Psychological Explanations for Schizophrenia

• Psychological Explanations

  Some have focused on the psychological environment, in particular the family, and its role in making individuals vulnerable to developing SCZ. Others have focused on the mind of the person, emphasising the role of abnormal cognition in the experience of SCZ.
• Family Dysfunction: The Schizophrenogenic Mother

  Fromm-Reichmann proposed a psychodynamic explanation for SCZ based on accounts heard from clients about their childhoods. Noting that many spoke of a particular type of parent. Schizophrenogenic means SCZ causing. The schizophrenogenic mother is cold, rejecting and controlling which creates a family climate of tension and secrecy. Leading to distrust which develops into paranoid delusions, and ultimately SCZ.
• Family Dysfunction: Double-Bind Theory

  Bateson et al agreed that family climate is important in the development of SCZ, emphasising the communication style. The developing child regularly finds themselves in situations where they fear they are doing wrong, but receive mixed messages about what it is- they feel unable to seek clarification. When they get it 'wrong', they are punished by withdrawing love. Causing them to see the word as confusing and dangerous- linked to disorganised thinking and paranoid delusions.
• Family Dysfunction: Expressed Emotion & Schizophrenia

  EE is the level of emotion, in particular negative emotion, expressed towards a person with SCZ by their carers. Verbal criticism of the person, occasionally accompanied by violence; hostility, including anger and rejection; and emotional over-involvement, including needless self-sacrifice. These act as a serious source of stress; it is a primary explanation for relapses. It is seen as the environmental stressor for someone with a vulnerability (the diathesis-stress model).
• Cognitive Explanations:

  Focusing on the role of mental processes. SCZ is associated with abnormal information processing, and it can be seen in many of the symptoms. Reduced processing in the ventral striatum is associated with negative symptoms, whilst reduced processing in the temporal and cingulate gyrus is linked to hallucinations. Lower than usual information processing means that cognition is likely to be impaired.
• Dysfunctional Thought Processing: Frith et al

  Metarepresentation: cognitive ability to reflect on thoughts and behaviours, which allows us insight into our goals and intentions, and so we can interpret the actions of others. Disruption then disables our ability to recognise our own actions and thoughts as being carried out by ourselves. Explaining the hallucinations of voices and delusions, like thought insertion (experience of having thoughts projected in the mind by others).
• Dysfunctional Thought Processing: Frith et al

  Central Control: the cognitive ability to supress automatic responses while we perform deliberate actions instead. Disorganised speech and thought disorder could be a result of the inability to suppress automatic thoughts and speech triggered by other thoughts. E.g. people with SCZ tend to jump from topic to topic as each word triggers an association, and these cannot be suppressed.
• AO3: Support for Family Dysfunction as a Risk Factor

  Read et al reviewed 46 studies of child abuse and SCZ, concluding that 69% of adult women in-patients with a SCZ diagnosis has a history of physical abuse, sexual abuse, or both during childhood. For men it was 59%. Adults with insecure attachments to their primary caregiver are more likely to have SCZ; Berry et al.
• AO3: Counterpoint for Research Supporting Family Dysfunction

  Information about childhood experiences were gathered after the development of symptoms, and SCZ may have distorted patients' recall of childhood experiences. Causing an issue with validity. Though there have been some studies (e.g. Tienari et al) which have been carried out prospectively; and there is prospective evidence which links family dysfunction to SCZ, but not a large amount of results, and much of it is inconsistent.
• AO3: Weak Evidence for Family-Based Explanations

  Though there is evidence supporting the broad principle, there is few studies which support the schizophrenogenic mother or double-bind. Both theories were based on clinical observations of patients, and early evidence involved assessing the personality of mothers of patients for 'crazy-making characteristics'- an approach which is overly controversial to modern psychiatrists (Harrington).
• AO3: Ethical Implications of Family Explanations

  It has led to parent-blaming. Parents who have had to observe their child's decent into SCZ, and who will have to carry out lifelong care and responsibility then undergo further trauma by receiving the blame for the condition. The shift in the 1980s from hospital to community care (often involving parental care) may have been one of the factors which caused the decline in the theories, as parents no longer tolerated the blame.
• AO3: Strong Evidence for Dysfunctional Information Processing

  Stirling et al compared 30 SCZ suffers with 18 controls on a range of cognitive tasks, including the Stroop Test (p's have to name the ink colour of colour words). In line with Frith's theory of central control, people with SCZ took twice as long to name the ink colour due to difficulties suppressing the urge to read the word.
• AO3: Cognitive Explanation Criticisms

  The links between symptoms and cognitive explanations are clear; however, it doesn't tell us about the origins of the cognitions or the SCZ. Cognitive theories can explain the proximal causes of SCZ (what causes the current symptoms) but not the distal causes (the origins of the condition).
• AO3: Evidence for Biological Factors isn't Considered

  In their pure forms, psychological explanations for SCZ are hard to be compatible with the biological explanations. It could be that both biological and psychological factors can separately produce the same symptoms, raising the question if both the outcomes are SCZ. Alternatively, it can be viewed using the diathesis-stress model, where the diathesis can be both biological and psychological- taking an Interactionist Approach.
• AO3: Direction of Causality

  There is a mass of information concerning abnormal cognitions, and a mass of information concerning abnormal biology in SCZ. However, it remains unclear what causes which- whether the cognitive factors are the cause of neural correlates, or the result. Meaning the origin of SCZ is questionable- unless researchers can untangle the cause and effect.