Psychological Explanations for Schizophrenia

Question 1

What are the 4 psychological explanations for schizophrenia?

Answer 1

Psychodynamic explanations

Family dysfunctions.

The double-bind theory.

Expressed emotions (EE).

Question 2

What did Freud (1924) believe about behaviour?

(Psychodynamic explanations)

Answer 2

Much of our behaviour is driven by unconscious motives:

Childhood is a critical period in development.

Mental disorders arise from unresolved, unconscious conflicts originating in childhood.

Resolution occurs through accessing and coming to terms with repressed ideas and conflicts (insight).

Question 3

Freud assumed that psychological disorders are manifestations of what three things?

(Psychodynamic explanations)

Answer 3

Imbalances between the id, ego, and superego.

Fixation and regression.

Attempts to deal with unacceptable repressed material.

Question 4

Who agreed with Freud’s views that the origin of disorders come from childhood?

(Psychodynamic explanations)

Answer 4

Bowlby.

Question 5

Freud (1924) believed that schizophrenia was a result of two processes. What were they?

(Psychodynamic explanations)

Answer 5

Regression to the pre-ego stage, (the id).
Attempts to re-establish ego control.

This creates a cycle between id and ego where the two fight for pleasure or reality.

Question 6

Freud viewed schizophrenia as an infantile state. What reflects this?

(Psychodynamic explanations)

Answer 6

Some symptoms (delusions of grandeur) reflect this primitive condition.

Other symptoms (e.g. auditory hallucinations) reflect a schizophrenics attempts to re-establish ego control.

Question 7

When a schizophrenic regressed to the infantile (id) state, they experience primary narcissism. What happens here?

(Psychodynamic explanations)

Answer 7

Id takes over.

There is no distinction between reality and fantasy, self and others.

There is an inability to function, as well as delayed gratification.

Question 8

What did Freud assume that regression to id (primary narcissism) was due to?

(Psychodynamic explanations)

Answer 8

Caused by maternal behaviour, (a schizophrenogenic mother).

Question 9

What is a schizophrenogenic mother?

(Psychodynamic explanations)

Answer 9

The stereotypic mother of an individual with schizophrenia.

Question 10

Freud stated that hallucinations are based in the ego (reality), what is wrong with this?

(Psychodynamic explanations)

Answer 10

If hallucinations are based in the ego (reality) then why are they sometimes unhelpful, causing distress in the schizophrenic person?

Question 11

Who supported Freud’s ideas of schizophrenia being a ‘childish’ state?

(Psychodynamic explanations)

Answer 11

Freud’s ideas of schizophrenia being a ‘childish’ state is supported through Dr. Kraepelin (1896) who used the term ‘dementia praecox’ - believing schizophrenia only affected young people.

Question 12

What did Fromm-Reichmann state in 1948?

(Psychodynamic explanations)

Answer 12

Stated that they agreed with Freud that disordered family patterns are the cause of schizophrenia.

They then identified the characteristics of a schizophrenogenic mother.

Question 13

Outline Fromm-Reichmann’s characteristics of a schizophrenogenic mother.

(Psychodynamic explanations)

Answer 13

Rejecting.

Overprotective.

Dominant.

Cold.

Moralistic.

Conflict-inducing.

Question 14

State 3 evaluative points for the psychodynamic explanation of schizophrenia.

(Psychodynamic explanations)

Answer 14

Deterministic, as it assumes that all childhood events are carried forward to adulthood.

Reductionist, as it doesn’t consider other explanations and only focuses on unconscious conflicts.

Very subjective, as the concept is unfalsifiable.

Freud took an idiographic approach, but incorrectly applied these nomothetically.

Cultural bias, as the concept doesn’t suggest how the idea differs e.g. between Western and Eastern cultures.

Favours nurture over nature, as it assumes childhood upbringing and the role of the mother is the primary schizophrenia influence. However, Freud’s concept does feature unconscious biological drives (id, ego, superego).

Freud’s view of schizophrenic as an infantile state is highly socially sensitive, as it suggests that people with schizophrenia are child-like.

Question 15

What allows schizophrenogenic mother issues to be resolved?

(Psychodynamic explanations)

Answer 15

Dream analysis, free association, and hypnosis, all allow the unconscious mind to be accessed, and these issues to potentially be resolved.

Question 16

How does family dysfunction see schizophrenia?

(Family dysfunction)

Answer 16

Sees maladaptive relationships and patterns of communication within families as sources of stress, which can cause or influence the development of schizophrenia.

Question 17

Parents of schizophrenics often display three types of dysfunctional characteristics. What are they?

(Family dysfunction)

Answer 17

1.) High levels of interpersonal conflicts (arguments).

2.) Difficulty communicating with each other.

3.) Being excessively critical and controlling of their children.

Question 18

Outline Tienari et al’s study from 1994.

(Supports the importance of family relationships in the development of schizophrenia)
(Family dysfunction)

Answer 18

Supports the importance of family relationships in the development of schizophrenia.

This is because they completed an adoption study, finding adopted children who had schizophrenic biological parents were more likely to become ill themselves than children with non-schizophrenic biological parents.

However, this difference only emerged in situations where the adopted family was rated as disturbed.

This suggests that illness only manifests under appropriate environmental conditions; genetic vulnerability alone was not sufficient.

Question 19

Double-bind theory and expressed emotion theory, are both types of what?

(Family dysfunction)

Answer 19

Family dysfunction.

Question 20

Who proposed double-bind theory?

(Double-bind theory)
(Family dysfunction)

Answer 20

Bateson et al 1956.

Question 21

What did Bateson et al’s suggest in 1956.

(Double-bind theory)
(Family dysfunction)

Answer 21

Suggested that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia.

E.g. if a mother tells her son that she loves him, yet at the same time turns her head away in disgust. The child receives two conflicting messages about their relationship.

There interactions prevent the development of an internally coherent construction of reality.

The child’s version of reality is one of contradiction.

Over time, these can manifest as schizophrenic symptoms, e.g. affective flattering and withdrawal.

Question 22

Does the double-bind theory make sense?

(Double-bind theory)
(Family dysfunction)

Answer 22

Yes, as affective flattening is a reduction in communication.

The child may do this as a means of ignoring the unhelpful and potentially confusing statements.

It also makes sense for withdrawal, as the child is able to minimise their parents statements by removing themselves from hearing them all together.

Question 23

Outline Berger’s study from 1965.

(Supports double-bind theory)
(Double-bind theory)
(Family dysfunction)

Answer 23

Supports double-bind theory.

This is because they found that schizophrenics reported a higher recall of double-bind statements by their mothers than non-schizophrenics.

This suggests that contradictory messages are much more common in schizophrenic households.

However, this evidence may not be reliable, as patients’ recall may be affected by their schizophrenia.

Question 24

Outline Liem’s study from 1974.

(Challenges double-bind theory)
(Double-bind theory)
(Family dysfunction)

Answer 24

Challenges double-bind theory.

This is because they measured patterns of parental communication in families with a schizophrenic child and found no difference when compared to normal families.

This suggests that there are no communicable differences in households.

Question 25

What does the EE explanation focuses on?

(Expressed emotion)

Answer 25

Focuses on the negative emotional climates, or more specifically a high degree of expressed emotion within families.

Question 26

EE is a type of what?

(Expressed emotion)

Answer 26

EE is a type of family communication system that involves: criticism, hostility, and emotional over involvements.

High levels of EE are most likely to influence relapse rates.

Question 27

What did Linszen et al state in 1997.

(Expressed emotion)

Answer 27

Stated that a patient that returns to a family with a high EE is 4x more likely to relapse, than if they went to a low EE family.

Question 28

Outline Hogarty et al’s study from 1991.

(Expressed emotion)

Answer 28

Supports expressed emotion.

This is because they found that EE therapy can significantly reduce relapse rates.

This suggests that expressed emotion caused the schizophrenia.

However, as with all therapies, it is not clear whether the EE intervention was the key element of the therapy or whether other aspects of family intervention may have helped.

Question 29

How does the cognitive explanation view schizophrenia?

(Cognitive Explanation)

Answer 29

Maladaptive behaviour is caused by faulty or irrational thinking.

It is the way you think about the problem, rather than the problem itself, that causes mental disorder.

Question 30

How does the cognitive explanation of schizophrenia believe the disorder can be overcome?

(Cognitive Explanation)

Answer 30

Individuals can overcome mental disorders by learning to use more appropriate cognitions.

Aim to be positive and rational.

Question 31

What did Beck and Rector do in 2005?

(Cognitive Explanation)

Answer 31

Proposed a cognitive model that combines a complex interaction of neurobiological, environmental and cognitive factors to explain the disorder.

Abnormalities within brain functioning are seen as increasing vulnerability to stressful life experiences, which could lead to dysfunctional beliefs and behaviours.

Question 32

Beck and Rector suggested that cognitive deficits occur when sufferers experience problems with what 3 things.

(Cognitive Explanation)

Answer 32

Attention (poor)

Communication, e.g. alogia, affective flattening.

Disorganised thinking (information overload).

Question 33

What did McKenna argue in 1996? What does this reinforce?

(Cognitive Explanation)

Answer 33

That many of the symptoms of schizophrenia occur as a result of defect selective attention.

This reinforces the idea that patients may be overloaded, not knowing what to attend to (what is or isn’t important).

Question 34

Outline Bowie et al’s study from 2006.

(Supports Beck and Rector’s cognitive model)

Answer 34

Supports Beck and Rector’s cognitive model.

This is because they reviewed evidence, finding that cognitive impairments are the core feature of schizophrenia mainly affecting attention, working memory, verbal learning and executive functions.

These impairments pre-date the onset of the disorder and are found throughout the course of the illness.

This suggests that a vulnerability (diathesis) has allowed the schizophrenia to trigger and present itself.

Question 35

What did Frith et al identify in 1992? What were they?

(Cognitive explanation)

Answer 35

Identified two kinds of dysfunctional thought processes that can explain some of the symptoms:

Metarepresentation and central control.

Question 36

Outline metarepresentation as one of Frith’s dysfunctional thought processes.

(Cognitive explanation)
(Metarepresentation)

Answer 36

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 (Theory of Mind).

It has been proposed that a dysfunction in metarepresentation would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else.

Question 37

What symptoms does metarepresentation help us to explain?

(Cognitive explanation)
(Metarepresentation)

Answer 37

Hallucinations: Hearing an internal voice (e.g. inner voice), this may be interpreted as someone else.

Delusions: They may think that someone has inserted thoughts, maybe trying to control their behaviour.

Question 38

Outline central control as one of Frith’s dysfunctional thought processes.

(Cognitive explanation)
(Central control)

Answer 38

The cognitive ability to suppress automatic responses while we perform deliberate actions instead.

Disorganised speech and thought disorder could result from the inability to suppress automatic thoughts and speech triggered by other thoughts.

Sufferers with schizophrenia tend to experience derailment of thoughts and spoken sentences because each word can trigger associations, and the patient can’t suppress the automatic responses to these.

Question 39

Outline McGuigan’s 1996 study.

(Supports Frith’s metarepresentation)

Answer 39

Supports Frith’s metarepresentation.

This is because they found that the larynx of patients with schizophrenia was often active during the time they claimed to be experiencing auditory hallucinations.

This suggests that the mistook their own inner speech for that of someone else.

Question 40

Outline Helmsley’s cognitive theory of schizophrenia.

Answer 40

starting point was that perception and memory combine effectively in healthy individuals but fail to do so in individuals with schizophrenia.

We use stored knowledge (schemas) to allow us to predict what is going to happen next.

Memory helps to ensure that we attend to and perceive the most important stimuli in the environment, it also allows us to keep track of current goals.

Thus, schizophrenia is caused by a breakdown in the relationship between memory and perception.

As a result, individuals with schizophrenia are unable to predict what will happen next, their concentration is poor, and then attend to unimportant or irrelevant aspects of the environment.

Poor integration of memory and perception = disorganised thinking and behaviour.