Schizophrenia- social psychological explanations Flashcards
What are the 2 social psychological explanations of SZ
1- Dysfunctional families
2- Socio-cultural factors
What is my FIRST choice social psychological explanation for SZ?
Dysfunctional families
What are the 2 key aspects of dysfunctional families?
1- Double bind theory
2- Expressed emotion
What is double bind theory?
explain SZ as being a consequence of abnormal and inadequate patterns of communication within the families of Zs
What does BATESON say about double bind theory?
Families of SZ communicate in a destructively ambiguous fashion
- if a child is repeatedly exposed to this sort of communication, they become unable to respond logically to others
Paralinguistic and double bind statements
Tone of voice, racial expressions that run alongside communication, become able to respond logically to others
- may not match with the words said by parents
How does double bind statements confuse the child?
Getting 2 separate messages, contradict each other, causes conflict
- whether they ignore or respond they cannot win
- they are in a double bind
How does Bateson argue DBS lead to SZ?
Hallucination and delusions- means of escaping conflict
Negative symptoms (avolition, anhedonia)- withdrawal due to confusion
What is expressed emotion?
A family communication style, indicates emotional over-involvement and concern
- explanation for relapse
- causal for someone who is already vulnerable
What is Brown find about expressed emotion?
Investigated SZ patients after they had been discharged from a mental health facility and found those returning to homes with high levels of expressed emotion were more likely of relapse
What is Butzlaff and Hooley find about expressed emotion?
Reviewed over 200 studies of EE
- found that 70% of SZs in families with high EE relapsed within a year
- compared with 30% relapse rate of patients from families with low levels of EE
What 5 component of EE did Brown identify?
1- Critical comments
2- Hostility
3- Emotional over-involvement
4- Warmth
5- Positive regard
HIGH EE
Critical comments
- low acknowledged behaviour was due to illness not ‘they so lazy’
Hostility
- unmanageable anger, irritation and rejection of patient
Emotional over-involvement
- excessive self-sacrifice, overprotective, felt guilty, reparative efforts
LOW EE
Warmth
- empathy expressed
Positive regard
- reinforcing statement which caregiver express support and appreciation of SZ individual
Evaluation: Dysfunctional families
Research support
Role of DB statements
Berger- (I) SZ reported higher rate of recall of DBS by mothers than non-SZs
X methodology, accuracy of recall, lack validity, positive symptoms
X if R flawed, must remain critical
Evaluation: Dysfunctional families
Practical applications
Understand dynamics f communications has led to family therapy
- improve communication, reduce DBS, EE, relapse
- reduce expressions of anger and guilt, stress/burden on relatives, encourage them to set appropriate limits
- useful as successfully applied
Evaluation: Dysfunctional families
X Cause and effect
Not all R has fund a significant difference in the quality of communications within SZ families
LIEM- communications no more disordered in parent with SZ or not 11
X differences in parental communication may be detecting parents having to adapt their communication styles as a result of having an SZ child
X DB theory based on potentially the effect of SZ not the root cause of it, reducing validity of the exp at explaining root origin of SZ
What is the second social psychological explanation of SZ?
Socio cultural factors
How is sociocultural factors split?
1- Urbanicity
2- Social isolation
3- Ethnicity
Urbanicity
Rate of SZ in urban areas is much higher than rural areas
What did Faris and Dunham find about urbanicity?
Incidences of SZ were higher in the densely populated centre of Chicago compared to less densely populated suburbs surrounding the city
How has urbanicity affected lifestyle changes over time?
Human population lived rural lifestyle- agriculture etc
- unprecedented urban growth
- 70% of world populated will be urban by 2050
Urban living does not suit the evolutionary traits of humans (hunter-gatherers)
- explains higher rates of MH disorders in comparison to rural areas
What specific environmental features of urban life to Krabbendam and Van Os identify in relation to the development of SZ?
- increased socioeconomic adversity/poverty in urban areas could contribute to a stressful home life for families
- higher levels of drug or substance abuse
- overcrowding
- pollution, exposure to toxins
Overall, factors that cause greater social stress may be a causal factor of SZ
Social isolation
SZs are often very socially isolated from others
- few friends, estranged from family, more likely to live alone
How might lack of social interaction link to symptoms of SZ?
- don’t get feedback on inappropriate thoughts n behaviours
- lack of corrective feedback allows SZ to nurture inappropriate ways of thinking and behaving so strange B can flourish unchecked
- strong social network=more likely to receive help
What does Faris say about social isolation?
SZ may find interaction with others to be stressful and confusing so they may retreat and withdraw from society
- combination of urbanicity and overcrowding can lead to social isolation
What did Jones do and find in relation to social isolation?
Longitudinal study, prospective
- individuals diagnosed with SZ were more likely to:
> show solitary paly at age 4-6
> 13- more likely to rate themselves as less socially confident
Ethnicity
SZ much more prevalent in immigrants, Afro-Caribbean descent
What does Ineichen say about ethnicity?
Since 1970s, rates of diagnosis for AC people were higher than expected
- higher rates of compulsory admission to psychiatric facilities as apposed to voluntary admission
What do Cochrane and Sashidharan say about ethnicity?
AC immigrant are 7X more likely to be diagnosed with SZ than white people
Ethnicity explanation cannot be genetic
Increased risk is nor apparent in studies carried out in the Caribbean
- higher rate of SZ in the immigrant community may be due to increased stress being caused by being an immigrant or an ethnic minority
How can this idea be contested?
- Ethnicity cannot be genetic
Discrimination
In society- social isolation, urbanicity more likely
In psychiatry- dominated by white males, lead to discrimination in diagnosis
Evaluation: Sociocultural factors
Research support
Jones
4-6 solitary play, 13 less socially confident
- longitudinal and prospective
- establish cause and effect
- social isolation started before SZ
SI has a role in development of SZ
Evaluation: Sociocultural factors
Practical applications
R into SI, suggests solitary play could be an indicator of onset SZ later in life, put early intervention in place
- increase socialisation by encouraging social interaction with other children through play therapy
- increase confidence and reduce SI
Useful exp, created preventative measures
Evaluation: Sociocultural factors
X Cause or effect
Living in urban environment leads to greater risk of SZ or does SZ mean you’re more likely to live in an urban area
- smaller social circles, hard to make friends, does having SI cause SZ or does having SZ make individual isolated
THE SOCIAL DRIFT HYPOTHESIS
- hard to maintain employment, move to inner cities, deprived areas- C or E
X cannot be definite that living in an urban environment is a cause of SZ it may be an effect
