Psychological explanation

• Stress is an activating agent for the onset of schizophrenia
• Communication is families can be a source of stress
• Parents can display dysfunctional characteristics:

  1. Interpersonal conflict (arguing)
  2. Difficulty communicating with each other
  3. Being excessively critical and controlling of their children
• Schizophrenogenic mother

  • Freida Fromm Reichmann (1948)
  • Schizophrenic patients often described a childhood with a cold, rejecting, controlling mother who caused tension and anxiety
• Schizophrenogenic mothers can lead to distrust causing paranoid delusions in later life
• Double bind

  • Gregory Bateson et al (1956)
  • Children who received contradictory messages from parents were more likely to develop schizophrenia
• Children receiving mixed messages are unable to comment on the unfairness or seek clarification
• Bateson said that double bind was a risk factor for schizophrenia, that it was not the only factor contributing to symptoms
• Children receiving mixed messages leads them to develop a disorganised and paranoid internal working model (links to Bowlby)
• Expressed emotion

  • An explanation for relapse
  • Stress triggers a vulnerable person
• Negative emotional climate- a high degree of expressed emotion
• Expressed emotion

  • family communication style
  • Talk about the patient in a critical or hostile manner
  • Talk about the patient in a way that indicates emotion over-involvement or over-concern
• Kavanagh (1992)

  • Relapse in expressed emotion families: 48%
  • Relapse in non-expressed emotion families: 21%
• Butzlaff and Hooley (1998)

  • Meta analysis of 26 studies
  • Relapse was two times as likely in expressed emotion families
• Strengths

  • Concurrent validity
  • Real life application
• Weaknesses:

  • Alternative explanation
  • Unreliable
  • Not useful
  • Socially sensitive
  • Deterministic
• Concurrent validity

  • Expressed emotion has 2 supporting studies
  • Butzlaff and Hooley (1998), relapse is 2x as likely in EE families
  • Kavanagh (1992) relapse= 48% in EE familes, 21% in non-EE families
• Real life application

  • Emphasises the importance of ensuring children are in emotionally stable households
  • Shows the importance of not sending schizophrenic patients back to EE families
• Alternative explanations

  • Biological explanations: genetic, neural correlates, dopamine hypothesis
• Unreliable

  • Potentially delusional and depressed schizophrenic patients are recalling their childhood
  • Could have a more negative view
• Not useful

  • Double bind (Gregory Bateson et al)
  • If children cannot communicate with their parents, then they cannot communicate with those who could help
• Socially sensitive

  • Blames the parents, especially mothers
• Deterministic

  • Might make it so schizophrenic patients lose hope with recovery
  • EE families= 48% relapse rate