family dysfunction

• What is the main focus of psychological explanations?

  Psychological explanations focus on the patients family environment growing up (cold parenting, family conflict etc) or abnormalities in cognitive processing in the patients mind
• What is family dysfunction as an explanation of schizophrenia?

  Maladaptive relationships & patterns of communication within families are sources of stress which can influence the development of schizophrenia. Emphasises early childhood experiences
• What are the three explanations of family dysfunction?

  - Schizophrenogenic mother - Double-bind theory - Expressed Emotion (EE)
• Schizophrenogenic mother

  Fromm-Reichmann: Suggests the schizophrenogenic mother, a psychodynamic account of schizophrenia, based on accounts of her patients' childhood. Cold, controlling, rejecting & creates a tense family environment where children feel compelled to hide things from their mother because they can't effectively communicate, leading to distrust, paranoid delusions & schizophrenia.
• Double-bind theory


  Bateson et al - Communication is most important risk factor in families with regard to development of Sz. Children are left in situations where they feel they cannot do the right thing , the parent is critical and dismissive. Child feels trapped, receives mixed messages about what is ‘wrong’ and are unable to seek clarification leaving them in a ‘double-bind’. This leaves the child with the view that the world is confusing and dangerous. This is reflected in social withdrawal, disorganised thinking and paranoid delusions and ∴Sz Double-bind is hard to spot
• Expressed emotion (EE)

  Family communication style that is: Highly critical, Hostile, Emotionally overbearing. EE is the heightened expression Brown et al suggests that EE is more relevant in maintaining than causing schizophrenia
• Kavanagh (1992) - strength for EE


  Kavanagh reviewed 26 studies of expressed emotion, finding that the mean relapse rate for schizophrenics who returned to live with high EE families was 48% compared with 21% for those who went to live with low EE families. This supports the idea that EE increases the risk of relapse in recovering schizophrenics.
• Read et al (2005) - strength of family dysfunction


  Found 69% of adult women who have schizophrenia have a history of physical/sexual abuse. (59% for men)
• Berry (2008) - strength of family dysfunction

  Found that adults with an insecure attachment to their primary caregiver are also more likely to have schizophrenia.
• Berger (1965) - strength for double-bind theory


  Schizophrenic patients recalled more double-binds from childhood than non-schizophrenics.
• Socially sensitive research - limitation of family dysfunction

  Parent blaming!- Parents who have already seen their child go through terrible symptoms and had to care for schizophrenia sufferer then traumatised by being blamed for causing the condition!Deeply misogynistic theories!!! - Schizophrenogenic mother
• Case and effect - limitation of family dysfunction

  It has been suggested that rather than a dysfunctional family causing Sz, it is a schizophrenic patient that causes dysfunctions within the family itself. Many children who grow up in dysfunctional families, do not go on to develop schizophrenia.
• Interactionist explanation - strength of family dysfunction

  Tienari et al - followed children of schizophrenic mothers who had been adopted 5.8% of children adopted by ‘healthy’ families developed schizophrenia 36.8% of children adopted by dysfunctional families developed schizophrenia. Supports family dysfunction theory as well as genetic vulnerability.