Social Explanations Of Schizophrenia - Dysfunctional Families

Question 1

What is the double bind theory and how does it explain schizophrenia?

Answer 1

• it means children being stuck and confused within the environment created by their parents
• it explained schizophrenia as being a consequence of abnormal and inadequate patterns of communication within the families of schizophrenics

Question 2

Bateson (1956)

Answer 2

• families of schizophrenics communicate in a destructively ambiguous fashion.
• for example a mother would tell the child that she loves him but in a tone of voice that suggests she doesn’t
• if a child is repeatedly exposed to this sort f communication, they become unable to respond logically to others
• words are only on part of communication; they are accompanied by paralinguistic (tone of voice, body language, facial expressions etc)

Question 3

How can double bind statements lead to SZ symptoms?

Answer 3

• can lead to hallucinations and delusions
• these symptoms arise as a means of escaping the conflict caused by these contradictory double bind statements
• can also link to negative symptoms; abolition and flatness

Question 4

What is expressed emotion according to the NHS?

Answer 4

• expressed emotion is a term used to represent quality and intensity of expression of a range of emotions within a family context.
• resulting in relapse of SZ

Question 5

Expressed emotion

Answer 5

• refers to high levels of emotions expressed specifically towards the individual or within the family context
• can be considered as negative ‘negative’ (hostility/anger) or positive (caring concern)
• it’s an explanation for relapse
• could also be causal factor in developing schizophrenia
• families who engage in high expressed emotion show high levels of criticism, hostility and emotional overprotectiveness

Question 6

Brown 1959

Answer 6

• investigated SZ patients after they had been discharged from a mental health facility and found those returning to homes with high levels expressed emotion were more likely of relapse
• interviews conducted later with the wives and parents of individuals with SZ suggested a link between the amount of expressed emotion and the likelihood of relapse

Question 7

What did Butzlaff and Hooley find ?

Answer 7

• they reviewed over 200 studies of expressed emotion and found that 70% of schizophrenics in families with high expressed emotion relapsed within a year compared with a 30% relapse rate of patients from families with low levels of expressed emotions

Question 8

Browns 5 components of EE

Answer 8

• critical comments
• hostility
• emotional over - involvement
• warmth
• positive regard

Question 9

Hostility

Answer 9

• was noted as generally present in the interviews with high EE Caregivers
• result of unmanageable anger, irritation and ultimately the rejection of the patient

Question 10

Warmth

Answer 10

• measured by the vocal qualities, smiling and empathy expressed when the caregiver was talking about the individual with SZ
• warmth was evident in low EE caregiver

Question 11

Critical comments

Answer 11

• critical comments about behaviour were made by high EE caregivers while low EE caregivers tended to acknowledge that theses behaviours were due to their illnesses

Question 12

Emotional over involvement

Answer 12

-manifesting itself in high levels of both happiness and sadness, excessive self-sacrifice and extreme overprotective behaviour of the caregiver toward the individual with schizophrenia
- evident in parent caregivers as they frequently reported feeling guilty for their child’s illness which led them to excessive reparative effort