AQA A-level Psychology: Revision Made Easy - Jean-Marc Lawton 2017

Psychological explanations for schizophrenia
Schizophrenia

Description

Psychological theories focus on non-physiological explanations for schizophrenia. The family dysfunction explanation sees maladaptive relationships and patterns of communication within families as sources of stress, which can cause or influence the development of schizophrenia. Parents of schizophrenics often display three types of dysfunctional characteristics: (1) high levels of interpersonal conflict, (2) communication difficulties and (3) being excessively critical and controlling of their children. Another feature of family dysfunction is expressed emotion, where families which persistently exhibit criticism and hostility exert a negative influence, especially upon recovering schizophrenics, who may then relapse. Cognitive explanations see schizophrenia as developing due to irrational thought processes. Abnormalities within brain functioning are seen as increasing vulnerability to stressful life experiences, which in turn may lead to dysfunctional beliefs and behaviour. Cognitive deficits then occur, with sufferers experiencing problems of attention, communication and information overload. Dysfunctional thought processing concerns the idea that the development of schizophrenia is related to abnormal ways of thinking. Metacognition (the monitoring of one’s own thoughts) allows individuals to ’view’ their mental states and the intentions of others. Schizophrenics though experience metacognitive dysfunction, which affects executive functioning, the higher level cognitive processes that control and manage cognitive and behavioural processes.

Fig 12.3 Dysfunctional families are associated with high levels of schizophrenia (photo posed by models)

Focal study

Patino et al. (2005) assessed the effectiveness of the family dysfunction explanation for the development of schizophrenia in migrant families. The researchers used self-reports to identify common factors in family interactions that were associated with the development of schizophrenia. They found that migrants who had experienced at least 3 out of the following 7 problems associated with family dysfunction — (1) poor relationship between adults in the household; (2) lack of warmth between parents and child; (3) visible disturbance of the mother—child (4) father—child, or (5) sibling—child relationship; (6) parental overprotection; and (7) child abuse — had four times the normal level of vulnerability to developing schizophrenia, compared to the double level of risk for migrants not experiencing family dysfunction. This suggests that family dysfunction increases the likelihood of life stressors triggering the onset of schizophrenia, especially in migrant families.

OTHER STUDIES

• Tienari et al. (2004) found that the level of schizophrenia in adopted individuals who were the biological children of schizophrenic mothers was 5.8 per cent in those adopted by healthy families compared with 36.8 per cent for children raised in dysfunctional families, which supports the family dysfunction theory and supports the idea that individuals with high genetic vulnerability to schizophrenia are more affected by environmental stressors.

• O’Carroll (2000) found that cognitive impairment is found in 75 per cent of schizophrenics, particularly in memory, attention, motor skills, executive function and intelligence, supporting the cognitive explanation. Cognitive impairments often pre-dated illness onset, did not occur as a result of substance abuse and were related to social and functional impairments.

• Brune et al. (2011) reviewed 20 years of evidence to report that many symptoms of schizophrenia and the resulting impairments in social functioning result from poor metacognition, especially the ability to self-reflect and empathise with others, which suggests that metacognition dysfunction is an important part of schizophrenia, therefore supporting the idea of dysfunctional thought processing.

Positive evaluation

The family dysfunction explanation is supported by the fact that therapies which successfully focus on reducing expressed emotions within families have low relapse rates compared with other therapies.

Although there is a lack of general support for family dysfunction as a causal factor of schizophrenia, research evidence into expressed emotion does suggest that family dysfunction plays a major role in maintenance of the disorder.

A strength of the cognitive explanation is that it can account for both positive and negative symptoms. It can also be combined with the biological explanation to give a fuller understanding of the causes of schizophrenia.

Negative evaluation

Although dysfunctional thought processing seems linked to impairments in memory ability, research indicates that deficits occur only in specific areas of memory functioning, especially the central executive component of working memory and specifically tasks for which the visuospatial system is needed for central executive control.

Having a schizophrenic within a family can be problematic and stressful on family relationships, therefore rather than dysfunctions within families causing schizophrenia, it could alternatively be that having a schizophrenic within a family leads to dysfunctions.

A problem with the family dysfunction explanation is that it cannot explain why all children in such families do not develop schizophrenia.

Practical application

The family dysfunction explanation has led to the development of family therapy, the treatment of schizophrenia by alteration of communication systems within families. The treatment has proven to be effective.