Social Psychological Factors

Question 1

Bowen’s family system theory (1957)

Answer 1

highlighted key features of dysfunctional families relating to differentiation of self and triangulation

• Differentiation of self: ability to separate the individual’s own intellectual and emotional functioning from that family
• Triangulation: the idea that people respond to anxiety in a relationship by forming a triangle shifting the focus to the third person

Question 2

Miklowitz (1994)

Answer 2

provides a review of 3 family attributes as indicators of risk in scz selected due to their ability to meet 4 key criteria of scientific research

Question 3

Communication deviance (CD)

Answer 3

the degree to which a relatives communication is unclear, fragmented and or disruptive
- relates to the form, clarity or structure of communication rather than its emotional content

Question 4

Affective style

Answer 4

a relatives emotional and verbal behaviour when interacting with the patient, AS was designed to provide a more direct measure than EE of how the attitudes of relatives are expressed during interactions with patients.

Question 5

Amaresha (2012)

Answer 5

High EE emphasises criticism, hostility and emotional overinvestment as key features.
Low EE families in contrast are more warming and have more positive regard

Question 6

Brown and Rutter (1966) - Camberwall Family Interview

Answer 6

• how the relatives of a scz talk about the individual on tape
• answers to questions and non verbal cues used to determine EE level
• alternative measure 5 minute speech sample (FMSS) relatives asked to speak about patient
• tone of voice conveys feelings (anger, rejection, irritability) High EE means worse prognosis

Question 7

Strength and Weakness

Hooley and Hiller (2001)

Answer 7

empirical studies have consistently shown higher levels of CD in the parents of patients with scz compared with either the parents of healthy control children or the parents of children with non-psychotic disorders

Issue however is whether the unusual patterns of communication found in parents of scz contributes to the development of the disorder or whether such communication deficits simply represent a reaction to the child’s developing disorder

Question 8

Strength and Weakness

Butzlaff and Hooley (1998)

Answer 8

a consistent finding is that patients suffering from scz who return to homes containing high EE relatives have higher relapse rates that are double those found in patients returning to families who are low EE.

However, EE is not a relapse risk indication for scz alone but also a range of disorders

Question 9

Goldstein (1987)

Answer 9

conducted 15 year prospective study to examine whether parental CD predicted the developments of scz of adolescents in genetic risks, results predicted scz and suggest that disturbed patterns of communication may play a role

Question 10

Wahlberg et al (2000’s)

Answer 10

earlier study supported by this, parental CD may interact with genetic risk that could trigger the development of scz. High risk children were less likely to develop scz when raised in low CD than any other group of disorders

Question 11

Bebbington 1994

Answer 11

analysed data from 1346 patients and found relationships between high levels of EE and relapse and also the protective factor of reduced face to face contact for patients in high EE families.

Question 12

Strengths and Weakness

Brown 1996

Answer 12

families where communication is commonly to do with criticism, hostility and disapproval are said to have high EE. Interviews were conducted to determine the level of expressed emotion. The experimental group had a rate of relapses of 8% over nine months while the control group had a rate of 50%.

This type of assessment is quite western or modernised so it may not apply to every culture, it is more evident in western countries/families