Family Dysfunction

Family dysfunction refers to the workings of dysfunctional families, and the effects of bring brought up in one, contributing to schizophrenia.

The schizophrenogenic mother was proposed by Fromm-Reichmann (1948). who noted that many of her patients with schizophrenia described a particular type of parent, which she termed 'schizophrenogenic'.

These characteristics are:
- Cold
- Uncaring
- Rejecting
- Controlling
- Suspicious
- Creates tension and secrecy

This leads to an atmosphere of distrust and the development of paranoid thoughts which become delusions.

Double-bind theory was proposed by Bateson et al (1956), who suggest that children who frequently receive contradictory messages from their parents are more likely to develop schizophrenia, because this prevents them from developing an internally coherent construction of reality. 

For example, if a mother tells her son that she loves him, yet at the same time turns her head away in disgust, the son receives two conflicting messages about their relationship on different communicative levels: one of affection on the verbal level and one of animosity on the non-verbal level (one invalidates the other).

The child is unable to decide what is 'good' behaviour, and is often punished for 'wrong' behaviour. 

This may lead to the child developing a false concept of reality and an inability to communicate effectively, explaining delusions, hallucinations, and disorganised speech.

Bateson did not suggest that double-bind communication caused schizophrenia on its own, but it may be a contributing factor.

Another family variable associated with schizophrenia is a negative emotional climate, or more specifically, a high degree of 'expressed emotions'. 

Expressed emotion (EE) is a family communication style that involves criticism, hostility, and emotional over-involvement.

High levels of this may influence relapse rates, or the onset of schizophrenia in a vulnerable person. 

The negative emotional climate in these families arouses the patient and leads to stress beyond his or her already impaired coping mechanisms, triggering a schizophrenic episode.

+ Berry et al (2008) found that 69% of women and 59% of men with schizophrenia in their sample had a history of physical and / or sexual abuse in childhood, supporting that family dysfunction is a risk factor in developing schizophrenia.

- Research in this area is often retrospective, meaning that patients with the disorder are asked to think back to their childhood and explain what it was like. Such recollections are unlikely to be completely trustworthy, therefore reducing the validity of the evidence and therefore the explanation.

- There is hardly any evidence supporting the particular explanations of the schizophrenogenic mother or the double-bind theory, and it leads to the blame for the disorder being put on the parents, which many psychiatrists today find unacceptable.