Psychological explanations

• What do psychological explanations of SZ suggest?


  Psychological explanations suggest that the development of schizophrenia is due to abnormal family communication styles created by the schizophrenogenic mother, mixed messages according to double-bind theory, and the stress caused by high levels of expressed emotion. Despite none of these three factors explicitly causing schizophrenia, they are involved in its development and maintenance as contributory factors.
• Outline SZ mother as an explanation for SZ

  In 1948 Fromm-reichmann suggested that a schizophrenogenic mother i.e. one that is toxic, negative, and dysfunctional creates a cold rejecting environment that leads to distrust, paranoia, and delusions and subsequently schizophrenia in her children.
• Outline double blind theory as an explanation of SZ

  In 1972 Bateson proposed the double blind theory that suggested that mixed messages from parents and peers e.g. being told to be more independent but receiving criticism when doing so causes children to feel as if they can never do the correct thing. And this leads to disorganised thinking, paranoia and subsequently schizophrenia.
• Outline expressed emotion as an explanation for SZ

  Thirdly, expressed emotion was proposed that suggested that how a family member communicates their thoughts and feelings towards the schizophrenic person in their family can aid in developing or relapsing schizophrenia. For example, hostility (anger and resentment) ; criticism (being openly judgemental) and over-involvement in the life of the schizophrenic person.
• Strengths of SZ mother explanations

  Research support -

  
  

  Butzlaff and Hooley (1998) showed using a meta-analysis of 27 studies that relapse into schizophrenia is significantly more likely in families that have issues with expressed emotion.
• What are the strengths of double blind theory

  Research support -

  
  

  Tienari et al. found SZ in adopted children whose bio mother had SZ was 5.8% in healthy families, in 36.8% in dysfunctional families.

  
  

  Berger in 1965, who found that schizophrenics reported a higher recall of double bind statements by their mothers than non-schizophrenics.

  
  

  Bateson reported a case study, where a recovering SZ was visited in hospital by his mother. he embraced her warmly, but said 'don't you love me anymore?' when she left, he assaulted an aide
• What are the weaknesses of double blind theory

  However, evidence may not be reliable as it remains unclear whether cognitive factors cause schizophrenia or if schizophrenia causes these cognitions so their recall may not be accurate.

  
  

  A second weakness of the double bind theory is the ethical issues involved. When blaming the family with little empirical evidence to support it, negative consequences can occur in the form of guilt and poor mental health. Furthermore, gender bias is also an issue as the mother tends to be blamed the most, which means such research is highly socially sensitive. These suggests that the research therefore does not protect individuals from harm.
• What are the strengths of expressed emotion

  practical applications. For example Hogarty (1991) produced a type of therapy session, which reduced social conflicts between parents and their children which reduced EE and thus relapse rates.

  
  

  This suggests that gaining an insight into family relationships allows psychiatric professionals to help improve the quality of patient's lives.

  
  

  Research support - Kavanagh reviewed 26 studies of expressed emotion, finding the mean relapse rate for schizophrenics who returned to live with high EE families was 48%, compared to 21% for those with low EE families
• What are the weaknesses of expressed emotion

  does not explain why all children in dysfunctional families don't develop SZ

  
  

  
  

  Alforfer found 1/4 of patients showed no physiological response to stressful comments from relatives
• Evaluate the psychological explanations of SZ as a whole

  Ignores biological factors

  
  

  Most research is correlational

  
  

  Doesn't explain why not all SZ patients experience these
• What do cognitive explanations of SZ suggest?

  Frith et al (1992) suggested that dysfunctional thought processes (abnormally-functioning thought processes which lead to unpleasant/ undesirable outcomes), including metarepresentation and central control, as well as cognitive defects, bias, and strategies contribute to the development of schizophrenia.
• Outline meta representation


  Metarepresentation is the cognitive ability to differentiate between our own actions and the actions of others, allowing us insight into the intentions and emotions as others, as well as maintaining a realistic/functional view of our own goals and intentions.

  
  

  Dysfunctions in metarepresentation have been associated with auditory hallucinations, and specifically thought insertion, due to the inability to differentiate between our own thoughts and that of others. This may lead to paranoid delusions due

  to the contents of inserting others' thoughts into the mind of the patient.
• Outline central control


  Central control is the cognitive ability to carry out a deliberate action whilst suppressing an automatic response, and is often measured using the Stroop Test. This test involves identifying the colour of each word, where there is often a discrepancy e.g. the word 'brown' written in a yellow font. Therefore, the automatic response of reading the word must be suppressed, to allow for identification of the font colour.

  
  

  People with SZ often have dsyfunctional central control abilities, and so often suffer from derailment because they cannot suppress the automatic associations that each new word in a sentence brings, and so begin to talk off-topic.
• Outline Cognitive Deficits


  sufferers experience problems with attention, communication and information overload
• Outline Cognitive Biases


  sufferers think in irrational ways, often attributed to paranoia and positive symptoms
• Outline Cognitive Strategies


  maladaptive strategies are used to try and cope with the schizophrenic symptoms, which are usually negative
• Strengths of cognitive explanations

  support from cognitive treatments like CBTP

  
  

  can explain both positive and negative symptoms

  
  

  Research support -

  
  

  Stirling et al (2006) found that SZ sufferers made significantly more mistakes and twice as long to complete a task, compared to a healthy neurotypical control group.

  
  

  joshua et al. used the hayling sentence completion test to compare 39 SZ with 40 bipolar patients and 44 healthy patients, finding SZ had a slower response time

  
  

  Evans et al. gave behavioural assessment DS tests, IQ tests and memory tests to 31 SZ patients, finding SZ patients have impaired central executive functioning
• Weaknesses of cognitive explanations

  only offers explanations for the indirect, proximal causes of SZ, and not the distal causes, meaning that such theories can explain the symptoms but not the origin of SZ. This limits the utility of psychological explanations for schizophrenia.

  
  

  Ignores biological and environmental factors