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Psychological Explanations for Schizophrenia

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Psychological Explanations for Schizophrenia

Psychological explanations for schizophrenia attribute the origin and development of schizophrenia to psychological causes rather than focusing on a purely biological explanation. It considers thoughts, emotions, and external experiences and how these have affected the patient and relationships with others (social interactions, family members, and work/education friends). It asks how these experiences have influenced the development of schizophrenia.

There are two primary considerations that the exam will focus on:


  1. Family dysfunctions.

  2. Cognitive explanations.

What is the relationship between family dysfunctions and schizophrenia?

Family dysfunctions describe the unfavourable behaviours experienced between family members and the patient, such as cold, emotionless interactions, a lack of empathy, high levels of expressed emotions, and controlling behaviours.

These communication and behaviour methods create confusing situations based on unhealthy interactions between the parents and their child (the patient), resulting in abnormal behaviours. Conflict and uncertainty in a household commonly affect everyone, not just the patient in question.

  • Other family members feel stressed, which creates a loop of tension, guilt, and feelings of general unease in the patient, their siblings, and the parents.

Psychological Explanations for Schizophrenia Family dysfunctions cycles StudySmarterFamily dysfunctions cycles, Tyler Smith - StudySmarter Originals (Made in Canva)

Suppose this is a consistent issue within the family household. In that case, negative behaviours in the child (such as lashing out, behaving badly or erratically) can become more severe and can develop into symptoms of schizophrenia.

Three major theories seek to expand on family dysfunction and the psychological explanations for schizophrenia.

The schizophrenogenic mother

Proposed by Fromm-Reichmann (1948), the schizophrenogenic mother describes a particular type of parent. Typically, they are:

  • Uncaring
  • Highly critical
  • Controlling
  • Cold

These behaviours often manifest in a way that explicitly excludes or affects the child (such as a lack of affirmation or love), inducing paranoid thoughts and delusions. These then develop further, sometimes into positive symptoms.

It is important to note the theory of the schizophrenogenic mother is no longer held today.

The double bind theory

Developed by Bateson et al. (1956), the double bind theory is where a child (the patient) receives contradictory messages/signals from their parents throughout childhood.

For instance, a parent tells the child they love them whilst sneering at them with disgust. This disconnect between the statement and the emotion shown on the face creates a great deal of confusion, mistrust and paranoia in the child when it consistently happens.

If it is prominent throughout childhood, it is said to influence the development of schizophrenia. Paranoia and delusions, much like in the theory of the schizophrenogenic mother, are present as a result of these confusing interactions. These develop into full schizophrenic symptoms if left unattended.

Psychological Explanations for Schizophrenia The double bind theory diagram StudySmarterThe double bind theory diagram, Tyler Smith - StudySmarter Originals (Made in Canva)

Expressed emotions (EE)

Expressed emotions are where within a family, there are high levels of:

  • Criticism.

  • Hostility.

  • Emotional over-involvement (excessive self-sacrificing behaviours from the parent).

When a child is first diagnosed with schizophrenia, the child’s parent may feel a sense of immense guilt, affecting the parent’s behaviour towards the child.

They can become intrusive and overprotective, such as not allowing the child to go about their daily activities, discouraging their self-reliance. Parents, especially mothers, most commonly show emotional over-involvement. After some time of this overbearing behaviour, the patient may feel they can no longer cope and reverts to their illness as a coping device.

Households with high levels of expressed emotions significantly increase relapse rates in the hospitalisation of schizophrenic patients.

What are the cognitive explanations for schizophrenia?

Cognitive explanations for schizophrenia is the notion that the impairment of cognitive functions can explain the development of schizophrenia.

Cognitive explanations explore how a patient thinks and how those thought processes affect cognitive function.

Dysfunctional thought processing

Frith (1979) suggested that schizophrenia was due to a faulty attention system, known as the attention-deficit theory.

This is where, in a healthy person, preconscious thoughts act as a filter for the bombardment of information we sense automatically.

Usually, this is unimportant information such as:

  • Random smells

  • Brief attention distractions

  • Random thoughts

These pieces of information are filtered and dismissed as they are not necessary.

In a patient with schizophrenia, it is suggested there’s a fault in this filtering system, resulting in sensory overload. This fault accounts for the positive symptoms such as hearing voices and tangents with thoughts and speech.

It has also been suggested there is a breakdown between memory and perception; they are not working together as they should. Additionally, there may be a lack of schemas (building blocks of the mind) - patients become overloaded, as they cannot rely on past experiences to adapt to new ones.

There are also issues with attention biases in those with schizophrenia:

  • Abnormal attention is given to threatening stimuli in patients due to a lack of self-monitoring. These are cognitive biases.

  • They blame delusions and hallucinations on external sources, not internal sources. So, their thoughts are ‘alien’ to them; they do not see these thoughts as their own.

  • They have a cognitive deficit because they cannot fully process different types of information (usually auditory and visual). This causes issues with the expression of emotion, social situations and speech comprehension.

Dysfunctional thought processing can be further separated into two categories:

  1. Meta-representation

  2. Central control

Meta-representation

Psychological Explanations for Schizophrenia Meta-representation thought process StudySmarterMeta-representation thought process, Tyler Smith - StudySmarter Originals (Made in Canva)

The image shows how healthy people understand they are responsible for their own thoughts. It’s how the mind gets from thought A to thought B to thought C and so on. A healthy person can follow this process, understand where each step came from and how they got from A to B to C.

In a patient with schizophrenia, this process is faulty. They are missing steps or cannot explain when asked how they got from A to C, as they are missing B.

Faults in this process cause a delusion of control. It creates issues with self-awareness. When a patient has positive symptoms, such as hearing voices, it is hard for them to distinguish this from their thoughts. Patients can’t justify their decisions, as they cannot tell a person where thought B came from or if thought B even exists at all.

Central control

Central control can ignore and override automatic thoughts and responses to carry out a deliberate action.

This affects speech, as they cannot control associations from one thought to another, leading to disorganised thoughts. Sentences will be jumbled, and topics will change frequently.


Psychological Explanations for Schizophrenia - Key takeaways

  • Psychological explanations attribute the origin and the development of schizophrenia to psychological causes rather than focusing on a purely biological explanation. It considers thoughts, emotions, and external experiences and how these have affected the patient and relationships with others.
  • There are two main theories: family dysfunctions and cognitive explanations.
  • Family dysfunctions involve relationships within the household and how that affects the development of schizophrenia. Three theories can explain this: the schizophrenogenic mother, the double bind theory, and expressed emotions.
  • Cognitive explanations are the notion that the impairment of cognitive functions can explain the development of schizophrenia.
  • It suggests there are dysfunctions in thought processing. A patient has issues with meta-representation (the ability to reflect on our own and other people’s thoughts and behaviours) and central control (the ability to ignore and override automatic thoughts).

Frequently Asked Questions about Psychological Explanations for Schizophrenia

Psychological explanations attribute the origin and the development of schizophrenia to psychological causes (such as thoughts, behaviours, emotions, and relationships with family members and the environment), rather than focusing on a purely biological explanation.

Examples include symptoms such as hallucinations, paranoia, and delusions. These affect the person’s perception of the world around them.

In terms of psychological explanations, a schizophrenogenic mother, double-bind statements and expressed emotions can ‘trigger’ schizophrenia, or exacerbate existing issues that can develop into schizophrenia.

The biological model considers genetics, the dopamine hypothesis, and neural correlates as an explanation for schizophrenia.

This varies quite heavily depending on the patient. Commonly, in schizophrenia, delusions of persecution are seen often, alongside delusions of reference (belief that unrelated occurrences in the world have special personal significance).

Final Psychological Explanations for Schizophrenia Quiz

Question

What are psychological explanations for schizophrenia?

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Answer

Psychological explanations attribute the origin and the development of schizophrenia to psychological causes, rather than focusing on a purely biological explanation.

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What are the two main examples of psychological explanations for schizophrenia?

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Answer

Family dysfunctions and cognitive explanations.

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Question

What are family dysfunctions in schizophrenia?

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Answer

Family dysfunctions describe the unfavourable behaviours experienced between family members and the patient, such as cold, emotionless interactions, a lack of empathy, high levels of expressed emotions, as well as controlling behaviours.

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How do family dysfunctions lead to schizophrenia?

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Answer

They create hostile environments, encouraging paranoia and delusions in a child which develop into symptoms of schizophrenia.

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What are the three theories involved in family dysfunctions?

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Answer

The schizophrenogenic mother, the double-bind theory, and expressed emotions.

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What is the schizophrenogenic mother?

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Answer

The schizophrenogenic mother describes a particular type of parent. They are usually cold, uncaring, rejecting and hostile. 

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What is the double-bind theory?

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Answer

The double-bind theory is where a child (the patient) receives contradictory messages/signals from their parents throughout their childhood.

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How does the double-bind theory cause issues with schizophrenia?

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Answer

The contradictory messages create issues of distrust in the child, which develops into paranoia and delusions. These can develop further into full-blown symptoms of schizophrenia.

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​What do we mean by expressed emotions in schizophrenia?

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Answer

Expressed emotions are where within a family, there are high levels of hostility, criticism and emotional over-involvement.

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What does it mean when a parent is emotionally over-involved with a child?

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Answer

It means they are excessively self-sacrificing due to feeling guilt over the child’s diagnosis. They seek to absolve themselves, yet can suffer feelings of bitterness at the same time. 

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What are cognitive explanations for schizophrenia?

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Answer

Cognitive explanations for schizophrenia is based on the notion that the development of schizophrenia can be explained by the impairment of cognitive functions.

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What did Frith (1979) suggest schizophrenia was due to?

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Answer

He suggested it was due to attention-deficit issues, an inability to filter preconscious thoughts.

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What other issues in cognitive functions explain the development of schizophrenia?

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Answer

Issues with the relationship between memory and perception, and a lack of schemas cause an inability to adapt to new situations. There are problems with cognitive/attentional biases (schizophrenic patients pay more attention to threatening stimuli), and issues with cognitive deficits.

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What is meta-representation in schizophrenia?

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Answer

 This is where a patient with schizophrenia struggles to explain/plot their thought processes. Going from thought A to B to C is not possible, as patients struggling with meta-representation cannot remember or pinpoint thought B, for instance. This creates issues with delusions of control and self-awareness. 

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What is central control in schizophrenia?

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Answer

Central control is the ability to ignore urges and override automatic thoughts. A healthy person can involve a prompting stimulus (such as pressing a button). A schizophrenic person would struggle to resist, and when asked, would struggle to justify why they chose to do it.

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What is family dysfunction?

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Answer

A dysfunctional family is one that lacks empathy and shows signs of unhealthy interactions between parents, and/or between parents and their children. This may create a confusing situation for the child, which may, in turn, produce erratic behaviours in the child.

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Question

Name three traits of a ‘schizophrenogenic’ parent.

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Answer

Highly critical, controlling, and rejecting (other examples include cold, uncaring, suspicious. Any 3)

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What study introduced the idea of the Double Bind theory?

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Answer

 Bateson et al. (1956).

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Question

Give an example of a contradictory statement.

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Answer

A parent saying ‘I love you’ whilst turning away in disgust is an example of a contradictory statement. A parent telling a child they did something good whilst sneering and speaking angrily is also an example.

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Question

What effect can consistent exposure to contradicting statements have on a child?

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Answer

Consistent exposure to contradictory statements can cause confusion about what is real or true. Bonus point: This can lead to paranoid thoughts, which in turn can lead to delusions and hallucinations. These are known as schizophrenic symptoms.

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Question

Define emotional over-involvement.

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Answer

Emotional over-involvement is when a parent indulges in excessive self-sacrifice and overprotective behaviours, leading to patients relying on them and lacking self-reliance.

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Question

What happens if a patient returns to a family with high levels of expressed emotions?

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Answer

There is a higher chance of relapsing into schizophrenic behaviours and symptoms if a patient returns to a family with high levels of expressed emotions.

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Question

What did Lidz (1958) suggest in his study?

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Answer

Lidz suggested that having emotionally distant parents can lead to symptoms of schizophrenia. He also said that biological explanations are speculative compared to his research, which studies the whole patient. 

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Question

Name one strength of the theory that family dysfunctions lead to schizophrenia.

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Answer

In expressed emotion households, Kavanagh (1992) found that in over 26 studies, the mean relapse rate for patients living with caregivers or families with high levels of EE was 48%, compared to 21% for families with low EE. This suggests family dysfunction in households has an effect on the patient.

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Name one weakness of the theory that family dysfunction leads to schizophrenia.

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Answer

Placing blame on family members tends to cause parental guilt, which can result in feelings of stress and anxiety. It isn’t ethical to blame family members for a diagnosis of schizophrenia, and these views are considered outdated by most psychiatrists and psychologists.

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What did Laing and Esterson (1964) disagree with?

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Answer

They disagreed with the idea that mental health should be looked at purely from a biological point of view. They rejected the current medical model.

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Who first proposed the term ‘schizophrenogenic mother’?

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Answer

Fromm-Reichmann (1948)

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What did Berger (1965) find?

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Answer

He found that schizophrenic patients, when compared to controls, had a higher recall of double bind statements from their childhood.

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What did Butzlaff and Hooley (1998) find in their study?

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Answer

They found that schizophrenic patients living in high EE spaces produced more than double the baseline recurrent rate of symptoms.

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Question

Give an example of abnormal behaviours within the family.

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Answer

Parents being consistently cold towards the child.

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 What does the cognitive approach focus on?

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Answer

It focuses primarily on how a patient processes information and is concerned ultimately with how they think.

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 In Frith's Theory (1992), how do dysfunctional thoughts disrupt the normal function of thought processes?

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Answer

It affects the ability to filter preconscious thoughts due to a faulty attention system.

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Question

Which 1994 study found that schizophrenic patients have attentional biases?

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Answer

Bentall’s.

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What did Bentall find, exactly?

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Answer

Abnormal attention in those with persecutory delusions (an inability to recognise what is reality), is paid to threatening stimuli. Patients are biased towards these stimuli as a result of a lack of self-monitoring. Their delusions and hallucinations are blamed on the outside world or external sources.

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What did Hemsley find in his study?

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Answer

There is a fundamental breakdown in memory and perception in those with schizophrenia, an issue occurring between the two and how they work together. THERE IS A LACK OF SCHEMAS/ACTIVATION OF SCHEMAS.

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What is meta-representation?

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Answer

This is how we identify that we are responsible for our thoughts, behaviours and actions. It is the key to self-awareness and can explain multiple positive symptoms.

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Give one point of evaluation for meta-representation.

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Answer

Frith’s 1992 study, where PET scans revealed reduced blood flow to the frontal cortex. This is associated with negative symptoms such as avolition and the inability to suppress automatic thoughts.

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What is central control?

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Answer

This is the ability to suppress or override automatic thoughts, actions, and speech in response to stimuli.

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Why would issues with central control result in delusions?

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Answer

Patients find it hard to resist the urge to respond to stimuli, and then struggle to explain why. This can result in issues with delusions and their understanding of reality.  

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Give one point of evaluation for central control.

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Answer

Stroop test, where schizophrenic patients took twice as long to say the colour of the ink rather than reading the written word. This suggests issues with thought processing and central control dysfunction. 

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Question

Give one limitation of cognitive explanations for schizophrenia.

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Answer

It is reductionist (devolves schizophrenia to its simplest form).

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