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Schizophrenia: Psychological Theories

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  1. Schizophrenia: Psychological Theories • Family systems theory • Psychosocial & environmental stress

  2. Family Systems Theory • Origins in: • The psychoanalytical tradition (the influence of the family on abnormal behaviour) • Systems thinking (idea that things are best understood by looking at the relationships between a set of entities)

  3. F M C1 C3 C2 Family System A family can be seen as a set of entities, each interacting with all the others. The behaviour of each entity can only be understood by looking at its relationships with the others

  4. F M C1 C3 C2 Family System If one person starts to behave abnormally the problem might not lie within that person Their behaviour may be a manifestation of a problem occurring within the wider family system C2

  5. Double Bind Theory (Bateson, 1956) • Schizophrenia is a consequence of abnormal patterns in family communication • The patient is a ‘symptom’ of a family-wide problem • They become ‘ill’ to protect the stability of the family system

  6. Double Bind Theory • In a double bind situation a person is given mutually contradictory signals by another person • This places them in an impossible situation, causing internal conflict • Schizophrenic symptoms represent an attempt to escape from the double bind

  7. Double Bind Theory • Bateson (1956) reports clinical evidence (interviews, observations) illustrating use of double bind communication by parents of schizophrenia patients • Issues of researcher (confirmatory) bias • Problems with direction of causality

  8. Double Bind Theory • Liem et al (1974) compared communication patterns in families with & without a schizophrenic member • Abnormality in parental communication was a response to the schizophrenic symptoms, not vice versa • Some issues with ecological validity

  9. Double Bind Theory • Some evidence that family processes play a role in relapse of schizophrenia patients following stabilisation • Relapse more likely (58% vs. 10%) where family is high in ‘expressed emotion’ (Brown et al, 1966) • Families high in criticism, hostility & over-involvement lead to more relapse (Vaughn & Leff, 1976)