Psychological Explanations For Schizophrenia Flashcards
What are the two psychological approaches to explaining schizophrenia?
- Family dysfunction (psychodynamic & socio-cultural explanations)
- Cognitive Approach
What is the key points of double bind theory?
- Theory is based on psychodynamic ideas
- Focuses on communication within the family
- Blames the mother for a child’s schizophrenia
- Regression to primary narcissism
- Pre-ego state & Id takes over
- No distinction between reality & fantasy, self & others
- Ego tries to retake control & this conflict may cause hallucinations & delusions
What is the double bind theory?
(Bateson, 1956)
- Schizophrenic patients come from families where parents, espcially the mother, gives contradictory messages about their feelings for a child
- When a child receives mixed messages & struggles to respond clearly, they may have difficulty forming a clear understanding of reality. This can manifest itself in the positive symptoms of schizophrenia.
- This supports the idea from the anti-psychiatry movement that schizophrenia is a reasonable response to an insane world
What is a schizophrenogenic mother?
- Within double bind theory mother is described as this as they are accused of being the one who induces schizophrenia by their negative & overly controlling behaviour
Evaluate the double bind theory of schizophrenia.
- Berger (1965) found that schizophrenics reported a higher recall of double-bind statements by their mothers than non-schizophrenic. Data was gathered through retrospective interviews (this is why it may not be reliable- retrospectiveinterviews lack accuracy)
- Hall & Levin (1980) found no difference between families with & without a schizophrenic member in terms of verbal & non-verbal communications - Data was gathered through real-time recording
What is gender bias?
- Occurs when differences between males & females are either over exaggerated (alpha bias) or ignored (beta bias)
- Leads to incorrect conclusions being drawn about one gender - or it may be because a theory over-emphasises the differences between males & females
Define ‘expressed emotion’
- The critical, hostile, & emotionally over-involed attitude that relatives have toward a family member with a disorder. (McDonagh, 2005)
How does expressed emotion link with schizophrenia?
- Interactions between family members may be an explanatin for schizophrenia
- Types of expressed emotion-family communication been linked to relapses in schizophrenia
What is high expressed emotion?
- High expressed emotion involves more criticism, hostility & emotional over-involvement than low expressed emotion
- The stress from negative criticism & pity becomes a burden on the person with a disorder & the only way to cope is relapse
- Relates to interactions in the whole family, not just the mother
What was the taped interview to do with expressed emotion?
- Taped interview known as the Camberwell Family Interview
- A way to watch verbal & nonverbal answers to make an accurate assessment
- Family members high in expressed emotion cause relapse in psychological disorders such as schizophrenia, alcholism
Evaluate Family dysfunction theories
- Linszen et al (1997) found that high EE families had higher lvels of hostility, crticism and emotional over-involvement; patients returning to these families were more likely to relapse than patients returning to low EE families.
- Kalafi & Roabi (1996) found similar results in Iran
We can conculde research has high population validity as well as high in cultural validity
Give one weakness of family dysfunction theories.
- Socially sensitive research & there are ethical implications as a result.
- For example, a famly with a relative with schizophrenia may feel high levels of guilt if they are blamed for causing a relapse.
- They may also be stigmatised by friends, the community,leading to shame & isolation
- This could lead
How can the cognitive explanation explain schizophrenia?
- ## Schizophrenia is charactersied by disruption to normal thought processing & these can provide possible explanations for schiz as a whole
& also dysfunctional thought processing
What does the cognitive explanation of schizophrenia consist of?
-We could say that disorganised thinking & speech can lead to:
- Difficulty distinguishing between thinking & speech- hallucinations
- Delusions
- Deficits in STM & semantic memory
- Alogia/speech poverty
all occuring in the mind
What would the cognitive approach say hallucinations & delusions are a result of?
Hallucinations:
- Misattriuted inner speech
Delusions:
- Sometimes can be attempts to make sense of hallucinatory experiences
- Thought processes start in reality but become fantasy
- Once delusion arises, attentional bias, tend to maintain it, may aar ignore real world evidence to contradict their thoughts
What research is there on hallucinations?
Takahshi et al (2012) found that schizophrenic ppts less able to distinguish auditory sounds than non-schizophrenic ppts
- Suggests problem in directing attention (cognitive process) to new information
AND
- McGuigan (1966)- poor integration of memory & perception & schiz patients mistook their own inner speech for someone elses- supports explanation of hallucinations
What is dysfunctional thought processing?
- Speech poverty & thought disorder could result in ability to supress automatic thoughts & speech triggered by other thoughts
What are some other cognitive symptoms within dysfunctional thought processing?
- Problems w working memory e.g. complex tasks
- Stroop test- you ask someone to say the colour of the word instead of the word itself
- Stirling et al (2006) found schiz patients took 2x as long to name colours in stroop test than non-patient controls
Suggesting that infomation processing is different in people with schiz & that diysfunctional processing could lead to the symptoms that are visual to the people around them
Evaluate the cognitive explanation of schizophrenia.
Horga et al (2019) found:
- schiz ppts w delusions needed more info before making a decision than non-schiz ppts.
- They were less able to make inferences based on info provided.
Researchers suggested that need for greater info can explain why delusions are so rigid & difficult to change in patients.
- Researchers called these ‘sticky beliefs’.
These findings show that dysfunctional thought processing & problem solving leads to symptoms of schizophrenia
Give another evaluation point of the cognitive explanation of schizophrenia.
- CBT has been developed directly from cognitive explanation. If symptoms of schiz have a cognitvie cause, then using a cogntivie treatment can eliminate these symptoms- HAVE TO SAY THIS& WHY WE BRING IT IN
- Can be applied through cognitive therapies (but not as affective as depression)
- . CBT involve challenging patient by disputing their cognitive processes through therapy, so person is able to think more positively & create more rational beliefs & enage w the real world- supported by:
Turkington et al (2002) - Found that CBT treatment was more effective than other treatments by community healthcare teams in reducing symptoms & increasing patient insight into their disease.
What is the downside to treating schizophrenia with CBT?
- CBT is never given as a treatment without prior anti-psychotic medication to remove/stabilise the positive symptoms
- This leads us to question the validity of the cognitive approach- if a biological treatment is needed then a biological cause of symptoms is inferred
- Suggesting that the cognitive explanation is not the only or root cause of schiz
What research is there challenging the cognitive explanation?
- Cognitive explanation is reductionist at psychological level of explanation, too simple to say cognitive approach leads to schizophrenia.
- It ignores other factors such as environmental (family dysfunction & living in high expressed emotion environment
- & Ignores biological factors (e.g. genes that have been identified that make a person more vunerable to developing schiz)
- To support this:
- Beck & Rector (2005)suggest that schizophrenia is explained by a complex interaction of neurobiological, environmental, behavioural & cognitive factors.
- Abnormalities in brain may lead to dysfunctional beliefs & cognitive impairment, which leads to dysfunctional behaviours such as the positive & negative symptoms of schiz
- However, these may only be triggered by an environmental experience such as stressful life event.
- Therefore cognitive explanation is too reductionist.
- Although a reductionist explanation allows for scientists to conduct research into cognitive processes e.g. into disordered thinking, the explanation is too simplistic to be truly valid.
- You could argue that the cogntiive approach isnt an actual explanation & that it only explains the symptoms, in comparison to bioloigcal & environmental factors.
