Psychological Explanations For Schizophrenia

Double-Bind Theory:

• Family climate is important but emphasis on role of communcation style
• Developing child is trapped in situations where they fear doing the wrong thing but receive mixed messages about what is right
• When they do something 'wrong' they receive a withdrawal of love so see the world as confusing and dangerous, leading to paranoid dellusions and disorganised thinking
• Just a risk factor - not the only factor in developing Sz

Expressed Emotion (EE):

• Level of emotion, particularly negative, directed by carers towards patients
• Contains verbal criticism, occasionally followed by violence; hostility incl. anger and rejection; emotional over-involvement, incl. needless self-sacrifice
• High levels of EE is a source of stress for the patient so is an explanation for relapse in Sz
• Suggested that stress could be cause for onset of Sz for someone already vulnerable, e.g. diathesis-stress model

Schizophrenogenic Mother:

• Psychodynamic explanation based on accounts from patients about their childhood
• Mother characterised as controlling, cold and rejecting
• Creates a family climate based on secrecy and tension, leading to distrust that develops into paranoid delusions and ultimately Sz

Weakness:

• Assessing mothers for 'crazy-making characteristics' is an unsensitive approach that would not be used by modern psychiatrists - socially-sensitive research
• Historically led to parent-blaming - parents already suffered enough seeing their child's descent into Sz and were likely to care for them in the long-term, suffered further trauma by being the blame for their child's suffering
• Shift from hospital to community care in the 1980s, often involving parental care, has led to a decline in support for this theory - low in temporal validity

Evidence to suggest that difficult family relationships in childhood are associated with increased risk in developing Sz as an adult

• Read reviewed 46 studies of child abuse and Sz - concluded that 69% of female Sz patients suffered from either physical abuse, sexual abuse, or both as a child (59% of men)
• Adults with insecure attachment to primary carer are more likely to develop Sz (Barry)

However

• Information was collected from accounts after Sz had developed so Sz may have distorted the patients' recall of childhood experiences - issue of validity
• Tienari followed up adopted children to see if childhood experiences predicted any adult charcteristics - there is evidence linking family dysfunction and Sz but it is inconsistent and not huge amounts of it
• Psychological harm - recalling emotionally upsetting memories 
• Consent - Sz patients may not be well enough to consent
• Right to withdraw - Sz patients can display erratic behaviour; moods change quickly
• Cause and effect - Unsure whether Sz causes family dysfunction or whether family dysfunction causes Sz 

Sz is associated with several types of abnormal information processing and provide possible explanations for Sz as a whole

• Focuses on the role of mental processes
• Sz is characterised as disruption to normal thought processing, as seen in many of the symptoms
• Reduced processing in the ventral striatum is associated with negative symptoms
• Reduced processing of information in the temporal and cingulate gyri are associated with hallucinations
• Lower than usual level of processing suggests that cognition is impaired 

Metarepresentation

• Ability to reflect on thoughts and behaviour, allowing for insight into our own goals/intentions
• Dysfunction in this means that we struggle to recognise that our thoughts/actions are our own and not carried out by someone else
• Explains hallucinations of voices

Central Control

• Cognitive ability to supress automatic responses while carrying out a deliberate action
• Dysfunction of this would explain disorganised speech 
• Sz sufferers usually experience derailment of spoken sentences and thoughts because each word triggers associations anf these cannot be suppressed

• Stirling gave 30 Sz patients the Stroop test and compared results to a control group
• Ps have to name ink colour rather than the word itself, supressing the urge to say the word
• Sz patients took twice as long to complete task than control group, suggesting difficulty in suppressing automatic thought processing

• Although there is evidence supporting difficulty processing information in those with Sz, there are difficulties with cognitive explanation
• Does not say anything about origins of those cognitions or of Sz
• Explains what causes symptoms - proximal causes - but not origins of Sz - distal causes