AO1: Psychological theories
Psychodynamic- Freud believed schizophrenia was result of two related processes, regression to a pre-ego stage and attempts to re-establish ego control. If the schizophrenic had a harsh childhood or past(cold uncaring parents), they may regress to this early stage before there ego was properly formed and before they had developed a realistic awareness of the real world. Seen as an infantile state with symptoms reflecting this primitive condition(delusions of grandeur) and symptoms such as auditory hallucinations reflecting persons attempts to re-establish ego control.
Cognitive- acknowledges role of biological factors in causing initial sensory experiences of schizophrenia, but claims further features of disorder appear as individuals attempt to understand those experiences. When schizophrenics first experience voices or hallucinations they turn to others to confirm validity of their experience. when other people fail to confirm reality of experiences, they come to believe that others must be hiding the truth(paranoia begins).they begin to reject feedback from others and develop delusional beliefs that they are being manipulates by others.
Psychotherapeutic explanations- Little evidence to support Freuds specific ideas concerning schizophrenia, except that other psychoanalysts have claimed that disordered family patterns are the cause of disorder.e.g.Fromm-Reichmann described schizophrenogenic mothers or rejecting, overprotective, dominant and moralistic families as important contributory factors in development of schizophrenia. studies have shown that parents of schizophrenics behave differently from parents of other kinds of patient, particularly in presence of offspring-likely to be as much consequence of childrens problems as cause.
cognitive explanations- Support for cognitive deficits associated with schizophrenia.e.g.Meyer-Lindenberg et al found link between excess dopamine in prefrontal cortex and working memory.
Biological processes allow us to process information rationally. Brain nerve cells are interconnected. When we learn we strenghthen pathways. however when a person does not have coherent biological processes it is said to be caused by an abscess in the dorsal pons.
AO1: Socio- cultural factors
Life events- Occurrence of stressful life events has been associated with higher risk of schizophrenic episodes.(e.g.death of a spouse). Brown and Birley found that prior to schizophrenic episode, pateints who previously experienced schizophrenia reported twice as many stressful life events than healthy control group. Falloon et al- stress factor that triggers schizophrenia not known but thought to be high leves of physiological arousal associated with neurotransmitter changes(andrenaline).Double-bind- Bateson et al- children who frequently recieve contradictory messages from parents more likely to develop schizophrenia(mother tells son she loves him but looks away in disguist)- child recieves two conflicting messages.childs ability to respond incapacitated as one message invalidates the other.prevent development of internally coherent construction of reality and this manifests itself as schizophrenic symptoms.Expressed emotion-A family communication style that invloves criticism,hostility&emotional over involvement.Linzen et al-pateint returning to family with high EE about 4x more likely to relapse compared wih family of low EE.relapse rates among schizophrenics in iran-Kalafi and Torabi-high prevelance of EE in iranian culture was one main cause of relapse.negative emotional climate arouses patient & leads to stress beyond their already impaired cpoing mechanisms.
Life events-Van Os et al reported no link between life events and onset of schizophrenia.Pateints were not more likely to have experienced a major life event in the three months preceeding onset of illness.Pateints who had major life event went on to have lower liklihood of relapse.Evidence that does suggest link is only correlational.It could be beginnings of disorder(earratic behaviour)were cause of life events.Life events after onset of disorder(losing job)may be consequence rather than cause.Family relationships-Tienari et al-adopted children&biological schizo parents=more likely to become ill.This difference only emerged if adopted family rated as disturbed.illness manifests itself in appropriate environmental conditions.DBT-some evidence-Berger-schizophrenics reported higher recall of DB statements by their mothers then non S.May not be reliable as patient recall may be affected by S.Hall&Levin-analysed data from studies,found no difference between families with & without scizo member in the degree to which verbal & non verbal communication were in agreement.EE-Much universal& empirical support.cause/effect?-led to therapy where high EE relatives shown how to reduce EE.Hogarty et al-such therapy can reduce relapse rates.However,as with all therapies,it is not clear whether EEintervention was the key element of therapy or whether other aspects of family intervention may have helped.
AO1, AO2 & AO3
Labelling theory- Popularised by scheff.When someones symptoms of scizophrenia are displayed, such as hallucinations and delusions and bizzare behaviour, they are seen as deviant from the social group and norms we ascribe to. once the diagnostic labell is applied it becomes a self- fulfilling phrophecy that promotes the development of other symptoms of schizophrenia.
Commentary- in a review, Scheff evaluated 18 studies related to labelling theory. he judged 13 to be consistent with the theory and 5 to be inconsistent, thus concluding that theory was supported by evidence. another study that supports labelling theory is Rosenhan's being sane in insane places study- he found that once the label of schizophrenia had been applied, the diagnosis continued to influence behaviour of staff towards the patient, even when this was no longer warranted.
AO3- Synoptic links
EE and culture-Jenkins amd Karno claimed that although findings on EE have been replicated corss- culturally, EE is much less common in families of people with schizophrenia outside the west. one possible explanation for this is that non-western cultures are less individualist and less committed to concepts of personal responsibility. thus they are less likely to blame someone with S for their actions.