(psychological) family dysfunction

• what is family dysfunction?


  abnormal patterns of communication within the family
• what are the components of family dysfunction?

  double bind theory

  expressed emotion
• what is double bind theory


  • receiving conflicting messages
  • suggested by Bateson et al
  • children are more likely to develop SZ if they receive conflicting messages from their parents due to the childs ability to respond is incapacitated by the contradictions because one message invalidates the other
• what symptoms does double bind theory lead to?


  • prevents the development of an internally coherent construction of reality which can lead to flattened affect and withdrawal
• what is expressed emotion?


  a negative emotional climate with high levels of expressed emotion

  • this can be through emotional over-involvement or over-concern or through a hostile approach to interacting
  • high levels of expressed emotion are more likely to influence relapse rates
• what does expressed emotion lead to?


  • higher relapse rates (linszen et al)
  • lower tolerance for an intense environmental stimuli especially negative comments
  • leads to stress beyond coping mechanisms and triggers a schizophrenic episode
• support for the importance of family relationships

  • demonstrated by tienari et als adoption study
  • it demonstrated that whilst children with sz parents were more likely to develop sz, this difference only emerged where the adopted family was rated as disturbed
  • suggesting the illness only manifests under certain environmental conditions + family dysfunction is important
• support for the double bind theory 


  Berger

  • found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics

  however, other studies eg by Liem found no difference of communication in sz families compared to normal
• what is the value of double bind theory?


  gibney argues it led to the development of family therapy
• what is a negative of expressed emotion?


  individual differences in vunerability

  • not all patients who live in high EE families relapse and not all patients who live in low EE homes avoid relapse
  • there are individual differences in stress responces to high EE behaviours
  • Altorfer et al found 1/4 of patients showed no responses to stressful comments from relatives