family dysfunction

• what is the family dysfunction explanation for sz?

  how living in a dysfunctional family & tway you communicate in family is related to development of sz

  maladaptive relatioships & communication patterns in families are a source stress
• 3 factors how family dysfunction is related to developing sz?

  1. expressed emotion
  2. double bind theory
  3. schizophrenogenic mother
• what is expressed emotion?

  • level of emotion (mostly negative) expressed by parent towards child
  • individuals who have suffered from sz & who live in families with high EE are 4x more likely to relapse compared with those who live in families with low EE - kavanagh 1992
• 3 examples of expressed emotion that leads to relapse of sz?

  1. verbal criticism
  2. hostility
  3. emotional over involvement
• double bind?

  • when theres abnormal & inadequate patterns of communication with families
  • child who gets mixed messages from parents are more likely to develop sz
• who proposed double bind theory?

  • bateson 1956 - members of families in sz patients communicate in destructively ambiguous fashion
• example of double bind theory?

  • mother tells child she loves him but looks away in disgust as if child did something wrong
  • leads to negative symptoms - speech poverty child will want to talk less so they dont disappoint parent as it prevents them from doing anything wrong
• schizophrenogenic mother?

  • frieda fromm reichmann - sz children come from this mother
  • mother is cold, rejecting & controlling - creates family climate characterised by tension & secrecy
  • leads to distrust but later develops into positive symptoms - delusions of persecution
• 3 X of family dysfunction?

  1. socially sensitive
  2. issues with cause & effect
  3. does not explain why sz common in mz twins
• * evidence to support from kavanagh 1992?

  • carried out meta analysis of 26 studies on EE
  • results showed that when patients returned to live with high EE family average relapse rates was 48& compared to 21% for low EE family
  • shows higher EE family causes relapse rates to double
  • EE & family dysfunction does play role in development of sz
• X socially sensitive?

  • emphasises family communication & relationships
  • leads to blame on parents - mothers mostly
  • SM explanation presents women as inferior - alpha bias
  • eg exaggerates gender differences between men & women/stereotyping mothers as being cold & rejecting leads to issues with mental heath
  • negative implications for portrayal of women
  • impacts patient with sz & families
  • affects likelihood of them seeking support for treatment
• X issues determining cause & effect?

  • not clear whether family dysfunction causes sz/family dysfunction occurs as a result of getting disorder
  • eg does EE play role in developing sz/does having sz lead to EE - emotional over involvement from family
  • may also be 3rd variable - hypodopaminergia causing negative symptoms - speech poverty
  • ? internal
  • cause & effect relationship between dysfunctional families & sz cannot be made
  • so accurate treatment not developed
• X does not explain why sz common in mz twins?

  • family dysfunction explanation explains why sz runs in families
  • eg when parents send mixed messages child more likely to develop sz
  • gottesman - 48% concordance for mz twins & 17& for dz
  • family dysfunction cannot explain why theres difference in concordance rates for mz & dz twins
  • both live together so would be subjected to same amount of fd
  • may be better alternative
  • fd not only factor
  • may be hereditary genetic component to developing sz
  • more genes individual shares increased likelihood of them both developing sz
• X interactionist approach better explanation?

  • psych explanation - sz caused by family interactions & communication
  • fails to recognise importance of biological factors - neural correlates
  • diathesis stress model better explanation - biological vulnerability to sz & stress trigger from environment necessary to develop sz
  • eg someone with enlarged ventricles in brain are bio predisposed to have sz but environmental cause - family dysfunction triggers sz
  • diathesis stress model better interactionist approach of explaining sz