Psychological Explanations And Treatments Flashcards
Family dysfunction: Schizophrenogenic mother
- Fromm-Reichmann: cold, rejecting, fearful of intimacy, a perfectionist and controlling
- Creates tension and secrecy in the family environment
- Can be confusing for the child as the mother might be overprotective but then rejecting
- Lead to the child to distrust others which leads to the development of paranoid delusions
Family dysfunction: Schizophrenogenic Mother, Mednick (1984)
- Identified 207 children considered to be high risk of developing schizophrenia because of their dysfunctional families
- Compared to a control group of 107 people
- Within 10 years, 17 high risk diagnosed with Sz compared to only 1 of the control group
Family dysfunction: Schizophrenogenic Mother, :( Logical explanation
Heavy influence of parental figures is a plausible explanation of mental illnesses in children
-> good face validity
Family dysfunction: Schizophrenogenic Mother, :( Doesn’t establish cause and effect
Maybe mothers are cold and rejecting because of child’s Sz symptoms
Family dysfunction: Double Bind Theory
- Bateson et al (1956): importance of communication style
- Children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia
- Child finds themselves fearing doing the wrong thing but receive mixed signals about what that is
- Understanding of the world is confusing and dangerous
Family dysfunction: Double Bind Theory, Berger (1965)
Schizophrenics reported A higher recall of double bind statements by their mothers than non-schizophrenics
Family dysfunction: double-bind theory, :( Liem (1974)
Measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families
Family dysfunction: double-bind theory, :( Weak evidence
Based on clinical observations NOT systematic evidence
Family dysfunction: double-bind theory, :) Gibney (2006)
Led to the development of family therapy
Family dysfunction: Expressed emotion
- Family communication style where communication is done in a critical/hostile manner in a way that indicates over-involvement or over-concern with the patient
- Elements include:
→ verbal criticism
→anger & rejection
→ emotional over-involvement in the person’s life
Family dysfunction: expressed emotion, :) Supporting Research
- Kuipers et al (1983): high levels of EE are more whey to influence relapse rates
- Linszen et al (1997): a patient returning to a family with high EE is 4x more likely to relapse than a patient whose family is low in EE
Family dysfunction: expressed emotion, :( individual differences
- Alforter (1998): 25% of the patients they studied showed no physiological responses to stressful to stressful comments from their relatives
Family dysfunction: expressed emotion, :( Lebell et al (1993)
- How patients think of the behaviour of their relatives is more important
- patients do well regardless of how the family environment is rated
Family therapy: Treating Schizophrenia
- Used in conjunction with routine drug treatment and outpatient clinical care
- Pharoh et al (2010): reduce negative emotions, improve the family’s ability to help
- Garety et al (2008): relapse rates are 25% compared to 50% for standard care alone
Family therapy: Burbach et al (2008)
- Model of practise for families wearing with Sz
→Phase 1: sharing basic information
→Phase 7: maintenance for the future
Family therapy: :( McFarlane (2016)
Family therapy is consistently an effective treatment for those with Sz
-> relapse rates were reduced by 50-60%
Family therapy: :) NICE guidelines
Everyone who has Sz and is in contact with their family should receive family therapy as it is useful for early and acute Sz
Family therapy: :) Is also beneficial for the family
- Lobban et al (2013): 60% of researched family therapy studies reported a significant positive impact of the intervention on at least one outcome category for relatives
Family therapy: :) Cost effective due to low relapse rates
- NICE Review: family therapy is associated with significant cost savings
- Larger financial reduction in costs of hospitalisation
- Reduces relapse rates for a significant period after the completion of the intervention
Family therapy: :( Garety et al (2008)
- No significant difference between the outcomes of patients who has family therapy and patients who just had a carer
- Both groups had unexpectedly low relapse rates
- Most carers displayed low rates of expressed emotion, which may reflect widespread cultural changes
Family therapy: :( Pharoah et al
- Main reason for efficacy is that it increases medicine compliance
-> therefore more likely to comply with their medication regime
:( 10 of the 53 studies reported did not use any form of blinding, a further 16 didn’t mention if blinding had been used
Cognitive Explanation: Egocentric Bias
- Individual perceives him or herself as the central component in events
- Jump to conclusions, leads to delusions
- Interprets neutral events as centred around them
Cognitive Explanation: Meta-Representation
-
Frith (1992): ability to reflect on our behaviours
-> patients unable to differentiate between thoughts and behaviours carried out by ourselves or others
