Schizophrenia - Psychological explanations & treatments (Family Dysfunction)

Question 1

Schizophrenogenic mother

Answer 1

A cold, controlling, rejecting (+calculating) parent who creates a tense & secret dynamic (pos. symptoms develop)

Question 2

Double-bind theory

Answer 2

Issues with communication & mixed messages when doing wrong things (neg. symptoms develop)

Question 3

Expressed emotion

Answer 3

Negative emotions expressed -> verbal criticism, hostility, emotional overinvolvement (pos. symptom develop)

Question 4

Strengths of FD explanation

Answer 4

+ Practical application (family therapy development)
+ Schizophrenic patients with insecure attachment types more commonly have history of abuse (59% M & 69% F)
+ High predictive validity for relapse rates in high EE families (can lead to earlier intervention & development of other treatment)
+ Berger -> patients with Schz recalled more double-bind statements by their mothers than non-schz

Question 5

Limitations of FD explanation

Answer 5

• Social sensitivity & ethical issues (parental blaming and stigmatisation, outdated views are destructive)
• Retrospective accounts (lack validity due to memory unreliability)
• Lack of cause & effect (Mischler & Waxler -> differences in mother talking to schz. & non-schz. daughters -> result of living with schz. not cause)
• Individual differences (not all high EE families relapse)

Question 6

Treatment: Family therapy

Answer 6

Improve quality of communication between members of family & identified patient (1x a fortnight for 18 months)

Question 7

Pharaoh et al’s family therapy

Answer 7

• Form therapeutic alliance (where all agree on aims)
• Reduction of anger & guilty (reducing EE -> relapse rates)
• Reduce stress of caring for someone with schizophrenia
• Maintain a balance between caring for individual & maintaining their own lives

Question 8

Burbach’s family therapy

Answer 8

1: Share basic information about themselves & providing emotional/practical support
2: Identify sources (inc. what family can/can’t offer)
3: Mutual understanding & create a safe space for everyone to express their feelings
4: Identify unhelpful patterns of interaction
5: Skill training (stress management techniques)
6: Planning for relapse prevention
7: Maintenance for the future

Question 9

Positives of family therapy

Answer 9

+ Free will encouraged (helps patients anticipate & overcome issues without medical intervention)
+ Idiographic & holistic approach (improves unique deficits of each individual)
+ Lacks any side effects

Question 10

Effectiveness of family therapy (+)

Answer 10

+ McFarlane - reduced relapse rates by 50-60%
+ Pilling et al - reduces psychotic relapses and readmission rates significantly [economic benefit]

Question 11

Negatives of family therapy

Answer 11

• Ethical issues (informed consent reliant, patient may have discomfort sharing some issues, issues with confidentiality)
• Free will (requires active involvement)
• Lengthy process & expense (incidents during sessions may lead to higher drop out rates)
• Not a cure (works to improve home life & treating the symptoms)