Discuss PSYCHOLOGICAL
explanations for
schizophrenia

Psychological explanations of schizophrenia include a family dynamics explanation and a cognitive explanation.

Family dynamics explanations are essentially saying that schizophrenia is caused by the stresses of family life.

One of the earlier explorations of "what is wrong" with the families of schizophrenics is that their parents confuse them and make them lose touch with reality through the use of "Double Binds". This means that they may say one thing and mean another, such as saying "Give me a hug", and then complaining that they are too old for this behaviour.

Another aspect of family life is the emotional pressure put on young people by their families. This is known as high "Expressed Emotion", and although it is unlikely to cause schizophrenia, it may lead to a breakdown in people who already have schizophrenia.
Evidence for this comes from Brown, who classified the homes of a group of schizophrenics as "high EE" or "low EE". After being sent home after hospital admission, rates of relapse into an acute schizophrenic breakdown were 58% in high EE homes and 10% in low EE homes.

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An entirely different psychological approach focuses on trying to specify exactly what is wrong with the cognitive processes of schizophrenics. Frith's cognitive theory notes three main types of problem. One cognitive difficulty is attending to the right things. Another is self monitoring: schizophrenics are often unclear about whether they planned their actions, or whether they carried them out.
e.g. they may hear a voice criticising them, but be unaware that they themselves planned the criticism, so they make the assumption that aliens or spirits said it.

A third problem is Theory of Mind tasks, in which we are required to be aware of what others are thinking. Evidence for this inability to assess the intentions of others comes from Frith, who gave a group of schizophrenics and a control group a range of scenarios with hints in them:

e.g. "Paul wants to go out and says to his wife, 'I'm really late, but my shirt needs ironing'. What does he want his wife to do?"

Schizophrenics scored significantly less than non-schizophrenics.

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In evaluation, there are a range of difficulties with all of these explanations.

Although the idea of the “double bind” was once popular, it is now largely dismissed because the evidence is so weak.
It is also highly offensive to the parents of schizophrenics. It's bad enough having a schizophrenic son or daughter, without the additional stresses of being blamed for it.
In the UK a charity was set up by the parents of schizophrenics just for the purpose of opposing the idea.

Expressed Emotion has not been entirely dismissed as an explanation for some aspects of schizophrenia (though not its CAUSE). The idea of the parent as "overly involved" is interesting, because it is very different from the original suggestion (from the 1940's) of one that is cold-hearted and disinterested.
It is very probable that schizophrenics create highly emotional scenes within the family, and in fact it is more likely that they create high emotion than it is that they create the "double bind".

Frith’s cognitive deficits are probably more of a description of schizophrenia than an explanation, but the attentional deficits account for a number of schizophrenic behaviours (as opposed to cognitions), e.g. Repetitive activity such as cutting out shapes could be a failure to divert attention. However, some of the obsessions of schizophrenics are much more complex, and arise from their delusions rather than their attention failures. For example, they may hoard newspapers in an attempt to prove that the government are trying to kill them.

Despite our lack of knowledge of how the brain does self-monitoring, failure in self-monitoring accounts for a range of positive symptoms:
-Hearing voices
-Thought insertion
-Delusions such as the TV or the devil trying to communicate with you
-Delusions that people are plotting against you

Although psychological explanations have been a focus of this essay, there are a number of reasons why it is difficult to identify an explanation for a mental disorder such as schizophrenia.

Not everyone with the same mental disorder has the same psychological problem (such as an emotionally involved family) or the same biological problem (such as too much dopamine), and this means that an explanation that seems logical for one person may not be for another.