Psychological Explanations

Question 1

What are the 2 types of psychological explanations for SZ?

Answer 1

1) Psychological

2) Socio-cultural

Question 2

What are psychological theories of SZ?

Answer 2

Arise from major psychological perspectives

Question 3

What are socio-cultural factors of SZ?

Answer 3

They stress the role of social and family relationships

Question 4

How many different sub-theories of the psychological theories of SZ are there?

Answer 4

2

Question 5

What are the 2 sub-psychological theories of SZ?

Answer 5

1) Psychodynamic

2) Cognitive

Question 6

Outline the psychodynamic explanation for SZ

Answer 6

Freud (24) believed it is the result of 2 related processes, regression to a pre-ego stage and attempts to re-establish ego control - if the world of SZ particularly harsh (parents were cold or uncaring), individual may regress to early stage in development before ego properly formed and before had developed realistic awareness of external world - thus seen by Freud as an infantile state, with some symptoms like delusions of grandeur reflecting this primitive condition and other symptoms like auditory hallucinations reflecting person’s attempts to re-establish ego control

Question 7

Outline the cognitive explanation for SZ

Answer 7

Acknowledges the role of biological factors in causing the initial sensory experiences but claims further features of disorder appear as individuals attempt to understand those experiences - when SZs first experience voices and other worrying sensory experiences, they turn to others to confirm the validity of what they’re experiencing, but other people fail to confirm the reality of these experiences so SZ comes to conclusion others must be hiding the truth so they begin to reject feedback from those around them and develop delusional beliefs they are being manipulated and persecuted by others

Question 8

How many socio-cultural factors are there for SZ?

Answer 8

4

Question 9

Name the 4 socio-cultural factors for SZ

Answer 9

1) Life events & SZ
2) Double-Blind Theory (family relationships)
3) Expressed Emotion (family relationships)
4) Labelling Theory

Question 10

Outline life events and SZ for psychological explanations

Answer 10

A major stress factor associated with a higher risk of SZ episodes is the occurrence of stressful life events

Question 11

What are the 2 studies associated with the link between life events and SZ?

Answer 11

1) Brown & Birley (68)

2) Falloon (96)

Question 12

Outline Brown & Birley (68)

Answer 12

Found, prior to a SZ episode, patients who had previously experienced SZ reported twice as many stressful life events compared to a control

Question 13

Outline Falloon (96)

Answer 13

Mechanisms through which stress factors trigger SZ are unknown, although high levels of physiological arousal associated with neurotransmitter changes are thought to be involved

Question 14

Who came up with the double-blind theory for SZ?

Answer 14

Bateson (56)

Question 15

Outline the double-blind theory for SZ

Answer 15

Suggest children who frequently receive contradictory messages from parents more likely to develop SZ - e.g. if a mother tells son she loves him, yet at the same time turns head away in disgust, child receives 2 conflicting messages about relationship on different communicative levels - child’s ability to respond to mother is incapacitated by such contradictions as one message invalidates the other - these interactions prevent the development of an internally coherent construction of reality and in the long run, this manifests itself as SZ symptoms

Question 16

Outline expressed emotion for SZ

Answer 16

A negative emotional climate or more specifically a high degree of EE - EE is a family communication style that involves criticism, hostility and emotional over-involvement - high levels of EE are likely to influence relapse rates, it appears negative emotional climate of these families arouses patient and leads to stress beyond their already impaired coping mechanisms, thus triggering a SZ episode

Question 17

What are the 2 studies supporting EE for SZ?

Answer 17

1) Linszen (97)

2) Kalafi & Torabi (96)

Question 18

Outline Linszen (97)

Answer 18

Patient returning to family with high EE is four times more likely to relapse than a patient returning to family with low EE

Question 19

Outline Kalafi & Torabi (96)

Answer 19

Found high prevalence of EE in Iranian culture (overprotective mothers and rejective father) was one of the main causes of SZ relapse rates

Question 20

Who put the labelling theory forward?

Answer 20

Scheff (99)

Question 21

Outline the labelling theory

Answer 21

States that social groups construct rules for members of their group to follow - symptoms of SZ like hallucinations, delusions and bizarre behaviour seen as deviant from these rules - if a person displays these unusual forms of behaviour, is considered deviant and label of SZ may be applied - once this diagnostic label is applied it becomes a self-fulfilling prophecy that promotes development of other symptoms of SZ

Question 22

Name 2 negative points about the psychodynamic approach to SZ

Answer 22

1) No research evidence to support it

2) Deterministic as implies SZ always due to previous issues - does not consider the role of freewill

Question 23

Name and explain the main positive about the psychodynamic approach to SZ

Answer 23

Psychoanalysts have claimed disordered family patterns are cause of the disorder - Fromm-Reichmann (48) described ‘SZ mothers’ or families who are rejecting, overprotective, dominant and moralistic as important contributory influences in the development of SZ - other studies shown parents of SZs behave differently from parents of other kinds of patients, particularly in presence of disturbed offspring, but this is likely to be a consequence of their children’s problems as a cause

Question 24

What is the main positive point about the cognitive approach to SZ?

Answer 24

Much evidence of a physical basis for cognitive deficits associated with SZ - Meyer-Lindenberg (02) found a link between excess dopamine in prefrontal cortex and working memory

Question 25

Name 3 negative points about the link between SZ and life events

Answer 25

1) van Os (94)
2) Link is just correlational
3) Could be that beginnings of the disorder like erratic behaviour cause the major life events and life events after onset of SZ may be a consequence rather than a cause of mental illness

Question 26

Outline van Os (94)

Answer 26

Reported no link between life events and onset of SZ - patients not more likely to have had major stressful life event in 3 months preceding onset of their illness

Question 27

What is the positive about the link between SZ and life events?

Answer 27

Prospective studies support - monitor presence/absence of stressful life events prospectively (in the future)

Question 28

What is the prospective study supporting the link between SZ and life events?

Answer 28

Hirsch (96)

Question 29

Outline Hirsch (96)

Answer 29

Followed 71 SZ patients over 48 weeks and found clear life events made significant cumulative contribution in 12 months preceding relapse rather than just having a more concentrated effect in the period just prior to SZ episode (as suggested by Brown & Birley)

Question 30

What is the study for the evaluation of the role of family relationships in general?

Answer 30

Tienari (94)

Question 31

Outline Tienari (94)

Answer 31

Adopted children who had SZ biological parents are more likely to become ill themselves than children with non-SZ biological parents - however, difference only emerged in situations where adopted family were rated as disturbed - essentially, illness only manifested itself under appropriate environmental conditions and genetic vulnerability alone was not sufficient

Question 32

What is the main positive of the double-blind theory?

Answer 32

Some supporting evidence with Berger (65)

Question 33

Outline Berger (65)

Answer 33

Found SZs reported higher recall of double-blind statements from their mothers than non-SZs, however patient’s recall may be affected by SZ and therefore not reliable

Question 34

Name the 6 negative points about the double-blind theory

Answer 34

1) Hall & Levin (90)
2) Based on methodologically flawed studies
3) Did not include control groups
4) Used poorly operationalised definitions of SZ
5) Families studied retrospectively, after person’s SZ may have affected the family system
6) Deterministic

Question 35

Outline Hall & Levin (90)

Answer 35

Analysed data from various previous studies and found no difference between families with and without a SZ member in the degree to which verbal and non-verbal communication were in agreement

Question 36

How is the double-blind theory deterministic?

Answer 36

It implies SZ always due to previous issues - does not consider the role of freewill

Question 37

Name 3 positive points about expressed emotion

Answer 37

1) Much more empirical (universal) support than double-blind theory
2) Led to an effective form of therapy where high EE relatives are shown how to reduce levels of EE
3) Hogarty (91)

Question 38

Outline Hogarty (91)

Answer 38

Found such therapy for EE can significantly reduce relapse rates

Question 39

Name 3 negative points about expressed emotion

Answer 39

1) Cause or effect
2) Not clear whether EE intervention was key element of therapy or whether other aspects of family intervention may have helped
3) Culturally biased

Question 40

What study shows expressed emotion is culturally biased?

Answer 40

Jenkins & Karno (92)

Question 41

Outline Jenkins & Karno (92)

Answer 41

Found EE much less common outside the West - possible explanation is non-Western cultures are less individualist and less committed to concepts of personal responsibility than Western societies thus they’re less likely to blame someone with SZ for their actions

Question 42

What is the main study supporting labelling theory?

Answer 42

Scheff (74)

Question 43

Outline Scheff (74)

Answer 43

Evaluated 18 studies related to labelling theory - judged 13 to be consistent with theory and 5 to be inconsistent - one of the supporting studies was Rosenhan (73) who found once the label of SZ had been applied, the diagnosis continued to influence the behaviour of staff toward the patient, even when this was no longer warranted