Psychological Explanations for Schizophrenia

• ATHYNEA BURCHALL

Assignment 6 Outline and evaluate one or more psychological explanations for schizophrenia. In your evaluation you should refer to research evidence.

Many people perceive Schzophenia (sz) as a personality disorder relating to a split personality. This interepratation could be because in Greek the name translates as skhizen (to split) and phren (mind). Sz “is a mental disorder characterized by a breakdown in thinking and poor emotional responses., Kapur ( 2009).[1]

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It is actually a detachment from reality with common symptoms including hallucinations, delusions, hearing voices and paranoia to name a few. ” schizophrenia does not imply a “split personality”, or “multiple personality disorder“—a condition with which it is often confused in public perception. Rather, the term means a “splitting of mental functions”, reflecting the presentation of the illness. Baucum, (2006).[2]

The symptoms are so many and varied that it has been argued that they are actually many disorders umbrelled under the term sz. It is estimated to effect 1% of the population however “It is estimated that there are over half a million schizophrenics and that 10%of all NHS beds contain a schizophrenic. As a nation we spend an estimated £1.7 billion on treating schizophrenia each year. That is more than we spend on cancer!” psychology4a[3]

There have been many psychological explanations for sz from Biological to Psychodynamic, in this essay I will analyse and evaluate a few of these explanations.

The Psychodynamic Approach.

The main characteristic of the Psychdynamic approach is that it all stems from the persons childhood and the childhood experiences the person has had, and the disruption between the child and it development of a personality as Freud termed Ego. “Freud believed that if the world of a schizophrenic has been particular harsh in the childhood environment, the individuals may regress to an earlier stage in development before the ego was properly developed and before he or she had developed realistic awareness of the external world and so Schizophrenics have a loss of contact with reality because their ego is no longer functioning properly.” Anonamous (2014) [4]

Family model studies done in the 1950’s and 60’s blamed dysfunctional families for the cause of sz. If communication in the family unit became tense or broke down then this could result in the child becoming with drawn and emotionally unstable. If this persisted and wasn’t treated sz symptoms could start to develop. In a study done by Bateson et al (1956) in his double blind study where children who receive contradictory messages from their parents are more likely o develop Sz. For example, a mother telling her son she loves him yet, at the same time turning away in disgust. It is thought that the child will receive conflicting messages about verbal and non verbal communication and these interactions prevent coherent constructions of reality, and in the long terms manifest itself into Sz symptoms. “when a child has repeated experiences with one or more family members in which he/she receives contradictory messages. Repeated exposure to such contradictory messages causes the child to resort to self-deception and to develop a false concept of reality and inability to communicate. Those who are exposed to numerous counts of contradictory messages (the double blind theory) are more likely to develop schizophrenia and experience the negative symptoms of schizophrenia in their later life, such as flattened affect and social withdrawal.” Studymode 2014[5]

Another dysfunctional family factor that has been associated with sz is the degree of of expressed emotions (EE). Expressed emotions can be to a high degree or a low degree and is in relation to how families communicate and interact with one another. High dgree of ee have family members who are frequently hostile to each other, critical, over involved and over concerned in each other lives. Resulting in the child not been able to form its own identity, formulate its own ideas and been able to learn through exploration. Low ee families don not exhibit these characteristics. Various studies have found that there is a relationship between high degree ee families and relapse rates. “Brown (1972) showed that patients who returned from hospital to homes where there was a high level of emotionality (High levels of Emotion were Expressed — HEE) were more likely to have a relapse, and would have it sooner than those with LEE (Low levels of Emotion Expressed) families” alevelpsychologynotes (2007)[6] Such as 51% of sz relaspsing once they go back into the high degree ee family environment, but these statistics are only slightly higher than relapse rates in a lower dgree ee family. No evidence has been found that clearly states that the ee rate of a family is actually a cause of sz in the first place. Waring and Ricks also disagrees with blaming parents and the childs upbringing for causing sz. They found “Instead they found they tended to be anxious, shy, withdrawn, and incoherent. It can also be argued that there is no difference between parents of schizophrenics and those of non-schizophrenics and that any differences in family interactions are an effect of having a relative with schizophrenia rather than a cause.” Waring and Ricks[7]

Others studies done have also found that similar number of families who had children exhibiting sz symptoms came from ‘normal families’. “It is hardly surprising that communication becomes strained and routines are disrupted when a family is trying to live and cope with the behaviour of a schizophrenic member. It seems highly likely that the dysfunctional behaviour observed in some families with a schizophrenic member is caused by having to live with someone who has lost contact with reality. Furthermore, more recent studies of dysfunctional families show that few people reared in such homes actually develop schizophrenia and most schizophrenia sufferers come from ‘normal’, well adjusted families.” alevelpsychologynotes (2007)[8]

The psychodynamic theory also does not account for why Sz develops so suddenly in late teens and early twenties, and therefore emphasised the importance of biological factors. McLoed (2007)[9] It has been suggested that Schizophrenics regress back to an earlier life stage, but there is little empirical research evidence to back this up and a lot of sz behaviour does not resemble a child inquisive nature such as children like to explore and play whereas schizophrenics may demonstrte instead the creativity and imagination a child shows in their thinking.

Another point is if there is more than one child in the family unit, and only one child develops sz. If this explanation was correct then all the children in the family would develop sz as they are exposed to the same environmental conditions, the same parental conditioning and level of communication ect.

The psychodynamic approach does not offer effective treatments. In general, psychodynamic treatments aim of find childhood conflicts however; this is no relevant for Sz. Comer found that psychodynamic therapy for Sz has generally proved to be unsuccessful which suggests that the psychodynamic explanation for Sz is not accurate. Recent research has actually suggested that psychodynamic therapies far from making schizophrenics better, may actually make them worse which suggests that the explanation is heavily flawed. Rosen tried to claim some success with the treatment of psychoanalysis however; he was heavily criticised and accusing of using patients who were not Sz and faking data. Therefore his data was discredited.

In the 1970’s scientists were also starting to find other explanations for sz such as genetics resulting in the Biological explanation of sz which then over took the Psychodynamic approach and discredited a lot of the research done in the filed of explanation. Another psychological explanation for sz is the cognitive explanation.

The cognitive explanation of sz

The cognitive explanation regards sz as a thought disorder and instead of symptoms may actually be the cause. Hemsley study (1993) suggested that people suffering from sz cannot filter information coming in from their senses and they let too much irrelevant information in over whelming their capacity to make true sense from the information obtained, losing touch with what is real and what is not. Hence hullinations were internal thoughts that were not recognised by the person suffering symptoms of sz, and therefore the person interpreted them as their external reality.”Hemsley who suggested that the central deficit in schizophrenia is a breakdown in the relationship between information that has already been stored in memory and new, incoming sensory information. Hemsley suggests that this processing break down in schizophrenia and those schemas are not activated. As a result, people with schizophrenia are subjected to sensory overload and do not know which aspects of a situation to attend to and which to ignore.” Alevelpsychologynotes (2007)[10] Helmsey himself wrote “The basic automatic cognitive disturbance may be conceptulised in two ways firstly it may be viewed as a weakening of the influences of stored memories of regularities of previous input on current perception which leads to ambiguous unstructured sensory input and the subsequent intrusion into consciousness of unintended material from memory.” Hemsley (1993)[11]

Another psychologist who also believes in the cognitive approach to explanning sz was Frith. Frith agreed with Hemsley stating the basic cognitive dysfunction may be recently developed difficulties with the self monitoring of intentions and actions, which would lead to individuals own intentions to act not being recognised and therefore being experienced as alien.” Frith (1992) [12]“Frith’s model (1992) was an attempt to explain the onset and maintenance of sonic of the positive symptoms of schizophrenia. His idea is that people schizophrenia are cognitively impaired in that they are unable to distinguish between actions that are brought about by external forces and those that are generated internally. He believes that most of the symptoms of schizophrenia can be explained in terms of deficits in three cognitive processes. Alevelpsychologynotes (2007)[13] He also went on to futher explain that the faulty filtering mechanism caused irregular neural pathways to be created between the hippocampus and the prefrontal cortex, resulting in the disruption of the production of dopamine levels. Both Hemsley and Frith studies found that basic cognitive disturbances resulted in the cause of sz symptoms, such as heightened perceptions, hearing voices, hullcinations, and unintentional thoughts, but is this explanation for symptoms of sz and not actually a cause of sz in itself.

The cognitive explanation becomes closely untwined with the Bilogical explanation and because it is hard to discern between the two, and becomes a combination of both explanations, and the so the cognitive model may then become too over-dependant on biological explanations and therefore cannot be relied as a model solely on its own. The cognitive explanation also lacks empirical data to support it unlike Biological explanations. For example Helmsley has tried to link his cognitive model to an underlying neurological system. However, there is very little clear-cut empirical evidence. On the other hand, there has been some promising research supporting his ideas however, this research involves the use of animals. This is a problem as we cannot learn much about human behaviour from animal experiments and we cannot generalise any animal research findings to humans and at the very least we need to verify these animal findings with findings from human studies.

Psychologist have also argue that cognitive explanations of Sz, such as Frith’s model are too reductionist in that they fail to take into account the role of social and environmental factors. Research has shown that traumas and major stress in a person life has contributed to higher risk of schizophrenic episodes. Sz symptoms seemed to rise and start after a highly stressed or traumatic event had happened in a person life and this became a triggered to the start of sz symptoms. Brown and Birley study found that prior to a schizophrenic episode, patients who had experienced Sz had reported twice as many stressful life events compared to a healthy control group. “Other triggers that herald the onset of an episode include momentous life events (Serious illness, Unexpected Bereavement etc.) or a combination of factors which could in isolation be dealt with. E.g. Unemployment, lowered sense of self worth, heavy drinking, marital problems, minor criminal activity, apprehension by the police and a magistrate courts appearance could all trigger an episode.” alevelpsychologynotes (2007)[14]

Conclusion

I do not feel one psychological explanation of sz clearly explains the complexity of the nature of sz and a combination of explanation approaches are needed, such as the Cognititve approach is so closely linked with the Biological approach you cannot consider one explanation with out considering the other. In the treatment of sz a more combined approach has seen a higher success rate. I believe the body and mind to be a interrelated organism and therefore what effects the mind must therefore effect the body and vice a versa and cannot be taken as a individual parts but must be investigated as a whole, hence why more than one explanation is needed. One approach that combines the two is Diathesis model, it is now accepted as the most likely cause of sz, since many factors contribute to the complexity of the disorder, and is considered less reductionist in comparison to other models as it takes a broader approach. As more information and research is done in this area I feel a more holistic explanation will evolved which will incorporate aspects from several of the pre existing explanation models.

Biblography

http://en.wikipedia.org/wiki/Schizophrenia

McLeod, S. A. (2007). Psychodynamic Approach. Retrieved 18/4/14 from http://www.simplypsychology.org/psychodynamic.html

http://www.slideshare.net/sssfcpsychology/psychological-explanations-of-schizophrenia

http://www.psychology4a.com/Psychopathology.htm

http://alevelpsychologynotes.blogspot.co.uk/2007/10/schizophrenia.html

http://psychwinter.files.wordpress.com/2010/06/a-level-psychology-notes-for-schizophrenia.doc

[1] Kapur ( 2009).“Schizophrenia”.Lancet374(9690): retrieved 19/4/14 from http://en.wikipedia.org/wiki/Schizophrenia

[2] Baucum, (2006).Baucum, Don (2006).Psychology(2nd ed.). Hauppauge, N.Y.: Barron’s. retrieved 18/4/14 from http://en.wikipedia.org/wiki/Schizophrenia

[3] Psychology4a Retrieved 19/4/14 from http://www.psychology4a.com/Psychopathology.htm

[4] Anonamous 2014Outline And Evaluate One Or More Psychological Explanations For Schizophrenia retrieved 18/4/14 from http://www.allfreepapers.com/Psychology/Outline-Evaluate-One-More-Psychological/53012.html

[5] Studymode 2014 psychological explanation to schizophrenia.StudyMode.com. Retrieved 18/4/14, from http://www.studymode.com/essays/Psychological-Explanation-To-Schizophrenia-46393398.html

[6]alevelpsychologynotes (2007) retrieved 19/4/14 from ttp://alevelpsychologynotes.blogspot.co.uk/2007/10/schizophrenia.html

[7] Waring and Ricks retrieved18/4/14 from http://cw.routledge.com/textbooks/9781848720091/downloads/Chapter_10/Revision_Guide_-_Psychological_Explanations_of_Schizophrenia.do

[8]alevelpsychologynotes (2007) retrieved 19/4/14 from ttp://alevelpsychologynotes.blogspot.co.uk/2007/10/schizophrenia.html

[9] McLeod, S. A. (2007). Psychodynamic Approach. Retrieved 18/4/14 from http://www.simplypsychology.org/psychodynamic.html

[10] alevelpsychologynotes (2007) retrieved 19/4/14 from ttp://alevelpsychologynotes.blogspot.co.uk/2007/10/schizophrenia.html

[11] Hemsley 1993 Psychological Medicine, 2001, 31, 189±195. Printed in the United Kingdom ” 2001 Cambridge University Press retrieved 19/4/14 from http://eprints.ucl.ac.uk/7199/1/7199.pdf

[12] Psychological Medicine, 2001, 31, 189±195. Printed in the United Kingdom ” 2001 Cambridge University Press retrieved 19/4/14 from http://eprints.ucl.ac.uk/7199/1/7199.pdf

[13] alevelpsychologynotes (2007) retrieved 19/4/14 from ttp://alevelpsychologynotes.blogspot.co.uk/2007/10/schizophrenia.html

[14] alevelpsychologynotes (2007) retrieved 19/4/14 from ttp://alevelpsychologynotes.blogspot.co.uk/2007/10/schizophrenia.html