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Psychological explanation of Schizophrenia: Family dysfunction
By Molly and Sibel
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The Schizophrenogenic mother
Friedo Fromm-Reichmann proposed a pschycodynamic explanation for Schizophrenia based on the accounts that she heard from her patients about their childhood. Fromm-Reichmann noted that many of her patients spoke of a particular type of parent, which she called the Schizophrenogenic mother. According to Fromm-Reichmann, the Schizophrenogenic mother is cold, rejecting and controlling, and tends to create a family climate characterised by tension and secrecy. This leads to distrust that later develops into paranoid delusions and ultimately schizophrenia.
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Interpersonal communication – Double Blind Theory
Some theorists have argued that there are abnormal and inadequate patterns of communication within the families of schizophrenics. Bateson (1956) put forward the double blind theory, according to which the members of families of schizophrenics communicate in a destructively ambiguous fashion. For example, the mother will tell the child that she loves him, but in a tone of voice that does not suggest any love. This theory therefore states that it is the way the mother interacts with the child that causes the schizophrenia. The double blind theory can account for some of the disordered thinking of people with schizophrenia. However, a serious problem with this theory is that there is very little evidence to support it.
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Interpersonal communication – Expressed emotion
While the evidence for the double blind theory is limited, there is some evidence that the interactions within a family can play a key role in maintaining the symptoms of individuals who are already suffering from schizophrenia. Families who engage in expressed emotions show high levels of critism, hostility and emotion over protectiveness. Kavanah (1992) found that schizophrenics in families with high expressed emotion were four times more likely to relapse compared with those who live in families with low expressed emotion. High levels of expressed emotion in carers directed towards the patient are a serious source of stress for the patient. This is primarily an explanation for the relapse in patients with schizophrenia. However, it has also been suggested that it may be a source of stress that can trigger the onset of schizophrenia in a person who is already vulnerable (for example; due to their genetic make up).
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Evaluation – Support for family dysfunction as a risk factor
There is evidence to suggest that difficult family relationships in childhood ate associated with increased risk of schizophrenia in adulthood. For example, Read et al (2005) reviewed 46 studies of child abuse and schizophrenia and concluded that 69% of adult women in-patients with a diagnosis of schizophrenia had a history of physical abuse, sexual abuse of both in childhood. For men, the figure was 59%. Adults with insecure attachments to their primary carer are also more likely to have schizophrenia (Berry et al 2008). There is thus a large body of evidence linking family dysfunction to schizophrenia. However, most of this evidence shares a weakness. Information about childhood experiences was gathered after the development of symptoms, and the schizophrenia may have distorted patients’ recall of childhood experiences. This creates a problem with validity. A much smaller numbers of studies have been carried out prospectively. They followed up children following childhood experiences to see if the childhood experience predicted any adult characteristics. There is prospective evidence linking family dysfunction to schizophrenia but not a huge amount and the results have been inconsistent.
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Debates Reductionist: Deterministic:
It doesn’t merge with the biological explanations of schizophrenia. It could be that both biological and psychological factors can separately produce the same symptoms, which raises the question of whether both outcomes are really schizophrenia. Deterministic:
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