Sociocultural Explanations Of Schizophrenia

Question 1

What did Szaz claim?

Answer 1

In 1962 and 1979, Szaz claimed that SCHIZOPHRENIA DOES NOT EXIST.

He believes that it is a way of classifying people whose behaviour is bizarre and difficult to control

Question 2

What did Scheff (1966) argue?

Answer 2

That receiving a psychiatric DIAGNOSIS creates a STIGMA of SOCIAL DISGRACE

Question 3

Scheff (1966) proposed labelling theory. Outline labelling theory

Answer 3

Social groups construct RULES for members to follow. The SYMPTOMS of schizophrenia are seen as DEVIANT from the rules we ascribe to ‘NORMAL EXPERIENCE’. If a person displays these unusual forms of behaviour, they are considered deviant, and the LABEL of ‘schizophrenic’ may be APPLIED. Once this diagnostic label had been applied it becomes a SELF-FULFILLING PROPHECY that promoted the DEVELOPMENT of other schizophrenic symptoms - people act in ways which fit the ‘label’

Question 4

What does the labelling explanation deny?

Answer 4

The labelling explanation denies the existence of any illness or medical condition and places the blame on society

Question 5

Who provided a powerful example of the effect of labelling?

Answer 5

Rosenhan

Question 6

What year did Rosenhan’s conduct his study?

Answer 6

1973

Question 7

Outline Rosenhan’s 1973 study in which he aimed to investigate the RELIABILITY of DIAGNOSING mental illness

Answer 7

8 ‘PSEUDO-PATIENTS’ who were actually psychologically healthy made appointments at various different hospitals in the USA. At the appointment they complained of HEARING an UNFAMILIAR VOICE often using the words ‘THUD’, ‘HOLLOW’ and ‘EMPTY’

Question 8

What were the results from Rosenhan’s 1973 study?

Answer 8

ALL 8 patients were ADMITTED to hospital

Once admitted they BEHAVED NORMALLY and showed NO schizophrenic SYMPTOMS

They had GREAT DIFFICULTY in CONVINCING staff that they were SANE

They reported being IGNORED BY STAFF and felt the staff had CREATED a sense of POWERLESSNESS and FEAR in them

Staff interpreted the ‘normal’ behaviour as ‘ABNORMAL’

SOME OTHER hospital PATIENTS realised they were NORMAL and NOT MENTALLY DISTURBED

On DISCHARGE they were given the LABEL ‘schizophrenia in REMISSION’

Question 9

What did Rosenhan conclude from his 1973 study?

Answer 9

The DIAGNOSIS of mental illness is UNRELIABLE as individuals were perceived and treated according to the label they were given

The LABEL of ‘schizophrenia’ caused OTHERS to RESPOND to the patients DIFFERENTLY, interpreting ‘normal’ behaviours as ‘abnormal’

The label of ‘schizophrenia in REMISSION’ suggests they may be a SUFFERER in the FUTURE

Question 10

Given one strength of Rosenhan’s 1973 study

Answer 10

It shows how PERCEPTIONS of mental health patients patients are AFFECTED by the LABEL they have been given

More likely correct…

Question 11

Give one criticism of labelling theory

Answer 11

Had been criticised for TRIVIALISING a very SERIOUS DISORDER

People who should be diagnosed may not be and therefore may not get the right/any treatment
Could lead to symptoms getting worse - ‘self-fulfilling prophecy’

Question 12

Explain why Rosenhan’s 1973 study was UNETHICAL

Answer 12

The ‘pseudo-patients’ were FORCED to take anti-psychotic DRUGS, which can have serious negative consequences. (Protection of participants)

Right to withdraw

Therefore, theory unethical and unable to test

Question 13

Give one limitation of labelling theory

Answer 13

CAUSE and EFFECT

INCOMPLETE

Question 14

Give a limitation of labelling theory

Answer 14

Dose NOT PROVIDE any viable means of TREATMENT meaning the person may remain disordered for the foreseeable future, creating DISRUPTION for families who may be unable to cope with their behaviour

PESSIMISTIC

DETERMINISTIC

Question 15

Give one positive outcome of Rosenhan’s 1973 study

Answer 15

Has PROVOKED many practitioners to RE-EXAMINE their own EXPECTATIONS and resulted in REVISION of the DIAGNOSTIC CRITERIA (DSM-III, 1980)

ADVANCES - DIAGNOSIS + TREATMENT

Question 16

Give a limitation of labelling theory

Answer 16

REDUCTIONIST

IGNORES BIOLOGICAL factors and other environmental factors such as STRESS

SIMPLISTIC - likely to have a more COMPLEX explanation

Question 17

Give one limitation of Rosenhan’s 1973 study

Answer 17

May be ERA-DEPENDENT

Since Rosenhan’s stidy, the way in which mental illness is diagnosed/diagnostic criteria has changed

Question 18

Describe he basis of the family distinction explanation for schizophrenia

Answer 18

The main idea that a person develops schizophrenia because they have been RAISED in a DYSFUNCTIONAL FAMILY ENVIRONMENT

The family is dysfunctional because of the way in which the family members COMMUNICATE with each other

Question 19

What are the three dysfunctional characteristics shown by parents of schizophrenics? Shown by Schiffman et al. (2002)

Answer 19

HOGH LEVELS of INTERPERSONAL CONFLICT (family arguments)

DIFFICULTIES in COMMUNICATION with each other

HIGHLY CRITICAL and CONTROLLING of their children

Question 20

Describe what is meant by the term DOUBLE BIND

Answer 20

Bateson (1956) thought that FAULTY COMMUNICATION in families could cause schizophrenia.

Parents place children in a ‘NO-WIN’ situation by giving them CONTRADICTORY MESSAGES (a double bind)

A parent might SAY ONE THRING, but their BOSY LANGUAGE and TONE could SUGGEST the OPPOSITE

Question 21

Explain how a double bind may cause schizophrenia to develop

Answer 21

The LONGER this goes on, the MORE the child will MISINTERPRET the parents CONTRADICTORY MESSAGES and become INCREASINGLY CONFUSED

the child will ASSUME that they can DO NOTHING but DISPLEASE the parent and this will AFFECT their ABILITY to RESPOND to the parent

Eventually this confusion will DISTORT the child’s SENSE OF REALITY and could lead to symptoms such as the NEGATIVE SYMPTOMS of SOCIAL WITHDRAWAL and FLAT AFFECT could be an appropriate response to double bind situations

They could also GROW UP to MISTRUST ALL COMMUNICATIONS CHARACTERISTICS of PARANOID schizophrenia

Question 22

Describe what is meant by EXPRESSED EMOTION

Answer 22

Research has focuses on a particular EMOTIONAL COMMUNICATION STYLE known as EXPRESSED OTION (EE)

Question 23

What did Brown et al. (1958) find in relation to expressed emotion?

Answer 23

Found that schizophrenic PATIENTS DISCHARGED from hospital had LOWER RATES of REMISSION if they had LESS rather than more CONTACT with their FAMILIES

Question 24

What are the key factors in communication patterns in families with high EE?

Answer 24

CRITICISM (disapproval)

HOSTILITY (animosity)

EMOTIONAL OVER INVOLVEMENT (both positive and negative intrusiveness)

Question 25

What is the effect of key factors of EE being high in a family on the patient?

Answer 25

Patients are significantly more likely to RELAPSE

Question 26

What did Kavanagh (1992) find? EE

Answer 26

That where EE is HIGH, you are 3.7 TIMES MORE LIKELY to RELAPSE than if you lived in a family with low expressed emotion

Question 27

Brown et al. (1966) conducted a key study into EE. Outline his study

Answer 27

Aimed to investigate the IMPACT of FAMILY RELATIONSHIPS on the RECOVERY of schizophrenic patients

9 MONTH FOLLOW UP of schizophrenic patients DISCHARGED from hospital. INTERVIEWS were conducted with FAMILY MEMBERS. The CONVERSATIONS were RATED for the NUMBER of CRITICAL COMMENTS or HOSTILITY to the patient

Question 28

What were the results from Brown et al’s 1966 key study into EE?

Answer 28

Families with levels of HIGH EE resulted in 58% of patients RETURNING to hospital for further treatment compared to ONLY 10% from LOW EE families

Question 29

What could Brown et al conclude from the 1966 study into EE

Answer 29

FAMILY RELATIONSHIPS and levels of EE are IMPORTANT FACTORS in determining how well people will RECOVER from schizophrenia

Question 30

Outline the supporting evidence from Butzlaff and Hooley (1998)

Answer 30

Reviewed OVER 20 studies of EE and found that 70% of schizophrenics in families with HIGH EE RELAPSED within a YEAR, compared with 30% RELAPSE in families with LOW EE

META-ANALYSIS

MORE REPRESENTATIVE as larger sample size

Question 31

Outline the supporting evidence from Doane et al. (1985)

Answer 31

Found TREATMENTS focuses on REDUCING EE in families resulted in REDUCED RELAPSE RATES

MORE LIKELY CORRECT as more supporting evidence

Question 32

Outline the contradictory evidence shown by Hall and Levin (1980)

Answer 32

Did a REVIEW of FAMILY STUDIES and found NO EVIDENCE of contradiction in VERBAL and NON-VERBAL MESSAGES between parents and children

Goes AGAINST DOUBLE BIND

Question 33

Outline the issue with CAUSE and EFFECT

Answer 33

CAUSE and EFFECT

Lantern et al. (1987) argues that it is very DIFFICULT to DISTINGUISH if HIGH EE families causes schizophrenia or does schizophrenia cause high EE families?

Question 34

Why is the EE theory reductionist?

Answer 34

Ignores BIOLOGICAL, LABELLING

OVERSIMPLISTIC

Question 35

What are he ethical issues raised with the theory of EE?

Answer 35

THEORY HARMS FAMILIES

CAUSE CANNOT BE INVESTIGATED as very unethical to do so

TREATMENT difficult as could cause mental harm to the rest of the family

Question 36

What is the issue with how EE is measured?

Answer 36

Assessing EE requires ONLY ONE OBSERVATION or INTERVIEW, which might NOT BE ENOUGH to give an ACCURATE picture of family interaction patterns

Very SUBJECTIVE

Question 37

What conclusion can been drawn from the evidence for and against levels of EE?

Answer 37

The idea of POOR family INTERACTION links well with the interactionist view of the ‘DIATHESIS-STRESS MODEL’ of schizophrenia in which a genetic predisposition interacts with areas from the environment to induce the onset of schizophrenia

MORE LIKELY CORRECT