Psychocial factors

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  • Created by: Rob D.
  • Created on: 12-03-14 13:37
Socio-economic status
Schizophrenia occurs more in lower socio-economic groups. Either low status is itself a risk factor or people with schizophrenia can no longer cope adequetly with jobs and relationships and so ''drift'' down the socio-economic hierarchy.
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Fox (1990)
Found no evidence for the social drift hypothesis. Therefore the factors associated with living in poorer conditions e.g. high stress levels may trigger the onset of schizophrenia.
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Migrant population
Schizophrenia occurs more frequently in migrant populations. Controversially, Afro Caribbean's are more likely to be diagnosed in the UK. It is not clear why - it might reflect a racial bias in diagnosis or a living conditions of migrant population.
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Life events and schizophrenia
A major stress factor that has been associated with higher risk of schizophrenic episodes is the occurence of stressful life events. The mechanisms are not known although neurotransmitter changes are thought to be involved (Falloon 1996)
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Brown and Birley (1968)
Found that prior to a schizophrenic episode, patients who had previously experienced schizophrenia reported twice as many stressful life events compared to a healthy control group.
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Evaluation of life events
Van Os (1994) reported no link between life events and the onset of schizophrenia. In fact those patients who had experienced a major life event went on to have a lower likelihood of relapse. Moreover the link is only correlational.
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Evaluation of life events (2)
Brown and Birley's study is a retrospective study, fortunetely a study by Hirsch (prospective study) provided further evidence to support Brown et al's claim.
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Hirsch (1996)
Followed 71 schizophrenic patients over 48-week period. It was clear that 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.
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Overall evaluation
There is evidence that acute life stresses can bring on schizophrenia but it is unlikely that class and economic status are anything more than just contributory factors.
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Family factors
Double bind theory (Bateson et al) states that members of families of schizophrenics communicate in a destructive and ambigous fashion. These contradicting messages prevent the development of an internally coherent construction of reality.
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R.D. Laing
Argued that what we call schizophrenia is actually a reasonable response to an insane world.
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Lidz (1965)
Coined the term 'marital schism' to explain an abnormal family pattern where discord between parents was associated with schizophrenia in offspring.
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Evaluation of Double-Bind theory
Theories are methodologically flawed. They did not include control groups and used poorly operationaliized definitions of schizophrenia. They rely on retrospective data and suggesting to families that they might've caused the disorder is destructive.
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Berger (1965)
Found that schizophrenics reported a higher recall of double-bind statements by their mothers than non-schizophrenics
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Expressed emotion (EE)
By the mid 70's psychologists became more concerned with the part that families played in the course rather than the cause. EE is the family communication style. High levels of EE are most likely to influence relapse rates.
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Vaughn and Leff (1976)
Published a paper suggeting that the extent of expressed emotion within a family was a strong predictor of relapse rates among discharged patients.
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Hogarty (1991)
Found that therapy (aimed to reduce the levels of EE) can significantly reduce relapse rates. However as with all therapies, it is not clear whether the EE intervantion was the key element of the therapy.
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Accepted maiteinance model
EE has now become a well-established 'meintenance' model of schizophrenia and many prospective cross-cultural studies have been conducted to support it. It has been found that relapse rates are lower in countries like India.
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Relapse rates and family estrangement
Many patients with schizophrenia are either estranged from their families or have a minimum contact and so they do not experience high EE and yet there is no evidence that such people are less prone to relapse (Goldstein 1988)
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High EE as a response to living with schizophrenia
There is some evidence that certain aspects of high EE behaviour are associated with abnormalities in patients. High EE is found to be less common in the families of first-episode patients than in those with frequent re-admissions.
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EE and culture
EE is much less common in families of people with schizophrenia outside the West. Non-western cultures are less individualist and less committed to concepts of personal responsibility thus they are likely to blame schizophrenics for their actions.
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Labelling theory
Scheff (1999) states that social groups construct rules for members of their group to follow. Schizophrenia is seen as deviant from the rules we ascribe as normal. Once this label is applied it becomes a self-fulfilling prophecy.
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Scheff (1974)
Evaluated 18 studies explicitly related to labelling theory. He judged 13 to be consistent with the theory and 5 to be inconsistent, thus concluding that the theory was supported by the evidence.
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Card 2

Front

Found no evidence for the social drift hypothesis. Therefore the factors associated with living in poorer conditions e.g. high stress levels may trigger the onset of schizophrenia.

Back

Fox (1990)

Card 3

Front

Schizophrenia occurs more frequently in migrant populations. Controversially, Afro Caribbean's are more likely to be diagnosed in the UK. It is not clear why - it might reflect a racial bias in diagnosis or a living conditions of migrant population.

Back

Preview of the back of card 3

Card 4

Front

A major stress factor that has been associated with higher risk of schizophrenic episodes is the occurence of stressful life events. The mechanisms are not known although neurotransmitter changes are thought to be involved (Falloon 1996)

Back

Preview of the back of card 4

Card 5

Front

Found that prior to a schizophrenic episode, patients who had previously experienced schizophrenia reported twice as many stressful life events compared to a healthy control group.

Back

Preview of the back of card 5
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