AO1
FAMILY DYSFUNCTION
- THE SCHIZOPHRENIC MOTHER à FROMM-REICHMANN: based on the ACCOUNTS she heard from her PATIENTS about their CHILDHOODS, noted that many spoke of a particular parent – SCHIZOPHRENIC MOTHER or ‘SCHROPHRANIA-CAUSING’ is COLD, REJECTING and CONTROLLING and develops a FAMILY CLIMATE that is filled with TENSION and SECRECY = DISTRUST then PARANOID DELUSIONS then SCHIZOPHRENIA
- DOUBLE-BLIND THEORY à BATESON ET AL: emphasises the role of COMMUNICATION STYLE in the family – THE DEVELOPING CHILD finds themselves TRAPPED in situations where they FEAR doing the WRONG THING, BUT received MIXED MESSAGES about what this is, and fell UNABLE to COMMENT on the UNFAIRNESS of the SITUATION or SEEK CLARIFICATION – when they ‘GET IT WRONG’, the child is PUNISHED by WITHDRAWAL OF LOVE = leaves them with the understanding that the world is CONFUSING AND DANGEROUS + this is reflected in the SYMPTOMS like DISRGANISED THINKING AND PARANOID DELUSIONS = COMMUNICATION is a RISK FACTOR
- EXPRESSED EMOTION AND SCHIZOPHRENIA: is a level of EMOTION (MAINLY NEGATIVE) expressed towards a patient by their CARERS like VERAL CRITICISM of the PATIENT (sometimes with violence), HOSTILITY towards the patient (inc. ANGER and REJECTION) and EMOTIONAL OVER-INVOLVEMENT in the life of the patient (inc. NEEDLESS SELF-SACRIFICE) = HIGHER STRESS FOR THE PATIENT – explanation for RELAPSE or an ONSET for someone that is VULNERABLE
COGNITIVE DYSFUNCTIONS
- FOCUSES on the role of the MENTAL PROCESS AND associates with several types of abnormal information processing
- REDUCED PROCESSING in the VENTRAL STRIATUM is associated with the negative symptoms and reduced processing of information in the TEMPORAL and CINGULATE GYRI are associated with HALLUCINATIONS
- FRITH ET AL: 2 TYPES of DYSFUNCTIONAL THOUGHT PROCESSING –
- METAREPRESENTATION: ability to REFLECT ON THOUGHTS and BEHAIOUR = able to know or own INTENTIONS and GOALS and INTERPRET THE ACTIONS OF OTHERS à DYSFUNCTION: disrupt our ability to recognise our actions and thoughts as being carried out by OURSELVES rather than SOMEONE ELSE = HALLUCINATIONS of VOICES and DELUSIONS
- CENTRAL CONTROL: ability to SUPRESS AUTOMATIC RESPONSES while we perform DELIBERATE ACTIONS INSTEAD à DISORGANISED SPEECH + THOUGHT DISORDER could result in this as it is triggered by OTHER THOUGHTS
AO3
- SUPPORT FOR FAMILY DYSFUNCTION AS A RISK FACTOR: READ ET AL: reviewed 46 studies of CHILD ABUSE and SCHIZOPHRENIA and concluded 69% of ADULT WOMEN in-patients with a diagnosis of schizophrenia HAD A HISTORY OF PHYSICAL or SEXUAL ABUSE or BOTH in CHILDHOOD, for men it was 59% =INSECURE ATTACHMENTS à SCHIZOPHRENIA
BUT the schizophrenia may have DISTORTED PATIENTS’ RECALL of CHILDHOOD EXPERIENCES = low VALIDITY – there is PROSPECTIVE EVIDENCE but not HIGH AMOUNTS and the RESULTS are INCONSISTENT
- WEAK EVIDENCE FOR FAMILY-BASED EXPLANATIONS: NO EVIDENCE to support the evidence of the SCHIZOPHRENIC MOTHER or DOUBLE-BLIND – they are BASED ON CLINICAL OBSERVATIONS and EARLY EVIDENCE involved with assessing the PERSONALITY OF THE MOTHERS = NOT VALID
AND led to PARENT-BLAMING – ALREADY suffered through seeing their child’s struggle into SCHIZOPHRENIA and they are now going through FURTHER TRAUMA
- STRONG EVIDENCE FOR DYSFUNCTIONAL INFORMATION PROCESSING: STIRLING ET AL compared 30 PATIENTS with SCHIZOPHRENIA with 18 NON-PATIENT CONTROLS on a range of COGNITIVE TASKS inc. the STROOP TEST ( name the INK COLOURS of the colour words – SUPRESSING the IMPULSE to READ THE WORDS) = PATIENTS took TWICE as long as the CONTROL
BUT IT DOESN’T say anything about the origins of the FAULTY COGNITIONS causing the SYMPTOMS
- EVIDENCE FOR BIOLOGICAL FACTORS IS NOT ADEQUATELY CONSIDERED: could be that BOTH BIOLOGICAL AND PSYCHOLOGICAL FACTORS can separately produce the SAME SYMPTOMS, where both outcomes are both SCHIZOPHRENIA – the DIATHESIS-STRESS MODEL where the diathesis may be BIOLOGICAL or PSYCHOLOGICAL