Psychological explanations for schizophrenia

Cognitive explanations

Explanations that focus on the mental processes like thinking, language and attention

Dysfunctional thought processing

Information processing that does not represent reality accurately and produces undesirable consequences

Family dysfunction

Refers to processes within a family like poor family communication, cold parenting and high levels of expressed emotion.

May be risk factors of the development and maintenance of schizophrenia

The Schizophrenogenic mother

Fromm-Reichmann

Proposed a psychodynamic explanation for schizophrenia based on accounts she heard from patients about their childhoods.

Many of her patients talked about a particular type of parent which she called the schizophrenogenic mother. ‘Schizophrenia-causing’ mother. Cold, rejecting and controlling, tends to create a family climate characterised by tension and secrecy. Leads to distrust that later develops into paranoid delusions and then schizophrenia

Double-bind theory

Bateson

Agreed that family climate is important in the development of schizophrenia but emphasised in the role of communication style in a family.

Developing child finds themselves trapped in situations where they fear doing the wrong thing and receive mixed messages about what this is.

When they ‘get it wrong’ they are punished by withdrawal of love and leaves them with an understanding of the world as confusing. Reflected in symptoms like disorganised thinking and paranoid delusion.

Expressed emotion

The level of emotion expressed towards a person with schizophrenia by their carers who are often family members:

• Verbal criticism of the person with schizophrenia

• Hostility towards them

• Emotional overinvolvement in their life.

High levels of expressed emotion directed towards the individual are a serious source of stress. Primarily an explanation for relapse. It can also lead to stress and can lead to the onset of schizophrenia due to their genetic makeup

Dysfunctional thinking

Schizophrenia is characterised by disruption to typical thought processing, seen in many symptoms.

Reduced thought processing in the ventral striatum is associated with negative symptoms while reduced processing of information in the temporal and cingulate gyri are associated with hallucination.

This lower level of information processing suggests that cognition is likely to be impaired.

Metarepresentation dysfunction

Frith

Focused on cognitive dysfunction as an explanation for schizophrenia.

The cognitive ability to reflect on thoughts and behaviour.

Dysfunction in metarepresentation disrupts our ability to recognise our own actions as being carried out by ourselves rather than by someone else.

This can explain hearing voices and delusions like thought insertion

Central control theory

Frith also identified dysfunction of central control as a way to explain speech poverty

The cognitive ability to suppress automatic responses while doing deliberate actions

People with schizophrenia experience derailment of thoughts as each word suggests automatic associations that they cannot suppress.

Family S Read

Research support

Indicators of family dysfunction include insecure attachment and exposure to childhood trauma.

Adults with schizophrenia are disproportionately likely to have insecure attachment, particularly IR and disinhibited.

69% of women and 59% of men with schizophrenia have a history of physical and/or séxual abuse.

Suggests that family dysfunction makes people more vulnerable to schizophrenia

Family W Poor evidence base for any explanation

Not a lot of evidence to support the importance of traditional family-based theories like the schizophrenogenic mother and double bind theory.

Both of these are based on clinical observation of people with schizophrenia and informal assessment of their parents’ personalities but not systematic evidence.

Suggests that not all of the research evidence has been able to validate the link between childhood trauma and schizophrenia

Cognitive S Research support

Stirling

Compared performance on a range of cognitive tasks in 30 people with schizophrenia and a control group of 30 people. e.g. Stroop task where participants have to name the font colours of colour words so have to not read the words aloud.

People with schizophrenia took longer to do the Stroop task.

Suggests that the cognitive processes of people with schizophrenia are impaired.

Cognitive W Only explain the proximal origins of symptoms

Cognitive explanations are proximal (close to) explanations because they explain what happens now to produce the symptoms rather than focusing on what initially caused the condition

Possible distant explanations are genetic and family dysfunction explanations. How genetic variation or childhood trauma might lead to problems with metarepresentation or central control is not made clear and isn’t well-addressed.

Suggests that cognitive theories on their own only provide partial explanations for schizophrenia