Psychological explanations for Schizophrenia Flashcards
what did Fromm-Reichmann propose?
a psychodynamic explanation for schizophrenia - based on accounts she heard from patients and their childhood
she noted that many patients spoke of a particular type of parent - that she calls the schizophrenogenic mother
according to Reichmann the schizophrenogenic mother is cold, rejecting and controlling and created a family climate with tension and secrecy
this leads to distrust which develops into paranoia and delusions - ultimately schizophrenia
what did Bateson suggest- double bind?
he agreed that family climate is importnant in the development of schizophrenia but emphasised the role of communication style within a family
the developing child regularly finds themselves trapped in situations where they fear doing the wrong thing, but receive mixed messages about what this is and unable to comment on the unfairness of a situation
when they get it wrong the child is punished by the withdrawal of love
leaving them to believe that the world is confusing and dangerous - reflected in symptoms of disorganised thinking and paranoid delusion
Bateson was clear that this was neither the main type of communication in the family of someone nor the only factor in developing schizophrenia - just a risk factor
what is expressed emotion?
the level of emotion, particularly negative emotion, expressed toward a person with schizophrenia by carers - often family members
EE has several elements
what are the several elements of expressed emotion?
- verbal criticism of the person, occasionally accompanied by violence
- hostility to the person, including anger and rejection
-emotional overinvolvement in the life of the person, including needless self sacrifice
what is the impact of the high levels of expressed emotion toward the individual?
a serious source of stress - this is primarily an explanation for relapse in people with schizophrenia
but is has also been suggested that it may a source of stress that can trigger the onset of schizophrenia in a person who is already vulnerable - e.g. due to their genetic makeup
what is dysfunctional thought processing?
they can provide possible explanations for schizophrenia as a whole
schizophrenia is characterised by disruption to normal thought processing - can be seen in lots of the symptoms
reduced thought processing in the ventral striatum is associated with negative symptoms - whilst 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 be impaired.
what did Frith identify?
two kinds of dysfunctional thought process
first is meta representation - the cognitive ability to reflect on thoughts and behaviour - allows us insight into our own intentions and goals
also allows us to interpret the actions of others
dysfunction in metarepresentational 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/ delusions like thought insertion
what is central control dysfunction?
Frith 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 thought
e.g. people with schizophrenia tend to experience derailment of thoughts because each word triggers associations, and the person can’t suppress automatic responses to these
strength - for family dysfunction explanation - linking to schizophrenia
indicators of family dysfunction include insecure attachment and exposure to childhood trauma - especially abuse
Review by Read - adults with schizophrenia are disproportionately likely to have insecure attachment - particularly Type C or D
Read - 69% of women and 59% of men with schizophrenia have a history of physical/ sexual abuse
in the Morkved study - most adults with schizophrenia reported at least one childhood trauma - mostly abuse
strongly suggests that family dysfunction makes people more vulnerable to schizophrenia
Limitation of family explanations is poor evidence base for any of the explanations
Although there is evidence supporting the idea that childhood family based stress is associated with adult schizophrenia, there is almost none to support the importance of traditional family based theories such as the schizophrenogenic mother and double bind
both these theories are based on clinical observations of people with schizophrenia and also informal assessment of their mothers’ personalities, but not systematic evidence
this means that family explanations have not been able to account for the link between childhood trauma and schizophrenia
extra -
although early explanations for the family - schizophrenia link have no research support, research in this area may be useful in showing that insecure attachment and experience of childhood trauma affect individual vulnerability to schizophrenia
but, research linking family dysfunction to schizophrenia is highly socially sensitive as it can lead to parent-blaming
mothers seem particularly blamed - for parents having to watch their child experience the symptoms of schizophrenia and take responsibility for their care, to be blamed literally adds insult to injury
strength - cognitive explanations - research support
S of cognitive explanations is evidence for dysfunctional thought processing
Stirling compared performance on a range of cognitive tasks in 30 people with schizophrenia and a control group of 30 people without schizophrenia
task included Stroop task - pp would have to name the front-colours of colour-words - so have to suppress the tendency to read the words aloud
predicted by Frith’s central control theory, people with schizophrenia took longer - over twice as long on average - to name front colours
means that cognitive processes of people with schizophrenia are impaired
Limitation of cog explanation - they only explain the proximal origins of symptoms
cognitive explanations for schizophrenia are proximal explanations as they explain what is happening now to produce symptoms - as distinct and distal explanations which focus on what initially caused the condition
possible distal explanations are genetic and family dysfunction explanations
what is unclear and not well addressed is how genetic variation or childhood trauma might lead to problems with meta representation or central control
this means that cognitive theory on their own only provide partial explanations for schizophrenia
extra -
cognitive approach provides an excellent explanation for the symptoms of schizophrenia
but there is an argument seeing schizophrenia primarily as a psychological condition
but it appears that the abnormal cognitive associated with schizophrenia is partly genetic in origin and the result of abnormal brain development
this would suggest that schizophrenia is a biological condition
