked other significant factors, such as genetic predisposition, which can also be influential in the development of schizophrenia.
Implication: Consequently, this increases the stigma surrounding schizophrenia because it places unfair blame on parents, reinforcing negative stereotypes. This exacerbated their emotional distress and increased their level of responsibility to ensure that they were exonerated from such accusations proposed by these theories, which highlights its negative psychological and societal impact.
Weakness
Point: A major limitation of the family dysfunction and cognitive explanations for schizophrenia is that much of the supporting evidence is correlational, making it difficult to establish a clear cause-and-effect relationship.
Evidence: Studies examining the families of individuals with schizophrenia have found correlations between dysfunctional family dynamics, such as a domineering mother, and the onset of schizophrenia. However, these studies cannot determine whether the domineering behaviour caused the schizophrenia or whether it developed as a response to the child’s schizophrenic symptoms. Similarly, while there are clear links between cognitive impairments, e.g., memory deficits, and schizophrenic symptoms, it remains unclear whether these impairments are the cause of the disorder or a consequence of underlying biological factors, such as brain abnormalities.
Justification: The reliance on correlational evidence makes it difficult to determine whether dysfunctional family dynamics or cognitive impairments are a cause or a consequence of schizophrenia. This demonstrates that without experimental or longitudinal evidence, it is difficult to determine the direction of causality.
Implication: This reduces the internal validity of family dysfunction and cognitive explanations because the lack of causal evidence limits their ability to fully explain the origins of schizophrenia. This ambiguity challenges the idea that these factors directly contribute to the onset of the disorder.
Weakness
Point: A strength of psychological explanations, like family dysfunction, is that they can be integrated with biological factors in the interactionist approach.
Evidence: Biological explanations in schizophrenia, such as genetic factors or brain abnormalities, highlight the role of biology in the development of the disorder. On the other hand, psychological theories like family dysfunction focus on environmental influences on the onset of schizophrenia. The interactionist approach, however, proposes that both biological and psychological factors interact to produce the disorder. Specifically, the diathesis-stress model suggests that schizophrenia may develop when an individual with a biological predisposition (diathesis) is exposed to environmental stressors, such as family dysfunction, which trigger the disorder.
Justification: The diathesis-stress model offers a more comprehensive and integrated explanation by acknowledging both genetic and environmental factors. It suggests that the interaction between these factors, rather than one alone, is more likely to lead to the development of schizophrenia. Therefore this approach overcomes the difficulty of reconciling biological and psychological factors by proposing that both are necessary contributors to the disorder.
Implication: As a result, the interactionist approach offers a more holistic explanation of schizophrenia that accounts for both biological and psychological perspectives. This could lead to more effective treatments that address both genetic vulnerability and external stressors, ultimately providing a more tailored approach to managing and preventing schizophrenia.
