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Psychological Explanations of Schizophrenia
Approach
Behavioural
Psychodynamic
Family Models
Explanations
Evidence
Evaluation
Schizophrenia often funs in families so symptoms are
learnt through observing others.
Positive reinforcement, e.g. attention, and negative
reinforcement, e.g. avoiding behaviour, encourages
schizophrenic symptoms.
Time spent in institutions means that old symptoms
are maintained and new symptoms are learnt of
other schizophrenics.
Abnormal upbringing (particularly if there is a cold,
rejecting ‘schizogenic’ mother) leads to a weak and
fragile ego, which can’t contain the id’s desires,
therefore the ego in broken down leaving the id in
overall control of the psyche.
The person loses contact with reality as they can no
longer distinguish between themselves and others,
their desires and fantasies and reality (you need an
ego to be able to do this).
Regression to a state of ‘primary narcissism’ leads to
hallucinating as a result of their basic inability to
distinguish between their imaginations and reality.
Paul and Lentz (1977) found
that operant conditioning can
be used to treat schizophrenia,
by rewarding ‘normal
behaviour’
P: This approach cannot fully account for core features of schizophrenia.
Oltmanns et al (1999) found
that parents of schizophrenic
patients do behave differently
from parents of other kinds of
patients.
P: There is a lack of reliable research to support this theory.
Fromm-Reichmann (1948)
suggests families who are
overprotective, dominant and
moralistic contribute to the
development of schizophrenia.
P: The psychodynamic approach is deterministic.
Double-bind theory (Bateson, 1956)
Contradictory signals by family members, usually the
mother lead to internal conflict; therefore the
schizophrenic symptoms are a result of trying to
escape the double-bind.
Berger (1965) found that
schizophrenics reported a
higher recall of double bind
statements by their mothers
than non-schizophrenics.
Expressed Emotion (Brown, 1972)
Family members display high levels of expressed
emotion (EE) , e.g. hostility, criticism or over
concern. This increases stress levels in the patient
beyond their coping mechanisms, triggering
schizophrenic episodes.
Tarrier et al (1988) found a
strong relationship between
relapse and living with a high EE
relative.
Brown et al (1966) found that
relapse more likely (58% vs.
10%) where family is high in
‘expressed emotion’
P: Most schizophrenics suffer from similar symptoms.
P: The approach is too simplistic as it fails to take into account biological
explanations.
P: Psychodynamic therapies have not been successful in treating schizophrenia.
P: The psychodynamic approach isn’t falsifiable.
P: The approach is too simplistic as it fails to take into account biological
explanations.
P: Research has not found a correlation between early childhood experiences
and diagnosis
P: There is some support for the double-bind theory for example Berger (1965)
P: However the support may not be reliable.
P: There is contradictory evidence against this theory for example Liem (1974).
P: You cannot establish cause and effect.
P: Studies looking into EE and mainly correlational.
P: EE is not a defining characteristic of schizophrenia as it is also found in other
disorders
P: Measurement of EE only requires one observation or interview.
Vaughn & Leff (1976) found
that families high in criticism,
hostility & over-involvement
lead to more relapse.
P: Most studies into family models are carried out after schizophrenia is
diagnosed.
P: Studies rarely used control groups.
P: The approach is too simplistic as it fails to take into account biological
explanations.
Cognitive
Frith
Explains positive symptoms of schizophrenia, where
patients are unable to distinguish between actions
generated externally and those generated internally.
Can be explained by 3 cognitive deficits:
1. Inability to generate willed action
2. Inability to monitor willed action
3. Inability to monitor beliefs and intentions of
others
Faulty operation is due to functional disconnection
between frontal areas of the brain concerned with
action and more posterior areas of the brain that
control perception.
Delusions and hallucinations are formed by a
breakdown of the filter between conscious and
preconscious processing.
Helmsley (1993)
Breakdown of relationship between information that
has already been stored in memory (schema’s) and
new, incoming information. Schizophrenic people do
not know which information to pay attention to and
which to ignore leading to sensory overload.
Delusions: Superficial information appears relevant
Hallucinations: Believe that their own internal
thoughts are real
Helmsley believed this is caused by abnormalities in
the hippocampus.
Meyer-Lindenberg at al (2002)
found a link between the excess
dopamine in the pre-frontal
cortex and the working
memory.
P: An issue with this approach is that you cannot establish cause and effect.
P: The models do combine neurological and cognitive explanations.
P: There is a lot a scientific support for this theory, such as Meyer-Lindenberg et
al (2002)
P: Research support is far from conclusive and the theory is still regarded as
speculative.
P: The cognitive explanations have practical applications to improve the lives of
schizophrenics, for example Yellowless et al (2002)
P: Blaming the individual can make the disorder worse
P: The cognitive explanations are deterministic, suggesting that cognitive deficits
lead to schizophrenia.
Labelling Theory
Scheff (1999)
Schizophrenic symptoms are seen as deviant from
the rules of ‘normal behaviour’. If a person displays
these behaviours they may be labelled schizophrenic
leading to them diplaying more of the symptoms.
Comer (2003) suggest that
labelling causes a self-fulfilling
prophecy, which promotes the
development of other
symptoms.
P: Doesn’t explain the cause of the symptoms in the first place.
P: There is scientific support by Scheff to support labelling theory.
P: The approach is too simplistic as it fails to take into account biological
explanations.
Rosenhan (1973) found that
once a label of schizophrenia
had been applied it influenced
that way the staff behaved
towards the patient.
Diathesis-stress
Model
Schizophrenics have a biological predisposition to
the disorder then stressful life events trigger the
psychotic symptoms.
Biological predisposition
Psychological vulnerability
Faulty thinking
Environmental triggers
Psychotic symptoms
Brown and Birley (1968) found
that approximately 50% of
people experienced a major life
event in the 3 weeks prior to a
schizophrenic episode, whereas
only 12% reported one in the 9
weeks prior to that.
Hirsch et al (1996) found life
events made a significant
cumulative contribution in the
12 months preceding relapse
rather than having a more
concentrated effect in the
period just prior to the
schizophrenic episode.
P: This model poses more of a holistic approach to the explanation of
schizophrenia.