Psychological explanations

• Family dysfunction

  • Abnormal processes within a family such as poor family communication, cold parenting and high levels of expressed emotion.
  • these may be risk factors for both the development and maintenance of SZ.
• Schizophrenogenic mother

  • Fromm- reichmann, claimed that the schizophrenogenic mother caused an individual to develop SZ.
  • Mother is cold, rejecting and controlling.
  • This creates a family climate of tension
  • Consequently this leads to distrust which develops into paranoid delusions.
• Who introduced the double bind theory?

  Bateson et al
• Double bind theory

  • Family climate is important in the development of SZ, but emphasises the role of communication style within the family.
  • Developing child finds themselves trapped in situations where they fear they are doing the wrong thing, but receive mixed messages about what this is and feel unable to comment on the unfairness of the situation or seek clarification.
• Example of double bind theory

  Being told they need to be independent but being overprotected and receiving criticism for being independent.
• What are the consequences of double bind theory?

  • When they get it wrong, which is often, they are punished by withdrawal of love.
  • This makes the world seem confusing and is reflected in symptoms like disorganised thinking and paranoid delusions.
• Expressed emotion

  • The level of emotion
  • Particularly negative emotions, expressed towards patients by their carers.
  • Verbal criticism, occasionally including violence
  • Hostility, including anger and rejection
  • Emotional over-involvement in their life, including needless self-sacrifice.
• What are the consequences of expressed emotion?

  • Serious source of stress, which may trigger a SZ episode in someone who is genetically vulnerable or can lead to relapse.
• Types of family dysfunction

  • Double bind theory
  • Schizophrenogenic mother
  • High expressed emotion
• Research support for family dysfunction

  • Indicators of family dysfunction include insecure attachment and exposure to childhood trauma, especially abuse.
  • Read et al, found that adults with schizophrenia are disproportionality likely to have insecure attachment.
  • Ripke et al reported that 69% of women and 59% of men with schizophrenia have a history of physical and sexual abuse.
  • Family dysfunction makes people more vulnerable to schizophrenia.
• How to the family dysfunction explanations lack support?

  • Although there is plenty of evidence supporting the idea that childhood family-based stress is associated with adult schizophrenia, there is none to support the importance of traditional family-based theories, such as schizophrenogenic mother and double bind theory.
  • Both theories are based on clinical observations of parents and informal assessment of the personality of mothers of patients but not systematic evidence.
  • No reliable evidence to account for the link between childhood trauma and SZ.
• How does the family dysfunction explanation lead to parent blaming?

  • Parents already have to watch their child experience the symptoms of SZ and take responsibility for their care, to be blamed adds insult to the injury.
  • A psychological theory should not cause harm to people, and theories like the schizophrenogenic mother and double bind have done harm.
  • This means that research into family dysfunction and SZ will always be controversial.
• 2 aspects of dysfunctional thinking

  • Metarepresentation
  • Central control
• Who identified the 2 kinds of dysfunctional thought processing?

  Frith et al

  Metarepresentation

  Central control
• Metarepresentation

  • The cognitive ability to reflect on thoughts and behaviours.
  • It helps us to understand our own intentions and goals and interpret the actions of others.
  • Disruption to it makes it difficult to recognise thoughts and actions as our own leading to the belief that they are caused by someone/something else.
  • Explains hallucination and delusions
• Central control

  • The ability to suppress automatic responses while performing a deliberate action.
  • Sometimes during a conversation with one person, other ideas on an unrelated issue pop into your mind. There was a trigger to it. But this does not interfere with your conversation and you can suppress the thought.
  • People with SZ cannot ignore the association from the trigger so this leads to disorganised thought and speech patterns.
• Research support for cognitive explanations

  • Stirling et al, compared performance on cognitive tasks in 30 people with SZ and 30 without (control). Included the strop task, in which participants must name the font colours of the colour words. This required them to suppress the tendency to read the words aloud.
  • As predicted by Frith et al, people with SZ took longer to complete the task, twice as long to name the font colours.
  • This delay in cognitive processing in SZ patients supports the idea that cognitive processes are impaired.
• How is the cognitive explanation a proximal explanation?

  • Cognitive theories can explain what causes the current symptoms (proximal cause) but not the origins of the condition (distal cause).
  • Possible distal explanations are genetic and family dysfunction explanations. We do not understand how genetic variations or childhood trauma might lead to problems with meta-representation or central control.
  • Cognitive theories only provide a partial explanation.