16 marker AQA Psychology Psychological explanations for schizophrenia
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Discuss psychological explanations for schizophrenia - 16 marks
One psychological explanation of schizophrenia is family dysfunction. Psychologists have attempted
to link schizophrenia to childhood and adult experiences of living in a dysfunctional family. The
psychiatrist Fromm-Reichmann (1948) proposed a psychodynamic explanation for schizophrenia
based on the accounts she heard from her patients about their childhoods. Fromm-Reichmann
noted that many of her parents spoke of a particular type of parent, which is now called the
schizophrenogenic mother. “Schizophrenogenic” means “schizophrenia-causing.” Fromm-
Reichmann described the schizophrenogenic mother as cold, rejecting and controlling, and someone
who tends to create a family climate characterised by tension and secrecy. This leads to distrust that
later develops into paranoid delusions and ultimately schizophrenia, which is defined as the loss of
contact with reality.
Bateson et al (1972) agreed that family climate is important in the development of schizophrenia,
but emphasised the role of communication style within the family. The developing child regularly
finds themselves trapped in situations where they fear doing the wrong thing, but receive mixed
messages about what this is, and feel unable to comment on the unfairness of this situation or seek
clarification. When they “get it wrong”, which is often, the child is punished by withdrawal of love.
This leaves them with an understanding of the world as confusing and dangerous. This is reflected in
symptoms such as disorganised thinking and paranoid delusions. Bateson called this the double-
blind theory. He made it clear that this was neither the main type of communication in the family of
someone with schizophrenia, nor the only factor in developing schizophrenia, just a risk or
contributory factor.
Expressed emotion is the level of emotion, usually a negative emotion, expressed towards a person
with schizophrenia by their carers who are often family members. Expressed emotion contains
several elements such as verbal criticism of the person, occasionally accompanied by violence,
hostility towards the person, including anger and rejection, and emotional overinvolvement in the
life of the person, including needless self-sacrifice. These high levels of expressed emotion directed
towards the individual are a serious source of stress for them. This is primarily an explanation for
relapse in people with schizophrenia. Furthermore, it has also been suggested that high levels of
expressed emotion may be a source of stress that can trigger the onset of schizophrenia in a person
who is already vulnerable. They could have a certain vulnerability or predisposition to schizophrenia,
which may be genetic. This interaction between the environment and genes is known as the
diathesis stress model.
One strength of family explanations for schizophrenia is the strong evidence from research studies.
Indicators of family dysfunction include insecure attachment and exposure to child trauma, in
particular abuse. According to a review from Read et al (2005) adults with schizophrenia are
disproportionately likely to have insecure attachment, particular type C or type D. In addition, Read
et al also reported that 69% of women and 59% of men with schizophrenia had a history of physical
and/or sexual abuse. In another study, Morkved et al (2017) found that 67% of people with
schizophrenia and related psychotic disorders reported at least one childhood trauma, mostly abuse,
as opposed to 38% of a match group with non psychotic disorders. This is a strength of the family
dysfunction explanation for schizophrenia because strongly suggests a family dysfunction makes
people more vulnerable to schizophrenia.
One limitation of family explanations is some poor evidence base for any of the explanations.
Although there is plenty of evidence supporting the idea that childhood-based stress is associated
with adult schizophrenia, there is almost none to support the importance of traditional family based
theories such as the schizophrenogenic mother and double bind theory. Both of these theories are
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