Family dysfunction

• Schizophrenogenic mother

  Psychiatrist Freida Fromm Reichmann

  Cold, rejecting and controlling -> creates a tense family climate.

  Leads to distrust, develops into delusions .
• Double bind theory

  Bateson et al (1956) -

  Mixed messages from parents

  Caring + critical at the same time, contradiction between verbal + non-verbal behaviour.

  Leads to confusing + dangerous perception of the world, develops into delusions.

  Only a risk factor
• Expressed emotion

  Negative emotion expressed towards person with SZ by carers/family.

  Verbal criticism - sometimes violence.

  Hostility - anger + rejection

  Emotional overinvolvement - needless self sacrifice.

  Source of stress.

  Explains relapse and a trigger for vulnerable people.
• Support: (Tienari et al, adoption study)

  SZ developed in adoptees who were adopted into a family with a negative climate.

  Shows evidence for family dysfunction triggering SZ.
• Support: (Bateson, double-bind case study)

  Recovering SZ visited by mother while in hospital.

  Mixed messages - hugged mother, she said something negative.

  Once the mother left, SZ symptoms worsened.
• Support: (Kavanagh, expressed emotion)

  Reviewed 26 case studies.

  High EE families had relapse rate of 48%

  Low EE families had relapse rate of 21%

  Therefore, family is a cause of relapse in SZ.
• Limitation: (Direction of causality)

  Unclear whether the families dysfunctional behaviour is in response to the SZ or causes the SZ.
• Limitation: (alternative explanation)

  Family dysfunction is weak on its own. Only the trigger.

  Other vulnerabilities are present for it to cause SZ.

  For example, genetics, diathesis stress model