Psychological Explanations for Schizophrenia

Psychological explanations attribute the origin and the development of schizophrenia to psychological causes, rather than focusing on a purely biological explanation.

Family dysfunctions and cognitive explanations.

Family dysfunctions describe the unfavourable behaviours experienced between family members and the patient, such as cold, emotionless interactions, a lack of empathy, high levels of expressed emotions, as well as controlling behaviours.

They create hostile environments, encouraging paranoia and delusions in a child which develop into symptoms of schizophrenia.

The schizophrenogenic mother, the double-bind theory, and expressed emotions.

The schizophrenogenic mother describes a particular type of parent. They are usually cold, uncaring, rejecting and hostile. 

The double-bind theory is where a child (the patient) receives contradictory messages/signals from their parents throughout their childhood.

The contradictory messages create issues of distrust in the child, which develops into paranoia and delusions. These can develop further into full-blown symptoms of schizophrenia.

Expressed emotions are where within a family, there are high levels of hostility, criticism and emotional over-involvement.

It means they are excessively self-sacrificing due to feeling guilt over the child’s diagnosis. They seek to absolve themselves, yet can suffer feelings of bitterness at the same time. 

Cognitive explanations for schizophrenia is based on the notion that the development of schizophrenia can be explained by the impairment of cognitive functions.

He suggested it was due to attention-deficit issues, an inability to filter preconscious thoughts.

Issues with the relationship between memory and perception, and a lack of schemas cause an inability to adapt to new situations. There are problems with cognitive/attentional biases (schizophrenic patients pay more attention to threatening stimuli), and issues with cognitive deficits.

 This is where a patient with schizophrenia struggles to explain/plot their thought processes. Going from thought A to B to C is not possible, as patients struggling with meta-representation cannot remember or pinpoint thought B, for instance. This creates issues with delusions of control and self-awareness. 

Central control is the ability to ignore urges and override automatic thoughts. A healthy person can involve a prompting stimulus (such as pressing a button). A schizophrenic person would struggle to resist, and when asked, would struggle to justify why they chose to do it.

A dysfunctional family is one that lacks empathy and shows signs of unhealthy interactions between parents, and/or between parents and their children. This may create a confusing situation for the child, which may, in turn, produce erratic behaviours in the child.

Highly critical, controlling, and rejecting (other examples include cold, uncaring, suspicious. Any 3)

 Bateson et al. (1956).

A parent saying ‘I love you’ whilst turning away in disgust is an example of a contradictory statement. A parent telling a child they did something good whilst sneering and speaking angrily is also an example.

Consistent exposure to contradictory statements can cause confusion about what is real or true. Bonus point: This can lead to paranoid thoughts, which in turn can lead to delusions and hallucinations. These are known as schizophrenic symptoms.

Emotional over-involvement is when a parent indulges in excessive self-sacrifice and overprotective behaviours, leading to patients relying on them and lacking self-reliance.

There is a higher chance of relapsing into schizophrenic behaviours and symptoms if a patient returns to a family with high levels of expressed emotions.

Lidz suggested that having emotionally distant parents can lead to symptoms of schizophrenia. He also said that biological explanations are speculative compared to his research, which studies the whole patient. 

In expressed emotion households, Kavanagh (1992) found that in over 26 studies, the mean relapse rate for patients living with caregivers or families with high levels of EE was 48%, compared to 21% for families with low EE. This suggests family dysfunction in households has an effect on the patient.

Placing blame on family members tends to cause parental guilt, which can result in feelings of stress and anxiety. It isn’t ethical to blame family members for a diagnosis of schizophrenia, and these views are considered outdated by most psychiatrists and psychologists.

They disagreed with the idea that mental health should be looked at purely from a biological point of view. They rejected the current medical model.

Fromm-Reichmann (1948)

He found that schizophrenic patients, when compared to controls, had a higher recall of double bind statements from their childhood.

They found that schizophrenic patients living in high EE spaces produced more than double the baseline recurrent rate of symptoms.

Parents being consistently cold towards the child.

It focuses primarily on how a patient processes information and is concerned ultimately with how they think.

It affects the ability to filter preconscious thoughts due to a faulty attention system.

Bentall’s.

Abnormal attention in those with persecutory delusions (an inability to recognise what is reality), is paid to threatening stimuli. Patients are biased towards these stimuli as a result of a lack of self-monitoring. Their delusions and hallucinations are blamed on the outside world or external sources.

There is a fundamental breakdown in memory and perception in those with schizophrenia, an issue occurring between the two and how they work together. THERE IS A LACK OF SCHEMAS/ACTIVATION OF SCHEMAS.

This is how we identify that we are responsible for our thoughts, behaviours and actions. It is the key to self-awareness and can explain multiple positive symptoms.

Frith’s 1992 study, where PET scans revealed reduced blood flow to the frontal cortex. This is associated with negative symptoms such as avolition and the inability to suppress automatic thoughts.

This is the ability to suppress or override automatic thoughts, actions, and speech in response to stimuli.

Patients find it hard to resist the urge to respond to stimuli, and then struggle to explain why. This can result in issues with delusions and their understanding of reality.  

Stroop test, where schizophrenic patients took twice as long to say the colour of the ink rather than reading the written word. This suggests issues with thought processing and central control dysfunction. 

It is reductionist (devolves schizophrenia to its simplest form).