Psychological explanations for schizophrenia

Question 1

Schizophrenogenic mother

Answer 1

Fromm-Reichmann (1948)

• suggests a psychodynamic explanation for psychology based on the accounts from her patient’s childhoods
• Many of them talked about a certain type of parent which she refers to as the schizophrenogenic mother
• this is a type of mother that is cold, controlling, rejecting and has a tendency to create a tense and secretive family dynamic
• as a result of a schizophrenogenic mother, distrust develops, forming into paranoid delusions, then ultimately turning into schizophrenia

Question 2

Family climate

Answer 2

Bateson et al. (1972)

• argued that family climate is an important factor in the development of schizophrenia
• the role of communication style within the family is highlighted
• the child will find themselves trapped in situations where they fear they will do the wrong thing but don’t know what this is due to the contradicting messages from the parents - double bind
• they also feel unable to comment on the unfairness of the situation
• if the child slips up, they face a withdrawal of love
• they will then think that the world is a confusing and dangerous place, which is reflected in schizophrenic symptoms

Question 3

Expressed emotion

Answer 3

• the level of emotion expressed towards a patient by their carers
• typically this is negative emotions
• elements of EE include:
• verbal criticism of the patient, often accompanied by violence
• hostility towards the patient, which could include anger and rejection
• emotional over-involvement in the life of the patient, which could include self-sacrifice
• these expressed emotions are a serious source of stress for the patient, which is a primary explanation for schizophrenia relapse
• stress may also trigger the onset of schizophrenia in a person that is already vulnerable

Question 4

Cognitive explanations

Answer 4

• these focus on the role of mental processes
• a number of abnormal information processing mechanisms are linked to schizophrenia
• reduced processing in the ventral striatum is correlated with negative symptoms, whilst reduced processing in temporal and cingulate gyri are associated with hallucinations

Question 5

Two types of dysfunctional thought processing

Answer 5

• 2 types of processing identified by Frith et al. (1992) which may underlie some symptoms

Question 6

Metarepresentation

Answer 6

• the first is metarepresentation, which is our cognitive ability to reflect on thoughts and behaviour
• allows us to see our own goals and intentions, as well as allowing us to interpret the actions of others
• dysfunction in metarepresentation disrupts our ability to recognise our own actions as being done by ourselves as opposed to by others
• this explains hallucinations of voices and delusions

Question 7

Central control

Answer 7

• another ability which is affected by dysfunction
• this represents our ability to suppress automatic responses while performing deliberate actions instead
• an inability to suppress automatic thought and speech triggered by other thoughts may explain thought disorder and disorganised speech
• schizophrenia sufferers tend to experience derailment of thoughts and spoken sentences, since each word triggers associations and trees patient is unable to suppress automatic responses to these correlations

Question 8

(+) EVAL - support for family dysfunction as a risk factor

Answer 8

• there is evidence to suggest that difficult family relationships in childhood are associated with increased risk of schizophrenia
• Read et al. (2008) reviewed 46 studies of child abuse and schizophrenia, and found that 69% of female schizophrenia patients had a history of physical or sexual abuse in childhood
• for men this was 59%
• Berry et al. (2008) found that adults with insecure attachment to primary care givers were more likely to develop schizophrenia
• however, most of the data was collected form patients with schizophrenia who may have distorted recall of their childhood
• Tienari et al. (2004) conducted a longitudinal study which found inconsistent results between childhood experience and later onset of schizophrenia

Question 9

(-) EVAL - weak evidence for family-based explanations

Answer 9

• a link between childhood experiences and schizophrenia exists, but there is very little evidence for the schizophrenogenic mother and double bind
• both depend on observations of patients and assessing mothers for ‘crazy characteristics’
• this approach is not used in modern psychiatry
• these theories have historically led to parent blaming, which us unhelpful for patients who need care, and also adds trauma to many families who have already endured from having a schizophrenic child
• both of these theories have declined since the move to community care in the 1980s

Question 10

EVAL - strong evidence for dysfunctional information processing

Answer 10

• there is strong evidence to support the idea that shcizophrenic patents process info differently
• Stirling et al. (2006) compared 30 schizophrenics with 18 controls in a number of cognitive tasks
• these included the stroop test in which patients have to identify the colour of a word and not the words meaning
• for this task, patients are required to suppress automatic responses
• they found that the schizophrenic patients took twice as long as the control group to complete the tasks
• however, although the links are clear, we do not know the origin of these conditions
• they explain proximal causes of schizophrenia, not distal causes
• explains what causes current symptoms not what origins of conditions are