Schizophrenia: Psychological explanation

Question 1

What are the three divisions of family dysfunction? (AO1)

Answer 1

• The schizophrenogenic mother
• Double-bind theory
• Expressed emotion

Question 2

Explain the schizophrenogenic mother as a division of family dysfunction:

Answer 2

• Psychiatrist Fromm-Reichmann proposed a pscyhodynamic explanation for SZ based on the accounts she heard from her patients about their childhoods.
• Many of her patients spoke of a schizophrenogenic mother- a ‘SZ-causing mother’.
• The schizophrenogenic mother is cold, rejecting and controlling, and tend to create an atmosphere of tension and secrecy.
• This leads to distrust that later develops to paranoid delusions and ultimately SZ.

Question 3

Explain the double-bind theory as a division of family dysfunction:

Answer 3

• Bateson agreed that family climate is important in the development of SZ but emphasised the role of communication style within a family.
• The developing child finds themselves regularly trapped in situations where they fear doing the wrong thing, but receive mixed messages about what this is, and feel unable to comment on the unfairness of the situation or seek clarification.
• When the child gets it wrong the child is punished by withdrawl of love.
• This leaves them with the view that the world is confusing and dangerous, causing symptoms such as paranoid delusions.

Question 4

Explain the expressed emotion as a division of family dysfunction:

Answer 4

• Expressed emotion is the level of emotion, in a particular negative emotion, expressed towards a person with SZ by their carers who are often family members.
• EE contains several elements: Verbal criticism of the person, occasionally accompanied by violence; Hositility towards the person, including anger and rejection; Emotional over-involvment in the life of the person, including needless self-sacrifice.
• High levels of EE directed towards the individual are a serious source of stress- a primary explanation for relapse in those with SZ, and can trigger a predisposition to SZ (diathesis stress model).

Question 5

Name the 3 divisions of cognitive explanations for SZ:

Answer 5

• Dysfunctional thinking
• Metarepresentation dysfunction
• Central control dysfunction

Question 6

Explain dysfunctional thinking as a cognitive division for SZ:

Answer 6

• SZ is associated with several types of dysfunctional thought processes- providing possible explanations for SZ.
• SZ is characterised by disruption to normal thought processing- demonstrated by its symptoms.
• 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 information processing suggests that cognition is likely to be impaired.

Question 7

Explain metarepresentation dysfunction as a cognitive division for SZ:

Answer 7

• Frith identified two kinds of dysfunctional thought processes:
• Metarepresentation- the cognitive ability to reflect upon thoughts and behaviour. It allows us insight into our thoughts and goals, and the actions of others.
• Metarepresentation dysfunction would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else.
• This explains hallucinations of hearing voices and delusions.

Question 8

Explain central control dysfunction as a cognitive division for SZ:

Answer 8

• Frith identified two kinds of dysfunctional thought processes:
• 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 thoughts.
• E.g. people with SZ tend to experience derailment of thoughts because each word triggers associations, and the person cannot suppress automatic responses to these.

Question 9

What are the 3 evaluation points for the cognitive explanation of SZ?

Answer 9

• Research support (S)
• Proximal explanation (L)
• Psychological or biological (L)

Question 10

Explain research support (S) as an evaluation point for the family dysfunction explanation of SZ:

Answer 10

• There is evidence linking family dysfunction to SZ.
• Indicators of family dysfunction include insecure attachment and exposure to childhood trauma, especially abuse.
• Read found that adults with SZ are disproportionately likely to have insecure attachment, particularly type C or D.
• Also found that 69% of women and 59% of men with SZ have a history of physical/sexual abuse.
• This strongly suggests that family dysfunction makes people more vulnerable to SZ.

Question 11

What are the 3 evaluation points for the family dysfunction explanation of SZ?

Answer 11

• Research support (S)
• Explanations lack support (L)
• Parent-blaming (L)

Question 12

Explain explanations lack support (L) as an evaluation point for the family dysfunction explanation of SZ:

Answer 12

• A limitation is that there is a poor evidence base for family explanations.
• Although there is plenty of evidence supporting the idea that family-based stress is associated with adult SZ, there is almost none to support the importance of traditional family-based theories, e.g. schizophrenogenic mother, double-bind theory.
• Both of these theories are based on clinical observations of people with SZ and informal assessments of their mothers personalities, but not systematic evidence.
• Suggests that family explanations are not able to account for the link between childhood trauma and SZ.

Question 13

Explain parent-blaming (L) as an evaluation point for the family dysfunction explanation of SZ:

Answer 13

• A limitation is that research linking family dysfunction to SZ is highly socially sensitivve as it can lead to parent blaming
• For parents already having to watch their child show symptoms of SZ and are responsible for caring for them, being labelled the cause of their disorder is only detrimental.
• A psychological theory like this should be ensured not to cause harm, which theories such as the schizophrenogenic mother an double-bind theory have.
• Suggests that research lining family dysfunction to SZ can have serious ethical implications.

Question 14

Explain research support (S) as an evaluation point for the cognitive explanation of SZ:

Answer 14

• A strength is that there is evidence for dysfunctional thought processing.
• Stirling compared performance on a range of cognitive tasks- the stroop test- in 30 people with SZ and a control group of 30 people without SZ.
• As predicted by Firth’s central control theory, people with SZ took longer (over x2 as long) to name the font colours.
• Suggests that the cognitive processes of people with SZ are impaired.

Question 15

Explain A proximal explanation (L) as an evaluation point for the cognitive explanation of SZ:

Answer 15

• A limitation is that cognitive explanations only explain the proximal origins of symptoms.
• Cognitive explanations for SZ are proximal explanations because they explain what is happening now to produce symptoms- which differ from distal explanations which focus on what initially caused the condition.
• Suggests that cognitive theories on their own only provide partial explanations for SZ.

Question 16

Explain psychological or biological (L) as an evaluation point for the cognitive explanation of SZ:

Answer 16

• A limitation is that there are both significant psychological and biological explanations.
• Psychological explanations allow for SZ to be seen as an intense psychological condition e.g. both positive symptoms like hallucinations and negative symptoms like disruption to thinking and speech are psychological.
• However biological explanations argue that abnormal cognition associated with schizophrenia is partly genetic in origin and the result of abnormal brain development.
• Suggests that although SZ has psychological symptoms, SZ could be better seen as a biological condition.