social psychological explanations

Question 1

outline expressed emotion

explain

Answer 1

• this theory does not explain the cause of schizophrenia, but explains why people relapse
• a measure of family environment
• developed by George Brown in the 1950s.
• his research was prompted by findings from a study that recognised that those staying with parents/partners had a higher chance of relapse than those in staying in lodgings or with siblings
• the key features of a high EE family are criticism, hostility and emotional overinvolvement as identified by Amaresha (2012)
• low EE families are full of warmth and positive regard
• the Camberwell Family Interview is a tool for measuring EE Brown and Rutter (1966)
• the patient is not present and their family spontaneously talk about them in a taped interview which is later coded.
• the stress-diathesis model combines the biological approach with environmental factors to explain the triggering mechanism behind a relapse for schizophrenia
• the theory believes that an individual’s susceptibility to psychosis is determined by their tolerance of trauma and stress
• EE may be a major contributing factor to the stress levels of schizophrenics

Question 2

outline expressed emotion

research

Answer 2

• Amaresha (2012)

- Brown and Rutter (1966)

Question 3

evaluate expressed emotion

explain

Answer 3

strengths

• improvements (previous theories have been even more reductionist and have ignored family environment and as a social explanation, EE does not do this, theories and a greater understanding of the experiences of schizophrenia, everyday interactions)
• therapy (EE views schizophrenia from a new angle e.g family intervention therapy as opposed to drug therapy, focuses on the patient as an individual instead of just prescribing all schizophrenics with the same medication, showing warmth and positive regard, aims to alter the environment of the schizophrenic if it is believed to be damaging and slowing down their recovery rates - focuses on the wellbeing of the patient)
• research (the majority of studies support that high EE rates predict relapse)

limitations
- deterministic (relapses of schizophrenia are caused by high EE families, reduces the relapse of a complex mental disorder to someone’s relationship with their close family, EE is non-scientific and therefore cannot be measured objectively, for example compared to dopamine)
- methodology and therapy (self report data which is unreliable due to social desirability, retrospective and memory based, highly qualitative, difficult to analyse and open to interpretation between psychologists, the families views will change over time (inconsistent, lacks reliability) and The Camberwell Family Interview (traditional method) is time consuming and labour intensive - Hooley and Parker)
- research and relevance (should predict lower relapse rates in schizophrenics who are estranged by their families, but this is not the case as it suggests other factors - Goldstien (1998)
and may be outdated as social media has changed family interactions, research and theories are culturally biased (White Western male)

Question 4

evaluate expressed emotion

research

Answer 4

• Hooley and Parker

- Goldstien (1998)

Question 5

outline dysfunctional families

explain

Answer 5

• schizophrenia is caused by confusing and destructive family communication
• considers the fact that individuals do not live separate from society, and that our interactions with others can influence our mental state
• Bowen’s Family System Theory (1957) highlighted that a key feature of a dysfunctional family was differentiation of self (their ability to separate their own intellectual and emotional functioning from the abnormal behaviour of their family)
• therefore, individuals who develop schizophrenia are not able to differentiate their intellectual and emotional functioning from that of their families’
• moreover, the Family System Theory also found that triangulation (a relationship with someone left out leads to anxiety which develops into schizophrenia).

- Miklowitz (1994) identified 3 types of behaviour common in dysfunctional families:
Communication Deviance (CD) - 
The degree to which a relative’s communication is unclear, unusual and fragmented relating to structure and form of language use e.g. ambiguous or incorrect sentences

Expressed Emotion (EE, Brown et al 1972) - 
The key relative, usually a parent, has attitudes of criticism, hostility and overprotection.

Affective Style (AS) -
A member of the family’s behaviour when interacting with the patient measures the amount of dysfunction in their relationship. It is a more direct measure of EE and negative AS consists of critical or guilt inducing statements OR 6 or more intrusive “mind reading” statements towards the patient during a 10 minute discussion.

Question 6

outline dysfunctional families

research

Answer 6

• Bowen’s Family System Theory (1957)

- Miklowtiz (1994)

Question 7

evaluate dysfunctional families

explain

Answer 7

strengths
- improvements (previous theories have been even more reductionist and have ignored family environment and as a social explanation, DF does not do this, theories and a greater understanding of the experiences of schizophrenia, everyday interactions)
- therapy (DF views schizophrenia from a new angle e.g family intervention therapy as opposed to drug therapy, focuses on the patient as an individual instead of just prescribing all schizophrenics with the same medication, showing warmth and positive regard, aims to alter the environment of the schizophrenic if it is believed to be damaging and slowing down their recovery rates - focuses on the wellbeing of the patient)
- research (Miklowitz (1995) AS may distinguish families of schizophrenic patients from those with other disorders
Relatives of schizophrenics made twice as many negative statements compared to the relatives of people with bipolar disorder)

limitations
- deterministic (schizophrenia is caused by families, reduces the relapse of a complex mental disorder to someone’s relationship with their close family, DF is non-scientific and therefore cannot be measured objectively, for example compared to dopamine)
- methodology and therapy (self report data which is unreliable due to social desirability, retrospective and memory based, highly qualitative, difficult to analyse and open to interpretation between psychologists, the families views will change over time (inconsistent, lacks reliability)
- research and relevance (should predict lower relapse rates in schizophrenics who are estranged by their families, but this is not the case as it suggests other factors - Goldstien (1998)
and may be outdated as social media has changed family interactions, research and theories are culturally biased (White Western male)

Question 8

outline dysfunctional families

research

Answer 8

• Miklowitz (1995)

- Goldstien (1998)