Psychological Explanation of Schizophrenia

• Family Dysfunction Explanation of Schizophrenia

  - psychologists have attempted to link schizophrenia to childhood and adult experiences of living in a dysfunctional family
• The Schizophrenogenic Mother


  - (Reichmann, 1948) proposed a psychodynamic explanation for schizophrenia based on the accounts of her patient's childhoods

  
  

  - found many of her patients had a particular type of parent, she called the schizophrenogenic mother

  
  

  - the schizophrenogenic mother is cold, rejecting and controlling and creates a family environment typified by tension and secrecy

  
  

  - this leads to distrust and that later develops into paranoid delusions and ultimately schizophrenia
• Double-Bind Theory


  - (Bateson et al, 1972) also emphasised the role of communication style within the family

  
  

  - children who receive contradictory messages from their parents are more likely to develop schizophrenia

  
  

  - this style of communication leaves them understanding that the world is confusing and dangerous (reflected in symptoms such as disorganised thinking and paranoid delusions)

  
  

  - Bateson clearly stated that this was a risk factor and wasn't necessarily the main type of communication in the family
• Expressed Emotion (EE)


  - the level of emotion, usually negative, that is expressed towards a person with schizophrenia by the carers (often family members)

  
  

  - EE includes:

  . verbal criticism of the person, occasionally accompanied by violence)

  . hostility towards the person, including anger and rejection

  . emotional over-involvement in the life of the person, often including needless self-sacrifice

  
  

  - high levels of EE are a source of stress which can trigger the onset of schizophrenia in people with genetic vulnerability and is often used to explain relapses
• Cognitive Explanations of Schizophrenia

  - explains schizophrenia through the role of metal processes (thoughts, feelings, beliefs etc.)
• Dysfunctional Thinking


  - schizophrenia is characterised by disruption to normal thought processing

  
  

  - reduced thought processing in the ventral striatum is associated with negative symptoms

  
  

  - whilst reduced processing of information in the temporal and cingulate gyri is associated with hallucinations (Simon et al, 2015)

  
  

  - (Frith et al, 1992) identified 2 types of dysfunctional thought processes:

  . metarepresentation

  . central control dysfunction
• Metarepresentation Thinking


  - metarepresentation is the cognitive ability to reflect on thoughts and behaviour

  
  

  - this gives us insight into our own goals and intentions and allows us to interpret the actions of others

  
  

  - dysfunction of our metarepresentation would disrupt our ability to recognise our own actions and thoughts as being carried out by ourselves rather than someone else

  
  

  - this explains hallucinations and thought insertions (the experience of having thoughts be projected into the mind by others)
• Central Control Dysfunction

  - Frith et al also identified issues with the cognitive ability to suppress automatic responses while we perform deliberate actions

  
  

  - speech poverty and thought disorder could result form the inability to suppress thoughts and speech triggered by other thoughts

  
  

  - e.g. people with schizophrenia tend to experience derailment of thoughts due to each word triggering associations which must be responded to
• Family Dysfunction: Research Support (Strength)

  - there is evidence linking family dysfunction to schizophrenia; indicators of family abuse include insecure attachment and childhood trauma

  
  

  - (Read et al, 2005) adults with schizophrenia are disproportionately likely to have insecure attachment particularly type C or D

  
  

  - they also reported 69% of women and 59% of men with schizophrenia have history of physical/sexual abuse

  
  

  - (Morkaved et al, 2017) found most adults with schizophrenia reported a least one childhood trauma
• Explanations Lack Support: Limitations

  - there is almost no evidence to support traditional family-based theories

  
  

  - both these theories are based upon clinical observations and informal assessment of their mothers' personalities but not with systematic evidence

  
  

  - this means that family explanations have not been able to account for the link between childhood trauma and schizophrenia
• Parent-Blaming: Evaluation Extra

  - research investigating the family-schizophrenia link may be useful in showing that insecure attachment and experience of childhood trauma affect individual vulnerability to schizophrenia

  
  

  - family linking family dysfunction is socially sensitive because it can lead to parent-blaming (especially mothers)

  
  

  - for parents having to watch their child experience the symptoms of schizophrenia and take responsibility for their care, to be blamed adds insult to injury
• Cognitive Explanation: Research Support (Strength)

  - there is evidence for dysfunctional thought processing

  
  

  - (Stirling et al, 2006) compared the performance on a range of cognitive tasks (e.g. the Stroop task) in 30 people with schizophrenia and a control group of 30 people without

  
  

  - as predicted by Frith et al's theory, the schizophrenia group took longer (on average 2x longer) to name the font colours

  
  

  - meaning the cognitive processes of people with schizophrenia is impaired
• A Proximal Explanation: Limitation

  - the cognitive explanation only explains the proximal origins of symptoms (what is causing symptoms now) rather than a distal explanation (what initially caused symptoms)

  
  

  - possible distal explanations are genetic and family dysfunction explanations

  
  

  - what is currently unclear and not well-addressed is how genetic variation or childhood trauma might lead to problems with metarepresentation or central control

  
  

  - this means that cognitive theories on their own only provide partial explanations for schizophrenia
• Psychological or Biological: Evaluation Extra


  - the cognitive approach provides an excellent explanation for the symptoms of schizophrenia

  
  

  - there is therefore an argument for seeing schizophrenia primarily as a psychological condition

  
  

  - it also appears that the abnormal cognition associated with schizophrenia is partly genetic in origin and the result of abnormal brain development (Thoulopulou et al, 2019)

  
  

  - this suggests that schizophrenia is a biological condition