Psychological Explanation

of Schizophrenia
 Lesson Objectives
By the end of the lesson you will be able
to:

 Describe and evaluate psychological

explanations of schizophrenia
 Starter – Crossword

 Look through the pages on psychological explanations of

schizophrenia to find the answers to the clues.
 P198-199.

 Sociocultural / considers the role of social and family relationships

 Psychological / psychodynamic, behavioural and cognitive
 schizophrenia / profound disruption of cognition and emotion
 Positive / excess or distortion of normal function
 Negative / loss of normal function
 Freud / psychodynamic approach
 Liberman / behavioural approach
 Falloon / life events and schizophrenia
 Bateson / double bind theory
 Scheff / social labelling theory
 Psychological Explanations

 Includes Psychological explanations, e.g.

Psychodynamic approach and Sociocultural
factors.

 Sociocultural factors = considers the role of

social and family relationships
 Schizophrenia
 Characterised by a profound disruption of
cognition and emotion.
 This effects a persons language, thought and
perception, mood and sense of self.

 Positive symptoms = reflect an excess or

distortion of normal function
 Negative symptoms = reflect a loss in normal
function
 Diagnostic criteria of schizophrenia
Positive Symptoms
 Delusions – paranoia, grandiosity
 Experiences of control – believe
under control of alien force.
 Auditory hallucinations – bizarre,
unreal perceptions, usually
auditory.
 Disordered thinking – thoughts
have been inserted or withdrawn
from the mind.
Negative symptoms
 Affective flattening – reduction in
range and intensity of emotional
expression, including facial
expression, tone of voice etc
 Alogia – lessening speech fluency
 Avolition – reduction or inability
to take part in goal directed
behaviour.
Diagnosis requires 1 month of two
or more positive symptoms.
 Psychodynamic approach
 Freud (1924)
 Schizophrenia is the result of:

 Regression to a pre-ego stage.

 Attempts to re-establish ego control.

 Ego = driven by the reality principle which works to

satisfy the ID in realistic ways. Makes the child
accommodate to the demands of the environment.
 Regression to a pre-ego stage.
 If a schizophrenics world is harsh, e.g. cold and
uncaring parents, a child may regress back to a
developmental stage before the ego was properly
formed, before the child had developed realistic
awareness of the external world.

 Schizophrenia is seen as an infantile state, positive

symptoms of delusions of grandeur reflect this
condition.

 Whereas auditory hallucinations reflect a persons

attempt to re-establish ego control – control of
reality.
 Behavioural Explanations
 Explain schizophrenia as a consequence of faulty
learning.
 If a child receives little or no social reinforcement
early on in life (parental disinterest), the child will
attend to inappropriate and irrelevant environmental
cues e.g. sound of a word instead of meaning.
 Result – child’s verbal or other behavioural
responses will become bizarre and those who
observe the child's behaviour will either avoid it or
respond erratically therefore reinforcing the bizarre
behaviour.
 This cycle will eventually deteriorate into a psychotic
state.
 Cognitive Explanations
 Acknowledges biological factors as a cause of initial
sensory experiences e.g. hearing voices.
 BUT claims further features of the disorder appear as
individuals attempt to understand them.

 When an individual experiences first sensory

symptoms, turn to friends, relatives to help
understand them and validate them.
 These people fail to do this, so the schizophrenic
begins to believe they are hiding things from them,
paranoia – this then causes the individual to reject the
feedback and develop delusional beliefs that they are
being manipulated.
 Task Time
 Fill in to your boxes the criticisms for each
psychological theory

 Psychodynamic
 Behavioural
 Cognitive
 Sociocultural factors
 Life events and Schizophrenia:

 Occurrence of stressful LE’s have been linked to

schizophrenia.

 LE’s = death of a close friend, break up of a

relationship, job loss

 Falloon et al 1996 argues high levels of physiological

arousal associated with neurotransmitters in the stress
response are thought to be the cause.
 Life event and Schizophrenia –
Supportive research
 Retrospective studies (study past events)

 Brown and Birley (1968) LE’s play a significant role

in predicting episodes of schizophrenia.

 Found: 50% people experienced major LE in 3 weeks

prior to episode. Only 12% reported on 9 weeks prior.
Control sample reported a low and unchanging level
of LE’s over the same period, suggesting LE’s trigger
a relapse.
 Life event and Schizophrenia –
Supportive research
 Prospective Studies (study future):

 Hirsch et al (1996) followed 71 schizophrenic

patients over 48 weeks.

 Found: LE’s made a significant, successive

(continuous build up) contribution in 12
months prior to relapse than a concentrated
effect just prior to an episode.
 Sociocultural factors
 Family relationships
 Double Bind theory – Bateson et al 1956

 Children who receive contradictory messages from their

parents are more likely to develop schizophrenia.

 Conflicting message = mother says I love you, but turns

her head away in disgust. Child received conflicting
message about their relationship on different levels.
 Verbal affection, non-verbal animosity (strong dislike)
 Family relationships
 Bateson et al argued Child’s ability to respond is
incapacitated by the contradictions.

 Prolonged exposure to these interactions prevents the

development of a coherent construction of reality.

 Which in the long run manifests itself as

schizophrenic symptoms, e.g. flattened effect,
delusions, hallucinations, incoherent thinking and
speaking and some cases paranoia.
 Family relationships
 Expressed emotion:
 Negative emotion or a high degree of expressed
emotion (EE) is associated with schizophrenia.

 EE = a family communication style that involves

criticism, hostility, and emotional over-involvement.

 Linzen et al 1997 found a patient returning to a

family with high EE is 4 times more likely to relapse.
Expressed emotion research support
 Kalafi and Torabi 1996 studied the rate of relapse in
schizophrenics in Iran.

 Found: High prevalence of EE in Iranian culture

(overprotective mothers and rejecting fathers) was
one of the main causes of relapse.

 Conclusion: Negative emotional climate

(environment) in families seems to arouse patients
and leads to stress beyond his or her coping methods.
 Sociocultural Factors
 Social Labelling

 Scheff (1999) promoted the labelling theory of schizophrenia.

 Theory states social groups create the concept of psychiatric

deviance by constructing rules for group members to follow.

 Thus the symptoms of schizophrenia are seen as deviating (going

against) from the rules that we attribute to ‘normal’ experience or
behaviour.

 Therefore those who display unusual behaviour are considered

deviant and the label schizophrenic may be applied which becomes
a self fulfilling prophecy that promotes the development of other
symptoms of schizophrenia (Comer 2003).
 Fill in to your boxes the criticisms for each
psychological theory – Sociocultural factors

 Life events and Schizophrenia

 Family relationships
 Social Labelling
 Plenary
 Psychological explanations include:
 Includes Psychological explanations, Psychodynamic,
Behavioural, Cognitive and Sociocultural factors.

 Sociocultural explanations include:

 Life events and Schizophrenia
 Family relationships
 Social Labelling
 considers the role of social and family relationships