Schizophrenia - Psychological explanations and therapies Flashcards
The schizophrenogenic mother: Reichmann
cold, rejecting and controlling mother creates a family climate characterized by tension and secrecy
Tension and secrecy leads to distrust that later develops into paranoid delusions and ultimately schizophrenia
Double-bind theory: Bateson et al
Using double bind communication e.g. be spontaneous leads the developing child to find themselves trapped in situations where they fear doing the wrong thing, but receive mixed messages about what this is
When the child ‘gets it wrong’ (which is often), it is punished by a withdrawal of love that leaves them with an understanding of the world as confusing and dangerous which is reflected in symptoms such as disorganised thinking/paranoid delusions
Expressed emotion (EE)
Level of emotion (in particular negative emotion) expressed towards a person with schizophrenia by their carers such as verbal criticism, hostility and emotional over-involvement in the life of the person
High levels of EE are a source of stress for the patient which is primary explanation for relapse
Family dysfunction as a cause for schizophrenia
Linked to childhood and adult experiences of living in a dysfunctional family
1) The schizophrenogenic mother: Reichmann
2) Double-bind theory: Bateson et al
3) Expressed emotion (EE)
Cognitive explanations as a cause for schizophrenia
dysfunctional thought processes cause schizophrenia
characterised by disruption to normal thought processing which is seen in its symptoms
Metarepresentation + Central control
Metarepresentation
The cognitive ability to reflect on thoughts and behaviour
Dysfunction would disrupts the ability to recognise our own actions/thoughts as being carried out by ourselves rather than someone else.
Explains hallucinations of voices and delusions like thought insertion
Central control
The cognitive ability to suppress automatic responses
Schizophrenic patients have the inability to supress automatic thoughts/speech triggered by other thoughts so experience derailment of thoughts/spoken sentences because each the person cannot suppress these automatic responses
Read et al
Support for family dysfunction as a risk factor:
Read et al reviewed 46 studies of child abuse and schizophrenia and concluded 69% of adult women-in-patients + 58% men with a diagnosis of schizophrenia had a history of physical/sexual abuse in childhood.
C: acks validity as this information about childhood experienced was gathered after the development of schizophrenia so symptons and the schizophrenia may have distorted the patients recall of childhood experiences
Social sensitive research - psych explanations
Family dysfunction as a cause = parent blaming: adds trauma to parents who have already observed their child’s descent into schizophrenia.
Stirling et al
Compared people with a diagnosis with schixophrenia with control group on a range of cognitive tasks e.g. snoop test (naming ink colours not reading the words)
People with schizophrenia took twice as long to name the ink colours as the control group showing that information processing is different in the mind of a sxhiophrenic
C: does not tell us the origins of faulty cognitions/schixophrenia.
Cognitive behaviour therapy (CBT)
Aim: helping people identify irrational thoughts and try and change them
Involves: argument/discussion to how likely the person’s beliefs are true and considering less threatening possibilities
Family therapy
Aims to improve the quality of communication and interaction between family members
Concerned with reducing stress within the family that might contribute to a person’s risk of relapse - in particular reducing levels of expressed emotion (EE)
Pharoah et al
identify a range of stategies rhat improve the functioning of a family with a member experiencing schizophrenia: e.g.
1) helping family members achieve balance between caring for the individual and maintaining their own lives
2) improving families’ beliefs about/behaviour towards schizophrenia
3) the reduction of anger and guilt in family members
Token economies
Behavioural therapy based on operant conditioning
used to manage the behaviour of people with schizophrenia particularly those who have developed patterns of maladaptive behaviour i.e bad hygiene
Tokens are given to patients when they carry out desirable behaviour targeted for reinforcement - tokens are secondary reinforcers because they only have value one the patient has learned they can be used to obtain rewards
Anderson et al
Anderson et al found a relapse rate of almost 40% when patients had drugs only, compared to only 20% when family therapy was also used
