Psychological explanations for schizophrenia Flashcards
what does family dysfunction include
the schizophrenogenic mother
double-bind theory
expressed emotion
family dysfunction - the schizophrenogenic mother
Fromm-Reichmann (1948) proposed a psychodynamic explanation for schizophrenia. Fromm-Reichmann noted many of her patients spoke about a cold, rejecting, and controlling mother which she called the schizophrenogenic mother. She tends to create a family dynamic characterised by tension and secrecy. This leads to distrust that later develops into paranoid delusions and ultimately schizophrenia.
family dysfunction - double-bind theory
Bateson et al (1972) emphasised the role of communication style within a family. The developing child finds themselves in situations where they fear doing the wrong thing, but receive mixed messages about what this is and feel unable to seek clarification. When they get it wrong, the child is punished by withdrawal of love. Leaves the child with an understanding that the world is confusing and this is reflected in symptoms like disorganised thinking. Bateson was clear that this was a risk factor of schizophrenia not the only factor.
family dysfunction - expressed emotion
The level of emotion, in particular negative emotion, expressed toward a person with schizophrenia by their carers. EE contains several elements:
- Verbal criticism of the person, occasionally accompanied by violence
- Hostility towards the person, including anger and rejection
- Emotional overinvolvement in the life of the person, including needless self-sacrifice
The high levels of EE towards the person are a high source of stress. This is primarily an explanation for relapse in people with schizophrenia. It’s also been suggested that it may be a source of stress that can trigger the onset of schizophrenia in an already vulnerable person.
Evaluation of family dysfunction (brief)
:) insecure attachment, Read et al
:( poor evidence
strength of family dysfunction
there is research support for linking family dysfunction to schizophrenia. According to a review by Read et al (2005) adults with schizophrenia are disproportionately likely to have an insecure attachment. Read et al also reported that 69% of women and 59% of men with schizophrenia have a history of physical and/or sexual abuse. This strongly suggests that family dysfunction makes people more vulnerable to schizophrenia.
weakness of family dysfunction
poor evidence basis for any of the explanations. Although there is plenty of evidence supporting the idea that childhood family-based stress is associated with adult schizophrenia, there is almost none to support theories such as the schizophrenogenic mother and double bind. Both these theories are based on clinical observation of people with schizophrenia and also informal assessment of their mothers’ personalities, but not systematic evidence. Therefore this suggests that family explanations have not been able to account for the link between childhood trauma and schizophrenia.
what does cognitive explanation include
dysfunctional thinking
metarepresentation dysfunction
central control dysfunction
cognitive explanation - dysfunctional thinking
Schizophrenia is associated with several types of dysfunctional thought processing, and these can provide possible explanations for schizophrenia as a whole.
Schizophrenia is characterised by disruption to normal thought processing. Reduced thought processing in the ventral striatum is associated with negative symptoms, while reduced processing of information in the temporal and cingulate gyri is associated with hallucinations. This lower than usual level of information processing suggests that cognition is likely to impaired.
cognitive explanation - metarepresentation dysfunction
Frith et al (1992) identified two kinds of dysfunctional thought processes. The first is metarepresentation, 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 metarepresentation 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 hearing voices and delusions like thought insertion.
cognitive explanation - central control dysfunction
Frith et al also identified issues with the cognitive ability to suppress automatic responses while we perform deliberate actions. Speech poverty and thought disorder could result from the inability to suppress automatic thoughts and speech triggered by other thoughts. For example, people with schizophrenia tend to experience derailment of thoughts because each word triggers associations and the person cannot suppress automatic responses to these.
Evaluation of cognitive explanations (brief)
:) research support, Stirling et al
:( only explains proximal origins
strength of cognitive explanations
research support for dysfunctional thought processing. Stirling et al (2006) compared performances on a range of cognitive tasks in 30 people with schizophrenia and a control group of 30 people without schizophrenia. Tasks included the Stroop task, in which participants have to name the font-colours of colour words, so they have to suppress the tendency to read words aloud. As predicted by Frith et al’s central control theory, people with schizophrenia took longer, over twice as long on average. This means that the cognitive processes of people with schizophrenia are impaired.
weakness of cognitive explanations
they only explain the proximal origins of symptoms. Cognitive explanations for schizophrenia are proximal explanations because they explain what is happening now to produce symptoms – as distinct from distal explanations which focus on what initially caused the condition. Possible distal explanations are genetic and family dysfunction explanations. What is currently unclear is how childhood trauma might lead to problems with metarepresentations or central control. This means that cognitive theories on their own only provide partial explanations for schizophrenia.
