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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 their Relationships with others (social interactions, family members, and work or education friends). It asks how these experiences have influenced the development of Schizophrenia

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Psychological Explanations for Schizophrenia

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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 their Relationships with others (social interactions, family members, and work or education friends). It asks how these experiences have influenced the development of Schizophrenia.

So, what are the psychological explanations for schizophrenia?

  • We are going to explore psychological explanations for schizophrenia. First, we will provide a schizophrenia psychology definition.
  • Then, we will discuss the main arguments in psychological explanations for schizophrenia: family dysfunctions, cognitive explanations, and socio-cultural explanations.
  • We will discuss the schizophrenogenic mother, the double bind theory, and expressed emotions.
  • Following this, we will cover dysfunctional thought processing and central control in schizophrenia before exploring socio-cultural explanations for schizophrenia.
  • Finally, we will briefly touch upon Psychological Treatment for schizophrenia.

Psychological Explanations for Schizophrenia, woman sitting down with a spooky shadow ghost looming over her, Vaia

Fig. 1 - Schizophrenia causes psychosis and positive and negative symptoms.

Schizophrenia: Psychology Definition

Schizophrenia affects around 24 million people worldwide (WHO, 2022) and is a mental health disorder characterised by psychosis and positive and negative symptoms. Symptoms include paranoia, hallucinations, and affective flattening, to name a few.

Schizophrenia Examples

Examples of the symptoms schizophrenic patients experience fall within the positive or negative symptom bracket, typically. For instance, positive symptoms include:

  • Hallucinations (a person may hear other voices or see people that do not exist, perhaps traumatic images).
  • Delusion (a person may believe they are the next coming of Jesus or believe they are someone extremely important politically).
  • Paranoia (a person may believe someone is following them or listening in on their conversations, such as the police, or may believe family members are listening in on them).

Negative symptom examples include:

  • Slow movements (a person may become sluggish, moving more dispassionately)
  • Speech poverty (also known as alogia, speech poverty manifests as a decline in speaking; conversations slow down or stop altogether)
  • Avolition (lack of motivation, patients may struggle to motivate themselves to engage with the world, including family and friends.

Psychological Explanations for Schizophrenia

According to psychological explanations of schizophrenia, family dysfunction, cognitive dysfunction (dysfunctional thought processing), and socio-cultural factors can trigger schizophrenia. Family dysfunction focuses on the unfavourable behaviours experienced between family members and the patient. Cognitive explanations focus on the impairment of cognitive functions, and socio-cultural explanations focus on social status.

Schizophrenia: Family Dysfunction

Psychological explanations of schizophrenia highlight how family dysfunction affects the development of schizophrenia. So, what are family dysfunctions?

Family dysfunction describes 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 harmful 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, creating tension, guilt, of general unease in the patient, their siblings, and their parents.

Psychological Explanations for Schizophrenia Family, dysfunctions cycle diagram, Vaia

Fig. 2 - Family dysfunction includes chaotic, toxic cycles which affect everyone in the household.

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

The Schizophrenogenic Mother

As 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.

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 due to these confusing interactions, affecting a child's perception of reality, according to Bateson et al. (1956).

These develop into full schizophrenic symptoms if left unattended.

Psychological Explanations for Schizophrenia, The double bind theory diagram, Vaia

Fig. 3 - The Double Bind theory focuses on contradictory messages between parent and child in schizophrenia development.

Expressed Emotions (EE)

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

  • Criticism and critique.

  • Hostility and animosity.

  • Emotional over-involvement from parents (including 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.

Households with high levels of expressed emotions significantly increase relapse rates in the hospitalisation of schizophrenic patients (Vaughn & Leff, 1976).

Schizophrenia: Cognitive Explanations

Cognitive explanations for schizophrenia are the notion that the impairment of cognitive functions (dysfunctional thought processing) can explain the development of schizophrenia. Dysfunctional thoughts can eventually lead to delusions, Memory issues, and other concerning symptoms.

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 you sense throughout the day, such as coffee on your morning walk or cutting grass.

  • Brief Attention distractions that flag in your peripheral vision.

  • Random thoughts that are tangents from your main focus.

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

In a patient with schizophrenia, it is suggested there is 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.

Matussek (1952; as cited in Hemsley, 2005) highlighted how, in a patient with schizophrenia, there was a:

lack of continuity of his perceptions both in space and over time. He saw the environment only in fragments. There was no appreciation of the whole. He saw only details against a meaningless background. (p. 92)

When the building blocks schemas provide are longer there, context is lost, and attention is diverted to inappropriate or otherwise meaningless sources that would usually be ignored (Hemsley, 2005). Frith (1979) believed schizophrenic patients sought to explain the usually ignored information they perceived, which, according to Hemsley (2005), could allude to why they experienced delusions.

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. 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 expressing emotion, social situations and speech comprehension.

Frith (1992) separated dysfunctional thought processing into two categories:

  1. Meta-representation

  2. Central control

Meta-representation

Meta-representation highlights how ideas develop and naturally flow from one thought to the next. It is a patient's ability to reflect on personal thoughts and experiences and how they all combine to affect behaviour.

Frith suggests issues with meta-representation lead to positive symptoms, such as hearing voices.

Typically, in healthy patients, a flow exists between thoughts that they can trace back relatively easily. External influences, such as speech, shouldn't affect a healthy person's perspective of reality.

Speech heard from the external world affects how schizophrenic patient can understand their internal thoughts, however. Speech can interrupt thought processes, and it's hard to truly distinguish between external speech and internal thoughts for schizophrenic patients, according to Frith (1992).

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 to distinguish their thoughts from external speech.

Psychological Explanations for Schizophrenia, woman and man sitting and talking in a therapy session, Vaia

Fig. 4 - Issues with metarepresentation may lead to positive symptoms.

Central Control

Central control issues manifest in the person struggling to ignore and override automatic thoughts and responses when trying to carry out a deliberate action.

Central control can affect speech, for instance, as those with schizophrenia cannot control associations from one thought to another, leading to disorganised thoughts. Sentences will be jumbled, and topics will change frequently.

Schizophrenia: Socio-cultural Explanations

Those with a low social status may be more likely to experience issues with schizophrenia compared to others, according to the socio-cultural explanation. Increased chances could be due to:

  • Higher Stress levels.
  • Poor living conditions.
  • Poverty.
  • Social class status.

Each of the above can raise Stress levels in its own right, and research finds that some schizophrenic patients cited stressful life events before the onset of their schizophrenia.

Psychological Treatment for Schizophrenia

Psychological Treatment can be used for schizophrenia. Typically, Psychological Treatment involves Cognitive Behavioural Therapy (CBT), Family Therapy, and Token Economy systems.

  • CBT addresses dysfunctional thought processes using Ellis' ABC model, encouraging those with schizophrenia to perform reality tests.
  • Family Therapy involves the family and the patients, addressing household issues to treat schizophrenia.
  • Token Economy systems rely on Operant Conditioning, encouraging patients to perform approved behaviours for tokens to trade in for rewards.

Each treatment has its strengths and weaknesses and is not guaranteed to work.


Psychological Explanations for Schizophrenia - Key takeaways

  • Psychological explanations 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.
  • We consider three main theories: family dysfunctions, cognitive explanations, and socio-cultural explanations.
  • Family dysfunctions involve relationships within the household and how that affects the development of schizophrenia, focusing on the schizophrenogenic mother, the double bind theory, and high levels of expressed emotions.
  • Cognitive explanations are the notion that the impairment of cognitive functions (dysfunctional thought processing) can explain the development of schizophrenia.
  • Socio-cultural explanations suggest a low social status can contribute to the development of schizophrenia, highlighting how stressful events associated with low social status trigger schizophrenia.

References

  1. World Health Organisation. (2022, January 10). Schizophrenia. Who.int; World Health Organization: WHO. https://www.who.int/news-room/fact-sheets/detail/schizophrenia ‌
  2. David R Hemsley, M.A., M.Phil, Ph.D., The Schizophrenic Experience: Taken Out of Context?, Schizophrenia Bulletin, Volume 31, Issue 1, January 2005, Pages 43–53,
  3. Matussek, P. (1952). Studies in delusional perception. Psychiafric and Zeitschrif Neurologie, 189, 279-318.

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.

According to psychological explanations of schizophrenia, family dysfunction, cognitive dysfunction (dysfunctional thought processing), and socio-cultural factors can trigger 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).

The cognitive approach to schizophrenia ascribes the origin of the disorder as a result of dysfunctional thought processes. Examples include a faulty attention system and a lack of schemas. 

Cognitive impairments and symptoms in schizophrenia are related in that dysfunctional thought processing (cognitive impairments) can give rise to symptoms of schizophrenia. For example, dysfunctional thought processing can manifest into delusions, memory issues, and language impairment. 

Final Psychological Explanations for Schizophrenia Quiz

Psychological Explanations for Schizophrenia Quiz - Teste dein Wissen

Question

What is family dysfunction?

Show answer

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.

Show question

Question

What did Lidz (1958) suggest in his study?

Show answer

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. 

Show question

Question

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

Show answer

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.

Show question

Question

What did Laing and Esterson (1964) disagree with?

Show answer

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.

Show question

Question

What did Berger (1965) find?

Show answer

Answer

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

Show question

Question

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

Show answer

Answer

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

Show question

Question

Give an example of abnormal behaviours within the family.

Show answer

Answer

Parents being consistently cold towards the child.

Show question

Question

 What do cognitive explanations in schizophrenia focus on?

Show answer

Answer

Cognitive explanations for schizophrenia explore how dysfunctions in the thought process affect the development of schizophrenia.

Show question

Question

How do dysfunctional thoughts disrupt the normal function of thought processes?

Show answer

Answer

Dysfunctional thought processing leads to symptoms of schizophrenia by facilitating the development of delusions, memory issues, and other thought-associated issues. It affects the ability to filter preconscious thoughts.

Show question

Question

Which 1994 study found that schizophrenic patients have attentional biases?

Show answer

Answer

Bentall’s.

Show question

Question

What did Bentall (1994) find, exactly?

Show answer

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.

Show question

Question

What did Hemsley (1993) find in his study?

Show answer

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.

Show question

Question

What is metarepresentation?

Show answer

Answer

Metarepresentation 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. Schizophrenic patients struggle to differentiate between external sources of information, such as speech, and their own thoughts. 


Show question

Question

What is central control?

Show answer

Answer

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

Show question

Question

Give one limitation of cognitive explanations for schizophrenia.

Show answer

Answer

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

Show question

Question

Around how many people worldwide are affected by schizophrenia?

Show answer

Answer

24 million.

Show question

Question

True or False: 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. 

Show answer

Answer

True.

Show question

Question

True or False: When family dysfunction issues are present, family members feel stressed, which creates a loop of tension, guilt, and feelings of general unease in the patient, their siblings, and the parents.


Show answer

Answer

True.

Show question

Question

True or False: Family dysfunction will always lead to schizophrenia.

Show answer

Answer

False.

Show question

Question

Who proposed the theory on the schizophrenogenic mother?

Show answer

Answer

Fromm-Reichmann (1948).

Show question

Question

True or False: The schizophrenogenic mother is caring, empathetic, and not critical. 

Show answer

Answer

False.

Show question

Question

The double-bind theory proposes confusing messages affect a child's perception of _____.

Show answer

Answer

reality.

Show question

Question

True or False: High relapse rates are associated with expressed emotion (EE) in schizophrenia. 

Show answer

Answer

True.

Show question

Question

What did Matussek (1952) highlight about a schizophrenic person's perception of reality?

Show answer

Answer

According to Matussek (1952), in a schizophrenic patient, there was a "lack of continuity of his perceptions both in space and over time. He saw the environment only in fragments. There was no appreciation of the whole. He saw only details against a meaningless background."

Show question

Question

True or False: Frith (1979) believed schizophrenic patients sought to explain the usually ignored information they perceived, which, according to Hemsley (2005), could allude to why they experienced delusions.   

Show answer

Answer

True.

Show question

Question

Abnormal attention is given to __________ stimuli in patients due to a lack of self-monitoring.

Show answer

Answer

threatening.

Show question

Question

True or False: A dysfunctional family is when there exist certain unfavourable behaviours between family members, such as a lack of empathy, and unhealthy interactions between parents and their children. 

Show answer

Answer

True.

Show question

Question

What are the common traits of a dysfunctional family?

Show answer

Answer

  • Lack of empathy
  • Promoting unhealthy interactions between parent and child
  • Acting Coldly
  • Engaging in controlling behaviours


Show question

Question

What was the name of Laing and Esterson's (1964) work in which they suggested issues such as social pressures and family relationships play an important role in schizophrenia?

Show answer

Answer

Sanity, Madness and the Family.

Show question

Question

True or False: Through case studies of female schizophrenic patients, Laing and Esterson (1964) found family life was rife with fear and manipulation.

Show answer

Answer

True.

Show question

Question

True or False:  Low levels of Expressed Emotions (EE) increase relapse rates in schizophrenic patients. 

Show answer

Answer

False.

Show question

Question

What did Kavanagh (1992) find in their review of studies?

Show answer

Answer

Kavanagh (1992) found that in over 26 studies, the median relapse rate for patients living with caregivers or families with high levels of EE was 48%, compared to 21% for families with low EE.

Show question

Question

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

Show answer

Answer

Butzlaff and Hooley (1998) found living in high EE spaces produced more than double the baseline recurrent rate of symptoms in schizophrenic patients. 

Show question

Question

Why is relying on a patient's memory not a great way to test a theory in schizophrenia?

Show answer

Answer

Memory is not always a reliable and accurate account of what happened. Considering that many symptoms of schizophrenia affect a patient’s understanding of reality (for example, patients struggle with symptoms of hallucinations, delusions, and hearing voices) relying on the patient’s memory is not the most secure method. There is no way to verify if the patient's memories are an accurate record of reality.

Show question

Question

What did Nomura et al. (2005) find in their study?

Show answer

Answer

Nomura et al. (2005) found interesting cultural differences in expressed emotions (EE) when comparing England to Japan. They looked at the expression of EE in carers of schizophrenic patients rather than focusing on the patient's relatives. English carers were more critical and showed higher levels of EE to their patients than Japanese carers. 

Show question

Question

True or False: Firth (1979) also suggested that schizophrenia was due to a faulty attention system, known as the attention-deficit theory. 

Show answer

Answer

True. 

Show question

Question

_______ thoughts (thoughts occurring without active awareness or attention, which are automatic responses) filter the world so we are not bombarded with information

Show answer

Answer

Preconscious.

Show question

Question

Who provided support for Firth's (1979) theory on selective attention issues in schizophrenia?

Show answer

Answer

Beech (1989).

Show question

Question

What did Beech (1989) find in their study?

Show answer

Answer

Beech (1989) provided support for Firth's (1979) theory of selective attention issues, by examining the concept through negative priming. They found that there is an impaired ability to inhibit distracting information in schizophrenic people.

Show question

Question

True or False: Hemsley (1993) did not argue that there is a fundamental breakdown between memory and perception in those with schizophrenia, and schizophrenic patients struggle to activate schemas appropriately. 


Show answer

Answer

False.

Show question

Question

What are schemas?

Show answer

Answer

Schemas are cognitive frameworks that help organise the mind. Proposed by Piaget, they are categories of information and knowledge. Schemas help organise past experiences so an individual can process future events.

Show question

Question

What did Matussek (1952; as cited in Hemsley, 2005) highlight in schizophrenic patients? 

Show answer

Answer

There was a "lack of continuity of his perceptions both in space and over time. He saw the environment only in fragments. There was no appreciation of the whole. He saw only details against a meaningless background” (p. 92)

Show question

Question

True or False: Bentall (1994) states that abnormal attention in those with persecutory delusions in schizophrenia (an inability to recognise what is real), is given to threatening stimuli.  

Show answer

Answer

True.

Show question

Question

What did Navalón et al. (2021) find in their study?

Show answer

Answer

Navalón et al. (2021) found that there is an attentional bias towards threatening scenes in patients with schizophrenia. 


After viewing a 20-second video with four emotional scenes, positive symptoms were associated with a ‘late avoidance’ of sad scenes, and negative symptoms were associated with heightened attention to threats. Patients also showed increased attention to threatening scenes. 


Show question

Question

Positive symptoms (like hearing voices) in ________ make it hard for a person with schizophrenia to distinguish their thoughts from the voices they hear

Show answer

Answer

metarepresentation.

Show question

Question

What did Firth (1992) find in their study using PET scans?

Show answer

Answer

The scans in this study revealed that there was reduced blood flow to the frontal cortex in the brain. There was also increased activity in the temporal lobe, which is responsible for retrieving memories.

Show question

Question

In central control, topics can trigger thoughts that are hard to _____ and can result in disorganised speech. 

Show answer

Answer

suppress.

Show question

Question

True or False: Those with a low social status may be more likely to experience issues with schizophrenia compared to others, according to the socio-cultural explanation.

Show answer

Answer

True.

Show question

Test your knowledge with multiple choice flashcards

True or False: 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. 

True or False: When family dysfunction issues are present, family members feel stressed, which creates a loop of tension, guilt, and feelings of general unease in the patient, their siblings, and the parents.

True or False: Family dysfunction will always lead to schizophrenia.

Next

Flashcards in Psychological Explanations for Schizophrenia48

Start learning

What is family dysfunction?

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.

What did Lidz (1958) suggest in his study?

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. 

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

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.

What did Laing and Esterson (1964) disagree with?

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.

What did Berger (1965) find?

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

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

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

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