Family dysfunction + AO3

• The Schizophrenogenic mother - Fromm-Reichman

  • the mother is cold, rejecting and controlling
  • family environment is characterised by high emotional tension
  • secrest and conspiracies

  = distrust and paranoid delusions
• Double Bind Theory - Bateson

  • frequent contradictory messages from parents = schizophrenic symptoms
  • child feels trapped and fears making mistakes but cannot ask for clarification or protest
  • mixed messages makes them confused
  • mistakes = withdrawal of love from their parents
  • child is confused = disorganised thinking and paranoid delusions
• Expressed Emotion - Vaughn and Leff

  • COURSE of SZ not cause
  • the level of emotion expressed towards a patient from the family
  • involving
  • verbal criticism
  • hostility
  • anger
  • emotional over-involvement in the patient's life including unnecessary self-sacrifce
  • all of these are a serious source of stress and a primary explanation of relapse in patients
• Strengths - family dysfunction

  • Read supports the role of difficult family relationships in SZ
  • review of 46 studies
  • 69% of women with SZ had a history of sexual or physical abuse, or both
  • for men, 59%
  • SZ adults are also more likely to have insecure attachments to their primary caregiver
  • Tienari
  • 19,000 Finnish mothers and their children
  • assessed adoptive parents' parenting style
  • highly critical with conflict, and low empathy = implicated in the development of SZ (if genetic vulnerability)
  • suggests the importance in communication styles and relationships with families in the development of SZ
  • validating: family communication patterns are an important factor
  • Practical applications to treatment
  • family therapy has been developed
  • moderates hostility and expressed emotion
  • guidance and education for the family
  • effective form of treament
  • if family support can be improved, lower chance of relapse
  • benefits individual and NHS
• Limitations

  • SZG mother and Double Bind
  • only based on clinical observations and case studies of families (often done retrospectively and are subjective - conducted through asking family members to self-report the family communication styles they experiences in their childhood)
  • lack of supporting empirical evidence, affecting the validity of these claims as explanations for the onset of SZ
  • Issues with cause and effect
  • it's hard living with and raising a child who has SZ symptoms and behaviours, it would be very challenging and stressful
  • high levels of hostility and conflict within the family may be an effect of SZ rather than a cause
• Strength - expressed emotion

  • Kavanagh
  • review of 26 studies in expressed emotion
  • relapse rate (for those returning to live with families)
  • high expressed emotion - 48%
  • low expressed emotion - 21%
  • suggests expressed emotion is a valid account of the course of SZ and explains why those with SZ may experience multiple episodes
  • it is also useful as it can predict relapse - high predictive validity