Sociocultural Explanations Of Schizophrenia Flashcards
What did Szaz claim?
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
What did Scheff (1966) argue?
That receiving a psychiatric DIAGNOSIS creates a STIGMA of SOCIAL DISGRACE
Scheff (1966) proposed labelling theory. Outline labelling theory
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’
What does the labelling explanation deny?
The labelling explanation denies the existence of any illness or medical condition and places the blame on society
Who provided a powerful example of the effect of labelling?
Rosenhan
What year did Rosenhan’s conduct his study?
1973
Outline Rosenhan’s 1973 study in which he aimed to investigate the RELIABILITY of DIAGNOSING mental illness
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’
What were the results from Rosenhan’s 1973 study?
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’
What did Rosenhan conclude from his 1973 study?
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
Given one strength of Rosenhan’s 1973 study
It shows how PERCEPTIONS of mental health patients patients are AFFECTED by the LABEL they have been given
More likely correct…
Give one criticism of labelling theory
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’
Explain why Rosenhan’s 1973 study was UNETHICAL
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
Give one limitation of labelling theory
CAUSE and EFFECT
INCOMPLETE
Give a limitation of labelling theory
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
Give one positive outcome of Rosenhan’s 1973 study
Has PROVOKED many practitioners to RE-EXAMINE their own EXPECTATIONS and resulted in REVISION of the DIAGNOSTIC CRITERIA (DSM-III, 1980)
ADVANCES - DIAGNOSIS + TREATMENT
Give a limitation of labelling theory
REDUCTIONIST
IGNORES BIOLOGICAL factors and other environmental factors such as STRESS
SIMPLISTIC - likely to have a more COMPLEX explanation
Give one limitation of Rosenhan’s 1973 study
May be ERA-DEPENDENT
Since Rosenhan’s stidy, the way in which mental illness is diagnosed/diagnostic criteria has changed
Describe he basis of the family distinction explanation for schizophrenia
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
What are the three dysfunctional characteristics shown by parents of schizophrenics? Shown by Schiffman et al. (2002)
HOGH LEVELS of INTERPERSONAL CONFLICT (family arguments)
DIFFICULTIES in COMMUNICATION with each other
HIGHLY CRITICAL and CONTROLLING of their children
Describe what is meant by the term DOUBLE BIND
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
Explain how a double bind may cause schizophrenia to develop
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
Describe what is meant by EXPRESSED EMOTION
Research has focuses on a particular EMOTIONAL COMMUNICATION STYLE known as EXPRESSED OTION (EE)
What did Brown et al. (1958) find in relation to expressed emotion?
Found that schizophrenic PATIENTS DISCHARGED from hospital had LOWER RATES of REMISSION if they had LESS rather than more CONTACT with their FAMILIES
What are the key factors in communication patterns in families with high EE?
CRITICISM (disapproval)
HOSTILITY (animosity)
EMOTIONAL OVER INVOLVEMENT (both positive and negative intrusiveness)
What is the effect of key factors of EE being high in a family on the patient?
Patients are significantly more likely to RELAPSE
What did Kavanagh (1992) find? EE
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
Brown et al. (1966) conducted a key study into EE. Outline his study
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
What were the results from Brown et al’s 1966 key study into EE?
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
What could Brown et al conclude from the 1966 study into EE
FAMILY RELATIONSHIPS and levels of EE are IMPORTANT FACTORS in determining how well people will RECOVER from schizophrenia
Outline the supporting evidence from Butzlaff and Hooley (1998)
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
Outline the supporting evidence from Doane et al. (1985)
Found TREATMENTS focuses on REDUCING EE in families resulted in REDUCED RELAPSE RATES
MORE LIKELY CORRECT as more supporting evidence
Outline the contradictory evidence shown by Hall and Levin (1980)
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
Outline the issue with CAUSE and EFFECT
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?
Why is the EE theory reductionist?
Ignores BIOLOGICAL, LABELLING
OVERSIMPLISTIC
What are he ethical issues raised with the theory of EE?
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
What is the issue with how EE is measured?
Assessing EE requires ONLY ONE OBSERVATION or INTERVIEW, which might NOT BE ENOUGH to give an ACCURATE picture of family interaction patterns
Very SUBJECTIVE
What conclusion can been drawn from the evidence for and against levels of EE?
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
