Role Of The Family

Question 0

Marital Schism

Answer 0

Parents don’t like each other but stay together for the child’s sake.
Confuses child as they get mixed messages.

Question 1

Marital Skew

Answer 1

Parents have their own psychological problems a d convey a distorted view of reality to their children.

Question 2

Double Bind

Answer 2

Parents predispose children to schizo by placing them in no win situations.
Occurs when there is discordance between verbal and nonverbal communication in the household.
Requires an intense relationship between the relevant people.
Non-schizo expresses two meanings when making a statement,
The schizo cannot comment on the contradiction or escape.

Question 3

Evaluation of Parental Interactions

Answer 3

Lacks empirical support.
Unable to explain why some family members develop the disorder when others don’t.
Retrospective studies.
Some family patterns are correlated with schizophrenia but this probably reflects having an abnormal child.
Controversial: blames family.

Question 4

Theory of Expressed Emotion

Answer 4

Rates of EE may change over time.
During residual phases negative EE drops and vice versa.
Negative EE may reflect the strained communications.
Association between rates of negative EE an relapse rates has been replicated in many cultures.
Different cultures express different levels of emotion however.
Role of EE is applicable to patients and carers as well.

Question 5

Brown 72

Answer 5

Studies family communication patterns and found it to be a critical variable in whether patients would relapse into a psychotic state.
High levels of EE would make relapse much more likely.

Question 6

Vaughn & Leff 76

Answer 6

Followed 128 patients who returned home after being hospitalised.
High in negative EE were much more likely to cause a relapse.
High in negative EE = hostile, critical, fear and lack insight.
High in positive EE = prevention in relapse.

Question 7

Conclusions

Answer 7

EE is a well established maintenance model.
Supported by many cross cultural studies and its accepted that it affects the course but isn’t the cause.
Many schizos are estranged from their family but don’t have lower rates if relapse.
Any social contact however can be regarded emotional.
Expressed emotion does not relate to amount of emotion expressed but rather if it is positive or negative.