Family Dysfunction for Schizophrenia

• explanations based on family dysfunction claim that schizophrenia is caused by abnormal patterns of communication in the family, along with abnormalities in cognitive functioning
• schizophrenogenic mother

  • Fromm-Reichmann proposed this theory for the development of schizophrenia
  • based on most of her patients reporting that they had a cold, rejecting and controlling mother throughout childhood
  • creates a tense family climate
  • which can lead to delusions and paranoia
• double bind theory

  • when a child finds themselves trapped in situations where they receive mixed messages. When the child 'gets it wrong', they are punished by withdrawal of love
  • this can lead to a distorted view of the world which can be reflected in schizophrenia symptoms (disorganised thinking and delusions)
• Getting stuck in double bind situations continuously can lead to people developing psychosis as a way to cope with it.
• Degree of expressed emotion

  • the level of negative emotion that is expressed towards a patient
  • high expressed emotion can lead to worsening of schizophrenia symptoms and an increase in relapse likelihood
• elements of expressed emotion

  • verbal criticism of the patient and violence
  • hostility - negative attitude towards the patient due to family feeling that their disorder is controllable
  • emotional over-involvement - family members blame themselves, leading to guilt and concern which can cause patients to become stressed
• expressed emotion is primarily an explanation for relapse in schizophrenia patients

  but it has been suggested that expressed emotion may be a source of stress that can trigger the onset of schizophrenia in vulnerable people
• Kuipers et al

  found that high expressed emotion levels are most likely to impact relapse rates. A patient returning from hospital to a high expressed emotion family is 4 times more likely to relapse than a patient in a low expressed emotion family.
• Read et al reviewed 46 studies of child abuse and schizophrenia

  found that almost 70% of adult women inpatients and 60% of adult male inpatients with a schizophrenia diagnosis has experienced a history of physical or sexual abuse during their childhood.
• the double bind theory has led to parent-blaming.

  parents who have already suffered watching their child develop schizophrenia symptoms and who are likely to bare life-long responsibility for their care

  may undergo further trauma by being blamed for their child's condition