Family dysfunction

• What is the family dysfunction explanation of schizophrenia?

  • Claims that schizophrenia is caused by abnormal patterns of communication within the family
  • Focuses on the schizophrenogenic mother, the double bind theory, and expressed emotion
• What is the schizophrenogenic mother?

  • Fromm-Reichmann (1948) proposed a psychodynamic explanation for a particular type of mother who is cold, rejecting, and controlling, and tends to create a family climate characterised by tension and secrecy
  • This causes confusion in the child as the mother may be overprotective but then rejecting of the child, leading them to distrust others and develops into paranoid delusions and ultimately schizophrenia
• What is the double bind theory?

  • Bateson et al. (1972) focuses on the importance of communication style, suggesting that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia
  • They will feel trapped in situations where they fear doing the wrong thing but receive mixed messages about what this is, and are punished when they are wrong
  • Leads child to believe the world is dangerously confusing, reflecting in symptoms like disorganised thinking and paranoid delusions
• What is expressed emotion?

  • Families of schizophrenic patients being emotionally over-involved in their lives, showing a high and unhealthy amount of concern which is expressed through negative emotions
  • This be seen as verbal criticism, hostility, anger and rejection - these high levels of emotion are a serious source of stress for the individual beyond their already impaired coping mechanisms - can trigger schizophrenic episodes in someone with a genetic vulnerability to it
• What is one strength of the family dysfunction explanation?

  • Research support for schizophrenogenic mother: Mednick (1984) identified 207 children identified at high risk of developing schizophrenia due to having temperamental and emotionally aggressive mothers
  • Within 10 years, 17 of these were diagnosed with schizophrenia compared to only 1 out of a control group of 107 with no previous history of schizophrenia in their families
  • Shows there is evidence for the idea that particular types of parents can lead to schizophrenia development
• What is another strength of the family dysfunction explanation?

  • Further research support: Berger (1965) found that schizophrenics reported a higher recall of double bind statements from their mothers
  • Read et al. (2005)'s review reported that 69% of women and 59% of men with schizophrenia have a history of physical and/or sexual abuse
  • Suggests family dysfunction makes people more vulnerable to schizophrenia
• What is one limitation of the family dysfunction explanation?

  • Contrasting evidence: not all patients who live in high EE families relapse and not all patients who live in low EE homes avoid relapse
  • Altorfer et al. (1998) found that 25% of reviewed patients showed no physiological responses to stressful comments from relatives
  • Liem (1974) measured patterns of parental communication in families w/ a schizophrenic child and found NO difference when compared to normal families, questioning the validity of the theories proposed by this explanation
• What is another limitation of the family dysfunction explanation?

  • Socially sensitive and reductionist: places blame on parents and specifically mothers by not acknowledging other potentially schizophrenogenic family figures showing a clear gender bias
  • Ignores the impact of biological influences, such as Gottesman's studies, making the explanation too simplistic in that it doesn't consider all possible aspects of family dysfunction as well as non-psychological influences