dysfunctional family relationships

• what are high expressed emotion families

  high amounts of negative emotions expressed to each other in a family creates an emotional stressful environment which can then trigger symptoms to develop. this explanation is useful to explain onset but also high levels of relapse in the disorder as well as its maintanence. patients who returned to high EE environments were four times more likely to relapse than someone returning to a low EE family
• Leff


  reported a relapse rate of 51% for people with schizophrenia returning to homes with high rates of expressed emotion, compared to only 13% for those returning to homes with low rates of expressed emotions
• Butzlaff and Hooley


  conducted a meta analysis of 26 studies. those returning to high EE families were twice as likely to relapse
• Tienari


  studied children whose biological mothers had schizophrenia who were adopted.

  5.8% had schizophrenia raised by healthy families

  36.8% for children raised in dysfunctional adoptive families

  high genetic vulnerability + stressful environment resulted in higher levels of schizophrenia [diathesis-stress model]
• evaluation for high EE families

  its much more credible than some other family explanations.
• evaluation for high EE families

  hard to establish cause and effect
• evaluation of high EE families

  led to the development of family intervention as an effective therapy to reduce relapse rates in schizophrenia
• evaluation of high EE families

  its been criticised as some people with schizophrenia have minimal contact with their family or lack a family and there is no evidence to show that they're less prone to relapse. it could be argued that social interaction is high or low EE not just in a family setting
• evaluation of high EE families

  not all children in high EE families get schizophrenia
• Bateson- double blind theory

  this. suggests that children who frequently receive contradictory messages from their parens are more likely to develop schizophrenia. these parental interactions confuse the child and this alters their view of reality. they struggle to interact with the world around them, which manifests as schizophrenic symptoms. people 'learn' to be schizophrenic.
• Laing


  argued that schizophrenia was actually a reasonable response to an insane world
• Berger


  found that schizophrenics reported higher recall that may be affected by their schizophrenia
• Liem


  measured patterns of parental communication with a schizophrenic child and found no difference when compared to normal families
• Fromm-Reichmann - the schizophrenogenic mother


  proposed a psychodynamic explanation for schizophrenia based on the accounts she heard from her patients about their childhoods. many spoke of a type of mother - a schizophrenogenic mother. these are cold, rejecting or their child and controlling and tends to create a family environment based on tension and secrecy.
• evaluation of the schizophrenogenic mother

  Berry et al- adults with insecure attachments to their primary care-giver are more likely to have schizophrenia
• evaluation of the schizophrenogenic mother

  read et al- reviewed 46 studies of child abuse and schizophrenia, and concluded that 69% of adult women in-patients with a schizophrenia diagnosis had a history of physical abuse, sexual abuse or both iin childhood

  for men its 59%
• evaluation for the schizophrenogenic mother

  schizophrenics may not be reliable information sources because of a warped perception of reality
• evaluation of the schizophrenogenic mother

  research findings are inconsistent and lead to parent blaming