Psychological Explanation

• The Schizophrenogenic Mother


  Psychiatrist Frieda Fromm-Reichmann (1948) proposed an explanation based on the fact many of her patients spoke of a particular type of parent which she coined the Schizophrenogenic Mother who is cold, rejecting and controlling, who tends to create an environment of tension and secrecy. This leads to distrust that later develops into paranoid delusions and ultimately Schizophrenia.
• Double-bind theory

  Bateson et al (1972) agreed with Frieda Fromm-Reichmann but emphasised the importance of communication style. The developing child often finds them self trapped in situations where they fear doing the wrong thing, receive mixed messages and feel unable to comment on how this is unfair. When they 'get it wrong' (often) love is withdrawn. Leaving them with an understanding the world is confusing and dangerous, reflected in symptoms of disorganized thinking and paranoid delusions. This is however not the main type of communication or only factor.
• Expressed Emotion


  EE is the level of emotion particularly negative expressed towards a patient by carers. E.g:

  • Verbal Criticism (occasionally accompanied by violence)
  • Hostility (including anger and rejection)
  • Emotional overinvolvement including needless self-sacrifice
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  • These create stress, are a primary explanation for relapses, and may trigger it in a person already vulnerable to Sz.
• Dysfunctional Thinking

  A cognitive explanation is dysfunctional thought processing. Reduced thought processing in the ventral striatum is associated with negative symptoms, while reduced processing in the temporal and cingulate gyri is associated with hallucinations. This lower-than-usual level of information processing suggests cognition is likely to be impaired.
• Metarepresentation dysfunction

  Christopher Frith et al. (1992) identified 2 types of dysfunctional thought processes. The first is metarepresentation, the ability to reflect on thoughts and behaviour, allowing us insight into our own behaviour and also to interpret the actions of others. Dysfunction would disrupt our ability to recognize our actions as our own rather than being done by someone else. This could explain hallucinations of hearing voices and delusions like thought insertion.
• Central Control Dysfunction


  Frith et al also identified issues with the cognitive ability to suppress automatic responses while we perform deliberate actions. Speech poverty and thought disorder could be a result of the inability to suppress automatic thoughts and speech triggered by other thoughts. For example, people with Sz tend to experience derailment of thoughts because each thought would trigger associations and they can't suppress automatic responses to it.
• Research Support for the Family Dysfunction Explanation

  Indicators of family dysfunction include insecure attachment and exposure to childhood trauma, especially abuse. According to a review by John Read et al. (2005), adults with Sz are disproportionately likely to have insecure attachment, particularly type C or D. He also found 69% of women and 59% of men with Sz had a history of physical and/or sexual abuse. Morkved et al (2017) study found that most adults with Sz reported at least one childhood trauma. This strongly suggests that family dysfunction makes people more vulnerable to Sz.
• Limitation of the Family Dysfunction Explanation


  There is a poor evidence base for any of the explanations. There is plenty of evidence supporting the idea childhood family-based stress is associated with adult Sz, but there is almost none to support traditional family-based theories such as the schizophrenogenic mother and double bind. These theories are based on clinical observations and informal assessments of the personality of mothers of patients but no systematic evidence. This means that family explanations have not been able to account for the link between childhood trauma and Sz.
• Parent Blaming in the Family Dysfunction Explanation


  Although early explanations have no research support, research may be useful in showing that insecure attachment and childhood trauma affect an individual's vulnerability to Sz. However, it is socially sensitive as it can lead to parent blaming. For parents who are taking care of a person with Sz and having to watch them go through the symptoms, to be blamed for that can be very damaging.
• Research support for the Cognitive explanation


  On strength of the Cognitive Explanations evidence for dysfunctional thought processing. Stirling et al. (2006) compared performance a range of cognitive tasks in 30 people with Sz and 30 people without. Tasks included the Stroop Task in with patients had to name the font colours of coloured words, so they had to suppress the tendency to read words aloud. People with Sz took around double the time as predicted by Frith et al.s central control theory. This means the cognitive process of people with Sz is likely impaired.
• Limitation of the cognitive explanation of Sz

  One limitation is that it only explains the proximal origins of symptoms. They explain what is happening now to produce symptoms, not what caused it. Possible distal explanations are genetic variation or childhood trauma which may lead to issues with central control or metarepresentation. This means cognitive theories alone only provide a partial explanation for Sz.