Psychological explanations

• AO1 - Family dysfunction

  What is a dysfunctional family?

  How do you think SZ might develop in dysfunctional families?

  The family dysfunction explanation of schizophrenia sees maladaptive relationships and patterns of communications within families as a source of stress. 

   It is believed that this stress can cause or influence the development of schizophrenia.
• Explanation 1: The Schizophrenogenic mother (Fromm-Reichmann, 1948)

  This quite literally means ‘schizophrenia-causing.’ 

  Fromm-Reichmann proposed this type of mother from accounts that patients had given her about their childhoods.
• Explanation 2: Double Bind theory

  Bateson et al (1956)

  Children who frequently receive contradictory verbal and non-verbal messages from their parents develop incoherent representations of reality and could develop Sz.
• Explanation 2: Double Bind theory

  A type of communication style within the family. 

  Child fears doing the wrong thing yet receives mixed messages or signals. 

  They feel they can’t comment on the unfairness of the situation or seek clarification when they get it wrong. This leads to children ‘getting it wrong’ and being punished for it using love withdrawal. 

  As a result they view the world as confusing and dangerous.

  It’s important to note that Bateson stressed that this was not the main type of communication nor the only factor involved. It’s just a risk! 
• Explanation 2: Double Bind theory

  The child’s ability to respond appropriately is incapacitated by these contradictions because one message invalidates the other.

  These interactions prevent the development of an internally coherent construction of reality, and in the long run this manifests itself as SZ symptoms
• Explanation 3: Expressed Emotion (EE)

  Families who persistently express criticism and hostility exert a negative influence. 

  This can cause stress in those vulnerable to schizophrenia as they have lower tolerance for intense environmental stimuli. 

  Particularly on recovering schizophrenics who react to expressed emotion by relapsing into an active phase of the disorder. 
• Explanation 3: Expressed Emotion (EE)

  Linszen et al: Patients returning to high EE families are four times more likely to relapse than those with low EE families

  Noll: People with Sz may be less able to cope with a negative emotional climate while those with supportive families can reduce their dependence on antipsychotic medication.
• AO3 - Evaluation of FD

  (+) Evidence to support

  Adoption studies (Tienari et al) show that genetic vulnerability alone was not sufficient for development of Sz. Children with schizophrenic biological parents were more likely to become ill than those with non-Schizophrenic parents but only when their adopted family was also rated as disturbed.
• AO3 - Evaluation of FD

  (-) individual differences in vulnerability to EE

  Some patients become stressed by EE behaviours (stressful comments by their relatives), whereas others don’t, and this affects their outcome in the family. More resilient patients do not appraise their relatives’ behaviour as stressful, and are less vulnerable to it.
• Cognitive explanations emphasise the role of dysfunctional thought processing, particularly in the positive symptoms of Sz, such as delusions and hallucinations.
• Cognitive explanations

  Schizophrenic patients lack the ability to suppress automatic thoughts and responses for more deliberate ones! It’s thought that mechanisms that operate in normal brains to filter information are somewhat defective in those with schizophrenia. 

  Most people can focus attention selectively but schizophrenics can’t filter the information and so, let in too much irrelevant information. Therefore they’re inundated with external stimuli, which they’re unable to interpret appropriately. They then experience the world differently from the rest of us.
• The stroop test

  Remember I made you do the stroop test with “auditory hallucinations” playing in the background?

  Stirling et al (2006) studied the performance of people with SZ on the stroop test. Mean time for schizophrenic ppts was 123.30 seconds. Mean time for a control group of non schizophrenic ppts was 58.12 seconds.
• Cognitive explanations

  Cognitive explanations of delusions

  • Delusion thinking is characterised by egocentric bias, in which the ind. perceives themselves as central to events.
  • They interpret irrelevant events (such as muffled voices or flashes of light) as relating to themselves. 
  • They are unwilling to consider that they may be wrong or consider more realistic explanations – impaired insight.
• Cognitive explanations

  Cognitive explanations of hallucinations

  Hypervigilance leads to excessive attention on auditory stimuli, and difficulty distinguishing between imagery and sensory-based perception.

  Source misattribution means patients think that self-generated auditory experience originate externally and do not carry out reality-testing processes normally.
• AO3 - Evaluation of cognitive explanations

  (+) Evidence to support

  Faulty cognition as an explanation is reinforced by the success of cognitive-based therapies. 

  In cognitive-behavioural therapy for psychosis (CBT), patients are encouraged to evaluate the content of their delusions or of any voices, and to consider ways they might test the validity of their faulty beliefs.

  A review by the NICE found consistent evidence that, when compared with antipsychotic drugs, CBT was more effective in reducing symptom severity and improving levels of social functioning  (NICE, 2014).
• What is the diathesis-stress model in relation to schizophrenia?

  An integrated model of schizophrenia
• What is a limitation of psychological models of schizophrenia?

  They often ignore important aspects of the disorder
• How do Howes and Murray (2014) address the limitations of psychological models of schizophrenia?

  By proposing an integrated model
• What do Howes and Murray (2014) suggest sensitizes the dopamine system?

  Early vulnerability factors and social stressors
• What is the effect of sensitization on the dopamine system according to Howes and Murray (2014)?

  It increases the release of dopamine
• What are the components of the integrated model of schizophrenia proposed by Howes and Murray (2014)?

  • Early vulnerability factors (e.g. genes, birth complications)
  • Exposure to significant social stressors
  • Sensitization of the dopamine system
  • Increased release of dopamine